In just four years, deaths from assisted suicide/assisted dying in Alberta, Canada, increased by 109 percent. This is the reality Premier Danielle Smith’s government in Alberta faced when she introduced Bill 18, the Safeguards for Last-Resort Termination of Life Act, on 18 March 2026. It is also a reality that New Zealanders should pay close attention to, because Canada’s assisted suicide trajectory is linked to New Zealand’s story. It acts as a warning.
So what does the Bill actually do?
- Restrict who qualifies – Only adults 18 and over whose natural death is likely within 12 months (Track 1) would be eligible. Track 2 MAID — for those not facing imminent death — would be banned entirely. Also prohibited: MAID for those under 18, those lacking decision-making capacity, those whose sole condition is mental illness, and advance requests.
- Tighten the assessment process. Before assessing a patient, doctors and nurse practitioners must make reasonable efforts to contact every primary care provider the patient has seen in the past 12 months, and review all of the patient’s health and personal information.
- Require a family witness – A family member — defined as a parent, spouse or partner, child, sibling, grandparent, or grandchild — must be present when MAID is administered, unless the provider determines one is not reasonably available.
- Restrict what providers can say and do – Health professionals cannot raise MAID as an option with patients — the patient must bring it up first. Referrals out of province for MAID assessments would be banned. Public display of MAID information within healthcare facilities (such as posters) would also be prohibited.
- Mandate training and enforce compliance – All MAID assessors and providers would need to meet new training requirements. Sanctions — starting with remedial training and escalating to suspension or loss of the right to provide MAID — would apply to any provider who breaches the legislation.
- Protect conscientious objectors – Individual doctors and nurse practitioners would have an explicit legal right to refuse to participate in MAID. Certain facilities — including faith-based ones — would have the right to refuse MAID on their premises entirely, and could establish a 150-metre exclusion zone around their building where MAID services would not be permitted.
Should the bill pass, Alberta would become the first Canadian jurisdiction to place these kinds of limits on federally permitted assisted suicide deaths. The legislation would also proactively limit access to MAID in situations where the federal government has indicated it might implement changes.
Critics are framing this legislation as cruel because it forces suffering people to live against their will. However, supporters of the bill say otherwise.
Inclusion Alberta CEO Trish Bowman stated that MAID was sometimes causing medical systems to offer death as an alternative to supporting people with disabilities, rather than providing the necessary support for a better quality of life. She mentioned that Alberta’s limits could help save lives.
“We know it reinforces incredibly negative and dangerous stereotypes about the value and worth of the lives of people with disabilities. And so we’re very pleased to see this legislation today that serves to protect them,” Bowman said.
Krista Carr, CEO of Inclusion Canada, says she hopes other provinces follow Alberta’s example. However, she said the limits should also compel governments to invest more into programs and support that improve the quality of life for people with disabilities.
Canadian Mental Health Association research librarian Robert Olson called the legislation “heartening” and noted that their organisation opposes the expansion of MAID to people with mental illness.
Dr. Ramona Coelho, an Ontario family doctor who spoke at the bill’s introduction, has documented something deeply troubling in her practice: marginalised patients — people struggling with poverty, social isolation, inadequate housing — being offered assisted death instead of the comprehensive care that could actually ease their suffering. “Patient suffering can be addressed,” she said, “and their lives can greatly improve if we take that time.”
This is the heart of the bill. A refusal to let the medical system off the hook by offering death where it should be offering care.
Canada introduced medical assistance in dying in 2016, initially for the terminally ill only. By 2021, a court ruling expanded eligibility to include people who were not dying imminently. By 2024, Quebec began allowing advance requests — meaning people could arrange their death while still lucid, for a future date. And by March 2027, the federal government is scheduled to allow assisted suicide for people whose sole underlying condition is a mental illness.
Read that again. Mental illness. Alone. As grounds for an assisted suicide death.
New Zealand’s End of Life Choice Act came into force in November 2021, limiting assisted dying to adults with a terminal illness likely to end their life within six months. Canada started with similar bones.
Our law may be due for change. The pressure to expand eligibility to non-terminal conditions, to those suffering from psychological conditions, to younger people, will come. It always does. The Canadian experience shows us exactly where that pressure leads when it is not resisted.
Alberta’s Bill 18 is significant because it reflects a government willing to oppose and take action on the MAID programme, which has shown itself to be spiralling out of control – not just in Alberta but across Canada.
The solution to suffering isn’t a faster, cheaper, tidier way out. It is investing in palliative care, mental health services, disability support, and resources to assist families supporting loved ones through difficult times. That is the alternative Alberta’s own critics of the bill acknowledged was missing. That is what our most vulnerable truly need.
Now, the “slippery slope” in the euthanasia debate, whether here at home or internationally, was not merely a scare tactic; it functions as a roadmap, and we are witnessing it happen in real time. Perhaps, the better metaphor is that the slope is no longer slippery—it’s a cliff.
New Zealand must pay attention and take note.
*Written by Family First staff writers*
