Tightening Rules for Medical Assistance in Dying

Summary#

Bill 18 sets new provincial rules for medical assistance in dying (MAID) in Alberta. It narrows who can get MAID, adds approval and documentation steps for clinicians, and lets some facilities refuse MAID on their sites. It also creates a provincial care coordination service to guide patients and train/approve providers.

Key changes:

• Limits MAID to adults whose natural death is reasonably foreseeable within 12 months, and bars MAID when mental illness is the only medical condition.
• Requires two practitioner opinions and adds extra steps to review records and contact recent primary care providers.
• Requires an in-person family member to witness the MAID procedure, unless no family member is reasonably available.
• Sets up a provincial “approved practitioner” list; only approved clinicians may provide MAID or the required opinions.
• Allows prescribed health facilities to refuse MAID on-site; if they do, a 150‑metre exclusion zone will apply where MAID (or eligibility opinions) cannot be provided.
• Bans public display of MAID information inside health facilities and bars clinicians from raising MAID unless the patient asks first.
• Creates complaint pathways and mandatory penalties for rule breaches, including possible licence cancellation.
• Establishes a care coordination service to assist patients and providers. Existing written MAID requests made before the law takes effect are exempt.

What it means for you#

• Patients and families

  • MAID would only be available if two approved clinicians agree your natural death is likely within 12 months and you meet federal eligibility. People with chronic suffering whose death is not near would not qualify in Alberta under this bill.
  • MAID is not allowed if mental illness is your only medical condition.
  • A family member must be physically present to witness the MAID procedure, unless the provider decides no family member is reasonably available. No one can be forced to witness.
  • You must ask for MAID information; clinicians and facilities cannot bring it up first or post MAID materials in public areas.
  • If your local hospital or care home refuses MAID, you may need to move to another location. MAID could not occur on that site or within 150 metres of its property line.
  • The province will offer a care coordination service to help you understand options and make a MAID request.
  • You must be 18 or older and able to make a health decision right before MAID, unless federal “waiver of final consent” rules apply in limited cases.

• Health-care workers (physicians, nurse practitioners, nurses, pharmacists)

  • You may refuse to provide MAID or to give an eligibility opinion. If you refuse, you must direct the patient (or their representative) to a resource that gives accurate information on all medical options.
  • To provide MAID or give an eligibility opinion, you must be approved through the provincial care coordination service and meet its training requirements.
  • Before giving an opinion, you must make reasonable efforts to review the patient’s health and relevant personal information and to contact any primary care provider seen in the last 12 months.
  • You may not seek required opinions from outside Alberta.
  • You cannot publicly display MAID information in a facility and cannot discuss MAID unless the patient asks.
  • Knowingly giving false information or destroying MAID-related records is prohibited. Complaints can lead to mandatory sanctions, including licence cancellation for serious breaches.

• Health facilities (hospitals, continuing care, supportive living, some clinics)

  • If prescribed by regulation, your facility may refuse to allow MAID or eligibility opinions on-site. If you refuse, you must notify the Minister and direct patients to an information resource.
  • After notice, the Minister must set a public 150‑metre exclusion zone around your legal boundary where the refused service(s) cannot be provided.
  • You must prevent public display of MAID information inside the facility.

• Rural and small communities

  • If your only nearby hospital or care home opts out, the exclusion zone may make access harder. Travel to another site may be needed.

• Timing

  • The Act takes effect on a date set by the government (by Proclamation). MAID requests made in writing before that date are not affected by this Act.

Expenses#

No publicly available information.

Proponents' View#

• Keeps MAID a true last resort by limiting it to people near the end of life and excluding cases where mental illness is the only condition.
• Adds safeguards (two approved opinions, record review, contact with primary care) to prevent errors and protect vulnerable people.
• Respects conscience rights of individual clinicians and faith-based or values-driven facilities.
• Family-witness requirement adds support for the patient and another layer of oversight.
• The care coordination service provides clear training, consistent standards, and a single place for patients to get help.
• Limits on promotion and unsolicited discussion of MAID reduce the risk that patients feel steered toward it.

Opponents' View#

• Significantly narrows access compared with federal rules, barring people who are suffering but not near death; could lead to unequal access across Canada.
• Facility opt-outs and 150‑metre exclusion zones may create large no‑access areas, especially in small towns, forcing patients to move or travel.
• Extra approval and contact steps could delay care and add red tape for both patients and clinicians.
• Requiring a family witness may breach privacy, exclude people estranged from family, or expose them to pressure.
• Bans on proactive information may hinder informed consent and frank end‑of‑life discussions.
• The ban on out‑of‑province opinions and strong penalties may chill clinicians from participating, reducing provider numbers.
• Critics also warn parts of the bill could conflict with the federal MAID framework and face legal challenges.