BC Requires Certain Hospitals to Provide Abortions 

In a country of 9.985 million square kilometres – the second largest on earth – access to health care can be quite a challenge. If the Canadian population were evenly spread out across the country, making sure that everyone is close to a hospital would require a vast number of hospitals. But even with two out of three people living within 100 km of the American border and three in four Canadians living within forty-one urban census metropolitan areas, many Canadians still live far from hospitals.  

And, of course, our limited amount of health care resources makes it impossible that every hospital can offer every medical procedure. Small, rural hospitals offer a fairly narrow range of services, and even hospitals in large cities might not offer a certain procedure if a hospital in a neighbouring city does.  

Unsurprisingly, not all hospitals provide abortions, either. Surgical abortions – which still make up almost 60% of all abortions – must be performed either in hospitals or standalone abortion clinics. Consequently, some Canadian women travel hours to get a surgical abortion even if they live close to a hospital.  

Pro-abortion activists often decry the lack of access to abortion across the country. The fact that Canada is the only democratic country in the world that has zero legal restrictions on abortions simply isn’t enough for them. No, abortion activists insist that every woman needs to be able to quickly, easily, and affordably access abortion. 

The solution to this perceived problem in some provinces was to legally require hospitals to provide abortion, something which hasn’t been done for any other medical procedure. 

The Example of British Columbia 

Take British Columbia. In 1996, British Columbia passed two pieces of legislation that directly or indirectly require certain hospitals to provide abortion services: the Hospital Act and the Hospital Insurance Act. In Schedule A of the Hospital Act, the B.C. government enumerates hospitals that must provide abortion. The government can amend the list via regulation, meaning it need not pass a bill through the legislature to add or remove hospitals from this list. Instead, a cabinet minister (in this case, the Minister of Health) can change this list as he sees fit. 

Yet there is a second list in a different regulation that also requires certain hospitals to perform abortions. Under the authority granted to him through the Hospital Insurance Act, the Ministry of Health enacted the Hospital Act Regulations, which also lists hospitals that must provide abortions. 

The only difference between these two lists (aside from slight differences in hospital names) is that the Hospital Act includes the Campbell River and District General Hospital and the Kelowna General Hospital, while the Hospital Act Regulations does not. 

The government chooses hospitals to ensure abortion will be available throughout the entire province. This is readily apparent from the map of these hospitals below. 

Almost 60% of British Columbians live in a city with a hospital that is required by law to provide abortions. Given that most sizeable communities whose hospitals are not required to provide abortion (e.g. Abbotsford or Penticton) are near to communities whose hospitals are so required (e.g. Mission or Kelowna), the great majority of British Columbians need to drive less than an hour or two to have an abortion. 

British Columbia does not require certain hospitals to provide any other procedure, like brain surgeries, knee replacements, or even to deliver babies. Ironically, some hospitals like Mission Memorial Hospital are required to abort babies but do not deliver babies. The services that each hospital provides depend on the level of local demand for a procedure and the decisions of the regional health authority or local hospital administrators. For example, it suffices that one or two hospitals in B.C. perform brain surgeries, since they are relatively rare.  

This is all the more striking given that abortion is not healthcare. Pregnancy is not a disease, illness, or injury in need of treatment. Abortion is the deliberate taking of the life of a pre-born child. It may use medical means – pharmaceuticals or surgery – but it is only one of two medicalized procedures in Canada in which a successful outcome is a dead human being (the other being euthanasia).  

It is tragically ironic that the only procedure that hospitals in provinces like British Columbia are forced to do is a procedure that has nothing to do with health care. 

But why? 

So why is this the case? Why require some hospitals to perform abortion but no other medical procedure?  

The likely rationale is that the government of the day viewed abortion to be a right. The Morgentaler decision of 1988 struck down Canada’s federal abortion legislation. In response, both then and now, many abortion advocates claimed a Charter right to abortion. In their minds, the government had to provide abortion. Furthermore, the Supreme Court hasn’t recognized the broad right for Canadians to receive any other specific medical intervention, even if access to health care generally is seen as a right.  

Linking these two ideas together, the British Columbia government of the day likely decided that it wasn’t enough just for there to be no criminal laws against abortion or even that just a few hospitals would have the resources and the desire to offer abortion. In the absence of such legislation, there would likely be far fewer hospitals that would provide abortion in British Columbia, and these hospitals would have been concentrated in urban centers like Vancouver or Victoria. Instead, to recognize the perceived right to abortion, they legally mandated that three dozen hospitals scattered across the province must provide abortion.  

But just like the mischaracterization of abortion as health care, abortion is not a Charter right either. Yes, the Supreme Court struck down certain provisions in the Criminal Code as unconstitutional in Morgentaler, but it fully expected that Parliament would craft a new abortion law. It certainly didn’t require provinces or hospitals to provide abortion. But, either through a misunderstanding of the legal decision or because of a political ideology in favour of abortion, that’s what British Columbia did. 

All this goes to show just how entrenched abortion is in our system of health and justice.