Canada's top court on Friday dismissed the case of a Manitoba girl — a Jehovah's Witness — who said her rights were violated when she was forced to get a blood transfusion against her will when she was a minor.
In a 6-1 ruling, the Supreme Court ruled that such medical interventions are constitutionally sound, striking a balance between the choice of the child and the state's protection of the child.
However, the ruling also said lower courts from now on must consider the maturity and decision-making skills of minors before deciding on enforced treatment.
"The more a court is satisfied that a child is capable of making a truly mature and independent decision on his or her own behalf, the greater the weight that must be given to his or her views when a court is exercising its discretion" regarding the best interests of the child, said Justice Rosalie Abella, writing for the majority.
"If, after a careful analysis of the young person's ability to exercise mature and independent judgment, the court is persuaded that the necessary level of maturity exists, the young person's views ought to be respected."
The court stressed that this in no way means that a child should be allowed to make a decision that might endanger his or her life.
"I don't want to die, which is why I went to the hospital for treatment. I just wanted the best medical treatment without blood …" the young woman, who is now 18, told CBC.
"There almost are no words to say just how brutal of an act [blood transfusion] is. I once compared it to almost being raped. There are no options for you, there's nothing you can do about it and it's very hard to deal with."
David Day, the girl's lawyer, called the ruling a huge moral victory.
"For the past 38 months, my client … has been looking for respect in the Canadian courts for her medical treatment wishes. Today, she got respect," he told CBC.
They argued her case so convincingly that the Supreme Court awarded her costs so she doesn't have to pay for the pricey legal action. Instead, the government of Manitoba will have to pay her legal costs, which are reported to be at least $450,000.
"There aren't necessarily any winners or losers in a situation like this," Claudia Ash-Ponce of Manitoba Child and Family Services told CBC.
"We acted [in] protecting the best interests of the child and, in this case, the highest court … upheld our action and endorsed our legislation."
With regard to the court's direction to consider the maturity of children in future cases, Ash-Ponce said that is already being done.
"We've always as a province acted in a way that considers the wishes and desires of the child, whether they're over or under 16. We do hold that in high regard and it is an important piece that even in this case was considered."
The then-14-year-old Jehovah's Witness, identified only as A.C., received a court-ordered blood transfusion in 2006 at a Winnipeg hospital to treat internal bleeding from her bowel associated with Crohn's disease.
The girl and her parents opposed the transfusion, based on their religious belief that the Bible forbids ingesting blood.
A.C. had signed an advanced medical directive stating she didn't want a blood transfusion. Three psychiatrists who assessed her all concluded she understood her medical condition and the consequences of not getting a transfusion.
Under Manitoba law, people under the age of 16 can be given medical treatment against their will.
Believing the girl's life to be at risk, doctors contacted Child and Family Services, which deemed A.C. to be "a child in need of protection." After lawyers for the child welfare agency obtained an order from Manitoba's Court of Queen's Bench, the girl was given three units of blood.
The Manitoba Court of Appeal had also unanimously upheld the imposed transfusion.