Gratl & Company filed a representative class complaint of discrimination in the provision of liver transplants at the British Columbia Human Rights Tribunal (“BCHRT”). The representative claimant is the Union of British Columbia Indian Chiefs (“UBCIC”). The respondents are the Provincial Health Services Authority (“PHSA”), British Columbia Transplant Society (“BCTS”) and Vancouver Coastal Health Authority (“VCHA”) (collectively referred to as the “Respondents”).
The policy-based aspect of the representative claim was settled on November 1, 2025. To their great credit, PHSA, VCHA and BCTS agreed to make significant amendments to British Columbia’s liver transplant policy to remove barriers to eligibility and priority for liver transplants for Indigenous patients. The policy amendments should ensure that health providers identify barriers to transplant eligibility and priority and make best efforts to assist patients to mitigate or eliminate those barriers. The amendments also ensure that MELD-Na scores for patients with Primary Biliary Cholangitis will not impede their access to transplant eligibility.
This settlement has no effect on the rights of individual Indigenous patients to bring a lawsuit or human rights complaint. Individual patients who are or may have been a member of the potential class should contact Jason Gratl at 604-694-1919 for advice on the scope of the settlement agreement. Limitation periods may apply to individual claims – please respond without delay.
If you have any questions about the settlement of this representative claim, please contact Jason Gratl at 604-694-1919.
Background to the Representative Claim
The representative complaint asserted that the process for providing access to liver transplants discriminates against Indigenous people, contrary to section 8 of the British Columbia Human Rights Code. Section 8 of the Code protects individuals from discrimination in the provision of a service on the basis of Indigenous identity, ancestry and race. A copy of the complaint can be found here. Three aspects of the liver transplant process were challenged.
First, UBCIC challenged a requirement for patients with alcoholic liver disease to abstain from alcohol for six months before being eligible for a liver transplant as lacking a scientific justification. The class was characterized as “Indigenous persons who have been adversely impacted by a policy requiring six months of abstinence from alcohol before a liver transplant” (the “Abstinence Class”).
Second, UBCIC says that the medical assessment tool used to assess the degree of liver dysfunction, called a “MELD-Na score”, is ineffective where the patient has Primary Biliary Cholangitis (“PBC”). Indigenous people, particularly women, have higher rates of PBC. A patient’s MELD-Na score was used to assess the patient’s need for a transplant, and influences their placement on waiting lists. The settlement should improve outcomes by stating that for PBC patients, the MELD-Na score may not accurately express a patient’s need for a transplant and by putting the emphasis when assessing transplant priority on the patient’s overall condition rather than their MELD-Na scores.
Third, UBCIC challenged the use of standardized assessment tools and factors to exclude from transplant eligibility or deprioritize patients who lack social supports, financial resources, housing and other factors that may tend to effect the success of the transplant procedure. For Indigenous patients, for whom these factors may arise as a result of historical and generational oppression, the settlement addresses adverse effects of oppression by requiring health care providers to identify and take best efforts to mitigate, eliminate or accommodate these barriers to transplant eligibility or priority.
For more information about the settlement of this representative complaint, please contact:
Gratl & Company
511-55 East Cordova Street
Vancouver, BC
V6A 0A5
Telephone 604-694-1919 and ask to speak with Jason Gratl, the lawyer working for UBCIC and class members.
Or contact Jason Gratl by email at jason@gratlandcompany.com.
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