Alberta to impose restrictions on MAID, limiting it to those with terminal illness who will die in the next 12 months
· Toronto Sun
Alberta has introduced legislation that will add restrictions to medical assistance in dying (MAID).
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The legislation tabled on Wednesday, if passed, would prohibit those with mental illness as their “sole underlying condition” from accessing MAID. To access MAID, an individual’s “natural death” has to happen within 12 months and would introduce mandatory sanctions against health care professionals who’ve violated the legislation.
Premier Danielle Smith said her government is prepared to defend the bill if it is challenged in court and says she fully anticipates the legislation will become law in Alberta. She said MAID should be limited to terminal illness.
“Sometimes the courts disagree, and they offer to strike down our bills, at which point we have the way of engaging with them in conversation by using the notwithstanding clause,” Smith said.
“We think that our bill should qualify as reasonable and justified under section one (of the charter).”
Bill 18 — Safeguards for Last Resort Termination of Life Act — will be the first legislation of its kind, according to officials.
MAID is primarily governed by federal laws, but is provided by individual provinces and territories.
Prohibits Track 2 MAID cases and limits Track 1
Under the proposed legislation, only Track 1 MAID will be allowed in Alberta, where the “natural death” of an individual is likely to happen within 12 months.
It would prohibit Track 2 MAID, which refers to individuals whose “natural death” is not “reasonably foreseeable.” Those with mental health illness as their only underlying medical condition will not be able to access MAID.
In 2021, the federal government passed legislation to expand access to MAID, to include those with mental health illness as their sole underlying medical condition — known as Track 2. The federal expansion would be implemented on March 17, 2027.
Officials said those with degenerative diseases like Parkinson’s, or dementia and Alzheimer’s would not be eligible for MAID, saying an individual must have capacity to qualify.
Justice Minister Mickey Amery said he believes the legislation strikes a balance between the original intention of MAID and protecting vulnerable Albertans.
“If it falls within the framework of what the original intention of MAID was and it complies with Bill 18, then that is a conversation that has to happen between a patient, a doctor and perhaps family members. It wouldn’t be my place to say anything in that regard, because it’s assessed on a case-by-case basis,” Amery said.
Inclusion Alberta CEO Trish Bowman told reporters on Wednesday the organization is in favour of the limitation as it relates to individuals with disabilities. She said under the federal legislation, the only group eligible for Track 2 are people with disabilities, which she said is unequal and discriminatory.
“We don’t think that is the answer. We think our efforts and our answer needs to lie in ensuring and advocating for appropriate supports,” Bowman said.
Bowman said the legislation does not diminish other harmful policies. She said there needs to be continued efforts to push governments across Canada to provide supports for people with disabilities.
Those unable to access MAID include advance requests, pre-approvals for MAID before an individual loses capacity to provide informed consent, those without capacity to make their own decisions, and minors. Those under 18 are already prohibited from accessing MAID under the federal legislation.
According to the province’s survey results on the issue, 47 per cent of Albertans disagreed with the government implementing more safeguards, compared to the 38 per cent that agreed or strongly agreed.
“We appreciate that Albertans will have different opinions on this,” Amery said.
“We know that people with severe depression may struggle to fully appreciate the implications of their choices. We know that people who are suffering from mental illness and capacity issues, as well, are ones that might need the benefit of greater oversight.”
Restrictions on health care professionals
If passed, physicians and nurses would be prohibited from making referrals for individuals seeking MAID outside of Alberta.
Practitioners would also be required to undergo training and education about MAID procedures and eligibility before being able to assess or provide MAID.
The legislation would also give regulatory colleges the ability to introduce mandatory sanctions for physicians and nurse practitioners who have violated Alberta’s MAID legislation.
Officials said sanctions would depend on which contravention the college finds a practitioner has made. For the most serious ones, a college could cancel the practitioner’s practice permit and registration. Other sanctions include remedial training, restricting practitioners from providing MAID services for at least 30 days and permanently restricting the practitioner from providing MAID services.
Inclusion Canada CEO Krista Carr said the organization is focused on the aspects of the bill that deal with Track 2 MAID.
“ I’m very hopeful that provinces and territories that already are seeing difficulties with the regime that they have been forced to implement and have real concerns about further expansion of it will see this as a way for them to go forward and do the same,” Carr said.
Health care professionals would be restricted from providing information on MAID unless initiated by their patient. Any public display of MAID information will also be restricted within health care facilities.
Physicians and nurse practitioners would have the right to refuse to conduct MAID assessments or provide MAID. Specific health care facilities would also have the right to refuse to allow MAID assessment or provision on their property.
Officials said an “exclusion zone” of 150 metres would be established for facilities that refuse to provide any MAID service and is intended to provide a space for those who do not wish to be exposed to MAID.
The legislation would come into force upon proclamation. No date was given.
A statement from the Alberta NDP said the party recognizes the need for proper guardrails and oversight for MAID and that it will need time to review the legislation.
“We recognize there are many different perspectives on MAID, and we are committed to listening to and respecting the communities affected by this,” the statement said.