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Opinion: Bill 18 undermines patient care: Alberta MAID doctors

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We write as clinicians involved in medical assistance in dying (MAID) across Alberta to express our strong concern and opposition to the proposed Bill 18, the Safeguards for Last Resort Termination of Life Act.

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This legislation signals a fundamental lack of trust: in Albertans to receive information about MAID, in patients experiencing intolerable suffering to make informed decisions, and in clinicians to provide ethical, compassionate care.

It effectively removes meaningful choice for most Albertans except for those “in the final 12 months of life.” To be clear, this excludes people with chronic and life-limiting diagnoses (COPD, kidney failure, heart failure) who may suffer intolerably but are not yet in the last year of their life.

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These people, though they may suffer intolerably, will not qualify under proposed legislation.

MAID assessments are careful, rigorous, and never taken lightly. Patients engage in deeply personal deliberation, and clinicians approach this work with seriousness and compassion. Clinicians have engaged with national curriculum, and we are subject to provincial practice standards.

The proposed mandates and sanctions place clinicians in ethically untenable positions, undermining professional judgment and eroding trust within the therapeutic relationship. The threat of punitive measures will deter participation and reduce access to care.

The impact on Albertans with a diagnosis of dementia is especially concerning. Almost all will be excluded under these changes as dementia progresses slowly and by the time one is in the “last 12 months of life” capacity is gone.

This will force some people with diagnoses of dementia to make the decision to die of suicide if they want to avoid the course they explicitly sought to avoid — one without capacity or autonomy. This is not theoretical; one can read the blog of Gillian Bennett from 2014 before MAID was available. https://www.deadatnoon.com/

The proposed Bill 18 will also worsen inequities. The dismantling of care co-ordination services and restrictions on referrals will disproportionately affect rural, remote, and marginalized populations, while those with greater resources will continue to find alternatives elsewhere.

In sum, this bill represents a significant step backward. Alberta’s current MAID system reflects years of thoughtful development grounded in patient autonomy, clinical expertise, and ethical integrity. Introducing barriers and bans will not improve care — it will undermine it.

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We urge the Government of Alberta to reconsider this legislation. End-of-life policy must be shaped by our shared values of compassion, equity, and respect for individual autonomy. Albertans facing intolerable suffering deserve a system that supports informed choice — not one that extinguishes it.

We would be pleased to meet with the government committee deliberating the proposed bill or any MLA to answer questions and discuss our concerns.

R. Chris Altmeyer, MD, CCFP

William Ruzycki, MD,CCFP

Trevor Byers, MD,CCFP

Michael Trew, MD, FRCPC

Craig Buchholz, MD, FRCPC

Jason Voldeng, MD, CCFP

David Candler, MD, CCFP

Adrian Wagg, MB, FRCP, GCGS, FHEA

Dionne Walsh, MD, CCFP

Jane Clarkson, MD, CCFP

Deanne Watrich, MD, CCFP

Mary Cummins, MD, FRCPC

Trent Dusang, MD, CCFP

A. Gaylene Grange, MD, CCFP

Christine Gibson, MD, CCFP

Robert Hayward, MD, MPH, FRCPC

Andrea Létourneau, MD, FRCPC

Patrick Linehan, MD, CCFP

Elizabeth McKoen, MD, CCFP

Alexandra McPherson, MD, FRCPC

Jody Nicholson, MD, FRCPC

Curtis Rabuka, MD, CCFP

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