Rebecca Luna, a 49-year-old Canadian content creator diagnosed with young-onset Alzheimer’s disease, died by medical assistance in dying (MAID) on July 25 in Victoria. Ms. Luna had shared openly about her diagnosis and progression of the disease with her more than 90,000 TikTok followers. Days before her passing, she posted that she no longer felt safe in her body and had decided to access MAID to find relief.

Ms. Luna, a single mother of two, began noticing cognitive decline at age 46 and received her Alzheimer’s diagnosis two years later. The disease advanced more rapidly than expected, prompting her to seek MAID before she lost the capacity to consent—an eligibility requirement under federal law.

Currently, Quebec is the only province in Canada permitting residents with serious and incurable illnesses that lead to incapacity to request MAID in advance, before losing decision-making ability. This provision enables individuals with conditions like Alzheimer’s to secure approval for MAID months or years ahead of time.

Advocates argue that this allows patients outside Quebec, including Ms. Luna, to face pressure to end their lives earlier than they might prefer, because losing capacity would otherwise make them ineligible. Helen Long, CEO of Dying with Dignity Canada, called it “not appropriate” that only one province offers advance requests and urged for nationwide availability.

The issue has been under legislative consideration. A parliamentary committee in February 2023 recommended allowing advance requests in specified circumstances such as dementia. The Alzheimer’s Society of Canada reversed its previous opposition to advance consent for MAID in 2019, recognizing the right of individuals with dementia to advocate for their best interests, including advance requests.

Quebec enacted legislation allowing advance requests in June 2023 and has approved approximately 2,100 such requests as of early 2026. It remains unclear how many patients have undergone MAID through this process.

The federal Criminal Code currently restricts MAID eligibility to those with a terminal or incurable physical medical condition capable of consenting at the time of the procedure. Mental illness as a sole underlying condition for MAID access has been contentious, with a parliamentary committee recommending its indefinite exclusion and the government reviewing these findings.

Independent Senator Pamela Wallin has introduced legislation to amend the Criminal Code to permit advance requests nationwide. Citing her late mother’s struggle with Alzheimer’s, Ms. Wallin emphasized growing public support for such measures, particularly given Canada’s aging population and increased dementia diagnoses.

Health Canada’s national consultations in late 2025 found broad support for advance requests, reflecting values of personal autonomy and choice. However, concerns persist about the ethical implications of proceeding without contemporaneous consent.

Medical experts such as Dr. Catherine Ferrier, a geriatrician at McGill University, emphasize caution due to the potential inability of patients to comprehend or consent at the time of MAID. Conversely, individuals living with early-onset Alzheimer’s like Sandra Demontigny from Lévis, Quebec, advocate for access to advance requests to avoid prolonged decline. Ms. Demontigny described the trauma of witnessing her father’s disease progression and the desire not to subject her own children to similar experiences.

The evolving debate highlights complex ethical, legal, and personal dimensions as Canada grapples with accommodating patients facing progressive cognitive diseases within its MAID framework.