Ten Years of MAID in Canada: An Evolving Conversation

This June marked ten years since medical assistance in dying (MAID) became legal in Canada, following a significant shift in the country’s approach to end-of-life care and personal autonomy.

MAID was legalized on June 17, 2016, after the Supreme Court decision in Carter v. Canada determined that Canada’s prohibition on assisted dying violated certain rights protected by the Canadian Charter of Rights and Freedoms. The case was the result of years of advocacy and legal challenges by Canadians including Kay Carter and Gloria Taylor, and followed earlier efforts by advocates such as Sue Rodriguez, whose story brought national attention to the issue in the 1990s.

Over the past decade, MAID has become an established part of Canada’s healthcare system. Eligibility rules have changed over time, shaped by new legislation, court decisions, and public discussion. In 2021, for example, the requirement that a person’s natural death be “reasonably foreseeable” was removed for some applicants, creating a second pathway for people living with serious and incurable conditions whose deaths were not imminent.

While MAID is available across Canada, access is not always consistent. Availability can vary depending on where a person lives, whether trained assessors and providers are available locally, and the type of illness or condition involved. Rural and remote communities, in particular, can face additional challenges in accessing assessments and services.

One of the most debated issues today is whether MAID should be available to individuals whose sole underlying medical condition is a mental illness. The federal government had originally planned to expand eligibility in this area, but implementation has been postponed several times and is currently delayed until March 2027.

On June 17, 2026, the federal government’s Special Joint Committee on Medical Assistance in Dying released a report recommending that this exclusion remain in place indefinitely. The federal government is expected to respond to the committee’s recommendations later this year.

Meanwhile, provinces continue to make decisions that affect how MAID is delivered within their healthcare systems. In Alberta, for example, Alberta Bill 18 received Royal Assent in 2025 and proposes changes that would limit access for some people whose deaths are not considered reasonably foreseeable. The legislation has not yet been brought into force.

Another topic gaining attention is the idea of advance requests for MAID. Under current law, most people must be capable of providing consent immediately before MAID is provided. Some Canadians, particularly those living with progressive illnesses such as dementia, have argued that individuals should be able to make legally binding requests earlier in the course of their illness, while they still have decision-making capacity.

Ten years after legalization, Canada’s conversation about MAID continues to evolve. Questions about access, safeguards, eligibility, and personal choice remain the subject of ongoing discussion in courts, legislatures, healthcare settings, and communities across the country.