OTTAWA — Gaye and Jim O’Neill have spend countless hours thinking about their daughter’s final hours in April 2023.
It’s a memory they say they’d wish on no one — and it’s the reason why they joined a years-long legal campaign to change the way medical assistance in dying is delivered in British Columbia.
The O’Neills are at the centre of a Charter of Rights challenge, now before the B.C. Supreme Court, that seeks to end the practice of so-called “forced transfers” — compelling patients to leave faith-based medical facilities before receiving medical assistance in dying.
Sam O’Neill died with medical assistance at age 34, roughly a year after she was diagnosed with cervical cancer that had spread to other parts of her body.
Her family remembers Sam, the eldest of three children, as stubborn and fiercely independent, kind and encouraging. She loved animals — so much so that she tried to convince loved ones to take up her vegan lifestyle.
“She would stick up for the rights of animals, but she also stuck up for the rights for people. She never wanted a bad word about people,” said Gaye O’Neill.
Sam travelled the world before moving from her home province of Ontario to Vancouver, where she built a rich life with a close-knit circle of friends. She wrote a travel blog, which Gaye said was “hysterically funny.”
Sam was active: she played soccer and hockey as a kid, and her kind nature and big heart endeared her to teammates. She logged a personal best time in her 10th marathon in California in December 2021.
So it was a shock to her parents when, just four months later in April 2022, they learned she was sick.
Gaye and Jim flew to Vancouver on May 1 to see her.
“She was supposed to be running (a marathon) that day, but she was in a hospital with cancer. So it was terrible,” Jim said.
She went through chemotherapy and radiation treatments, spending that year in and out of Vancouver’s St. Paul’s Hospital. The hospital is operated by Providence Health Care Society, a Catholic organization that runs 18 health care facilities in the Vancouver area.
Sam was assessed for medical assistance in dying, better known as MAID, early in 2023 — something she didn’t tell her family about in advance.
“I was talking to her over the phone. She said she qualified for MAID and I thought she was getting someone to clean her house,” Jim said.
Sam wanted the option of MAID in the event that things got worse, he said.
Things got worse in March 2023. Sam hurt herself while unpacking from a move, her parents said, and she was taken back to St. Paul’s by ambulance.
Over the next several weeks, the staff tried to help her manage the pain.
“I remember one palliative care doctor saying, ‘She’s on as high a dosage that’s safe. We can’t give her more pain meds,’” Jim said.
After two painful procedures in early April, Sam decided to obtain a medically assisted death. She needed first to move from the hospital where she was receiving treatment — because Providence does not allow assisted dying in its facilities. The province of B.C. allows faith-based organizations to be exempt from its MAID policies.
Court documents filed by Providence state that Sam was aware that she wouldn’t be allowed to end her life at St. Paul’s.
Sam was transferred to St. John Hospice. The hospice itself is also run by Providence, but there is an adjacent space in the same building, which is operated by Vancouver Coastal Health, where MAID is permitted.
Her parents said her final hours were spent in agony and her ability to say goodbye to loved ones was impeded by the need to sort out logistics for her transfer.
Her parents said that when they went to see her one final time before the move, they were distressed to find her sitting on a commode and wrapped in a sheet.
“It was shocking and terrible … it was just so humiliating for her,” Gaye said.
Sam was heavily sedated for the transfer and did not wake up again.
Providence defended the care Sam received in court filings, stating that her family and friends were able to “say goodbye to her privately in her room throughout the day.” The organization also said she chose to be sedated before the move.
Its statement of defence also says that Sam’s condition affected her gastrointestinal function and she was “on a commode for her comfort and at her request.”
Daphne Gilbert, a law professor at the University of Ottawa, said she heard about the O’Neill family’s story through the media and contacted them to see if they’d be interested in taking the case to court.
“I had been looking for and thinking about ways to litigate the issue of forced transfers, and I knew that we needed a plaintiff who would be willing to be part of the lawsuit,” she said.
Alongside advocacy group Dying With Dignity Canada and Dr. Jyothi Jayaraman — a palliative care physician who left her job with Providence Health because she disagreed with the practice of transferring MAID patients — the O’Neills are now arguing their case before the B.C. Supreme Court.
The court will be asked to decide whether institutions like Providence have the same rights to protection of freedom of religion as individuals. Providence will argue that it does and that being required to deliver MAID would infringe upon its rights.
The Charter challenge likely will end up being appealed to the Supreme Court of Canada, Gilbert said.
That means Gaye and Jim O’Neill have a fight ahead of them that could last years.
“We cannot do anything at all to help Sam. There’s nothing we can do. What’s done is done,” Gaye said.
“We want to protect other people,” Jim added.
