A Charter challenge to British Columbia’s policy of letting publicly funded faith-based hospitals refuse medical assistance in dying on site opened in B.C. Supreme Court on Monday, in a case plaintiffs say is about patients forced to transfer, in pain, to die elsewhere.
Sam O’Neill’s last ride
The B.C. Supreme Court has begun hearing a case that questions whether faith-based, publicly funded hospitals have the right to refuse certain procedures on the basis of their religious beliefs. Dying With Dignity Canada is part of a group of plaintiffs bringing the Charter challenge against the B.C. government, Vancouver Coastal Health and Providence Health Care, the Catholic organization that operates 18 health and long-term care facilities in Vancouver.
The plaintiffs include Gaye and Jim O’Neill, whose daughter Sam was 34 and living with stage 4 cervical cancer when she was admitted to St. Paul’s Hospital in Vancouver. She was assessed and approved for medical assistance in dying — but St. Paul’s, run by Providence, does not provide MAID, so in April 2023 she was transferred to another facility to receive it. Her family says she was in excruciating pain during the transfer, had to be heavily sedated, never regained consciousness, and that her loved ones did not get the chance to say goodbye. “There was no medical justification for the transfer,” Gaye O’Neill told reporters at a press conference in Vancouver on Monday. The family believes the transfer violated Sam’s Charter rights to freedom of religion and to life, liberty and security of the person.
Providence, in its statement of defence, defended the care Sam O’Neill received and argued she knew a transfer would be required and had the choice of continuing treatment at St. Paul’s or moving to a hospital where assisted dying could be provided.
Two Charter rights collide
British Columbia allows faith-based organizations to opt out of providing MAID in their facilities as long as patients are transferred elsewhere — an arrangement rooted in the province’s 1995 Master Agreement with denominational providers. The plaintiffs argue that in a publicly funded system, no institution’s religious doctrine should restrict access to legal medical care. “This case highlights the harm caused when patients are forced to leave the care settings they know and trust in order to receive medical assistance in dying,” said Dying With Dignity Canada CEO Helen Long.
The third plaintiff, Dr. Jyothi Jayaraman, is a palliative care physician and MAID provider who resigned from Vancouver Coastal Health in February 2023 after Providence took over two hospices where she worked. In court documents, she said she could not, as a matter of principle, certify transfers she believed were medically unnecessary, and that since 2016 she has provided MAID to 44 people who first had to be moved out of faith-based facilities — some of them in severe pain, or so heavily sedated they could not communicate with family.
Providence argues the Charter shields it in the other direction: freedom of religion protects it from being “compelled to provide services that are contrary to deeply and sincerely held beliefs.” Rev. Dr. Andrew Bennett of the think tank Cardus said the trial will centre on choice in health care, noting that many Canadian hospitals have faith foundations and most do not want to allow assisted dying. St. Paul’s itself was founded by an order of nuns in 1894, and its Catholic identity is “grounded in the principle that every human life has inherent dignity from conception to natural death,” court documents say. Eight organizations — among them the Canadian Civil Liberties Association and the B.C. Humanist Association — sought intervener status, and the trial before Chief Justice Ronald Skolrood was expected to last several weeks.
The numbers behind the case
Since 2023, 122 people have been transferred out of faith-based facilities within Vancouver Coastal Health to obtain MAID, including 49 who were moved to an “adjacent space.” Nationally, Health Canada’s 2024 data show 349 people who died with medical assistance that year were first transferred out of a facility because of its policies — a figure the court will weigh as it decides whether B.C.’s compromise between institutional conscience and patient rights can stand.
