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Opinion: Who is being protected? Rethinking Alberta’s MAID announcement

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On Feb. 24, Alberta Government house leader Joseph Schow announced the province would move to “protect vulnerable Albertans” by regulating medical assistance in dying (MAID). He pledged to prohibit access for mature minors, individuals with mental illness as their sole underlying condition, those seeking advance requests and adults without health-care decision-making capacity.

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There are two issues with this announcement — none of these groups is currently eligible for MAID under Canadian law, and Alberta’s announcement signals a pre-emptive refusal to recognize potential future rights of Albertans.

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It is important to understand that MAID emerged from the courts, not politics. Originally, in 2015, the Supreme Court struck down the blanket prohibition on assisted dying as a violation of the Canadian Charter of Rights and Freedoms. Parliament responded with Bill C-14, which allowed MAID for people whose deaths were reasonably foreseeable. In 2019, a Quebec court decision led to the passage of Bill C-7, which extended MAID to people whose death was not reasonably foreseeable.

Current federal law still excludes mature minors, advance requests, those lacking capacity and mental illness as a sole condition. The Alberta government’s promised policy is nothing more than a restatement of the status quo.

We must ask, then, if the very categories Alberta is promising to ban are already banned, who exactly is being “protected”? The answer is, no one.

This announcement is a weak attempt to display concern for vulnerable citizens, while distracting us from the shortcomings of the very systems that should be supporting everyone. If Alberta truly seeks to protect vulnerable people, it could strengthen disability supports, palliative services, mental-health care and long-term care. Limiting access to MAID does absolutely nothing to address the causes of patients’ suffering or improve their quality of life.

The repeated mention of “vulnerability” by Schow deserves scrutiny. Vulnerability does not automatically arise from illness, disability, cognitive decline or mental illness. There are safeguards in the MAID legislation that require voluntary informed consent, independent medical assessments and consideration of treatments that would alleviate suffering.

The most consequential issue in this debate is not MAID for mental illness as the sole underlying medical condition, which remains outside eligibility for now. The issue that could affect most Albertans is advance requests for MAID — a question that goes to the heart of autonomy and dignity when facing the realities of degenerative illness.

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“An advance request involves a competent person making a written request for MAID that could be honoured later, after they lose the capacity to make medical decisions for themselves. This would include people who have been diagnosed with neurocognitive disorders or other conditions that may affect cognitive abilities, such as dementia, Alzheimer’s, Huntington’s or Parkinson’s” (Dying with Dignity Canada, n.d.).

Quebec has already implemented a carefully designed framework, permitting it under strict safeguards. Physicians are guided by detailed protocols. Requests must be specific, documented and triggered only under clearly defined circumstances.

Nationally, federal consultations have reflected significant public support for legalizing advance requests for MAID. If federal law evolves in that direction, will Alberta simply refuse to comply?

Alberta’s announcement signals a pre-emptive refusal to recognize potential future rights, even if courts determine that such rights are constitutionally required. It is one thing to debate safeguards. It is another to declare, in advance, that no matter how the law develops, the province will stand opposed.

We should all be asking our government whether it is willing to show care for vulnerable citizens by meaningfully investing in measures that improve dignity in life.

And how is regulating MAID through prohibitions on rights that do not yet exist helping improve any Albertans’ lives?

Cynthia Clark is the author of The Many Faces of MAID.

Tracy Powell is an associate professor at Mount Royal University.

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