Death has never been a truly fashionable theme, especially when it concerns us, because, as Montaigne said: “it is not death that I fear, it is dying”. Behind the philosopher’s words, there is obviously the fear of the much-feared suffering. In his work Life care: who decides?essayist Jocelyne Saint-Arnaud approaches the subject with a 360-degree vision, because the end of life can raise many ethical questions with repercussions on the patient as well as on loved ones or medical staff.
These questions concern not only the cessation of life-sustaining treatments, but also the use of palliative care, pain relief and medical assistance in dying, all realities difficult to grasp when one is in good health, but which can become reality for each of us at any moment in life. It is therefore preferable to worry about it before you no longer have the capacity to do so, indicates the researcher in health ethics at the University of Montreal.
When the medical means available no longer help the patient’s state of health, many make the choice at the end of life to have access to medical assistance in dying (MAID), where Quebec is a leader. The fact remains that rules, often complex, and procedures to be respected exist regarding consent and that they are not always known to the general public. Note that in Quebec, the number of acts of medical assistance in dying is constantly increasing. In 2022-2023, 1,633 doctors participated in the AMM, which represents an increase of 15% compared to the previous year.
The essay, written in collaboration with lawyer and ethicist Delphine Roigt, is intended both for the general population and for health professionals, with the aim of filling the lack of information on health care issues. end of life which, according to Saint-Arnaud, are often little discussed in the healthcare environments themselves. By precisely dissecting the issues relating to any decision regarding end-of-life care, the author hopes to demystify and clarify the available avenues, beyond the taboo of death.
As such, Jocelyne Saint-Arnaud does not hesitate to propose an exercise that she calls “Clarification of values” in order to help the reader become familiar with a situation that forces us to think about possible choices regarding the end of life. life. She also takes care to illustrate her remarks with stories depicting different situations, sometimes extreme, which nevertheless highlight the questions to ask a care team. Should we, for example, attempt to resuscitate a person who is in the final stages of an incurable degenerative disease? Or should we continue to artificially feed a person who is in a persistent vegetative coma?
The book is all the more relevant as medical assistance in dying has evolved over time and has just been extended to people with disabilities and those suffering from serious illnesses that cannot be cured, such as ‘Alzheimer’s. The interdisciplinary work, which alternates between philosophical reflections and legislative reminders, also offers legal, clinical and legal references, providing information on the means available to everyone to make their wishes known in terms of care and treatment.