Liana Brittain: How assisted dying has changed the way Canadians experience death

The passage of Canada's medical assistance in dying law has transformed the way some Canadians experience the dying process. In her latest blog post, Liana Brittain reflects on this change and reminisces about how she and her husband, Paul, planned for his assisted death. 

When the Canadian federal government passed Bill C-14 into law, it created a new cultural experience: medical assistance in dying (MAID). Until that legislation, death was generally perceived as a random, unpredictable event. With MAID, suddenly, life had a potential time stamp. Theoretically, a person could legally choose the date, hour and location of their departure from life, if they met the prescribed criteria. This new approach to death is a radical deviation from tradition and requires some mental gymnastics as our society adjusts to this new option: the right to die, empowered, and in a manner of your own choosing. It’s time for our nation to open a dialogue about this new reality.

Death — it comes to us all. My husband, Paul, always knew that when he faced dying, he wanted it to be on his own terms. MAID empowered him to create the ultimate life experience: his own unique swan song. This is the surreal nature of MAID. Sandra Martin, award-winning journalist and broadcaster, broaches the subject in her book A Good Death – Making the Most of Our Final Choices. She writes, “The more I thought about the scheduling — as I noted the appointment in my electronic calendar — the more bizarre it seemed to know the precise day and time that death would occur…”

The flame in the centre of Liana Brittain's "Maxima" is similar to a memorial flame.

The Walrus published “When Death Is a Choice” by Dave Cameron on July 20, 2017. In his account of a friend's medically assisted death, Cameron wrote about how his friend's housemate "cried and laughed" when they were setting the date. “Who wants to die on a Wednesday night at seven?” she had asked. This new phenomenon is being faced by survivors whose loved ones make MAID their end-of-life choice. Several people have reached out to me to express the same feelings. I found it one of the strangest aspects of the MAID experience, from the perspective of the survivor. As time goes on and this becomes a normal occurrence, it will be as accepted as choosing between burial and cremation. In the meantime, we must endeavour to view death from a new perspective and talk about it.

In my experience, there are several keys to making the MAID procedure as successful as possible.

  • The first is communication. Discussing the person’s end-of-life choice, openly and honestly, with loved ones and friends, provides everyone with an opportunity to process this transformative event.
  • The second is planning. Making sure that the person’s wishes are clearly defined in writing and witnessed gives the medical team, family and friends a clear and concise reference guide on how the person wishes to proceed.
  • The third is anticipation or expectation. It’s important for the survivors to know what the person wants or doesn’t want, in terms of remembrance or celebration of their life.

These keys can be found in advanced planning. It does require openness, honesty and strength to accomplish advanced planning, but it is critical to a smooth transition for everyone involved. With MAID, the opportunity is there to do these things together. Questions can be asked. Answers can be clarified. It doesn’t make grieving easier, but it does provide structure when everything seems to be in chaos. It is a blueprint for how to make this ultimate life experience into a beautiful occasion.

Paul's final days

Those final days are so important. Paul wanted a living wake, so we invited friends and family to come and spend time in our home, reminiscing, laughing, sharing food and drink — that was Paul’s wish. For an entire week, I made all his favourite meals. In the evenings, when we were alone together, he allowed me to be a witness to his life as he revisited old relationships and memories. We laughed, we cried, we held each other close, knowing our time together was drawing to an end. He was empowered by his choices. It was as if a weight had been lifted from his shoulders. He was excited about what lay ahead, on the other side of the veil that separates life from death. I felt relieved to know he would not suffer a slow, agonizing, and potentially humiliating final journey, but still I cried in anticipation of our parting. Soon we would each begin a new adventure, as he liked to tell me.

Paul’s choice was to be cremated and his ashes spread in a place that was meaningful to him. However, he wanted me to keep some of his ashes with me, so that a little part of him would always remain close at hand. So, a new type of memorial was created to celebrate a new type of death. I chose to have a keepsake created in the form of a teddy bear. Paul and I had met through an online dating service when we were in our fifties. His nickname was Teddy Bear 444. I had a collection of teddy bears at the time and four was my lucky number, so his profile popped out to me. That was the beginning of a great love story and marriage. Teddy is my keepsake. He’s made from our wedding clothes and contains a small vessel of Paul’s ashes inside.

Teddy

In this new era of MAID, it’s time to begin to think outside the box. Instead of the traditional tombstones, mausoleums and crypts, let’s look to contemporary remembrances such as keepsakes made from the clothing of our loved ones: quilts, pillows, vests, or even teddy bears. Perhaps a blown glass paperweight made from the ashes of your loved one or a memorial video featuring video clips, pictures and music might be the alternative you choose. The most important thing is communication. Open the dialogue. Talk to one another. Make MAID a beautiful experience, just as it was for Paul and me. I will always look back on that day with awe and thanksgiving. I’m so honoured to have been a part of his end-of-life choice.

Post script: I have been invited to speak at the Second International End of Life Conference in Halifax on September 14th. I will be presenting my perspective of the MAID experience as a survivor of a loved one who made this his end-of-life choice. I will be part of the Nova Scotia and PEI panel discussing MAID. I am honoured to be invited to participate and will be taking Teddy with me. His new role will be that of Cub Reporter. We will be blogging and tweeting our experiences through my Living in Pain Successfully website. I tweet as A Gentle Warrior @ljbritt50. Look for Teddy at #TeddyCubReporter.

Liana Brittain provides dual advocacy for chronic pain and medical assistance in dying. She is also the architect of the Living in Pain Successfully program. She has written about her chronic pain in her book, A Gentle Warrior.


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