A landmark constitutional trial opened in British Columbia this week, challenging the right of publicly funded religious hospitals to refuse providing medical assistance in dying (MAID) on their premises. The case, heard at the B.C. Supreme Court, stems from the 2023 transfer of a dying woman from a Catholic-run hospital to receive the procedure.
A Rushed Goodbye and a Constitutional Question
The lawsuit was initiated by the parents of Samantha (Sam) O'Neill, a 33-year-old woman who was terminally ill with cancer. In April 2023, O'Neill was a patient at St. Paul's Hospital in Vancouver, operated by Providence Health Care. Because of the institution's religious objections to MAID, she was transferred to a hospice 25 minutes away to undergo the legally permitted procedure.
Lawyers for Dying with Dignity Canada, representing the plaintiffs, argued that forcing a patient to transfer for a procedure not due to medical necessity or lack of resources, but solely based on a religious belief they do not share, is unconstitutional. "It's not consistent with principles of fundamental justice," lawyer Robin Gage told Chief Justice Ronald Skolrood.
Gage outlined witness testimony, including from O'Neill's parents, describing a rushed and traumatic transfer. They stated their final goodbyes were hurried, and O'Neill had to be sedated for the move. They were allegedly denied the chance to be with her when she died as a result.
The Core Legal Arguments
The plaintiffs, including Gaye and Jim O'Neill, are suing Providence Health Care, the province of B.C., and Vancouver Coastal Health Authority. They argue the policy violates Section 7 of the Charter (life, liberty, and security of the person) and Section 2 (freedom of conscience and religion, including the freedom to have none).
Their central claim is that a publicly funded institution should not have the right to deny a legal medical procedure within its walls. They argue that even short transfers within the same facility can cause significant harm to vulnerable, dying patients.
In her opening, the province's lawyer, Alison Brown, contended that transferring patients for MAID is a routine part of the healthcare system and that the hospital does not deny patients access—it merely requires them to go elsewhere. She argued that accommodating every procedure in every location is not feasible and "not what the Constitution compels."
Broader Implications for Healthcare in Canada
Providence Health Care's exemption is based on religious freedom protections in the Charter. The health authority has since established a separate, off-site location near St. Paul's where patients can receive MAID. However, the plaintiffs maintain this does not resolve the constitutional issue of forced transfers.
The trial, scheduled for four weeks, began on January 12, 2024, with a full public gallery and numerous lawyers in attendance. The outcome could set a significant precedent for how conscientious objection by institutions is balanced against patient rights to access legal medical services in Canada's publicly funded healthcare system.
The case highlights the ongoing tension between religious freedoms in healthcare delivery and the equitable access to medical services for all Canadians, particularly at the end of life.
