Assisted dying for non-terminal suffering: a legal analysis of existential distress as a threshold condition in Canada

Canada’s medical assistance in dying (MAiD) framework has transitioned from a complete prohibition to a regulatory scheme that permits access for individuals whose conditions are not imminently life-ending. This article examines whether persistent existential distress, including psychological or spiritual suffering associated with illness, may satisfy the eligibility criteria under the current legal regime. While the analysis recognises that such suffering can fall within the statutory threshold, it maintains that inclusion should remain narrow and guided by strong procedural safeguards. The central concern is how law and policy can acknowledge non-physical suffering without weakening protections for those who may still recover or require support. Through doctrinal analysis, it traces the evolution from the Supreme Court’s Carter decision to subsequent statutory amendments, with particular attention to the tension between safeguarding individual autonomy and protecting those considered vulnerable. Psychological literature is employed to delineate the clinical features of existential suffering and the complexities of assessing irremediability. Comparative insights from Belgium and the Netherlands illuminate procedural safeguards and mechanisms for error reduction. The article recommends statutory clarification, comprehensive psychosocial assessment protocols, and enhanced oversight to maintain ethical consistency and minimize foreseeable risk.