Matters of church and state appear poised to collide in the corridors of a Vancouver Island hospital.

And it really is a question of life and death.

On one side you have the Catholic church, owners of St. Joseph鈥檚 Hospital in Comox, which says the facility鈥檚 rejection of doctor-assisted death on its premises is a matter of faith and should be allowed to stand on those grounds.

On the other side you have a Comox doctor and his supporters who say assisted suicide is now a court-mandated right, one that Canadians should be able to access in all publicly funded hospitals.

And sitting ringside is Island Health, which is prepared to support St. Joseph鈥檚 in its position, at least until politically ordered to do otherwise.

鈥淚f an Island Health facility such as a religiously-affiliated hospital does not want to perform the service, we will work with the facility, patient, family, care providers and others in finding alternative locations and providers,鈥� the health authority said in a statement released Friday to Black Press.

The Supreme Court legalized doctor-assisted suicide in a will go into effect in June of this year.

As the federal government works on massaging that ruling into law, Comox general practitioner Dr. Jonathan Reggler is lobbying hard to make sure that law applies to hospitals across the board.

He believes leaving a loophole for faith-based institutions will create inequities for smaller communities like the Comox Valley that are only served by a single, faith-based hospital. He predicts patients being transported away from their families to hospitals in Campbell River or Nanaimo, and their care turned over to an unfamiliar team of doctors and nurses, when there is no good medical reason to do so.

鈥淚t鈥檚 something rather disturbing that we can boot someone because it doesn鈥檛 suit the doctrine of the hospital,鈥� he said. 鈥淭his is not about church-bashing. There is no place for a faith-based organization to assert its will over the Charter of Rights.鈥�

St. Joseph鈥檚 CEO Jane Murphy said her organization is awaiting legislative guidance, but the views of the church are clear.

鈥淲e can鈥檛 speculate as to the finer points of what the legislation may look like. Our position on physician-assisted death is consistent with the Catholic Health Care Ethical Guidelines, and St. Joseph鈥檚 will not be providing or promoting physician-assisted death,鈥� she said in a prepared statement. 鈥淲e are hopeful that legislation will respect the diverse perspectives on physician-assisted death.鈥�

Reggler said the lawmakers and the policy makers need to recognize that even though the church owns the hospital鈥檚 bricks and mortar, it serves a larger community. He said just 12 per cent of the community is Catholic, while 87 per cent of British Columbians support doctor-assisted suicide.

And while St. Joseph鈥檚 is Vancouver Island鈥檚 only Catholic hospital, the Comox situation is repeated in many communities across Canada and affects several big city hospitals as well.

He said he support鈥檚 the of the federal committee drafting the new law and encourages Vancouver Islanders to lobby their MPs directly and through the website to see them adopted.

鈥淭he whole point of what I鈥檓 doing is that it is crucial that all publicly funded hospitals be required to provide this service,鈥� he said. 鈥淭he hospital would prohibit it unless ordered otherwise.

Murphy said the hospital remains committed to providing exemplary care to those nearing the end of their lives.

鈥淲e will continue to emphasize compassionate end-of-life care through palliative and hospice care approaches and we will work within the legislative framework that is developed,鈥� she said.

Reggler agreed that the end-of-life care provided at St. Joseph鈥檚 is excellent, but said there is an opportunity to here to make it better that should not be missed.

鈥淲e will have in this community a few people who will die at St. Joseph鈥檚 in pain and distress and they did not need to. And it will happen.鈥�

Island Health statement on how it plans to deal with Vancouver Island-based doctor-assisted suicide requests prior to June

鈥淒uring the interim period before the federal government brings in legislation later this spring, the courts will ensure appropriate safeguards are in place if someone was to seek a physician-assisted death. No physician can engage in assisted dying unless there is an exemption granted by court order.

鈥淚n addition, both the B.C. Courts and the College of Physicians and Surgeons have published guidelines regarding safe and appropriate access to physician-assisted death during the interim period. These include requirements that two physicians submit evidence as part of a court application and that physicians must have the appropriate skills, training and competencies to carry out this service.

鈥淚n the event health authorities, including Island Health, became aware of an application for a physician-assisted death in our facilities, we would liaise with the Ministry of Health and follow processes set out by the courts, the college, the Ministry and any other regulatory agencies.鈥