A landmark case in British Columbia’s Supreme Court is examining whether publicly funded faith-based health-care facilities can prohibit medical assistance in dying (MAID) on their premises. The plaintiffs argue that this policy forces patients into unnecessary transfers during their final days, potentially violating constitutional rights. Should the matter escalate to Canada’s highest court, it could reshape MAID access nationwide.
Increasing Prevalence of MAID in Canada
MAID procedures have grown steadily in recent years. In 2024, a total of 16,499 individuals received MAID, compared to 9,950 in 2021. This accounted for 5.1 percent of all deaths in the country that year, highlighting the procedure’s expanding role in end-of-life care.
The Role of Patient Transfers in MAID
Transfers occur for various reasons, such as a patient’s preference to die at home rather than in a hospital. However, government reports indicate that facility policies often play a key factor. In 2023, nearly half of all MAID-related transfers stemmed from the receiving institution’s rules. By 2024, this proportion had decreased to about one-quarter. Comparable data for 2021 and 2022 remains unavailable.
Provincial Differences in Transfer Rates
While the current trial focuses on British Columbia—where roughly one-third of 2024 MAID transfers were policy-related—rates vary widely across provinces. Health data reveal higher incidences in Manitoba (77 percent) and Alberta (74 percent). In contrast, transfers due to facility policies are rare or nonexistent in the territories, Prince Edward Island, Newfoundland and Labrador, and Quebec, where faith-based sites either do not exist or must permit MAID.
Diverse Provincial Policies on MAID in Faith-Based Settings
During the trial, testimony from Sara Bergen, MAID director for British Columbia’s Ministry of Health, outlined approaches in other regions. British Columbia, Alberta, Manitoba, and New Brunswick mandate that faith-based facilities provide information on MAID requests but do not require on-site provision. Saskatchewan and Ontario lack overarching provincial guidelines, deferring to individual institutions. Quebec stands out by mandating MAID assessments and delivery in all long-term and palliative care facilities, irrespective of religious affiliation; a recent judicial ruling denied an exemption request from a Catholic archdiocese pending further proceedings.
Nova Scotia’s stance remains ambiguous, though one faith-based hospital there offers a designated area for MAID. Prince Edward Island and Yukon have no faith-based end-of-life facilities. Policies in the Northwest Territories and Nunavut are not clearly defined.
Balancing Access and Conscience Protections
Critics of the opt-out policy, including affected families, call for its elimination in publicly funded faith-based hospitals to ensure equitable care. The proposed changes would not compel unwilling staff to participate. Instead, they would enable qualified providers to perform MAID within these facilities, respecting individual conscience rights while prioritizing patient access.
