Families urge provinces to end faith-based hospital opt-outs from medical assistance in dying

On the final day of Risha Golby’s life, she was forced to leave the hospital room that had been her home for more than six weeks.

The room at St. Paul’s Hospital in Vancouver held her daughter’s drawings and had become a place of relative comfort as Golby, 47, underwent treatment for pancreatic cancer. But because the Catholic-run hospital does not allow medical assistance in dying (MAID) on its premises, Golby was transferred by ambulance to an outpatient facility at Vancouver General Hospital.

Her sister, Ashley Freeman, says the transfer was painful and distressing at every stage.

“They didn’t even have a bed for her to lie in,” Freeman said. “We did our best to settle her into a La-Z-Boy recliner.”

Minutes after the family said goodbye, a physician administered MAID. Golby died shortly afterward. Freeman says the family was then told the room needed to be cleaned for another patient.

“This is already the worst day of your life,” Freeman said. “And it’s made so much worse by a policy that inflicts unnecessary pain and distress on patients, families and health-care workers.”

Following Golby’s death in 2022, a clinical space connected to St. Paul’s Hospital was created so patients would no longer need to be transported by ambulance. But advocates argue that even short transfers remain harmful and undignified for patients at the end of life.

Providence Health Care, which operates St. Paul’s, says its MAID policy reflects its Catholic values and commitment to compassionate care that “neither prolongs dying nor hastens death.” The B.C. government has said faith-based facilities may opt out of providing MAID, provided patients can still access the service elsewhere.

Dying With Dignity Canada says those assurances fall short. The organization estimates more than 100 patients across Canada are forced to transfer each year to receive MAID, including cases where patients are extremely frail or in severe pain. In one instance, a single physician reportedly had 44 patients transferred in a single year.

Quebec is currently the only province that does not allow faith-based hospitals to opt out of providing MAID. That policy is being challenged in court by Catholic institutions, which argue it violates religious freedom. The case remains before the courts.

Law professor Daphne Gilbert, vice-chair of Dying With Dignity Canada, says individual health-care workers have conscience rights, but institutions should not.

“Institutional values should not override the rights of patients in publicly funded hospitals,” she said. “People don’t choose where they get sick.”

Similar stories have emerged elsewhere in the country. In Ottawa, 87-year-old Jim McCaffrey was transferred from a Catholic-run hospital to receive MAID. His wife, Helen, says delays and agitation during the transfer caused lasting trauma.

“He had such a zest for life,” she said. “And in the end, it was dreadful. I needed grief therapy for years after.”

Advocates note that more than 100 faith-based health facilities operate in Canada, controlling roughly 13,000 hospital beds. In some regions, they are the only hospitals available, forcing patients to leave their communities to access MAID, abortions or gender-affirming care.

The issue is now before courts in British Columbia as well, following a lawsuit brought by the family of Samantha O’Neill, a 34-year-old woman with advanced cervical cancer who was transferred from St. Paul’s Hospital in 2023. Her family says she was heavily sedated during the transfer and never regained consciousness, depriving them of a final goodbye.

Freeman hopes these cases will prompt provinces to act.

“What I don’t accept is that a publicly funded institution was allowed to deny my sister a dignified death,” she said. “That’s what needs to change.”