Discrimination when accessing health care

What are my rights?

Decisions about my health care have to be based strictly on my medical needs. I can’t be denied treatment because of who I am.
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When you access health care services in British Columbia, the law protects you from discrimination. Health care providers can’t mistreat you or refuse to treat you because of who you are. Learn what you can do if you’re treated unfairly when receiving health care services.

What you should know

Your right to be free from discrimination when accessing health care

"After working 12 hours straight on a construction site, I had sharp pains in my back and leg. I went to the hospital. I waited for five hours, even though it wasn’t busy. I felt weak and threw up a couple of times. I heard a nurse say I was probably drunk. When I finally saw a doctor, they asked me what I’d been drinking. It felt like because I’m Indigenous, they assumed I was drunk. X-rays showed I had a herniated disc. I’m hoping for an apology from the hospital."

– Joseph, Victoria, BC

When a health care provider is treating you, they have to make decisions based on their medical knowledge and professional experience. They can’t make decisions based on any of these personal characteristics:

  • your race, colour, ancestry, Indigenous identity, or where you're from

  • your sex, sexual orientation, or gender identity or expression

  • your age

  • your marital or family status

  • your religion

  • any physical or mental disability

These are known as protected characteristics under BC’s Human Rights Code

If, based on any of these characteristics, a health care provider treats you unfairly, or refuses to give you a health care service or treatment without a reasonable and valid reason, this is discrimination. It’s against the law in BC. 

These rules apply to everyone working in health care

It’s not just health care providers who can’t discriminate. No one in the health care field can mistreat you or refuse to provide you with a health care service on the basis of who you are. This means when you attend a doctor’s office for a medical appointment, the receptionist, custodian, or security guard can’t treat you badly because, for example, you’re Asian, transgender, or a Buddhist.

Who is considered a health care provider 

Under BC law, a health care provider is someone who’s “licensed, certified or registered” to provide health care. The same law says that health care is “anything that is done for a therapeutic, preventive, palliative, diagnostic, cosmetic or other purpose related to health.” This includes:

  • services provided at a health clinic or doctor’s office, in a hospital, in a care facility, assisted living residence, or group home 

  • one-off treatments (such as surgery) or a series of treatments over time for a particular health problem (for example, physiotherapy for a broken leg)

  • a plan for minor health care (to help manage a person’s diabetes, for example)

In BC, there are many types of health care providers, including family doctors, dentists, pharmacists, surgeons, and nurses. The list also includes optometrists (eye doctors), massage therapists, physiotherapists, hearing professionals, chiropractors, and psychologists, among others.

Others who work in the health care field may also be considered health care providers. These include, for example, registered care aides and community health workers, known as health care assistants. They provide care in publicly funded home support agencies and residential care homes. 

Health care providers have to follow human rights law and other rules

A health care provider can’t — without a reasonable and valid reason — treat you unfairly, or refuse to treat you, because of your race, age, ability, sexual orientation, or any of the other characteristics protected under the Human Rights Code.

Professional standards

Health care providers must also follow the rules of their licensing body. These professional groups set standards that require their members to act in the public interest. If a health care provider acts unprofessionally, unsafely, or unethically, the licensing body can take action against them to protect the public under its bylaws and BC’s Health Professions Act. In very serious cases, a health care provider could lose their licence. 

For example: doctors

Take the College of Physicians and Surgeons of BC, for example. It licenses doctors in BC. It has a practice standard about access to medical care. That standard says that all patients are:

  • equally entitled to have access to quality medical care, and

  • entitled to be free from discrimination when receiving medical services.

This practice standard is based on the BC Human Rights Code. It’s aimed at ensuring that all patients are treated fairly and respectfully. At the same time, it also recognizes that doctors have the right to not take on patients for valid reasons, including the following:

  • the facility’s already at capacity (that is, it’s reached the maximum number of patients who can be safely cared for)

  • the patient falls outside the practice’s special area of interest (such as sports or addictions) 

  • the doctor doesn’t have the specialized knowledge to treat a patient with a specific health issue (such as a hearing or skin problem)

But health care providers can’t use these reasons to avoid treating a patient when the real reason is personal. For example, a doctor can’t say they’re too busy to see you when the real reason they’re turning you away is that you’re a disabled or Indigenous or LGBTQ+ person. 

A doctor who makes decisions that are discriminatory could face severe consequences. These can include fines, penalties, suspension, or, in very serious cases, a permanent loss of their licence.

