How Alberta Is Curbing Federal Euthanasia Policy With New Bill

Alberta’s new bill on medically assisted death could dramatically change the use of euthanasia in the province—and set off a new phase in Canada’s highly controversial assisted dying regime.

Premier Danielle Smith’s government introduced a bill on March 18 that it said would “strengthen protections for vulnerable Albertans” and ensure medical assistance in dying (MAID) is not used “when other care and treatment options are available.”

At the core of the bill is a provision limiting MAID to those whose natural death is foreseeable within 12 months. The bill would effectively end “Track 2” MAID, or cases in which the patient is suffering but not near death. Track 1, by contrast, applies to cases where death is foreseeable.

The bill, called the Safeguards for Last Resort Termination of Life Act, would essentially set the clock back to the approach to MAID taken federally a decade ago, before a court challenge led to major expansions of eligibility.

Where It All Started

In 2015, the Supreme Court of Canada overturned the ban on physicians providing euthanasia in Carter v. Canada. In 2016, Parliament acted on the decision with Bill C-14, allowing doctors and nurse practitioners to provide MAID to patients in an advanced state of a “serious and incurable” illness causing them a great deal of suffering, and with a “reasonably foreseeable” natural death.

That changed in 2019, when the Superior Court of Quebec declared the “reasonable foreseeability of natural death” condition to be unconstitutional in Truchon v. Canada.

MAID eligibility began to expand sharply, with the federal government passing Bill C-7 in 2021, allowing access to euthanasia for Canadians 18 and over with serious and incurable conditions who provide free and informed consent.

Since the federal expansion of MAID eligibility in 2021, Track 2 deaths have increased by 226 percent in Canada and by 136 percent in Alberta, the province’s government said in a press release.

In 2024, the most recent year for which data on MAID is available, 16,499 people received the procedure in Canada. Track 2 deaths accounted for 4.4 percent of those cases, with the other 95.6 percent of cases being Track 1—where death is foreseeable.

The data shows that Track 1 skewed older, with a median age of 78. Cancer was by far the most common underlying condition. Deaths in Track 2 were predominantly women, somewhat younger, with a median age of 75.9, who typically lived with their illnesses for a much longer time period.

‘Isolation or Loneliness’

The most common conditions for Track 2 were neurological, and the top neurological conditions reported by MAID recipients were Parkinson’s disease, ALS, dementia, and multiple sclerosis. Also prominent in Track 2 was an “other” category that includes illnesses such as diabetes, autoimmune conditions, chronic pain, and “frailty.”

When describing their suffering, 44.7 percent of Track 2 recipients reported “isolation or loneliness,” compared to 21.9 percent of those in Track 1.

This data offers a look at what kinds of cases would become ineligible for MAID under the Alberta bill, but the statistics fail to reflect the series of controversial cases that emerged after eligibility expanded in 2021.

The controversy had already started in 2022, with a military veteran filing complaints and receiving an apology after he was offered MAID unprompted while on the phone with a Veterans Affairs agent. He was seeking help for a traumatic brain injury and PTSD.

That same year, the House veterans affairs committee heard from veteran and former Paralympian Christine Gauthier, who also received an unprompted offer for MAID while trying to arrange with Veterans Affairs to get a new wheelchair lift installed in her home.

“I was told that if I was that desperate, they could give me medical assistance in dying now,” she testified.

Cases like these began to receive international attention. The United Nations Committee on the Rights of Persons with Disabilities urged Canada in March 2025 to repeal Track 2 MAID, arguing that it “is based on negative, ableist perceptions of the quality and value of the life of persons with disabilities.”

At the March 18 press conference announcing Alberta’s MAID bill, Premier Smith referenced growing concern in other countries over Canada’s expansive approach to MAID.

“When we see that kind of international criticism saying this is really outside the norm, we have to take that seriously,” she said.

Canada’s decision to allow Track 2 MAID was again highlighted internationally during Conservative Leader Pierre Poilievre’s March 19 interview with pioneering podcaster Joe Rogan.

In the interview, viewed 2.4 million times in its first five days on YouTube, Rogan said he thought MAID could be appropriate in some cases but said Canada has gone too far.

Rogan cited the case of 26-year-old Ontario man Kiano Vafaeian, who managed to obtain MAID due to his suffering from diabetes, partial vision loss, and depression. Vafaeian’s mother, Margaret Marsilla, has sounded the alarm over the case, saying her son suffered from mental illness and was had an “obsession” with MAID, and that he shouldn’t have been allowed to receive euthanasia.

“Who allowed that to happen?” Rogan said in his show. “Who didn’t counsel this young guy? Who didn’t give him a hug?”

Mental Illness

While Alberta’s legislation seeks to end MAID in cases where death is not foreseeable, it also aims to head off an even greater expansion of eligibility that may come in the future: MAID for cases where the sole underlying condition is mental illness.

