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 seek to eliminate this policy, arguing it forces patients to endure unnecessary transfers during their final days. Should the matter escalate to Canada’s highest court, it could reshape access to end-of-life care nationwide.

Increasing Use of MAID in Canada

The provision of MAID has grown steadily across the country. In 2024, 16,499 individuals received MAID, compared to 9,950 in 2021. This accounted for 5.1 percent of all deaths that year, highlighting the procedure’s rising prominence in end-of-life options.

Frequency of Patient Transfers for MAID

Transfers for MAID occur for various reasons, such as a patient’s preference to die at home rather than in a hospital. According to federal data, in 2023, nearly half of all MAID transfers stemmed from facility policies prohibiting the procedure. By 2024, this figure dropped to about a quarter. Comparable data for 2021 and 2022 remains unavailable.

Provincial Differences in Transfer Rates

In British Columbia, where the trial is underway, approximately one-third of MAID transfers in 2024 were due to facility policies. However, rates vary significantly by province. Manitoba reported 77 percent of transfers linked to such policies, while Alberta saw 74 percent. Lower rates appear in the territories, Prince Edward Island, Newfoundland and Labrador—some of which lack faith-based health-care facilities—and Quebec, where MAID is mandated even in religious institutions.

Provincial Policies on MAID in Faith-Based Facilities

During the trial, Sara Bergen, MAID director for British Columbia’s Ministry of Health, testified about practices across provinces. Her insights reveal diverse approaches:

• British Columbia, Alberta, Manitoba, and New Brunswick require faith-based institutions to provide information on MAID requests but permit them to ban the procedure on-site.
• Newfoundland and Labrador follows a similar model.
• Saskatchewan and Ontario lack provincial guidelines, allowing individual facilities to decide.
• Quebec mandates that long-term and palliative care facilities, including faith-based ones, accommodate MAID assessments and provisions. A recent court ruling denied an exemption request from a Montreal Catholic palliative care home pending a full trial.
• Nova Scotia’s policy is ambiguous, though at least one faith-based hospital offers a designated space for MAID.
• Prince Edward Island and Yukon have no faith-based end-of-life facilities.
• Policies in the Northwest Territories and Nunavut remain unclear regarding faith-based palliative care.

Balancing Conscience Rights and Access

The case raises concerns about whether ending these opt-out policies would compel unwilling staff to participate in MAID. Experts clarify that such changes would simply enable consenting practitioners to perform and assist with the procedure in faith-based buildings. No staff would be forced to take part against their beliefs, preserving individual conscience rights while expanding patient access.