Pro-Euthanasia Activists to Sue Catholic Hospital in Canada

Pro-euthanasia activists are preparing to sue a Catholic hospital in Vancouver that refuses to provide assisted suicide.

“It would be my hope the case would pave the way for ending the ability of religion to dictate health care,” said Daphne Gilbert, vice chairwoman of Dying with Dignity Canada and a law professor at the University of Ottawa.

Gilbert and Dalhousie University law professor Jocelyn Downie have assembled a legal team to file a constitutional challenge against St. Paul’s Hospital, which is operated by a Catholic medical organization, Providence Health Care. St. Paul’s does not allow medical assistance in dying (MAID) within its walls, but the hospital arranges transfers to other facilities that provide MAID for patients who request it.

But Gilbert and other activists argue St. Paul’s must provide in-house access to assisted suicide.

Dying with Dignity Canada — “the country’s biggest pro-MAID lobby group,” according to Canadian outlet The Walrus — is helping to prepare the suit, according to Gilbert.

The challenge is a “test case,” Gilbert said, for compelling religious medical institutions to provide abortions and “gender-affirming care,” in addition to assisted suicide.

“It would pave the way for the secularization of medical care in Canada,” Gilbert said. “Religious institutions would either have to decide to get out of the business of offering medical care — and it could be taken over by the province — or these institutions would have to align their care with the Constitution, even if it opposes their values.”

The transfer of one St. Paul’s patient to access euthanasia, 34-year-old Samantha O’Neill, gained public attention last June. When O’Neill, who had been diagnosed with stage-four cancer, opted for a medically assisted death, St. Paul’s hospital could prepare her for the procedure but could not administer the drugs that would ultimately kill her. O’Neill’s parents said that the transfer, which took a couple of hours, robbed them of their final moments with their daughter.

In response to public pressure fueled by O’Neill’s transfer, the B.C. government in November appropriated land from the hospital, according to an Archdiocese of Vancouver publication, and announced it would build an assisted-suicide center adjacent to St. Paul’s Hospital. The new building will allow patients to more easily be transferred out of Providence’s care to receive MAID.

But Gilbert said the deal does not go far enough, since the transfer of the patient could still be painful and separate them from their families, and since other facilities under Providence’s umbrella would still not be required to provide MAID.

The constitutional challenge will cite the Canadian Charter’s fundamental freedom of conscience and religion, Gilbert said, and argue that patients have a “conscience right” to choose euthanasia. St. Paul’s, she said, must provide MAID on-site.

“My argument would be that there is no freedom of religion for an institution,” Gilbert said. “Bricks and mortar don’t have conscience and religious beliefs. People within them might — and those people need to be respected and accommodated — but the four walls of the building are publicly funded health-care institutions.”

The Canadian Civil Liberties Association takes a similar view. Harini Sivalingam, director of equality programs, said she would not comment on the developing lawsuit against St. Paul’s but said the CCLA believes religious hospitals “shouldn’t be granted an exemption from providing MAID.”

“All publicly funded hospitals, which includes anything religious, should not be able to deny equitable health services,” Sivalingam said, “whether that’s access to abortion, gender-affirming care, or providing end-of-life services such as MAID.”

The legal team hopes to launch the suit by late February, Gilbert said. MAID provider Jyothi Jayaraman, who resigned from Providence’s end-of-life facility last year because it refused to provide euthanasia, said she would be willing to testify in the suit.

Assisted suicide was illegal in Canada until 2015, when the Supreme Court found the nationwide prohibition unconstitutional. In response, the Parliament passed the Medical Assistance in Dying Act, which legalized assisted suicide in certain circumstances.

Patients could receive MAID if their death was “reasonably foreseeable” and their illness “grievous and irremediable.” A 2021 amendment removed the “reasonably foreseeable” requirement.

Brian Bird, a lecturer at the University of British Columbia’s Peter A. Allard School of Law, said the high court’s treatment of religious liberty has been on the wrong track. The St. Paul’s case, he said, could be “an opportunity to correct course.”

“It seems to me that what reconciliation could look like is allowing a health-care institution like St. Paul’s or other healthcare institutions to provide 99.5 percent of legal health-care services, but for conscientious or ethical or religious reasons, not provide certain procedures,” Bird said. “It’s quite a heavy-handed argument to say they must provide everything.”

Canada’s supreme court has been unfriendly to religious liberty claims in recent years. A 2018 ruling by the supreme court denied accreditation to a law school proposed by Trinity Western University, a private university that adheres to Christian teachings on traditional marriage. Despite the university’s academic achievements and contributions, the court ruled that the school’s faith-based community standards could potentially harm the dignity of LGBT students.

Canada is “five to seven years ahead” of the United States on these issues, said ​​Andrew Bennett, program director for faith communities at Cardus, a Canadian think tank.

“And I don’t mean in a positive direction — a very negative direction,” Bennett said.

Phil Horgan, president of the Catholic Civil Rights League, said Providence could invoke religious-freedom protections in court, even though it receives public money.

“The government says ‘we’re providing the funding, you can’t deny a service,’” Horgan said. “But follow that to its logical conclusion. What does that mean for the expression of religious views in the public square? What does that mean to various other possible tax exemptions available to religious institutions?”

The day after Providence and the British Columbia government struck the deal, on November 29, the Canadian Conference of Catholic Bishops released a statement saying they “unanimously and unequivocally oppose the performance of either euthanasia or assisted suicide within health organizations with a Catholic identity.”

Providence says on its website that it is a “Catholic health care community” that is “inspired by the healing ministry of Jesus Christ.”

A Providence spokesperson declined to comment on “an advocacy group’s potential future plans.”

Since its legalization, deaths from MAID have risen from 1,018 in 2016 to 13,241 in 2022, accounting for 4 percent of all deaths in Canada last year.