Tanya Secord watched Lewy body dementia, a progressive brain disease that erodes thinking and movement, take her father one piece at a time. What stayed with her was that he never had a way to say, in advance, how he wanted his final chapter to go. She wants that option for herself, and unless she lives in Quebec, she cannot have it. The reason is one document: an advance request for MAID, and your postal code.
What exactly is an advance request for medical assistance in dying?
Medical assistance in dying, or MAID, is a legal process where a clinician helps end the life of an eligible person who asks for it. Medical assistance in dying has one firm condition that trips people up. You must be able to consent at the moment it happens. That collides with diseases like dementia, which slowly erode capacity, the ability to understand a decision well enough to make it. An advance request is the workaround. While you still have capacity, you set out the future circumstances in which you would want MAID, and if you show any resistance when the time comes, everything stops.
Which parts of Canada allow this under current MAID laws in Canada?
Quebec passed its law in 2023 and began accepting advance requests the year after, and Ottawa did not challenge it. Everywhere else, the current MAID laws in Canada still require in-the-moment consent, so an advance request has no legal force. (The separate, much-debated federal review on MAID for mental illness is a different question entirely.)
Why does an early-stage dementia diagnosis change everything?
This group is caught most painfully. On the day someone is told they have early-stage dementia, they are usually still fully able to decide. The cruelty is timing, because by the point they might want MAID, the disease may have taken the capacity the law requires. Advocates like Dying With Dignity Canada say this pressures people to choose MAID earlier than they truly want, while they still can. Others counter that someone with advanced dementia who seems content may no longer share their past wishes. Both concerns are real.
How does end-of-life planning work if you might lose capacity?
So what can you do now? In Quebec, a family doctor or MAID assessor can explain the advance request process. Outside Quebec there is no binding MAID mechanism, but the wider tools of end-of-life planning are available nationwide, including an advance care plan (setting out treatments you would and would not want) and a named substitute decision-maker (someone who speaks for you if you cannot). If you are weighing an advance request for MAID, the best next step is an unhurried talk with a doctor who knows your history.
Common questions about advance requests
Can you make an advance request for MAID outside Quebec?
Not right now. An advance request for MAID is legally recognised only in Quebec, which began accepting them in 2024. Elsewhere in Canada you must be able to consent at the moment the procedure happens, so there is no binding way to arrange it in advance if you expect to lose capacity later.
How is an advance request different from an advance directive?
An advance directive records the care you would or would not want and names someone to decide for you, and it exists across Canada. An advance request goes further, asking specifically for MAID under conditions you set now. Only Quebec recognises that second document today.
Can an advance request be cancelled?
Yes. In Quebec you can update or withdraw it any time while you still have capacity, and if you resist when the described conditions are met, the process stops. The safeguards are built to keep the choice yours for as long as possible.
Where to turn next
These are hard questions about autonomy and consent, and Ottawa has set no timeline for acting nationally. The people best placed to help you think it through are the ones who know your health. To find a family doctor or specialist near you, medimap.ca connects you with providers across Canada, and the Health Hub has more guides on planning your care.
General information, not medical or legal advice. For decisions about MAID or a diagnosis, speak with a qualified healthcare provider.
Find an allergy or specialist clinic near you? Search through Medimap — no referral needed.
Search clinics →