Health care providers have a duty to accommodate

Health care providers have to take all reasonable and practical steps to accommodate your protected personal characteristics. This means they must ensure you get the same benefits of the service they provide as anyone else. 

This duty to accommodate includes changing a policy, practice, or service that negatively affects you due to your protected personal characteristic(s). You can ask your health care provider to make changes to better meet your needs. For example, if you have a disability, accommodation may include getting a wheelchair ramp built, or a button installed to automatically open the front door.

But there are reasonable limits on how far your health care provider has to go to accommodate your needs. Sometimes it isn’t possible because it would cost too much. Or it may create health or safety risks. This is called undue hardship. For example, a doctor may be unable, for various legitimate reasons (excessive cost, permits, and so on), to get an elevator installed in the 10-story, 75-year-old office building they work in. This might mean some patients are unable to access that doctor’s office. 

Accommodation may not always be possible. But if it is, and reasonable steps aren’t taken to make changes that help you, it could amount to discrimination.

Two young people in wheelchairs, one at bottom of stairs, one on an accessible ramp

Photos: Canva

Discriminatory treatment: What you have to prove

Let’s say you’re sitting in a hospital ER waiting room. You’ve been there for three hours. You’re a Sikh man who wears a turban, and you notice that some patients — who came in after you — have been seen before you. Not only are you uncomfortable and in a lot of pain, you feel this is unfair. But is it discrimination?

You have to show three components

To make out a case of discrimination, you have to show all of these:

  • you have (or are believed to have) a protected characteristic under the Human Rights Code,

  • the health care provider’s behaviour had a negative effect on your access to, or use of, the service or facility, and

  • there’s a connection between your protected characteristic and the poor treatment. 

You don’t have to prove the health care provider meant to discriminate against you. Nor do you have to show they were motivated by discrimination. You also don’t have to show that your protected characteristic was the main or only reason for the poor treatment, as long as it was one of the reasons.

Discrimination is often subtle

Discrimination may be explicit, such as when someone uses a racist slur. But most of the time, it’s likely to be hidden or subtle. In those cases, discrimination may be inferred by considering all of the circumstances. This includes, for example, looking at how others were treated in a similar situation, or whether the health care provider has shown a pattern of such behaviour.

In our example above, if the reason you were kept unnecessarily waiting at the hospital was because of your race, religion, or colour of your skin, that would be discrimination. If there’s no direct evidence (such as an overheard remark), then you’d need to gather circumstantial evidence. This might include showing that the other visitors to the ER who were seen before you (1) weren’t Sikh and (2) didn’t seem any more sick than you. Or that you’d been treated this way before on previous visits. 

Not all unfair conduct is discrimination

At the same time, not all unfair or negative conduct is discrimination. It’s possible that there’s a reasonable, non-discriminatory explanation for how they’ve treated you. In our example above, for instance, other patients may have been seen before you at the hospital because their medical needs were more urgent than yours. 

Examples of discriminatory treatment

There are different ways that a health care provider’s behaviour may or may not amount to discriminatory treatment. You can’t, for example, say that treatment is discriminatory because a doctor doesn’t provide you with the kind of treatment (say, certain medication) you want or think is appropriate. And, in some cases, even where the poor treatment seems like it could amount to discrimination, there may be a reasonable and valid reason for it. 

Here are some examples. (Note that these are sample scenarios only. Whether treatment is discriminatory or not will depend on all the circumstances in a particular situation.)

Table explaining whether certain behaviour by health care providers could be discriminatory

If you believe you’ve been treated in a discriminatory way by a health care provider, you have options. You can, for example, file a complaint with the regulatory body that oversees them. (Note that you can also do this if you’ve been treated in a way that is unfair, but not discriminatory.) Another option is to file a complaint with the BC Human Rights Tribunal. Or you can do both. We walk you through the choices below, under work out problems.

Protection from retaliation

If you file a human rights complaint for discrimination, the health care provider can’t punish you for doing so. Nor can they punish you if you help someone else complain. For example, say a patient files a complaint with the Human Rights Tribunal against a doctor. If the doctor learns about the complaint and raises the fees the patient has to pay because of it, this is considered retaliation. It’s illegal. To learn more, see the BC Human Rights Tribunal.

Indigenous peoples have experienced systemic discrimination in health care services

The tragic story of Joyce Echaquan

Joyce Echaquan was a mother of seven and a member of the Atikamekw Nation in southwestern Quebec. In the hospital with severe stomach pain, she didn’t get the medical help she needed. Instead, as she lay dying, health care workers ignored her calls for help and uttered racist comments and insults, which she broadcast on her phone through Facebook Live.

