Alberta Premier Danielle Smith’s government took steps Wednesday to drastically restrict who’s eligible for medical assistance in dying.
Smith’s United Conservative Party government introduced a bill that, if passed, would limit medical assistance in dying, better known as MAID, to those likely to die of natural causes within a year.
Those under 18 would still be prohibited regardless of condition, in line with current federal rules.
But Smith said Ottawa’s framework is largely missing the mark.
“I think that we’re failing in our duty to give people hope,” Smith told reporters before the bill was introduced in the house.
“We believe MAID must be a compassionate option reserved only for those who will not recover from terminal illness.”
Video: Alberta government moves to drastically reduce access to medically assisted dying
Alberta’s proposed law mirrors country’s original MAID program
Alberta’s bill largely resembles how Canada’s MAID program began in 2016. But a few years later, a Superior Court judge in Quebec ruled that restricting access to MAID unless it was reasonably foreseeable that someone would die was unconstitutional.
Ottawa responded by expanding the eligibility in 2021, permitting those suffering from a serious illness or disability that isn’t considered terminal and who are in an advanced state of irreversible decline to use MAID.
Alberta Justice Minister Mickey Amery said the Quebec decision isn’t binding on Alberta and that his government would defend the bill in court if challenged.
“We think that this bill finds the appropriate balance,” Amery said.
Proposed safeguards
The bill repeats many of the same safeguards currently in place under federal law, including a prohibition on children receiving MAID and on those deemed unable to make their own health-care decisions.
Alberta’s bill also prohibits mental illness as a sole condition. Ottawa had planned to allow it in 2024, subject to certain criteria and other safeguards. But the final decision was delayed until next year as the debate continues.
Smith said Alberta is acting now to prevent that possible change on mental illness from taking effect in her province, saying she has “profound misgivings” about it.
“MAID should not become a permanent response to a moment of crisis or despair that can change with care and time,” Smith said.
Proposed law vulnerable to constitutional challenge
Lorian Hardcastle, a health law professor at the University of Calgary, said that while Amery is right in that Alberta isn’t bound by the Quebec decision, the province is vulnerable to a constitutional challenge.
She described a hypothetical case where two people are suffering from amyotrophic lateral sclerosis, or ALS, and only one is determined to likely die within a year despite suffering at the same level.
“What is the government’s justification for allowing one of those people to access it but not the other?” Hardcastle said. “The minister needs to explain that.”
Federal government studying eligibility question
In Ottawa, a spokesperson for federal Justice Minister Sean Fraser acknowledged in a statement that Alberta has jurisdiction over health care.
“As for the federal government, Parliament is currently studying the question of eligibility expansion through (a special joint committee),” said Lola Dandybaeva. “We will be guided by that process.”
Alberta Health Services says 1,242 people died through MAID in the province last year, though the statistic isn’t broken down by eligibility factors.
The province says deaths in Alberta under Ottawa’s expanded eligibility rules increased by 136 per cent between 2021 and 2025.
Alberta’s bill would also prohibit medical professionals from referring patients to providers in other provinces.
It would create new professional sanctions for doctors and nurse practitioners who break provincial rules, including the potential loss of their licence. All medical professionals who provide MAID services would have to undergo new training.
Proposed restrictions
It aims to prevent medical professionals from discussing MAID with patients unless they raise the issue first. Hardcastle questioned that change, saying it’s a doctor’s duty to inform patients of all options.
The bill also restricts hospitals, doctors’ offices, and continuing care homes from displaying information about MAID, including on posters.
As with Ottawa’s rules, Alberta’s bill would prohibit patients from making advance requests.
That includes people recently diagnosed with diseases such as dementia or Alzheimer’s who may want to provide their consent for MAID before they lose the capacity to make the decision. Quebec currently permits such requests.
Disability advocacy groups welcome legislation
A number of disability advocacy organizations were at the legislature on Wednesday to support the bill.
Inclusion Canada CEO Krista Carr said Ottawa’s 2021 eligibility expansion was a “tragedy” that led to the deaths of thousands of people with disabilities.
“Disability in and of itself does not cause suffering,” Carr said. “It’s the social and economic conditions we impose on people with disabilities that cause the suffering.”
Carr said she hopes other provinces follow Alberta’s lead, or that Ottawa gets on board.
She also said that if a court challenge is launched, she’d like to see Alberta defend it all the way to the Supreme Court, something she and other organizations have criticized Ottawa for failing to do after the Quebec ruling.
Alberta’s Opposition NDP said it was reviewing the legislation.
— With files from Sarah Ritchie in Ottawa and Fakiha Baig in Edmonton.
This report by The Canadian Press was first published March 18, 2026.