EDMONTON — The Government of Alberta is moving to restrict MAiD in Alberta by banning the procedure from being done to individuals where natural death is not reasonably foreseeable within the next year, becoming the first Canadian province to do so. "We have a responsibility to protect vulnerable Albertans," said Justice Minister Mickey Amery. "This legislation will ensure that proper protections and oversight are in place and MAiD only remains as an option of last resort.”Canada's criminal code currently permits MAiD to be provided to individuals with an illness where physician assessments have established that a natural death can reasonably be anticipated (Track 1), or a serious, incurable condition causing intolerable suffering, but the individual is not approaching natural death (Track 2). Bill 18, the Safeguards for Last Resort Termination of Life Act, would ban MAiD from being performed on Track 2 individuals and clarify that "reasonably foreseeable" means the natural death is likely to occur within 12 months of the time of application. Track 2 MAiD was decriminalized in Canada in 2019 following a Supreme Court decision that ruled that the "reasonable foreseeability of natural death" criteria under MAiD laws violated charter rights. Health Canada reported 22,535 MAiD requests in 2024, with 16,499 seeing their requests fulfilled, including 732 under Track 2. Although Track 2 MAiD has been decriminalized nationwide in Canada, each province manages its own implementation, oversight, and administration. This is why Alberta's government believes it is justified in banning Track 2, aiming to enforce the legislation as originally intended. .Bill 18 also seeks to proactively ban MAiD from being performed on individuals whose sole condition is a mental illness, which the federal government paved the way for in 2024 but has put on hold until 2027. "Mental health and wellness are things many people manage throughout their entire lives, and periods of severe illness can feel dark, hopeless, and overwhelming," said Alberta Premier Danielle Smith. "But with the right support, many people regain stability and go on to live full and meaningful lives. MAiD should not become a permanent response to a moment of crisis or despair that can change with care and time."It would also prohibit the procedure from being performed on individuals under 18 and on those without the capacity to make their own health care decisions. As part of this, the bill would ensure that advanced requests, in which individuals who are at the time capable of making health care decisions can request MAiD in advance of qualifying, regardless of their capacity at the time it is performed. "I think that when you talk about advanced requests, they raise ethical, legal and practical concerns," Amery said. "Individuals who are making decisions about their future preferences, where they lack decision making capacity, may change their minds in the future.""There may be breakthroughs in treatment, and these are important considerations to keep in mind."Advanced requests have not been decriminalized across Canada; however, Quebec began allowing them in 2024, and the federal government has decided it will not challenge Quebec's legislation. Amery said Alberta is taking a proactive approach to prohibit them, though, anticipating that such federal changes may be coming. "We're not gonna come back and reconvene session, each and every time we want to make a change to this particular bill, we are gonna be proactive, in addition to introducing the safeguards that we've mentioned already," Amery said. .Physicians and nurse practitioners would also be prohibited from referring individuals for MAiD eligibility assessments outside the province.Bill 18 would require that a family member be present to witness a MAiD provision, unless the provisioner determines that one is not reasonably available. Practitioners assessing an individual's qualification for MAiD must make a reasonable effort to review the person's personal and health information and also contact their primary care provider. The proposed bill would also ensure that practitioners and health facilities have the right to choose not to assess or provide MAiD services; however, they would then be required to direct the patient to the resources that they reasonably believe will provide information on all available medical options. Along those lines, the Alberta government claims it is taking steps to ensure MAID decisions are initiated and driven by patients, by restricting all regulated health professionals from providing information about MAiD to an individual unless the patient initiates the idea. Smith said the vast majority of health professionals are not directing individuals towards MAiD, but there is concern when she reads stories about the few who are. "We don't want anyone to be counselled, to end their life prematurely, if they do not have a terminal illness," Smith said. "And if we have to make that clear in law, we'll make it clear in law."Further, the public display of information on MAiD, such as posters, will be restricted within health care facilities. Bill 18 would also institute regulations requiring MAiD providers to meet education and training requirements and introduce sanctions from regulatory bodies for MAiD assessors and providers who do not comply with the law.
