In Sickness and In Health

Published by BC Labour Heritage Centre on

1991 legal victory by the HEU broadened the definition of “spouse”

Researched and written by Natasha Fairweather

Vancouver’s first Pride Parade was held in 1981. This photo from Pride 1990 celebrated the Gay Games – open to all regardless of gender, sexual orientation or ability. City of Vancouver Archives | 2018-020.7735


As early as 1989 the Hospital Employees’ Union (HEU) had successfully negotiated medical benefits for same-sex partners into collective agreements. Without legal protection, however, recognition of these relationships was up to each employer or benefits provider.

Tim Knodel and Ray Garneau, both licensed practical nurses and HEU members, had been a couple for several years by 1985 when Ray was diagnosed with HIV/AIDS. Ray had to stop working due to his illness in 1988 and he consequently lost his health benefits. Despite their committed relationship, when Tim applied to add Ray to his medical plan as a spouse under his collective agreement, their application was denied by the B.C. Medical Services Commission. The hospital offered to pay the premiums themselves, but the denial was upheld. The commission cited regulations defining “spouse” in strictly heterosexual terms; whether married or common-law, they would only accept “a wife, in relation to a male subscriber; or a husband, in relation to a female subscriber.” 1


Bill 34, introduced by the Social Credit Party in 1987, would have forcibly quarantined people with AIDS/HIV. Activists pushed back and the bill was never passed. Attitudes towards homosexuality and HIV/AIDS were conflated in the 1980s and 1990s, and both were highly stigmatized. City of Vancouver Archives | 2018-020.0802


Ray Garneau died in March 1989. Tim was denied compassionate leave and told to use vacation leave for bereavement.  After threatening a grievance charge, he was allowed a few days. Despite the loss of Ray, the fight was not over.

By the end of 1989, the Hospital Employees’ Union had filed a petition to the Supreme Court of British Columbia. The case hinged on whether the denial of coverage infringed upon Tim and Ray’s right to equality, and the evidence presented in the case is a snapshot of prevailing social attitudes of the time. To prove their commitment, Tim testified about all the ways in which his relationship was like a stereotypical heterosexual marriage: they shared finances and decision-making, they integrated with each other’s families, they cared for each other in sickness and in health.2 Psychiatric expert testimony reinforced the idea that homosexuality did not preclude healthy, committed partnerships comparable to heterosexual relationships.3

The case was heard by Justice Mildred Rowles in a one-day trial in 1991. She engaged in a careful analysis of the definitions and implications of “spouse” and “living together as husband and wife” in the Medical Services Act. In her landmark ruling she concluded that the Act’s exclusion of same-sex couples did constitute discrimination and violated their right to equality. The definition needed to be changed.4


The ruling was headline news. The Province quoted Justice Rowles as commenting “Respect for the individual person means respect for the unique and diverse character of every human person.” The Province | Sept 4, 1991


HEU’s legal victory was headline news and signaled broad implications far beyond healthcare coverage. Unions fighting for equal rights went on to have many more wins through the 1990s and 2000s, and continue to push today for the rights of 2SLGBTQIA+ workers.


Multi-Union Pride float at the 2002 Vancouver Pride Parade. Over the years, the group has included The BC Federation of Labour, CUPW, HEU, PSAC, CUPE, HSA, and more. City of Vancouver Archives | 2018-020.8747

  1. As cited in Knodel v. British Columbia (Medical Services Commission) (1991), 58 B.C.L.R. (2d) 356 (B.C.S.C) []
  2. From affidavits referenced in Knodel v. British Columbia[]
  3. Testimony presented by Knodel v. British Columbia[]
  4. Knodel v. British Columbia[]