Alberta and Quebec are going in very different directions on MAID

OTTAWA — Alberta announced last week that it will be following Quebec’s lead in asserting provincial control over medical assistance in dying (MAID), but it will be taking a much different direction.

Quebec has taken steps to expand access to MAID, including via so-called “advance requests” allowing some residents to get pre-approval for assisted dying, but Alberta has signalled that restrictions are coming.

Alberta Government House Leader Joseph Schow said in a preview of the spring legislative session that the province will be introducing new legislation to prohibit MAID from being administered to members of various vulnerable groups, including mature minors and mentally ill or deficient Albertans without a qualifying physical ailment. He also said the forthcoming bill would pre-emptively ban advance requests for MAID such as those used in Quebec.

Schow said the federal government’s failure to build appropriate safeguards into its near-decade old MAID program has forced the province to act.

“The federal government has rapidly expanded (MAID) and even plans to make it available to those with mental health challenges as their sole underlying condition,” said Schow, referring to a temporary federal prohibition for persons suffering solely from a mental illness set to expire in March 2027.

Alberta Premier Danielle Smith signalled in September that an assisted dying bill was in the works, directing her attorney general in an updated mandate letter to work on legislation to create more safeguards for MAID and prohibit it when a person seeks the procedure based solely on a mental illness.

MAID became legal across Canada in July 2016, following a Supreme Court ruling one year earlier striking down criminal laws prohibiting assisted dying. The federal government initially restricted access to MAID to “competent adults whose deaths are reasonably foreseeable,” namely those suffering from serious and untreatable medical conditions.

Quebec’s Superior Court ruled three years later that the “reasonably foreseeable” criteria violated Charter-protected rights, leading to a 2021 rewrite of the federal MAID bill substantially expanding eligibility.

MAID is a federal program that exists as a carve-out from criminal law, but provinces retain the power to regulate its delivery within provincial health-care systems.

Quebec would further liberalize provincial access, passing a 2023 bill authorizing residents in the early stages of degenerative conditions like Alzheimer’s to make advance requests for MAID before they lose the capacity to provide informed consent. The bill also made Quebecers with “serious physical impairment leading to significant and persistent disabilities” eligible for MAID.

The federal government has not made corresponding changes to the Criminal Code to legalize advance requests for MAID, but says it won’t challenge the Quebec law .

Quebec regularly leads the country in MAID deaths. In 2024, the last year for which nationwide figures are available , it accounted for 36 per cent of recorded deaths while making up approximately 22 per cent of Canada’s population. Alberta saw seven per cent of deaths with roughly 11 per cent of the population.

Jasmin Lemieux-Lefebvre, a researcher with Quebec non-profit group Living with Dignity, says the province’s openness toward MAID is a reflection of its cultural distinctiveness from the rest of Canada.

“(MAID) has huge support among Quebec’s population, virtually all major civil society groups say they’re for it,” said Lemieux-Lefebvre. “And, when I look at the rest of Canada, there’s not been a popular uproar about the fact that, hey, why does Quebec have advance requests and we don’t?” said Lemieux-Lefebvre.

A 2024 Leger study of attitudes toward MAID across Canada found that Quebecers were most supportive of the program and Albertans were most likely to say they opposed it.

Lemieux-Lefebvre said that the MAID-critical stories that regularly appear elsewhere in the country are virtually absent from Quebec’s media ecosystem.

“There is very little place for that,” said Lemieux-Lefebvre, noting that he’s only aware of one Quebec news outlet that’s covered the story of Kiano Vafaeian , the 26-year-old Ontario man who obtained MAID in British Columbia in late 2025 after being denied authorization in his home province.

Trish Bowman, head of disability-rights group Inclusion Alberta, says she was “encouraged” by the provincial government’s speed on moving forward with legislation limiting MAID in the province.

“This is a big priority. This is literally life and death,” said Bowman.

Bowman said it was especially important for the province to roll out safeguards for Albertans suffering from mental health issues before the federal exemption on mental illness as a sole underlying condition expires next year.

“I think that (the expiring federal exemption) is, in some ways, the core of the issue here. We don’t believe that there is a particularly robust or credible system in place at the federal level,” said Bowman.

Bowman noted that the Alberta decision on MAID was incongruent with its move last year to claw back part of the new federal disability benefit, and said she’d like to see a better alignment of social and assisted-dying policies.

“There’s a contradiction that’s apparent to people with disabilities that, at the same time they’re looking at strengthening safeguards around MAID, they’re also limiting access to disability-related supports,” said Bowman. “We would like to see a more comprehensive social policy relative to supporting individuals with disabilities in Alberta.”

National Post rmohamed@postmedia.com

• This 26-year-old was denied assisted death in Ontario, but died by MAID in B.C.
• 76,475 Canadians have died by MAID. Is that too many?

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