We seek to highlight key ethical considerations that arise as Canada considers an expansion of medical assistance in dying (MAiD) to include advance requests. To do so, we will first highlight the ethical and practical concerns that arise with advance care planning and advance directives in general and then draw attention to the unique considerations that arise with advance requests for MAiD. Finally, we will take a closer look at the concerns that will arise with an expansion to include the population with dementia. We will argue that the stakeholder concerns for a vulnerable population such as dementia patients are significant. Legislative frameworks will need to address these concerns to ensure the safety of individual patients and support the role of surrogates and healthcare providers in this process.

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