Arguments began on Monday in B.C. Supreme Court in a case that questions if faith-based hospitals have the right to refuse medical assistance in dying (MAID).
Dying With Dignity Canada is among a group of plaintiffs bringing a Charter challenge against the B.C. government, Vancouver Coastal Health and Providence Health Care.
Providence is a Catholic organization that operates 18 health and long-term care facilities in Vancouver.
The B.C. government allows organizations like Providence to opt out of providing medical assistance in dying in their facilities, as long as patients are transferred elsewhere.
“What is at stake is the dignity, autonomy and Charter-protected rights of patients at the end of their lives,” Helen Long, the CEO of Dying with Dignity, said.
“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, also known as MAID. Conscientious objection is a right held by individuals, but it is not something held by a health-care institution or building.
“Publicly funded hospitals and health-care facilities do not have beliefs of their own, and institutional policies should never override a patient’s lawful health-care choices.”
The plaintiffs include the parents of 34-year-old Sam O’Neill, who had to be transferred from St. Paul’s Hospital to St. John’s Hospice to receive MAID in April 2023.
O’Neill was terminally ill with cancer when she sought MAID and her parents allege that the transfer to another facility where the procedure was performed caused her last hours to be filled with unnecessary pain and distress.
“There was no medical justification for the transfer,” Gay O’Neill, Sam’s mother, said on Monday.
“There was no specialized equipment. There was nothing special about the facility or room. And there was no specialized medical staff unique to St. John’s Hospice. There was nothing at St. John’s that was not readily available in Sam’s room at St. Paul’s Hospital.”
O’Neill said Providence Health Care disregarded her daughter’s safety, which is contrary to their legal obligation to take reasonable action to prevent harm.
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“We are here because we believe Sam’s rights to freedom of religion and beliefs and the rights to life and liberty and security of person were violated,” she said.
“We are also here because we do not want to see anyone else suffer needlessly from another unjustified forced transfer.”
O’Neill said her daughter was fiercely independent, loved running and completing marathons, was vegan and believed that she had to just shoot for the stars and good things would happen.
“On April 20th, 2022, Sam was in pain and went to St. Paul’s Hospital, which was less than a kilometre away from her apartment,” O’Neill said.
“There she learned she had a tumour and cervical cancer was suspected. A few days later, she was back at St. Paul’s, unable to urinate. She was admitted and received surgery to install nephrostomy bags because a large tumour blocked her ureters.”
O’Neill said her daughter received good care at St. Paul’s Hospital and was eventually sent home, only to be readmitted to the hospital again in late January 2023.
She was assessed for MAID while she was in hospital, O’Neill said, because her daughter wanted an option to control her life.
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As her condition worsened, O’Neill said her daughter requested MAID on April 4, 2023.
It was confirmed that a doctor would be available that evening at St. John’s Hospice and O’Neill said her daughter’s family and friends were told they should gather to say their goodbyes.
“At some point around 6 p.m. or shortly thereafter, a nurse came to tell us we could quickly say our final goodbyes to Sam before she was prepared for the transfer vehicle,” O’Neill said.
“We were told we would have to go in in groups of five, two groups of five. At that point, Sam was sitting on a commode in the middle of a room with a sheet wrapped around her. I was absolutely horrified. I was shocked and appalled by the indignity of what we were witnessing. I stifled my horror and I told Sam quickly that being her mom was the first most joyful part of my life. I love being her mom.
“I told her how proud I was of who she became and how sorry I was that this had snowballed so quickly.”
By the time they saw Sam again, she was heavily sedated and taken to the transfer vehicle and then driven to St. John’s Hospice.
“Our heavily sedated daughter moaned and writhed in pain with each bump on the approximately 25-minute drive… It is crushing to know that Sam’s last memory on this earth was out of extreme pain caused by the transfer,” O’Neill said.
She added that when they arrived at St. John’s Hospice, the room she was directed to had been used by Providence Health Care to store excess equipment.
“No one should ever be treated as Sam was on that day,” O’Neill said.
“The government of British Columbia supports Providence’s actions with a MAID policy that allows harm, and the public pays for it. The hypocrisy of a forced transfer is outrageous. Our Sam was gonna die. She knew that. There was no cure, and she was suffering terribly, living with a disease that had robbed her of her quality of life.
“We miss our daughter every minute of every day. We absolutely respect her wish to put an end to her own suffering and take control of her destiny and die with the dignity she deserved.”
Long said that religious beliefs should never interfere with a patient’s health care decision and no one religion or religious doctrine is allowed to restrict or override access to legal medical care.
“This case is about putting patients first,” she said.
“Every person deserves access to all of their end-of-life options without distress or forced transfer.”
-with files from The Canadian Press
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