加拿大提出《医疗协助死亡保障法案》：允许预先申请协助死亡，同时叫停以精神疾病为由的扩大适用
加拿大司法部10月27日在渥太华宣布，政府向议会提出《医疗协助死亡保障法案》（第C-41号法案）：成年人被诊断患有预计将令其丧失决定能力的不可治愈疾病后，可预先同意在日后接受医疗协助死亡（MAID），即使届时已失去决定能力，其意愿仍可得到尊重；同时，加拿大将不再推进把MAID扩大适用于仅以精神疾病为唯一病因的人群。
司法部长 Sean Fraser 说：「我们今天提出的立法将允许成年人预先同意接受医疗协助死亡，这样在他们被诊断出可能令其丧失决定能力的不可治愈疾病时，其意愿能得到尊重。法案同时将终止原定以精神疾病为由的扩大适用。我们将与各省和地区合作落实，并以严格保障确保决定出于自愿、不受外部压力。」卫生部长 Marjorie Michel 表示，处理MAID必须尊重个人自主与选择，同时为可能处于弱势的人群维持 robust 的保障。
按法案，预先申请并不意味着日后自动实施协助死亡：实施时全部资格条件必须满足、新增的严格保障必须遵守，且当事人当时必须正经历无法忍受的痛苦。是否提供预先申请由负责医疗规管与服务的各省和地区决定，联邦政府将继续与之协作。现行两条路径维持不变：死亡可合理预见者与死亡不可合理预见者均须经两名独立评估人确认、自愿知情同意，并可随时撤回申请。
司法部背景资料显示，加拿大自2016年起依法提供MAID，仅适用于符合严格资格的成年人。2025年10月公布的全国咨询结果显示，67%至69%的加拿大人支持为被诊断患有将导致丧失决定能力的严重不可治愈疾病者提供预先申请。今年10月，联邦政府另宣布2027至28年度投入12亿加元，继续支持心理健康、物质使用以及居家与社区护理服务。
Canada Tables MAID Safeguards Act: Advance Requests Allowed, Mental-Illness Expansion Halted
Canada's Department of Justice announced in Ottawa on October 27 that the government has introduced the MAID Safeguards Act, Bill C-41. Under the bill, adults diagnosed with an incurable illness expected to take away their ability to decide could consent in advance to receive medical assistance in dying (MAID) later, so their wishes could be respected even after they lose that ability. At the same time, Canada will not move ahead with expanding MAID to people whose sole underlying condition is a mental illness.
'Today, we introduced legislation that would allow adults to consent to medical assistance in dying in advance, so their wishes could be respected if they are diagnosed with an incurable illness that could take away the ability to make this decision. It would also end the scheduled expansion of MAID for people on the basis of a mental illness,' Justice Minister Sean Fraser said. 'We will work with provinces and territories on implementation, with rigorous safeguards to protect people and ensure the decision remains voluntary and free from external pressure.' Health Minister Marjorie Michel said the approach must respect personal autonomy while maintaining robust safeguards for those who may be vulnerable.
An advance request would not mean MAID is automatically provided later: all eligibility requirements would have to be met, the new safeguards followed, and the person would have to be experiencing intolerable suffering at the time MAID is provided. Provinces and territories, which regulate and deliver health care, would decide whether to make advance requests available. The two existing pathways remain, each requiring two independent assessments, voluntary informed consent and the right to withdraw at any time.
MAID has been lawful in Canada since 2016 for adults meeting strict eligibility requirements. Findings from a national conversation published in October 2025 showed 67% to 69% of Canadians support advance requests for people diagnosed with a serious incurable condition that will lead to loss of decision-making capacity. In October 2026 the federal government also announced a further $1.2 billion for 2027-28 to support mental health, substance use, and home and community care services.
来源：GSM·美国（原文链接）
图片来源：渥太华国会山庄。David Samuel, User:Hellodavey1902 摄，CC BY-SA 3.0，经 Wikimedia Commons。 / Parliament Hill in Ottawa, Canada. Photo by David Samuel, User:Hellodavey1902, CC BY-SA 3.0, via Wikimedia Commons.
