Sam O’Neill, a young woman dying of inoperable terminal cancer, requested medical assistance in dying (MAiD). She wanted a peaceful end to her excruciating suffering with her family and friends by her side, but she didn’t get that.
Instead, she was told that she couldn’t have MAiD at her hospital — St. Paul’s in Vancouver — because MAiD goes against the Catholic values that dictate which health services are provided there.
Sam chose to proceed the only way she could. Her final hours were spent preparing for a transfer to an unfamiliar place with unfamiliar staff. She was heavily sedated so that she could bear the brutal physical pain of being transferred by ambulance to a new facility.
She received MAiD without ever regaining consciousness. She missed her moment for that last goodbye and so did her loving family. Her family turned their grief into action, going public with her story to express their anger and sadness.
After the circumstances of Sam’s death became public, many people asked, “Can this really be true? Can a religious organization force a patient to leave a palliative care unit in a publicly funded hospital in downtown Vancouver to access a legal health service in another facility? A patient who is literally on her deathbed.”
Sadly, it is true, but it need not be and it should not be.
How then can it be true? Under the B.C. Health Ministry MAiD policy, an organization that receives more than 50 per cent of its funding from the province must generally allow the assessment and provision of MAiD in settings where end-of-life services are normally offered.
However, there is an exception: faith-based groups may decide not to allow the provision of MAiD in their facilities. St. Paul’s Hospital is operated by Providence Health Care, a “Catholic health-care community.”
So this is why Sam had to be sedated to the point of unconsciousness and transferred out of St. Paul’s to access MAiD. The B.C. MAiD policy is why she lost the opportunity for the assisted death she wanted.
Since 2016, 131 patients have, like Sam, had to transfer out of Providence Health Care facilities in order to access MAiD. And that’s just the numbers from one faith-based organization in B.C. From January through October 2022, 7.7 per cent of MAiD deaths in Vancouver Coastal Health involved forced transfers. And that’s just the numbers from one health authority in B.C.
Publicly funded health care institutions employ and, more importantly, serve people of all faiths and backgrounds. Sam didn’t have a choice about where she went for palliative care. She didn’t share St. Paul’s opposition to MAiD. But she was impacted by it in a devastating way.
So what’s the solution? The Health Ministry could change its stance toward publicly funded, faith based health-care organizations where end-of-life services are normally offered. It could immediately eliminate the exception in its MAiD policy, forcing these faith-based groups to allow the provision of MAiD.
The faith-based organizations would likely immediately raise an objection and point to what is known as the Master Agreement. This is an agreement signed in 1995 between the B.C. minister of health and the Denominational Health Care Facilities Association (a group of faith-based organizations). In this agreement, the province agreed to ensure that the members of this association would continue to have the right to determine the mission and values of their facilities and to “own, manage, operate and conduct the affairs of their respective facilities and to carry out their respective religious missions.”
But the Health Ministry could terminate the master agreement unless the faith-based organizations stop forced transfers for MAiD. The Health Ministry is free to terminate the master agreement by giving 365 days’ written notice. The ministry could tell the faith-based groups that they must allow the provision of MAiD or else the exit provisions of the master agreement will be triggered.
The B.C. government must now make a choice. Does it stand with the Catholic Church? Or does it stand with patients like Sam? It’s as simple as that. Will it defend the ability of the Catholic Church to determine that British Columbians can be denied legal health-care services just because they don’t accord with Catholic values? Or will it defend the ability of British Columbians to determine the course of their lives and their deaths according to their own values?
It’s too late to change Sam’s death and to give her and her family the peaceful end she deserved. But it’s not too late to prevent other egregiously cruel and harmful forced transfers.
May Samantha’s legacy be the end of forced transfers.
Jocelyn Downie is professor, faculties of law and medicine, at Dalhousie University in Halifax. Daphne Gilbert is professor, faculty of law, at the University of Ottawa.
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