It was a little before Christmas. Monique, Paul’s widow, was talking about the end of her husband’s life. She became angry saying these words: “The hospice has interfered with Paul’s rights to receive exceptional end-of-life care. »
Until then, Monique smiled as she told me about the life of Paul*. She spoke to me tenderly about him, about their 45 years of marriage.
From the work that Paul did with rigor, until the end – he settled his last files in his bed in the hospital. Of his love for her, for their two children and their three grandchildren.
And football, Sunday Mass: Paul’s religion was the NFL, remembers Monique, with a smile.
But it was while recounting Paul’s last days that Monique tensed up in an interview, that a dull rage still animated her six months after his death.
Paul would have liked to die at the Rivière-du-Nord palliative care home in Saint-Jérôme.
He wanted to leave in the serenity of this place that he and Monique knew: Monique’s sister spent her last moments there in 2013.
Monique praised the Rivière-du-Nord palliative care home for me: large rooms to accommodate several people at the patient’s bedside, adapted beds, the possibility for the spouse to sleep with the patient, meals on request, hygienic care, trained staff and amazing volunteers…
“And a magnificent garden, the Régine Garden, where you can pull out the bed. »
I knew all that: all the palliative care homes in Quebec are extraordinary in their way of softening the end, of giving it a soothing potential of beauty.
But instead of dying at the Maison de la Rivière-du-Nord, Paul died in the hospital. Not in appalling circumstances, but definitely not in exceptional circumstances.
The hospital room was small. The family was crowded. There were seats without backs. I couldn’t be with my husband last night: I can tell you that when I left the hospital last night I was spinning cheap…
Monica
Why didn’t Paul die at Rivière-du-Nord?
Because Paul had previously requested medical assistance in dying (MAID).
And his doctor, Dr.r Julien Auger, told Paul what was well known in the network, in the Laurentians: Rivière-du-Nord does not practice medical assistance in dying.
Monique: “It’s the Dr Auger who told Paul that the Rivière-du-Nord palliative care home was refusing patients who have already made a request for medical assistance in dying…”
I checked with the Dr Auger: he did tell Paul in the spring of 2022 that Rivière-du-Nord would not accept him, because his request for medical assistance in dying was already “in the system”.
The Dr Auger administered MAID to Paul in this small room of a dilapidated hospital.
Let’s press “Pause” here.
Hospices and hospital palliative care units won an exclusion when Quebec adopted a law on medical assistance in dying, as did palliative care units in hospitals.
That of not agreeing to practice medical assistance in dying within their walls.
After sometimes emotional debates, this seemed, in 2014, an acceptable compromise. The palliative care community was particularly angry against medical assistance in dying.
Time has done its work: a majority (25 out of 37) now offer it. Some houses found it cruel what happened if a sick person, within its walls, asked for medical assistance in dying1 : we put him in an ambulance so that he received treatment at the hospital…
Which is nothing sweet, serene or beautiful, in the last hours of his life.
When the Dr Julien Auger announced to Paul in the spring of 2022 that the Rivière-du-Nord palliative care home was refusing patients who had already requested medical assistance in dying, he was wrong…
Because in the summer of 2021, almost a year earlier, the Maison de la Rivière-du-Nord had changed its rules, MAID was now allowed there.
It’s the Dr Charles-Matthieu Grégoire, medical director of the Maison de la Rivière-du-Nord, who confirmed this to me last December. He practices AMM himself. He spoke to me at length about the change in mentality that has taken place in the face of MAID, in the palliative care community…
I deduced that Paul’s doctor – Dr.r Auger – was unaware that Rivière-du-Nord had changed its MAID rules, when he told Paul there was no need to apply for admission to Rivière-du-Nord.
Monique had even told me that after the “niet” of Dr Auger, a social worker had told him that indeed, it is well known in the Laurentians, the Maison de la Rivière-du-Nord refused patients who wish to receive MAID…
A few days ago I called back the people I interviewed in December – Monique, the Dr Gregory, the D.r Auger – to check if the facts had changed.
I told the Dr Auger that he had undoubtedly been the victim of an outdated perception, that Rivière-du-Nord was indeed practicing AMM in the spring of 2022…
The Dr Auger replied that he would be very surprised. That in the spring of 2022, while he was treating Paul, the form for the Maison de la Rivière-du-Nord still included the warning that MAID was not practiced there…
And he said to me, “I even think it’s still on their website. Hold on… ”
Two minutes later, the Dr Auger sent me a screenshot of the ACTUEL website of the Rivière-du-Nord Palliative Care Home2. I quote: “Cannot be admitted a patient who has, before his admission, a request for medical assistance in dying still active or in process. »
I was blue.
I called back the Dr Charles-Matthieu Grégoire, who was in his little shoes, who explained to me that yes, but no, that there is an interpretation that prevails, that, that, that…
I stopped taking notes. I can only tell you this: the Rivière-du-Nord palliative care home officially provides medical assistance in dying.
In fact, it’s not clear, maybe yes, but maybe not…
But on the website, it’s crystal clear: it’s no.
I will only say this: medical assistance in dying is a care and a right for all Quebecers. It is high time for Quebec to force palliative care homes and hospital units to respect this right and to provide the care that is MAID.
The Minister for Health and Seniors Sonia Bélanger will soon table a bill that updates the guidelines for medical assistance in dying in Quebec3. I hope she sees to it, for all the people who, like Paul, have seen their right to this care trampled on.
The exclusion granted to care homes and palliative care units is increasingly scandalous.
To paraphrase Monique: it deprives Quebecers of exceptional end-of-life care.
I called Monique back. I told him that the column was going to appear this Sunday.
” Sunday ?
– Yes, Sunday.
“Do you know what day it is, Sunday?” »
I stammered, I thought: uh, the day of the Lord?
“Uh, no, Monique… What day is it?
– It’s the Super Bowl, Paul loved football, as I told you. »
It’s a sign, Monique.
* The couple’s first names have been changed at the request of “Monique” for reasons of confidentiality.