Premier Smith argued at the March 18 press conference that “MAID should not become a permanent response to a moment of crisis or despair that can change with care and time.”

This aspect of Alberta’s MAID bill does not address a currently legal practice, but rather one which could be legalized as early as next year.

Canada’s 2021 legislation expanding MAID eligibility temporarily excluded mental illness, an exemption that was delayed until March 17, 2024, and delayed again until March 17, 2027.

Unless this provision is delayed again or modified in the coming year, Canadians will be able to access MAID even if their sole underlying condition is a mental illness. The Alberta government’s bill aims to prevent this option in Alberta.

Another potential eligibility expansion explicitly legislated against in Alberta’s bill is extending MAID to minors. While this is not actively proposed by the federal government, a parliamentary committee did endorse the extension.

The Special Joint Committee on Medical Assistance in Dying recommended in a February 2023 report that “mature minors” be able to access MAID under Track 1, the track for people with reasonably foreseeable deaths.

The Alberta bill would prohibit people under 18 from accessing MAID under any circumstance.

Under Canada’s federal system, provinces and territories have constitutional jurisdiction over health care, with Ottawa disbursing funds through the Canada Health Transfer. This means that Alberta can legislate on matters of health care such as MAID.

Quebec Seeks to Expand MAID

The province of Quebec, meanwhile, has also introduced a bill on MAID—although with the goal of expanding rather than limiting access.

In October 2024, Quebec moved to allow physicians to administer MAID with advance requests. This means that residents of that province with certain degenerative illnesses like Alzheimer’s can sign off on MAID before their condition renders them unable to provide consent.

Federal MAID legislation does not allow advance requests, placing Quebec in a legal situation of permitting an action banned under federal law.

Nevertheless, the federal government made it clear in 2024 that they would not intervene in Quebec’s approach to MAID. Instead, Ottawa held a Canada-wide consultation exploring the idea of allowing advance requests for MAID federally.

In imposing stricter limits on MAID than exist federally, Alberta appears to have steered clear of conflicts over federal-provincial jurisdiction, as so far the feds haven’t raised any objections. However, the provincial government could potentially have to defend its bill against possible court challenges.

Speaking at a March 18 press conference, the Ablerta premier defended the constitutional merit of her government’s MAID bill: “The Charter of Rights and Freedoms does say that government can put limits that are reasonable as long as they’re prescribed by law and demonstrably justified in a free and democratic society,” Smith said.

For precedent, opponents of the bill could draw on the September 2019 Truchon decision from the Superior Court of Quebec which found that the original federal legislation limiting MAID to cases where death was reasonably foreseeable was unconstitutional.

The court ruled that the federal limit on MAID violates Sections 7 and 15 of the Charter of Rights and Freedoms. Section 7 guarantees the right to “life, liberty and security of the person,” while Section 15 lays out the right to “equal protection and equal benefit of the law without discrimination.”

The problem with this potential method of attack is that the Truchon decision only applies to Quebec. The Trudeau government acknowledged in January 2020 that it was not legally bound by the ruling, but still “accepted the ruling” in principle, and went on to expand eligibility for MAID in 2021.

At the press conference announcing Alberta’s new MAID legislation, provincial Justice Minister Mickey Amery said Alberta is not directly impacted by the Truchon decision.

“The Quebec challenge was a decision in Quebec. It is not binding on Alberta,” he said.

Warding Off Court Challenges

Alberta does have a final, powerful tool in its legal toolbox.

If Alberta’s MAID bill is successfully challenged, the provincial government appears willing to invoke the notwithstanding clause, a constitutional provision allowing governments to temporarily override Charter rights.

Smith described the clause as a way to insulate her government’s MAID bill from any eventual court challenges:

“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,” she said.

Last year, the Alberta government invoked the notwithstanding clause twice to shield bills from court challenges.

The clause was used in October 2025 to order striking teachers back to work. It was invoked again in December 2025 to shield the Protecting Alberta’s Children Statutes Amendment Act, which prohibits transgender surgeries for minors, requires schools to notify parents when a student wishes to change their pronouns, and bars biological males from playing in amateur female sports.

In both of these situations, Alberta used the notwithstanding clause pre-emptively—shielding bills from court challenges rather than invoking the clause after a bill has already been ruled unconstitutional.

Meanwhile, the Supreme Court of Canada is currently hearing a case on the legality of Bill 21, Quebec’s ban on religious symbols for public sector employees, that will have implications for how Alberta can use the notwithstanding clause going forward.

Expecting Charter challenges, Quebec pre-emptively invoked the notwithstanding clause when it passed Bill 21 in 2019. The Supreme Court of Canada is expected to rule on the constitutionality of this practice.

Even if the Supreme Court limits the pre-emptive use of the notwithstanding clause, Alberta can still use the clause to protect its MAID bill—but it will have to do so after a court strikes it down, rather than before.

More developments are likely in the coming months as Alberta goes ahead with passing and implementing its new bill, and as potential court challenges arise.