A landmark trial in British Columbia’s Supreme Court is examining the policy permitting faith-based health-care facilities to prohibit medical assistance in dying (MAID) on their premises. The plaintiffs seek to invalidate this policy, arguing it forces patients into unnecessary transfers during their final days. Should the case escalate to Canada’s Supreme Court, it could reshape MAID access nationwide.
Rising Demand for MAID Across Canada
The utilization of MAID continues to grow annually. In 2024, 16,499 individuals received MAID, compared to 9,950 in 2021. This accounted for 5.1 percent of all deaths in Canada that year, highlighting the procedure’s increasing role in end-of-life care.
Transfers Due to Facility Policies
Patients may need to transfer locations for MAID for various reasons, such as preferring to die at home rather than in a hospital. According to federal data, in 2023, nearly half of all MAID-related transfers stemmed from the receiving facility’s policy against providing the service. By 2024, this figure dropped to about one-quarter of transfers. Information for 2021 and 2022 remains unavailable.
Provincial Differences in Transfer Rates
In British Columbia, approximately one-third of MAID transfers in 2024 were attributed to facility policies. However, rates vary significantly by province: Manitoba saw 77 percent of such transfers linked to these policies, while Alberta reported 74 percent. The lowest incidences occurred in the territories, Prince Edward Island, and Newfoundland and Labrador—regions with few or no faith-based health-care facilities—and in Quebec, where faith-based sites must permit MAID.
Provincial Policies on MAID in Faith-Based Settings
During the trial, Sara Bergen, MAID director for British Columbia’s Ministry of Health, testified about how different provinces handle MAID requests. Her insights reveal a patchwork of approaches.
British Columbia, Alberta, Manitoba, and New Brunswick mandate that faith-based institutions provide information on MAID but do not require them to perform the procedure. Saskatchewan and Ontario lack overarching provincial guidelines, allowing individual facilities to decide.
Quebec stands out by requiring both assessment and provision of MAID in all long-term and palliative care facilities, including faith-based ones. A recent court ruling denied a Roman Catholic archdiocese in Montreal an exemption for one of its palliative care homes pending a full trial.
Nova Scotia’s stance remains ambiguous, though at least one faith-based hospital there offers a designated area for MAID administration. Prince Edward Island and Yukon have no faith-based end-of-life care facilities. Policies in the Northwest Territories and Nunavut are not clearly defined regarding faith-based palliative care.
Balancing Access and Conscience Rights
A key concern is whether overturning these policies would compel health-care workers opposed to MAID to participate. The proposed changes would not require such involvement. Instead, they would enable willing and qualified practitioners to conduct MAID within faith-based facilities, ensuring patient access without infringing on individual beliefs.
