A Vancouver palliative care doctor who says she chose to resign rather than authorize patient transfers for the purpose of medical assistance in dying (MAID) took the stand in B.C. Supreme Court this week.
Dr. Jyothi Jayaraman is one of three plaintiffs in the case, which challenges the constitutionality of publicly funded, faith-based health-care facilities prohibiting the procedure in their buildings.
The others are Gaye O’Neill, the mother of a woman who died after having to transfer out of St. Paul’s Hospital, located in downtown Vancouver, to receive MAID in 2023, and Dying With Dignity Canada.
In her affidavit, Jayaraman says she resigned from her role providing palliative care in two Vancouver hospices in early 2023 because the operation of one was being handed over to Providence Health Care.
Providence, which is one of the defendants in the case, does not allow MAID in its facilities due to the Catholic church’s opposition to euthanasia.
This meant Jayaraman would no longer be able to provide MAID to patients in their rooms and would instead be forced to authorize a transfer due to the religious beliefs of the institution in question.
She says she has provided MAID for 44 patients who were then forced to transfer facilities for the procedure.
“I have seen forced transfers cause significant unnecessary physical, psychological and spiritual suffering. When someone is nearing end of life, every movement can be excruciating. And when a patient has only 15 minutes left to live, every minute seems like an hour,” she said in the affidavit.
“By not providing MAID at the bedside, when I know I can, I am being forced to add to a person’s suffering. I find this most distressing.”
In her cross examination of Jayaraman, Shauna Gersbach, a lawyer representing defendant Vancouver Coastal Health, noted the health authority has created spaces specifically for MAID provision, known as adjacent spaces, next to hospitals and hospices operated by Providence. These adjacent spaces are operated by Vancouver Coastal Health.
In fact, Gersbach noted Jayaraman was the MAID provider for the first two patients to have the procedure at Shoreline, the adjacent space next to St. Paul’s Hospital. She entered into evidence an email Jayaraman wrote complimenting staff on how smoothly the procedures went and how patient care was kept front and centre.
“From your perspective, the fact that this accommodation has been made to facilitate patients needing access to MAID in an adjacent space, similar to what is in place adjacent to the hospices, that’s not adequate?” Gersbach asked.
“No,” said Jayaraman.
“Is it fair to say that anything short of patients being able to receive MAID at a faith-based facility would violate your moral and ethical beliefs?” Gersbach pressed.
“Yes,” she answered.
“So there’s no room for compromise?” defence queried.
“No,” Jayaraman stated.
In her affidavit, Jayaraman noted even transfers to adjacent spaces can be disruptive because they mean the final minutes of a patient’s life, which she says should be spent in a calm, sacred space, are overtaken by logistics.
The Province of British Columbia, Providence Health Care and Vancouver Coastal Health are all named as defendants in the case.
The plaintiffs are expected to wrap their case later this week. The defence will then begin presenting evidence.
