A new bill introduced in Alberta aims to restrict access to medical assistance in dying (MAID) for individuals who are not expected to die within the next 12 months. Known as Bill 18, the Safeguards for Last Resort Termination of Life Act would prohibit healthcare providers from offering MAID to patients with only a mental illness as an underlying condition.
Under the proposed legislation, a close family member of the patient would need to be present during the administration of MAID in nearly all cases. Alberta Premier Danielle Smith expressed concerns about the potential expansion of MAID eligibility at a recent press conference, citing risks to vulnerable individuals.
Justice Minister Mickey Amery presented the bill in the legislature, making Alberta the first jurisdiction in Canada to impose such restrictions on federally permitted assisted dying. The bill also aims to limit access to MAID preemptively, anticipating potential changes at the federal level.
While federal regulations require individuals seeking MAID to have the mental capacity to request it, Alberta’s bill would disallow advance requests for MAID, unlike Quebec’s legislation that allows for such requests for those with incurable illnesses.
The federal government has also passed legislation to permit individuals with solely mental illnesses to request MAID starting in March 2027.
Alberta’s government is cautious about legalizing MAID for mental illnesses alone, highlighting potential risks. Dr. Ramona Coelho, a family physician from Ontario, supports the limitations to protect individuals who could benefit from alternative treatments.
Proposed Restrictions for Healthcare Providers
Bill 18 includes new requirements for healthcare providers administering MAID. It prohibits doctors and nurse practitioners from referring patients out of the province for MAID eligibility assessments and from suggesting MAID as an option without patient request.
The legislation also forbids healthcare facilities from displaying information about MAID publicly to prevent undue influence. It reinforces the right of healthcare workers to refuse to provide MAID and establishes exclusion zones around facilities that decline MAID consultations.
Catholic healthcare facilities that refuse to facilitate MAID assessments have faced criticism and legal challenges. About nine percent of MAID recipients in 2023 required transfer to another facility.
The bill mandates healthcare providers to review patients’ medical history and requires training for those providing MAID. Regulatory bodies would sanction violators, with penalties escalating for repeat offenses.
While federal laws have expanded MAID eligibility, Alberta officials believe the proposed legislation aligns with the Criminal Code.
Support and Opposition to the Changes
Advocacy groups for people with disabilities welcome the legislation, particularly the restrictions on MAID for those whose death is not imminent. Inclusion Alberta CEO Trish Bowman believes the limits could prevent offering death as an alternative to essential support.
However, opponents like Krista Carr from Inclusion Canada suggest the restrictions should prompt more investments in support programs for people with disabilities.
The Canadian Mental Health Association supports the legislation, emphasizing the potential for recovery from mental illnesses without resorting to MAID.
Concerns from Right-to-Die Advocates
Some individuals, like Tania Stilson, express disappointment with the proposed restrictions, citing personal experiences with loved ones opting for MAID due to intolerable suffering. Critics argue that limiting access to MAID could make it harder for those facing foreseeable death to utilize the service.
Advocates stress the importance of compassion for individuals in unbearable conditions and the need for better health and social supports. The legislation faces potential legal challenges, with uncertainties about conflicts between provincial and federal laws.