Patients diagnosed with progressive dementia may know exactly how much deterioration they are willing to endure. They can articulate their wishes, discuss alternatives, and put their instructions in writing. Should losing the ability to repeat those instructions invalidate them?
Canada is preparing to address that question. On October 23, its Justice Department announced planned rules that would allow adults diagnosed with an incurable illness expected to destroy their decision-making capacity to consent in advance to assisted suicide (or, as Canada calls it, medical assistance in dying (MAID)). Ministers will discuss the proposal on October 27, but it must pass both houses of Parliament and receive formal approval from Canada's governor general before becoming law. Parliamentary committees can hear testimony and consider amendments along the way. The announcement promises safeguards but offers few details. Those details will determine how well the proposal respects patients' choices.
