OTTAWA — A legal challenge in British Columbia over whether faith-based hospitals must provide medical assistance in dying is drawing renewed attention to the role of MAiD-free healthcare spaces in Canada and raising broader questions about patient trust and access to care, according to a new report from Cardus.
The British Columbia Supreme Court recently concluded hearings in a case involving transfer policies connected to St. Paul’s Hospital in Vancouver. The hospital, which operates under Catholic sponsorship, is permitted under provincial rules to remain a MAiD-free facility, meaning patients seeking assisted death must be transferred elsewhere.
The case has become a focal point in the national debate over how to balance access to assisted dying with religious freedoms and patient choice within Canada’s publicly funded healthcare system.
“Preserving the option of MAiD-free spaces is vital to maintaining Canadians’ trust in the healthcare system,” says Rebecca Vachon (PhD), director of the health program at Cardus and author of Disability and MAiD: A Discussion Paper of Public Opinion Polling. “Canadians living with severe disabilities are twice as likely as Canadians without severe disabilities to strongly agree that some healthcare facilities should be MAiD-free spaces.”
The Cardus discussion paper argues the implications of the lawsuit extend beyond a single hospital or province. It highlights concerns that systemic gaps in healthcare access — particularly for people with disabilities — could influence decisions around assisted dying.
“Fifty-seven percent of Canadians living with severe disabilities say they experience barriers or discrimination in healthcare, while almost half of healthcare workers say that people with disabilities receive ‘poor’ or ‘terrible’ healthcare in Canada,” says Dr. Vachon. “It is unjust and inexcusable if systemic barriers to healthcare lead people with disabilities to request MAiD because they feel they have no other alternatives.”
Medical assistance in dying has been legal in Canada since 2016 and has expanded in scope in subsequent years. The program allows eligible patients to seek assistance from physicians or nurse practitioners to end their lives under defined legal conditions. Its expansion has been closely watched by healthcare providers, policymakers, insurers, and advocacy groups, given its ethical, operational, and financial implications across the healthcare system.
Cardus says its latest analysis also suggests public opinion on MAiD may not be as firmly grounded as headline support levels imply. According to the report, many Canadians misunderstand key aspects of the program, including eligibility and how it differs from other end-of-life care options.
The study indicates some Canadians mistakenly believe MAiD is limited strictly to last-resort or exceptional circumstances, when eligibility criteria are broader. Others confuse assisted dying with practices such as withdrawing life-sustaining treatment or administering palliative sedation, which are medically and legally distinct.
The discussion paper draws on polling conducted in fall 2024 by the Angus Reid Institute in partnership with Cardus, along with additional research and national data. It examines how perceptions of assisted dying intersect with disability, healthcare access, and overall confidence in the medical system.
Healthcare access and system capacity remain major concerns for policymakers and healthcare administrators across Canada, particularly as provinces face staffing shortages, rising costs, and increasing demand linked to an aging population. The debate over MAiD-free spaces adds another layer of complexity, as governments attempt to reconcile patient access rights with institutional mandates and workforce considerations.
Faith-based healthcare providers continue to play a significant role in Canada’s healthcare delivery, operating hospitals, long-term care homes, and other facilities under public funding agreements. Court rulings and policy decisions affecting these providers could have operational and legal implications beyond British Columbia.
The Cardus report concludes that maintaining diverse care options — including facilities that do not provide assisted dying — may be important for sustaining public confidence.
Disability and MAiD: A Discussion Paper of Public Opinion Polling is available publicly through the organization’s website.
The British Columbia case is expected to be closely watched by healthcare organizations, legal experts, and policymakers nationwide, as its outcome could help define how Canada balances patient choice, institutional freedom, and equitable access within one of the country’s most sensitive and evolving areas of healthcare policy.