Alberta (Canada): a setback for the expansion of euthanasia?
With Bill 18,the Safeguards for Last Resort Termination of Life Act, the Canadian province of Alberta intends to restrict access to medical assistance in dying (MAID). Introduced in March 2026 and passed at third reading on 22 April, this legislation marks a major departure from the evolution of Canada’s euthanasia framework, which had been steadily expanding since 2016.
The main aim of the bill is to end second-tier medical assistance in dying (Track 2 MAID), that is to say, access to euthanasia for people for whom “a natural death is not reasonably foreseeable” (life expectancy of less than 12 months). The 2021 federal reform had indeed opened up access to euthanasia to people suffering from disabilities, chronic illnesses or suffering deemed intolerable, without a short-term life-threatening prognosis. It is notably against this development that the province of Alberta has decided to take action.
A response to abuses that have been denounced for several years
This move represents a significant shift in the Canadian landscape. Whilst the federal government still plans, from 2027 (having postponed it by three years in 2024), to extend medical assistance in dying (MAID) to people suffering exclusively from mental health conditions, Alberta states its intention to protect vulnerable people from a situation where death could become a response to a lack of care, social support or assistance.
Criticism of the Canadian expansion of euthanasia has grown in recent years, particularly from disability rights organisations, but also through UN reports. Several organisations have highlighted the fact that many people request assisted dying less because of uncontrollable pain than due to a lack of access to housing, healthcare or social support. The debate has centred particularly on Track 2. For its opponents, this development has gradually transformed assisted dying into a potential solution to situations of social or psychological vulnerability.
The bill also provides for a ban on advance requests for MAID (already permitted in Quebec), whereby a person could express in advance their wish to undergo euthanasia in the future should they become unable to consent when the time comes. Alberta thus asserts that MAID can only be carried out on the basis of current, clear and repeated consent given by a person deemed competent at the time of the act.
A major ethical divide
Beyond the legal debate, Bill 18 reveals a profound anthropological divide. Two visions of medicine and society are at odds. The first regards individual autonomy as the supreme principle: once a person deems their suffering unbearable, society should allow them to end their life within a medical setting. The second reminds us that autonomy cannot be considered in isolation from vulnerability. A society that offers death to people made vulnerable by illness, disability, isolation or precarious circumstances risks gradually transforming a ‘right’ into implicit pressure. In that case, can the patient’s consent still be considered fully free?
The Canadian case clearly illustrates the Pandora’s box that is the legalisation of euthanasia: in less than ten years, medical assistance in dying has gone from being a strictly regulated exception for people at the end of life to a normalised practice that has continued to expand. In seeking to halt this trend, Alberta reminds us that it remains possible – and indeed necessary – to put safeguards in place against a logic where the right to die risks supplanting society’s duty to protect the most vulnerable.