– as described in this report, on p. 72

Ms. Echaquan’s death is one of many examples of systemic discrimination against Indigenous peoples in health care across Canada. BC is no exception. A 2020 BC government report found that 84% of Indigenous patients have experienced some form of discrimination in BC’s health care system.

The report is a call to action:

“Indigenous peoples and health care workers have spoken clearly — racism is an ugly and undeniable problem in BC health care that must be urgently addressed.”

The discrimination has deep roots

According to the report, this racism is rooted in colonialism and stereotypes of Indigenous people abusing drugs and alcohol.

Indigenous peoples (and particularly Indigenous women and girls) have often experienced discrimination in health care, including:

  • being turned away from hospitals and denied treatment 

  • not being believed or having their concerns minimized

  • receiving inappropriate assessments, treatments, or referrals

  • being misdiagnosed or not being given a diagnosis at all 

  • being denied pain medication 

  • not having their cultural practices recognized or respected

Because of years of racist behaviours and attitudes, many Indigenous people mistrust and avoid the health care system in BC. Often, their experiences with health care providers have left them feeling unsafe and afraid. They are less likely to go to a doctor or a hospital, leading to poor health and even death. 

If you've experienced discrimination

If you’ve been discriminated against as an Indigenous person, there are steps you can take. For example, you can contact your band council. You can also contact:

See below under work out problems to learn about more options, including filing a human rights complaint. You can take more than one action at the same time.

"As a First Nations man who presented in hospital with a head injury, I was presumed to be drunk. I was discharged to walk home alone. Now, I avoid the hospital at all costs because as an Indigenous person I feel unsafe and feel like they won’t bother treating me.”

– Walter, based on the story on p. 52 of this report

Work out problems

Step 1. Talk to the health care provider 

If you’ve been treated unfairly by a health care provider, you can talk to them directly. They may not be aware that something they’ve said or done has upset you. Discussing your concerns could help stop the problem from getting worse. Or even resolve it altogether.

That said, raising a problem directly with the person who has mistreated you isn’t easy. You may find your health care provider intimidating, unapproachable, or unavailable. In that case, you might prefer making a written complaint (see steps 4 and 5). 

Step 2. Make notes and gather evidence

If you think your health care provider has discriminated against you, make detailed notes about what happened. Do this as soon as you can. The notes should include:

  • the date, time, and location of the incident

  • who was present at the time and what they saw, heard, and did

  • what the health care provider said and did

  • what you heard, said, and did

If someone was with you when the incident happened, ask them to write down what they saw and heard. If they took a video, ask them to share it with you.

Stay organized. Keep your notes and all your evidence in one place, like in a file folder or on your phone or computer. 

Consider contacting a lawyer and explaining your situation. They’ll tell you if they think there’s been discrimination, and what your legal options are. They’ll also tell you about time limits, or how long you have to take certain steps. 

You can contact the BC Human Rights Clinic, operated by the Community Legal Assistance Society, for free legal advice and information. They may be able to help you decide what to do next. (In some cases, that might even include contacting the police.)

See below under who can help for more legal advice options. 

Step 4. Make a complaint about a health care provider

If you believe your health care provider has discriminated against you, you can make a confidential complaint with the regulatory body for their profession.

How to make a complaint

The BC Health Regulators website links to the regulatory body for each type of health care provider. Each regulatory body has its own process for handling complaints; this video by the BC Health Regulators explains the general process.

Typically, complaints must be made in writing. There’s no firm deadline to make a complaint, but it’s helpful to make a complaint as soon as possible.

Once a complaint about a health care provider is made, the regulatory body can investigate and make a decision. They may decide, for example, to review the health care provider’s practice. They may require the provider to take further training. Or they may limit their practice or reprimand them. In serious cases, they may suspend them, or cancel their practising licence. 

If you're not happy with the result

If you’re not satisfied with the complaint outcome, you have options. They include: 

Review decisions are final and binding, except for one last avenue: a judicial review by the BC Supreme Court. These are complicated, and you should get legal advice. In the meantime, this guide explains how to bring a judicial review.

If your complaint is about a doctor

Say you’re concerned about how a doctor has treated you. You can file a complaint with the College of Physicians and Surgeons of BC. To do this, you can:

Send the signed form or letter to the complaints department at the College. They’ll investigate and send you a written decision. (This process may take up to six to eight months.) 

