Proceedings got underway in B.C. Supreme Court Monday in a case that will determine whether faith-based organizations can continue to prohibit medical assistance in dying (MAID) within their facilities.
The case was brought by the family of Samantha O’Neill, a woman who had to endure what her family says was a painful transfer from St. Paul’s Hospital to a hospice administered by Vancouver Coastal Health in order to receive MAID.
Flanked by half a dozen pro-MAID activists carrying signs on the steps of B.C. Supreme Court, Sam’s mother Gaye O’Neill, with Sam’s father Jim by her side, tearfully recalled her daughter’s final hours.
She described how Sam, who was 34 and suffering from Stage 4 cervical cancer, was taken by ambulance to St. Paul’s hospital in March 2023 in extreme pain. She was taken there because it was the closest available emergency room, O’Neill said.
By early April, her condition had deteriorated so much that any movement caused her extreme pain, O’Neill said, and she was requesting MAID.
In order to obtain it, she had to be transferred to a hospice 25 minutes away, because St. Paul’s, a faith-based institution run by the Providence Health Care Society, does not allow MAID in its facilities.
The last time O’Neill saw her daughter conscious, she was seated on a commode. Nurses told her she could quickly say her final goodbyes, as transport crews waited outside.
“I stifled my horror and told Sam quickly that being her Mom was the most joyful part of my life,” she said. “I told her I loved her, and she told me she loved me. I kissed her gently on her forehead. We were then asked to leave the room, so the nurses could prep her.”
O’Neill was then heavily sedated for the ambulance transfer. She received MAID at a Vancouver hospice later that day.
“We are here because we do not want anyone else to needlessly suffer from another unjustified forced transfer,” O’Neill said.
O’Neill, along with co-plaintiffs Dying with Dignity Canada and Dr. Jyothi Jayaraman, a Vancouver palliative care doctor, argue that forcing MAID patients in faith-based facilities to undergo a transfer to obtain the service violates their constitutional rights.
In her opening statement before B.C. Supreme Court Chief Justice Ronald Skolrood, lawyer Robin Gage said the plaintiffs will challenge constitutional validity of provision that prohibits MAID provision in publicly funded health care institutions.
Religious exemptions to MAID law face challenge in B.C. Supreme Court
The plaintiffs will present evidence to show that the policy of not allowing MAID within Providence facilities inflicts significant physical and spiritual harm on vulnerable patients based on religious beliefs they may not share, Gage said.
The court will hear from the families of others who have had to transfer facilities to receive MAID and from doctors who provide it, she added.
The plaintiffs’ goal is to have the policy overturned so patients can receive MAID in faith-based facilities by clinicians who are able and willing to provide it, said Helen Long, CEO, Dying With Dignity Canada. No Providence staff would be required to administer the procedure against their conscience.
B.C. government lawyer Alison Brown noted there is now a space adjacent to St. Paul’s called Shoreline, where MAID can be performed and which has accommodated all St. Paul’s MAID patients who have not wished to go home. There are similar adjacent spaces at two other Providence facilities, she said.
There is no constitutional entitlement to access a medical service within a specific room, she said in her opening statement.
“The heart of this case is the policy and whether it is constitutionally compliant.”
B.C.’s policy on MAID was developed to avoid pushing faith based institutions across a red line into an irreconcilable conflict, Brown said.
The government will call on policymakers who will explain how and why the province’s MAID regulations were developed, Brown said.
The other defendants named in the lawsuit are Vancouver Coastal Health and the Providence Health Care Society, each of whom are represented by their own lawyers.
Long, of Dying with Dignity Canada, said she expects the case will have implications for faith-based facilities across the country.
The trial is expected to last four weeks, plus another week in mid-April for closing arguments “and then a decision we would hope by late summer or early fall,” Long said.
