Alberta introduces law limiting eligibility for medical assistance in dying

A person whose sole underlying condition is mental illness would not be eligible for Medical Assistance in Dying (MAID) in Alberta under a new law introduced Wednesday.

Premier Danielle Smith and her United Conservative Party say the consequences of a decision to access MAID are “permanent and irrevocable” and it must consider any policy impacting MAID with the utmost care and caution.

“This legislation strengthens safeguards and restores clear limits on eligibility to protect vulnerable Albertans facing mental illness or living with disabilities,” Smith said. “Those struggling with severe mental health challenges need treatment, compassion and support, not a path to end their life at what may be their lowest moment.

“In Alberta, a patient whose sole underlying condition is mental illness will not be eligible for MAID.”

Justice Minister Mickey Amery says the Safeguards for Last Resort Termination of Life Act would ensure MAID only remains as an option of last resort.

Under the law, MAID eligibility would be limited to individuals who natural death is reasonably foreseeable and ban medically assisted death where a natural death isn’t likely, which is also known as Track 2 MAID.

Alongside banning mental illness as a sole qualifying factor, Alberta also plans to prohibit minors from accessing the program. The federal law already has this safeguard in place — a person must be over the age of 18 to apply for MAID.

Doctors and healthcare facilities will also be able to refuse to assess or provide MAID, prohibit physicians from making referrals to receive the care outside of Alberta, and restrict medical professions from initiating conversations about MAID with patients.

Alberta also wants MAID providers to meet education and training requirements and to introduce sanctions for MAID assessors and providers not complying with the law.

Various safeguards already exist under federal MAID law.

Two independent doctors or nurse practitioners must provide assessments and confirm all eligibility requirements are met, requests must be made in writing and signed by an independent witness, the person must be told about all available and appropriate means to relieve their suffering, including counselling services, mental health and disability support services, community services, and palliative care, and must be offered consultations with those who provide those services.

Eligibility assessments take at least 90 days and the individual must be given to opportunity to withdraw their request at any time.

Mental illness has never been approved as a sole eligibility factor for MAID, although the feds have considered permitting it.

Ottawa originally planned to start allowing it in 2023 but has since passed legislation delaying implementation to March 17, 2027.

Decision applauded by those who say MAID for mental illness has been ‘normalized’

Advocates in support of Alberta’s decision say MAID in this country has become normalized and steps are needed to protect the vulnerable.

“Alberta’s legislation is a positive first step in slowing the unacceptable amount of MAID deaths that Canada has normalized – drawing a line to protect minors, the mentally ill and those who cannot advocate for themselves,” said Kelsi Sheren, a former Canadian combat veteran and PTSD advocate.

The province claims since Track 2 MAID was introduced — eligibility where death is not reasonably foreseeable has seen a 226 per cent increase in deaths in Alberta.

It also says Canada passed three per cent of MAID deaths as a portion of total deaths five years after legalizing MAID, compared to Belgium and the Netherlands which have taken more than 20 years to reach three per cent.

“Recovery from mental illness and suicidality is possible, expected even. For that reason, we welcome the steps Alberta is taking to strengthen protections for those experiencing mental illness,” said Mara Grunau, CEO, Canadian Mental Health Association (Alberta) and Centre for Suicide Prevention. “Our organization remains deeply committed to ensuring everyone in Alberta can access the mental health and social supports they need to thrive and find hope, today and for the future.”

Inclusion Canada is also applauding the decision, saying the expansion of MAID beyond end-of-life contexts places people with disabilities at “profound risk.”

It says that disability poverty, lack of access to supports, inadequate housing, and gaps in health and community services have created conditions where people may feel pressured to use MAID not because they wish to end their life, but because they can’t live with dignity.

“This legislation demonstrates that governments can strengthen laws and better protect people whose lives are not nearing an end,” said Moira Wilson, president of Inclusion Canada. “We urge the federal government to review Canada’s MAID law and ensure the same level of protection exists for people with disabilities across the country as for those Canadians without disabilities. We also challenge other provinces and territories to follow suit.”

According to Alberta Health Services (AHS) 1,242 Albertans chose MAID in 2025. Since February 2016, 6,461 people in the province have died via MAID.

An online survey on MAID processes and regulation in Alberta was conducted from Nov. 18 to Dec. 20, 2024. According to the province, respondents expressed desire for the creation of a new public agency and legislation to provide oversight, the creation of a MAID decision dispute mechanism for families and eligible others, a framework for appropriate sharing of confidential medical information related to MAID determinations limitations on criteria for MAID eligibility and on MAID as an option for patients.