British Columbia

Under the Infants Act, minors under 19 years of age can consent to medical treatment in cases where the health care provider providing the medical treatment has explained to the minor and has been satisfied that the minor understands the nature and consequences as well as the reasonably foreseeable benefits and risks of the health care, and has made reasonable efforts to determine and has concluded that the health care is in the minor’s best interests.

The Access to Abortion Services Act was passed in 1995 after years of heavy and aggressive protesting at two clinics, especially Everywoman’s Health Centre, and also in response to the shooting of provider Dr. Gary Romalis in November 1995. It is the first piece of bubble zone legislation in Canada. 

Under the Act, facilities must apply for an “access zone,” which is then established through regulations. Homes and offices of doctors who provide abortion are automatically protected, and access zones for the residences of a class of service providers, or the residence of a specific service provider, may be established by regulation. Harassment of doctors and service providers outside of the safe access zone is also prohibited under the Act.

The dimensions of the access zones are calculated from the edge of the lot on which the home or facility is located and are set at: 

• 160 metres for a doctor's or service provider's home 
• 10 metres for a doctor's office (which can be extended up to a maximum of 20 metres through an Order in Council) 
• up to a maximum of 50 metres for a facility 

The Access to Abortion Services Act has faced legal challenges from anti-abortion protestors and has been upheld every time.

Physicians

The College of Physicians and Surgeons of British Columbia has a Practice Standard called Access to Medical Care Without Discrimination that states physicians are “expected” to provide patients with “enough information and assistance to allow them to make informed choices for themselves” in cases of “conscientious objection.” However, an expectation is not a requirement, and “information and assistance” is not the same as a referral to medical care.¹ Thus, the Practice Standard does not obligate a physician to refer a patient to the medical care they need if they object to providing a medical treatment due to their personal values or religious beliefs.

However, in emergency or urgent medical situations, the Practice Standard states that physicians “are expected to provide whatever medical care is appropriate, considering the patient’s safety, scope of practice and available options.” 

In cases of conscientious objection, the Practice Standard states that physicians should not “discuss in detail their personal beliefs if not directly relevant and should not pressure patients to disclose or justify their own beliefs.” It also directs physicians to practice in accordance with the  Canadian Medical Association’s Code of Ethics and Professionalism, which also doesn’t require physicians to provide or refer for a service they object to based on personal values or religious beliefs.

Nurse practitioners

Nurse practitioners in British Columbia follow the Practice Standard on Duty to Provide Care, which set out that nurses do not allow their personal judgements about a patient’s life or lifestyle to compromise their care by withdrawing or refusing to care for the patient, and explicitly states that “[n]urses do not abandon their clients.”

In cases of belief-based care denial, nurses are obligated to ensure uninterrupted continuity of care for the patient. Specifically, the Practice Standard directs nurses to:

• ​Listen and, when possible, explore the client’s reason for the request or refusal and their understanding of options that could meet thei​​r needs;
• ​Do not attempt to influence or change the client’s decision based on the nurse’s c​​onscientious objection;
• ​Do not allow their beliefs or values to alter or interfere with a client receiving safe, competent, and ethical care;
• ​Ensure that the most appropriate person within the organization is informed of the conscientious objection well before a client is to receive the requested treatment or procedure;
• ​Work with their organization/employer to ensure uninterrupted continuity of care including reporting the client’s request and, if needed, safe transfer of the client’s care to a replacement provider; and
• ​​​Despite their conscientious objection, provide safe care to a client in situations involving imminent risk of death or serious harm that arise unexpectedly and require urgent action for their client’s safety.

Abortion Services Statutes Amendment Act, 2001

This law requires 34 hospitals across British Columbia to provide abortion facilities and services. It may be amended by regulation in order to add other hospitals to the list.

Freedom of Information and Protection of Privacy Act provisions

This law gives the public a right to access information from public bodies, but it limits access to information in some cases. Access to abortion-related information is limited to protect the privacy and safety of those receiving abortion services and those who provide abortion care. Section 22.1 says that in general, public bodies cannot disclose information that relates to the provision of abortion services. Public bodies can only give abortion-related information in 3 situations:

1. If a person is requesting information about abortion services that they received,
2. If the information is statistical and discloses only the total number of abortion services provided in the province or a designated region, or
3. If the information is about a policy related to abortion services.

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In some instances, patients may have to travel outside of the country to receive abortion care currently not available in Canada. The Medical Services Plan includes out-of-country coverage for patients referred for insured health services not available in Canada.

The patient’s attending medical specialist must submit an application and receive prior approval from the Medical Services Branch in order for the patient to be eligible for coverage. Prior approval enables the province to negotiate a “reasonable and fair” compensation rate with the out of country service provider. If an application is received after the patient receives care, the patient’s specialist must provide the appropriate documentation.

Travel support

British Columbia’s out-of-country coverage program does not include travel and accommodation costs.

The Travel Assistance Program (TAP BC) helps alleviate some transportation costs for eligible B.C. residents who must travel within the province for services not available in their own community. There is no reimbursement for travel already taken. To be eligible, you must be a B.C. resident and enrolled in the Medical Services Plan, you must have a referral from a physician or nurse practitioner for the MSP insured service, and your travel expenses must not be covered by third party insurance. You must apply with a TAP BC form, which will be provided by your physician, nurse practitioner, or specialty clinic.