Doctors speak out against province’s proposed MAiD restrictions

Posted on April 23, 2026 by Vauxhall Advance

By Zoe Mason
Southern Alberta Newspapers

Doctors across Alberta are asking the UCP government to reconsider proposed changes to its policy on medical assistance in dying.

If passed, Bill 18 will introduce a slew of new constraints on the provision of medical assistance in dying. New restrictions prohibit doctors from initiating conversations about MAiD, prevent referrals for MAiD outside the province and eliminate MAiD for patients whose death is not considered “reasonably foreseeable,” which has been defined as patients expected to survive longer than 12 months.

“I think in essence, it’s the provincial government stepping into the consultation suite at a time of great suffering and getting in the way of honest and very sensitive decisions,” said former Alberta Chief Addiction & Mental Health Officer Michael Trew.

Trew, a retired psychiatrist, did additional consultations related to MAiD assessments, helping determine whether prospective MAiD patients had the capacity to make the decision or whether mental illness might be influencing their decision.

He also had a brother who was assessed for MAiD while dying of lung cancer. Although he was authorized to receive MAiD, Trew says he didn’t use it. But he says knowing he had the option brought his brother peace of mind at the end of his life.

“It is a way to offer some choice to the individual who has very few choices left.”

Medicine Hat physician Dr. William Ruzycki has been providing MAiD for more than 10 years.

He says the legislation is trying to address a problem that isn’t there.

“Physicians do not push MAiD as an alternative. We all realize this is a last resort for people who are desperate for some sort of relief from what they’re going through,” he said.

Both Trew and Ruzycki agree the medical community was not adequately engaged. Both signed onto an open letter endorsed by 19 physicians and nurse practitioners condemning the proposed reforms.

The Alberta Medical Association is also asking the province to pause the progress of the bill to allow for meaningful consultation and clarification with Alberta’s physicians.

The AMA conducted a poll of 1,306 practicing physicians across the province after Bill 18 was tabled.

Fifty-six per cent of respondents questioned the clinical appropriateness of the 12-month timeline the new legislation proposes.

“We can tell you pretty clearly what the path is going to look like, what the steps are going to be. The timing of those steps, we’re not so good at,” said Trew.

People with slow, progressive terminal illnesses are among those who will lose access to MAiD if the legislation passes. That would include many patients dealing with Parkinson’s, dementia, ALS, congestive heart failure, or profound disability following a major stroke.

“Medical science can keep them alive, but it can’t improve them,” said Ruzycki. “It will keep them alive and suffering. But to what end?”

Fifty-six per cent of respondents also expressed concern about the stipulation that physicians are prohibited from initiating conversations about MAiD. Eighty per cent said they believed the changes would have a significant impact on their clinical autonomy, including their ability to exercise judgement in patient-centred care decisions.

Ruzycki says doctors need to have the freedom to give patients all the options that are available to them, even if the doctor involved doesn’t provide or even agree with MAiD.

“Those restrictions are stupid, short-sighted and they won’t work,” he said. “Legally, patients are entitled to know about MAiD. To restrict what physicians tell them, it just doesn’t make any sense at all, and only further stigmatizes people with serious illnesses.”

Trew says the restrictions could have the impact of prolonging suffering for patients who don’t know what their options are.

“Ignorance means you don’t get it,” he said. “That’s not compassion.”

Premier Danielle Smith says the new restrictions are designed in part to prevent individuals whose sole underlying condition is a mental illness from gaining access to MAiD.

Ruzycki is blunt about the viability of that concern.

“It doesn’t happen,” he said. “We can’t do anything for someone with mental illness if they have no other qualifying conditions. For me, that’s very clear.”

“That’s not how the assessment works,” agreed Trew. “It really requires a progressive loss of capacity.”

In his 42 years in practice as a psychiatrist, he says he can think of three cases where MAiD could possibly have been authorized solely on the basis of mental illness.

The federal government implemented a hiatus on the expansion of MAiD in 2025 to include individuals whose sole underlying condition is a mental illness. That question is scheduled to be addressed in 2027.

Two thirds of physicians polled by the AMA also believe the new requirements that family be involved in MAiD provision will present moderate to significant additional barriers.

Trew says it wrongly assumes all families are functional, and has the effect of providing family members with undue control over a loved one’s decision.

“I can just imagine someone who is against MAiD being the one person who could be there. If they refuse to go, does that become a form of them having a veto?”

Trew says existing guidelines aren’t perfect. For example, he says recourse to an expert panel for difficult cases would be a welcome addition to current oversight, but what the province is proposing will not meaningfully resolve existing gaps.

He says the majority of feedback doctors receive from families who navigate MAiD is gratitude.

“Families who have had had their loved one go through MAiD, the biggest group and the most common response is that they’re thankful.”