Letter: Former chief addiction & mental health officer for Alberta blasts province’s MAiD restrictions

By Letter to the Editor on April 8, 2026.

Dear editor,

I am tiring of the name and defence of Bill 18 as “assisted death as a last resort,” as if current or planned MAiD regulations provide for anything else. MAiD is not “death on demand.” No one is an advocate for death, but what currently exists is choice when life without overwhelming suffering is gone.

MAiD is easy to preach about from a distance. Personal decisions such as this belong in quiet privacy. If there are complaints – the large majority are about MAiD not being assessed or provided quickly enough. Honestly, there are few complaints coming back to the system – it’s mostly relief and thanks.

The current organization of MAiD in Alberta (AHS) has arguably been the best system in Canada, with central co-ordination that allows equal access to patients (not doctor-dependent) and deters individuals who have been declined from simply continuing to knock on doors without a pause (one “yes” and one “no” leads to a third assessment, but not a fourth or more).

The focus of MAiD is on compassion for suffering, and if death is the only realistic option (I will not recount the required criteria and guidelines), then we may proceed with MAiD.

This legislation as it stands does not allow discussion of MAiD with patients as part of an overall end-of-life set of options – where this discussion belongs. Doctors and nurses continue to report people at the end of life not being aware that MAiD is available in Alberta. The most important aspect of its availability is choice – choice about one’s own life. Bill 18 removes this for some people.

The 12 months to death clause may sound fair – to anyone outside of medicine. We are not good at predicting time, even if we are very sure of the endpoint and the suffering between now and then.

It takes degenerative neurological diseases largely off the table for consideration. I worked with people with Parkinson and Huntington disease, and some of these folks would have wanted to “get off the train before the last stop” – a choice I can understand and support.

The memories of a man in his 50’s comes to mind. The last year-plus spent mostly alone in a long-term care bed, unable to get up, unable to speak, looking blank – and already “gone.”

This legislation needs to go back to the drawing board. It needs to have much discussion with people considering MAiD; families who have had their loved ones pass with Medical Assistance (and not just the small number who oppose MAiD), and realistic discussions with MAiD assessors and providers.

The federal legislation is not perfect and there is room for discussion, but it needs nuance and much consideration, not a baseball bat.

This is sold this as “protection of the vulnerable,” but it amounts to taking away choice from many who are fully competent. This loss of choice increases pain and suffering.

Michael Trew MD, FRCPC

Former Chief Addiction

& Mental Health Officer, Alberta

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