Why Alberta is proposing a ban on 'advance requests' for MAID
OTTAWA — Alberta’s normally straight-shooting Premier Danielle Smith was evasive when asked on Saturday about her government’s proposed ban on advance requests for medical assistance in dying (MAID).
Pressed on the issue by a caller on her weekend radio show , Smith noted that advance requests aren’t “allowed under the current (federal) law” while acknowledging that one province, Quebec, offers them “outside the Criminal Code provisions” regulating MAID.
“We’re not contemplating going beyond what the federal government has said,” said Smith before quickly pivoting to her opposition to offering MAID to people whose sole qualifying conditions are mental illnesses like depression and PTSD.
Advance requests, which allow those with degenerative conditions like Alzheimer’s to give advanced consent to MAID before they lose the capacity to do so, would be banned under a sweeping Alberta bill introduced last week. The bill also ends so-called “Track 2” MAID in the province, limiting access to doctor-assisted suicide to those over 18 with terminal conditions where death is reasonably foreseeable within a year.
Justice Minister Mickey Amery also had little to say when asked about advance requests at a media briefing on the MAID bill on Wednesday, speaking vaguely of “ethical, legal and practical concerns,” created by unknowns like future breakthroughs in treatment.
Advanced requests for MAID are not permitted under Canada’s Criminal Code but have been available in Quebec since October 2024. Since then, more than 2,100 Quebecers have had advance requests granted. Alberta is now moving in the opposite direction by banning advanced requests before Ottawa can decriminalize them.
Here’s what you need to know about the controversy surrounding advance requests for MAID.
How do advance requests for MAID work?
Quebecers who qualify may obtain an advance request form from a physician or specialized nurse practitioner. Similar to a living will, the advanced directive describes in detail symptoms of the illness that constitute the physical expression of one’s consent to be administered MAID, for example, “I can no longer feed and clean myself, or communicate intelligibly.” The request may be subsequently be withdrawn or modified, so long as the medical practitioner overseeing it agrees that the requester is still capable of consenting to care.
When it comes time for the assisted suicide to be administered, a second doctor or nurse practitioner must sign off, confirming the patient is exhibiting the advanced symptoms described in the written directive.
Quebecers must be 18 years or older and covered by the province’s public health-care plan to be eligible to submit advance requests for MAID.
What’s been Quebec’s experience with advance requests?
While more than 2,000 advance requests for MAID have been approved, few of these have been seen through to completion in the 17 months since advance request forms became available. Jasmin Lemieux- Lefebvre, a researcher with Quebec non-profit group Living with Dignity, says he’s only aware of two cases where advance requests have led to doctor-assisted suicides, and doesn’t know the details of either case.
This is to be expected as 17 months is generally a short period of time in the lifespan of someone in the early stages of a degenerative condition. However, one physician says doctors are already having a hard time identifying the point where the symptoms described on paper manifest in real life.
“It’s messier than we think,” says Dr. Félix Pageau, a geriatrician who opposed the introduction of advance requests for MAID in Quebec. “It’s a nice idea to think that something we write down today can be understood five, 10 years from now, but it doesn’t necessarily work like that.”
Pageau said public attitudes on degenerative illnesses are often shaped by negative perceptions and stereotypes.
“People see the guy incoherently yelling on the street and think ‘I don’t want to end up like that,'” said Pageau.
He added that Alzheimer’s and other types of dementia are a “complex spectrum” and that, with proper care, even people in fairly advanced stages can live meaningful lives.
Is the federal government likely to legalize advance requests soon?
Health Canada launched consultations on advance requests in fall 2024 and reported their findings in October 2025 . The report found that Canadians “generally supported” the idea in principle.
Seven in 10 Canadians who participated said they supported advance requests “for people diagnosed with a serious or incurable condition that will lead to a loss of decision-making capacity.” A similar proportion said they supported advance requests for conditions that “could lead to sudden or unexpected loss of capacity to make decisions.”
“The Government of Canada acknowledges that advance requests are important for many people in Canada and that there is a broad range of perspectives,” said Health Canada spokesperson Emmanuelle Ducharme in a statement.
Ducharme said the federal government is “carefully considering the findings from the national conversation.”
What happens if advance requests are decriminalized but still banned in Alberta?
If this happens, advance requests for MAID will be legal but unavailable in Alberta’s health-care system. This would be similar to the current situation between Ottawa and Quebec, only in reverse.
National Post
rmohamed@postmedia.com
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