Canada just announced a significant reversal on euthanasia, but also a troubling new expansion. 

The Canadian government says it will introduce legislation to indefinitely prevent people whose sole underlying condition is mental illness from qualifying for euthanasia.

That is welcome news.

The expansion was originally scheduled for March 2027, despite years of concern over whether doctors can reliably determine that a mental illness is irremediable, and whether people might seek death because adequate treatment and support are unavailable.

But at the same time, Canada announced plans to allow advance requests for euthanasia.

Under the proposal, someone diagnosed with an illness such as dementia could request euthanasia while they still have decision-making capacity. Years later, after they can no longer consent, a clinician could determine that the conditions in that earlier request have been met.

That should concern us.

People cannot know exactly how they will experience a future disability or illness. Someone living with dementia may value a life their younger self feared. Yet an advance request could allow a decision made years earlier to outweigh the wishes and experiences of the person living that life today.

In fact, in 2025, the United Nations Committee on the Rights of Persons with Disabilities urged Canada not to expand euthansia through advance requests.

There is a lesson here for the United States.

Canada is stepping back from one expansion of euthanasia while preparing to move forward with another. Once euthanasia or assisted suicide is legalized, the boundaries of who qualifies and under what circumstances continue to expand.

People facing mental illness, disability, dementia, or dependence deserve better care and stronger support, not an ever-expanding system of euthanasia and assisted suicide.

Canada is right to halt euthanasia for mental illness, but to allow advanced directives is really adding salt to the already gaping wound of Canada’s euthanasia regime.