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Guest host: Sheila Gunn Reid

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There’s a statistic that should make every Canadian stop and think. Medical Assistance in Dying — MAID — is now one of the leading causes of death in Canada.

Roughly one out of every twenty deaths in this country now happens through assisted suicide. Just stop and think about that for a second.

In less than a decade since MAID was legalized in 2016, it has expanded so quickly that it now accounts for about 5% of all deaths in Canada.

Belgium and the Netherlands — the countries everyone pointed to during Canada’s assisted-suicide debate — took more than 20 years to reach that level.

Canada did it in about five. That speed alone should make policymakers pause.

And now Alberta is stepping in with legislation meant to slow down a system that has been expanding at a remarkable pace.

The bill is called the Safeguards for Last Resort Termination of Life Act, and the goal is to establish a provincial framework around MAID with stronger safeguards than what currently exists under federal rules.

The biggest change is that Alberta would limit assisted suicide to what’s known as “Track 1 MAID” — cases where a patient’s natural death is reasonably foreseeable.

In practice, the legislation defines that as a situation where death is likely within roughly 12 months. That’s a significant shift from current federal law.

In 2021, Ottawa introduced “Track 2 MAID,” allowing assisted suicide even when a person’s natural death is not reasonably foreseeable.

In other words, people no longer have to be dying. They can be chronically ill, disabled, or living with long-term suffering the system considers intolerable.

Alberta’s bill would prohibit Track 2 MAID entirely in the province. The legislation also explicitly bans MAID where mental illness is the sole underlying condition.

That line matters because federal policy has been moving toward allowing assisted suicide for people suffering solely from mental illnesses like depression, PTSD or severe anxiety.

These are conditions that millions of Canadians struggle with and recover from every year. Alberta’s bill says that line should not be crossed.

The legislation includes several other new safeguards as well.

MAID would remain prohibited for minors. It would also be prohibited for people who lack decision-making capacity at the time the procedure is performed.

And the province would ban advance requests, meaning someone cannot sign paperwork years earlier authorizing doctors to end their life after they lose mental capacity.

Alberta’s legislation would also restrict physicians and nurse practitioners from referring patients outside the province for MAID assessments.

That rule is designed to prevent people from bypassing Alberta’s safeguards by simply being referred elsewhere.

The bill introduces mandatory education and training requirements for MAID assessors and providers, including training on recognizing coercion, evaluating capacity, and identifying alternatives such as palliative care.

And it introduces mandatory sanctions for physicians or nurse practitioners who violate the province’s MAID rules.

Another major change involves how MAID is discussed with patients.

Under the proposed law, health-care professionals would not be allowed to initiate conversations about assisted suicide unless the patient raises the topic first.

The province says that safeguard is meant to ensure that MAID decisions are patient-driven, not influenced by suggestions from doctors or health-care institutions.

The legislation also protects the rights of doctors and health-care facilities that object to assisted suicide.

That’s the line Alberta says it is trying to draw.

The province’s legislation attempts to re-establish limits around assisted suicide and slow the expansion that has taken place over the past several years.

The broader national debate over MAID is often framed as a question of personal autonomy.

But it also raises a larger question about the role of a health-care system when people are suffering.

Should the priority be expanding access to assisted death?

Or finding better ways to help people live through illness, disability, and hardship?

Given how quickly MAID has risen to become one of the leading causes of death in Canada, it’s a question the country may have to confront sooner rather than later.