Posted at 5:00 a.m.
“Like a gunshot”
Diane Marquis’ spouse, Pierre Camirand, received medical assistance in dying (MAD) last February at Maisonneuve-Rosemont Hospital. Reached at the age of 65 with “aggressive and dazzling” multiple sclerosis, he had lost the use of one leg and one eye and had great difficulty eating and defecating. “He was a workaholic, he worked all the time. To be confined, lying down without being able to do anything had become revolting for him, ”explains Mme Marquis.
Her husband had initially considered receiving euthanasia in Switzerland, before learning that Canada had extended access to MAID to patients with neurodegenerative diseases without hope of cure in March 2021. “He had three plans : Switzerland, Quebec, otherwise it was the Rivière des Prairies. She and her children indeed feared suicide.
Despite this, Pierre Camirand’s decision to receive medical assistance in dying was very difficult for his family, who was informed late. “I was in shock,” admits M.me Marquis remembering the moment when his spouse announced to him that he had already chosen the date of his death. “I saw life change, because it was the departure of someone with whom I had shared several years of my life. »
“Traumatizing” is the term she uses to describe the timing of the injections. “It’s like a gunshot. He was there, smiling, he was talking, and then suddenly it was over. After the death, Diane Marquis said she felt guilty, suffering from adjustment disorders for several weeks. Despite the offer of support available, she did not wish to be accompanied in her grief by health professionals.
PHOTO ALAIN ROBERGE, THE PRESS
Diane Marquis
I couldn’t see myself meeting a psychologist or people I didn’t know at all to tell them about my pain.
Diane Marquis, whose spouse has used MAID
Writing and sports helped her overcome the loss of her husband. “The pain is there, it comes back periodically, but I learned to tame it,” she testifies, adding that she received a lot of support from her family and work colleagues. Mme Finally, Marquis would like to salute the work and dedication of caregivers. “It’s demanding and very generous work,” she says. Sometimes people lose their own lives there. It takes a lot of love. »
“A moment of joy and deliverance”
Réjean Morin saw his adoptive father, Claude Vachon, receive medical assistance in dying in February 2021. Fighting a serious lung disease for ten years, the latter had become very dependent during the pandemic. Admitted to the hospital, informed by the doctors that he could no longer live alone, he experienced this loss of autonomy very badly. “He found it difficult to be taken care of. He blamed himself for being a burden for us, but he never was,” explains Réjean Morin in a voice of emotion.
After a few months of hospitalization, it was Claude Vachon himself who decided to resort to MAID. Despite initial reluctance, her son quickly understood why he wanted to put an end to his suffering.
If we had been thought of, we would have said, “No, we’ll take care of you.” But he explained to us that mentally, he suffered so much from being in that state, visibly wasting away, that he no longer saw any meaning in his life.
Réjean Morin, whose adoptive father used MAID
Mr. Morin’s adoptive father was then transferred to a palliative care center, where he and his three sons were able to experience precious moments of conviviality together. “We watched hockey, we had dinner with him. And my father, day in and day out, said: ‘It’s okay, I’m fine,'” says Réjean Morin, specifying that the patient who receives medical assistance in dying has the right to change his mind until last moment.
On D-Day, the whole family gathered to say goodbye to Mr. Vachon. “It was a moment of joy and deliverance, remembers his son. All the mental pain that appeared on his face suddenly disappeared. His father’s relief therefore helped him overcome his pain, as well as a psychologist friend and the staff of the center, “angels”, according to Mr. Morin.
Having already experienced a difficult mourning after the death of his parents, the AMM remains for him an extremely positive experience. ” If I could redo it, I would. This is what I would advise anyone who is unfortunately in this irreversible state. »
What is the grieving experience for loved ones?
PHOTO OLIVIER JEAN, LA PRESSE ARCHIVES
A recent study looked at the grieving process among relatives of people who have had recourse to medical assistance in dying.
Medical assistance in dying (MAID) does not necessarily facilitate the mourning of loved ones, reports a recent study. A finding that calls into question the support provided to the entourage of people using MAID, practiced in Quebec since 2015.
Is mourning more or less difficult to experience in the case of medical assistance in dying? This is the question explored by Philippe Laperle, a doctoral student in psychology at the University of Montreal, in a study published last month in the Journal of Death and Dying. The researcher questioned, by means of a questionnaire, 60 people who had lost a loved one for a minimum period of six months: 25 following medical assistance in dying, 35 from natural death in palliative care. He then conducted guided interviews with eight participants from each group, in order to compare how they had experienced their grief.
The results of his research are, to say the least, mixed. “At the quantitative level, by comparing the results of the two questionnaires with data related to other types of death, in particular accidents or suicides, medical assistance in dying seems to facilitate mourning”, explains Mr. Laperle in an interview with The Press. However, between the bereavement following a natural death and that following medical assistance in dying, he does not find any significant difference in the experience: “The results are quite similar [pour ces deux situations]. »
The qualitative data highlighted by the study, however, reveal a great plurality of experiences in the case of MA.
There are participants who experienced medical assistance in dying very difficultly, with the feeling that something had been rushed. Some people felt they weren’t at the same point as their loved one who was going to receive help, and it’s this disconnect that makes grieving more difficult.
Philippe Laperle, doctoral student in psychology at the University of Montreal
For other people, on the contrary, the AMM makes it possible to keep a positive memory of the loved one until their last moments. Philippe Laperle then speaks of a “metaphor of the hero”, the deceased person embodying “values of freedom, control and courage”. “We even mentioned the question of immortality,” explains Mr. Laperle. The grieving process can sometimes go through these two stages consecutively in the same person.
Follow-up for loved ones
These results lead the doctoral student to question the relevance of a specific bereavement follow-up in the case of medical assistance in dying. “Overall, I don’t think we need to develop specialized programs that would only address these people, given that the majority of them still seem to be doing well,” he says. .
An opinion far from being shared by Jean-Marc Barreau, holder of the Jean-Monbourquette Chair on the social support of bereaved people, who is currently supervising a research project around MAID.
“For mourning to happen, there needs to be a linear aspect to the mourning process. Medical assistance in dying comes to cut this aspect, because the relatives do not have that much time to prepare for a natural death, ”says the one who is also a professor at the Institute of Religious Studies of the ‘Montreal university.
According to him, the feeling of guilt is particularly present among relatives bereaved following medical assistance in dying, and therefore requires a different approach compared to a natural death, in order to anticipate the difficulties of accepting the decision.
This need for anticipation frees loved ones from this weight of guilt. They will thus know that the decision of the person who is going to have recourse to MAID is truly a free act, not interspersed with too many affects.
Jean-Marc Barreau, holder of the Jean-Monbourquette Chair
He also posits as a specific difficulty the “lack of total acceptance of society around this question, which means that the social support necessary for the resolution of grief is not the same today as it would be in the case of of a natural death. Faced with this situation, Mr. Barreau advocates the establishment of a real “culture of support” for people using medical assistance in dying, bereaved relatives and caregivers.
The two researchers nevertheless agree on the fact that personalized support for loved ones is essential to facilitate the grieving experience, regardless of the type of death. This support is provided in particular by palliative care centers practicing medical assistance in dying, which monitor the bereaved family before, during and after death. “When natural death is accompanied by palliative care, this has positive effects on bereavement, explains Philippe Laperle. So, if we can increase our offer of palliative care, in both cases we can imagine that the bereaved will be better off. »