Trial Underway Challenging Faith-Based Hospitals’ Right Not to Euthanize Patients in BC

A B.C. Supreme Court trial starting this week is challenging the constitutionality of faith-based hospitals in the province opting not to provide medically assisted death for terminally ill patients.

The case stems from the death of a terminally ill woman, Sam O’Neill, who sought medical assistance in dying (MAiD) while receiving care at St. Paul’s Hospital in Vancouver.

The woman’s parents, Gaye and Jim O’Neill, argue their 34-year-old daughter’s Charter rights were violated when she was subjected to “considerable pain and distress” while being transferred out of St. Paul’s to receive MAID in 2023, according to court documents. The trial began Jan. 12 and is scheduled to run until Feb. 6.

The case is being brought against the B.C. government, Vancouver Coastal Health, and Catholic health-care organization Providence Health Care, which runs St. Paul’s Hospital. Catholic doctrine forbids euthanasia and St. Paul’s is exempt from providing MAID due to a past B.C. government agreement with faith-based hospitals.

The plaintiffs include Gaye O’Neill, as well as Dying with Dignity Canada, and Dr. Jyothi Jayaraman.

The court will also hear from the Canadian Centre for Christian Charities, the Evangelical Fellowship of Canada, the Delta Hospice Society, Christian Legal Fellowship, the Canadian Civil Liberties Association, Canadian Physicians for Life, and the B.C. Humanist Association, as part of the case.

The organizations are considered intervenors, which are allowed to join an existing lawsuit to present a perspective that helps the court understand broader public interest issues. A number of the intervenors support the defendant’s stance on maintaining the religious exemption.

Chief Justice Ronald Skolrood determined in a judgment dated April 1, 2025, that the organizations contribute a distinct viewpoint and professional insight, and granted intervenor status to each one.

The Case

Sam O’Neill was diagnosed with an advanced stage of cervical cancer and admitted to St. Paul’s in early 2022, Skolrood noted in his judgement.

She was subsequently approved to receive MAID in February of 2023, but because St. Paul’s does not provide euthanasia, she was transported out of the hospital to another facility, a process which the plaintiffs say caused unnecessary suffering. The plaintiffs argue this violates Sections 2(a) and 7 of the Canadian Charter of Rights and Freedoms, which pertains to freedom of conscience and religion, as well as life, liberty and security of the person.

In addition to having potential implications for the future of MAID relating to religious exemptions, the trial comes amid the ongoing $2.18 billion construction of a new site for St. Paul’s Hospital in Vancouver. The B.C. government previously said it continues to support the right of faith-based hospitals to transfer patients out instead of performing MAID.

“While faith-based organizations may opt not to offer MAiD services at their facilities, they are expected to work with regional health authorities to ensure the option is available to patients who choose it,” the B.C. Ministry of Health wrote in 2023.

MAID

MAID became law in Canada in 2016, initially providing the option to the terminally whose death was “reasonably foreseeable.” Eligibility was expanded in 2021 to those with a “grievous and irremediable medical condition,” defined as an incurable condition causing enduring and intolerable suffering, removing the requirement for the illness to be terminal.

The 2021 MAID law kept a temporary exclusion for people whose only medical condition is a mental illness. That exclusion was originally set to expire in March 2023, meaning those whose sole underlying medical condition is a mental illness would be eligible for MAID at that time, but this has been delayed to at least March 2027 over concerns that the health-care system isn’t ready to implement these complex cases.

While the legal framework of MAID is contained in Canada’s federal Criminal Code, the specifics of how it’s delivered and whether health-care facilities must allow it on their premises differ in each province. B.C. signed a 1995 Master Agreement allowing faith-based health providers to opt out of procedures which violate their beliefs, and the province has therefore allowed such organizations to transfer their patients who have been approved to receive MAID.

Provincial policies vary. Quebec, Prince Edward Island, and Nova Scotia require that all publicly funded health facilities provide MAID regardless of religious affiliation. Alberta and Ontario allow individual medical professionals to personally refuse to carry out MAID procedures as conscientious objectors and faith-based hospitals are not legally required to perform MAID on-site.

The Sixth Annual Report on MAID in Canada published last November found that 16,499 people received MAID in 2024, up from 15,343 in 2023. Roughly 5.1 percent of all deaths in Canada were due to MAID in 2024, according to Health Canada.