For more about making a complaint about a doctor, see Dial-A-Law's coverage of if you have a problem with a doctor.

You can take multiple steps at the same time

You can take other actions at the same time that you file a complaint with the health care provider's regulatory body. For example, you can sue the health care provider or file a human rights complaint — you don’t have to wait for your complaint through the regulatory body to be resolved.

Step 5. Make a human rights complaint 

If you believe you’ve been discriminated against (see above under what you should know), you can file a complaint with the BC Human Rights Tribunal. You must do so within one year of the incident you’re complaining about.

How to make a complaint

You can file a complaint with the tribunal online or by printing and filling out a complaint form. It’s important to provide all the details of what happened to support your complaint. But you don't need to provide documents or other evidence. That part comes later. You only need to tell the story of what happened, and explain why it was discrimination.

What happens next

The tribunal will review your complaint. If it’s covered by the Human Rights Code, your complaint will be given to the health care provider. They can file a response. In the meantime, if there’s another proceeding (such as a court case) dealing with the same situation, you can ask the tribunal to put your complaint on hold until it has finished. 

When you’re ready to proceed with the complaint process, the tribunal may arrange a mediation if both parties agree. If you’re Indigenous, the process can include Indigenous protocols or ways of resolving disputes. 

If your complaint isn’t settled through mediation, the tribunal will hold a hearing. If the tribunal finds the health care provider violated the Human Rights Code, they can order the discrimination to stop. The tribunal can also require the health care provider to:

  • take steps or programs to address the discrimination (such as cultural sensitivity training)

  • give you money for injury to dignity, feelings, and self-respect (like monetary compensation you might get in a court case)

  • give you money for lost wages or other expenses such as costs of attending the hearing (so keep your receipts)

It will likely take one to two years to get to a hearing and get a final decision.

If you disagree with the outcome

If you disagree with the tribunal’s decision, you have 14 days to ask them to reconsider it. Or, you can ask the court to review it. There is a 60-day time limit to ask the court to review a final decision of the tribunal.

Common questions

How do I make a complaint about the way I was treated by a hospital?

If you’re concerned about medical care you received at a hospital, you can start by making a complaint to the hospital. If your concern involves a doctor in a hospital, you can reach out and raise your concerns with their department head or the hospital’s medical director. They will then follow the hospital’s complaints process.

If that doesn’t solve the problem, you can file a complaint yourself. You can do that online, in writing, or over the telephone with the Patient Care Quality Office in your health region. 

Each health authority in BC has such a Patient Care Quality Office. You can provide more information and supporting documents with your review request. They can, for example, make recommendations to the health authority for improving how services are provided. If you disagree with the decision by that office, you can ask the Patient Care Quality Review Board for a review

If you’re Indigenous, you can contact the First Nations Health Authority and file a complaint with the FNHA Quality Care and Safety Office. 

If you have a complaint about other types of health care providers, see the BC government’s page about health care complaints.

Can I get money for being treated unfairly if I file a complaint with a regulatory body?

A health care provider regulatory body can’t pay you any money. Nor can it order a health care provider to pay you any money. If you want monetary compensation from a health care provider, you’ll have to sue them in court or file a human rights complaint. If you want to start a court action against a doctor, in particular, you must do so within two years of when the malpractice occurred. Learn more about bringing a court action for medical malpractice.

Is there a time limit to file a human rights complaint?

Yes. There’s a one-year time limit from when the incident occurred to file a complaint with the Human Rights Tribunal. After the one-year limit passes, the tribunal may accept a complaint if:

  • it’s in the public interest, and 

  • the late filing won’t unfairly impact another person affected by the complaint. 

Who can help

Helpful agencies

BC Human Rights Tribunal
Deals with discrimination complaints under BC law.
BC Health Regulators
Represents regulators overseeing chiropractors, midwives, and other health care providers.
BC Human Rights Clinic
Provides free assistance and representation to those who qualify for help with a discrimination complaint under BC law.
Lawyer Referral Service
Helps you connect with a lawyer for a free half-hour consult.
Access Pro Bono Clinics
Volunteer lawyers provide free legal advice to people with limited means.

  • Reviewed for legal accuracy in March 2021
  • This information applies to British Columbia, Canada
  • Time to read: 18 minutes

Reviewed for legal accuracy by

Lisa C. Fong, KC, Ng Ariss Fong and Laura Track, Community Legal Assistance Society

Lisa C. Fong, KC
Laura Track

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