B.C. government struck compromise with assisted dying policy, court hears

The evidence of a woman who says her mother suffered needlessly in her final hours due to a transfer from St. Paul’s Hospital to a space right next to it for medical assistance in dying was accepted by the B.C. Supreme Court Tuesday.

The new evidence concerns the case of a woman who died by MAID on Jan. 7, 2026, just five days before the trial testing the constitutionality of allowing faith-based facilities to prohibit MAID got underway in court.

The affidavit of Alexi Rivera, who lives in Prince George, B.C., says the medically assisted death of her mother, Anna Chamberlain, was delayed a day and a half due to scheduling and clinical difficulties in transferring her to the Shoreline Space, which is an area adjacent to St. Paul’s in downtown Vancouver. It is administered by Vancouver Coastal Health specifically for MAID provision.

A key defence argument is that such areas, known as “adjacent spaces,” make these transfers easier. This is because Providence Health Care patients wishing to receive MAID no longer have to be transported by ambulance to another facility, as was the case for Sam O’Neill, whose mother Gaye is a plaintiff.

There are three defendants in the case, which is being heard by B.C. Supreme Court Chief Justice Ronald Skolrood. They are the B.C. government, Providence Health Care and the Vancouver Coastal Health Authority.

The defence began calling witnesses Monday, starting with the provincial government.

Current and former Ministry of Health officials took the stand this week to describe the origins of the province’s medical assistance in dying policy, which is at the centre of this case.

The policy allows publicly-funded, faith-based health-care providers to opt out of providing MAID in their facilities. It also requires them to work with health authorities to ensure an efficient transfer of care in these cases and to facilitate requests for information about MAID.

Government witnesses testified about the difficulties faced by officials when MAID became legal in 2016 in squaring B.C.’s agreement with faith-based health-care providers to deliver services with the new legislation.

A briefing note dated March 2016 to an associate deputy minister of health, entered into evidence by the province, stated it was unlikely the ministry could compel faith-based health-care providers, such as Providence, to allow MAID in their facilities.

Providence is a non-profit organization sponsored by the Catholic Church. It has an agreement with Vancouver Coastal Health to provide health-care services in the community, which include St. Paul’s and Mount Saint Joseph hospitals, two hospices and several long-term care facilities.

In 2024-25, 93 per cent of Providence’s funding was public, according to the Agreed Statement of Facts.

Providence was initially unwilling to even allow assessments for MAID to be conducted in its facilities, but the Ministry of Health was able to negotiate a compromise on this, according to Derek Rains, who oversaw MAID policy at the ministry in 2016 and testified for the province on Monday.

The compromise involved having MAID assessments done on-site and arranging for a transfer of care for the procedure itself, Rains said.

Government witnesses also described the importance of Providence Health Care in providing health services.

Tiffany Ma, an associate deputy minister of health who testified for the province on Tuesday, described Providence as “integral to the system.”

All heart transplants in B.C. – and some for out-of-province patients – are done at St. Paul’s Hospital. The hospital also provides specialized cardiac and renal care to patients throughout B.C., and contributed $850 million toward construction of the new St. Paul’s Hospital in the False Creek Flats, which is expected to cost more than $2 billion, Ma said.

Any withdrawal of service by Providence “would be quite expensive and disruptive,” she testified.

The trial continues.