MAID lawsuit puts spotlight on faith-based health organizations

A recent lawsuit over access to medical assistance in dying (MAID) in some British Columbia hospitals has put a spotlight on the practices of religious health organizations.

According to researchers, religious health organizations in British Columbia are prohibited from providing certain services if they conflict with their values ​​and beliefs. This includes access to abortion, contraception and reproductive health care in Catholic, publicly funded hospitals.

Providence Health Care, the Catholic health care organization that runs St. Paul’s Hospital in Vancouver, and the province of British Columbia are now being sued by the family of 34-year-old Samantha O’Neill, who was forcibly transferred from St. Paul’s because Providence did not want to give her MAID.

Her family says the forced transfer has caused O’Neill unbearable pain and the lawsuit is the only way to prevent anyone else from finding themselves in a similar situation.

“Assisted dying is central to this case. But it has broader implications,” said Jocelyn Downie, a professor emeritus at Dalhousie University’s faculty of law and medicine who has spent years studying health care in faith-based communities. health care networks across Canada.

“Canadians must recognize that they can be denied care that goes far beyond assisted dying,” Downie said.

“There are all kinds of care that can be denied to them because governments allow religious institutions that are publicly funded to deny care based on their religious beliefs and values.”

Ann Gibbon, a spokeswoman for Providence Health Care, told CBC News in an email that the organization is transferring patients who require MAID to a facility at Vancouver Coastal Health.

“Because we are a Catholic health care provider, there are some services not available in the facilities, especially those intended to end human life. MAID is one of those services,” Gibbon said.

“Providence’s approach is based on a centuries-old moral tradition of compassionate care that does not prolong dying, nor does it hasten it.”

A young white woman in a black vest participates in an organized race.
Samantha O’Neill is running in an undisclosed race. O’Neill was battling stage 4 cervical cancer when she chose assisted dying in April 2023 at age 34. (Submitted by Jim O’Neill)

Opt-out is allowed

The ability for religious health organizations to opt out of certain health care services in B.C. is set out in a 1995 framework agreement between the province and the Denominational Health Association.

The association represents 12 different religious denominations that oversee a total of 7,800 health care beds, including acute care, long-term care and senior living facilities across B.C.

The agreement states that faith-based health facilities have the right to determine the mission and values ​​of their facilities and “own, manage, operate and conduct the affairs of their respective facilities and carry out their respective religious missions .”

According to Gibbon, Providence Health Care does not provide abortions, but it does provide care for patients who have had a miscarriage. Because pharmacy restrictions apply by province, contraceptives are available at Providence Health Care affiliated pharmacies.

However, according to the Catholic Health Alliance of Canada’s health ethics guide, Catholic hospitals cannot perform abortions, provide contraception, or perform any form of sterilization to prevent future pregnancies.

For example, this means that if a woman gives birth to a baby by cesarean section in a Catholic hospital, she cannot undergo tubal ligation to prevent future pregnancies.

LOOK | Family sues health organization and province over MAID refusal:

Family of Vancouver woman sues province and hospital administrator over MAID policy

The family of a Vancouver woman who was forced to move to another hospital before she could receive medically assisted suicide (MAID) is suing the British Columbia government and Providence Health Care, alleging that the Catholic organization’s ban on MAID in its health care facilities violates patients’ Charter rights.

Jill Doctoroff, interim director of Options for Sexual Health, a women’s clinic in Vancouver, said it’s “a huge concern” that health care can differ depending on which hospital you go to, especially since people don’t often choose where they go to be treated.

“I think we all know there are so many challenges within our health care system right now, and added barriers, like the faith-based decision not to provide these services, make it more difficult,” she said.

“We all expect to be able to get the health care we need no matter where we are. And I think as tax-paying citizens we should also expect that health care facilities are based on health care and science and not on faith.”

Government response

Premier David Eby said last week that the government is negotiating with Providence Health Care over what services will be provided at the new $2.1 billion St. Paul’s Hospital, expected to open in 2027.

The province is contributing $1.3 billion, Providence Health Care $722 million and the St. Paul’s Foundation $131 million.

Providence Health received $700 million in funding from Vancouver Coastal Health last year, plus another $112 million from other health authorities and the BC government.

The BC government has closed a hospice in the past for refusing to provide MAID. It happened in 2021 when Fraser Health raised $1.5 million in public funding after the Delta Hospice Society stopped offering the service.

However, the Delta Hospice Society was not a religiously led health network.

After Samantha O’Neill’s parents, Jim and Gaye O’Neill, went public with their concerns, BC Health Minister Adrian Dix announced in November that his ministry would set up a clinical space next to St. Paul’s where MAID could be overseen by Vancouver Coastal Health staff.

“I appreciate that people want to see some kind of legal response, but my concern is that patients have access to the care that they need,” Dix said Tuesday during an unrelated news conference in Surrey, B.C. “And that’s the action we’re taking at St. Paul’s.”

However, Dr. Jyothi Jayaraman, a palliative care physician and MAID practitioner from Vancouver, said this solution fails to take into account the fact that there are at least two dozen faith-based hospices and long-term care facilities across British Columbia.

British Columbia Health Minister Adrian Dix looks thoughtful at a news conference.  He is a middle-aged white man wearing a navy blue suit, navy blue tie and white shirt.  He has brown hair and wears glasses with black frames.
Adrian Dix, British Columbia’s Minister of Health, during a press conference in Surrey, British Columbia, on June 18. (The Canadian Press/Ethan Cairns)

“Mr. Dix really needs to come out and acknowledge that this is not just a St. Paul problem. It’s a problem for all faith-based institutions,” said Jayaraman, a plaintiff in the O’Neill case.

According to the organization, nineteen people were forced to transfer to another health care facility (Providence Health Care) this year to access MAID.

Nine of these patients were transferred from St. Paul’s, four each from Mount Saint Joseph Hospital and May’s Place Hospice in Vancouver, and two from St. John Hospice on the University of BC campus.

Jayaraman left her job at May’s Place Hospice last year after the hospice was acquired by Providence Health Care and subsequently stopped offering MAID.

LOOK | Dr. Jyothi Jayaraman Discusses Why She Quit:

BC doctor speaks out on MAID access

Dr. Jyothi Jayaraman, who says she left her job at Vancouver hospice May’s Place after the hospital was taken over by Catholic nonprofit Providence Healthcare, is speaking out after reports that St. Paul’s Hospital, which is also overseen by Providence, denied medical assistance in dying to a terminally ill patient for religious reasons.

The Quebec government passed legislation last year requiring all palliative care facilities, including those run by religious health organizations, to provide medical assistance in death.

The office of the Roman Catholic Archbishop of Montreal is challenging this law, saying it violates religious freedom.

Daphne Gilbert, a professor at the University of Ottawa and co-founder of the human rights organization Dying with Dignity, helped lead the lawsuit in British Columbia. She says the Quebec government is taking the opposite approach than British Columbia, which has so far been reluctant to dictate what services religious health networks should provide.

“There you have the government protecting the rights of all Quebecers, despite the church’s position,” Gilbert said. “Whereas in BC the government protects the church and we challenge that protection. But the fundamental question is similar.”

Downie said it is “extremely unfair” that the BC government has essentially forced patients to file a lawsuit over the policy.

“It’s an abdication of government responsibility to do it this way – that is, we have an agreement, we have a policy. If you don’t like it – you’re the patient who is faced with this forced transfer – you need to go to court and fight for your rights.”

Gilbert expects the legal challenges in both British Columbia and Quebec to reach the Supreme Court of Canada.

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