Affected by illness and at the end of life, the dilemma of the last Christmas

This Christmas will be the last for thousands of people with an incurable disease. Their family faces a dilemma: should we respect the rules and deprive ourselves of a last December 25 reunion, or break them at the risk of spreading the disease?

From Vancouver to Halifax, Statistics Canada estimates that cancer kills more than 80,000 lives each year.

That of Lucille Loiselle will be among the number in 2022.

Fatality fell last Thursday, in the form of small spots on the negative image of his lungs. The x-ray showed lesions. Diagnosis: cancer quickly erodes the remaining days. Two more, at most four months, before Lucille dies.

Her only daughter, Marie-Josée, wonders how to celebrate this last Christmas. Prioritize the safety of your sick mother and avoid any gathering or treat yourself to a moment with the family at the risk of COVID-19 coming to the party?

One choice is imprudent, the other seems inhuman. “I’m really not good at it,” she says.

Especially since her mother, solitary by nature, can only count on her. “I have been his lifeline since the announcement,” adds Marie-Josée. “Her cancer is inoperable, and at 79, she does not have the strength to undergo the treatments. “

Individual choice, collective impact

“These are heartbreaking situations,” concedes Emmanuelle Marceau, bioethicist specializing in public health. “Not seeing each other at all for Christmas when it’s a person’s last Christmas, it’s dramatic. “

On the other hand, she recalls that “the virus does not discriminate”. “If the person with three or six months left to live dies precipitously from COVID, the moral weight of the guilt will be very difficult to take. Six months is always better than six days! “

To minimize the risks, it is better to favor alternative gatherings, believes Marceau. A stroll outside or a celebration by Zoom may offer a safe substitute, she says.

Marie-Josée suggested to her mother to celebrate at dinner time, in a well ventilated restaurant. For Lucille, explains her daughter, “a Christmas elsewhere than at home is not a real Christmas”. She wants to live this last New Year’s Eve at home, surrounded by the loved ones who remain to her. Chez les Loiselles, the family is less than 10 people, which avoids having to sacrifice guests to respect the limit imposed by the government.

For other larger families dealing with the incurable illness of a loved one, the dilemmas add up. Who to leave out at Christmas, when it comes to his last?

For the Dr Hubert Marcoux, doctor and ethicist specializing in end-of-life care, a dying person is entitled to grant himself a “privilege” by breaking the sanitary rules. On condition, however, to accept the consequences. “It’s a consistency test,” he says. “If we engage in civil disobedience to the detriment of the hospital network, we must, somewhere, agree to give it up. “

If, by “legitimate need to live a last Christmas with his loved ones”, continues Dr Marcoux, a family exceeds the limit authorized by the government, potential offenders must morally refrain from curative care to avoid clogging hospitals.

Emmanuelle Marceau compares a gathering that goes beyond the instructions issued by Public Health to driving while intoxicated. “It is not automatic that by taking the wheel with a drink in the nose, I will cause an accident,” she emphasizes. “It’s the same with Omicron: just because I get together doesn’t mean I’m going to contract the disease. “

“On the other hand, I considerably increase the risks,” she maintains. “Getting together at 20 at all costs, even if I understand the need for a family and the need for dignity of loved ones who want to surround themselves with love before leaving, it carries an enormous moral weight. “

Necessary for healing

Missing out on a last Christmas with the family also has consequences. The trauma of the first wave, during which elders died alone, without ceremony or relatives, remains vivid in the minds of many survivors.

“Mourning is a healing process that is relieved by the feeling of having done everything to create memories and to have fundamental moments with the deceased”, analyzes Dr.r Hubert Marcoux. “Our society underestimates the importance of rituals like Christmas. These are precious moments, very precious, because they will have an impact on the bereavement. To be deprived of it is what leaves scars. “

Marie-Josée Loiselle still has a few hours before Christmas. Unable to get a drug test to make sure she doesn’t carry COVID-19 as the holidays approach, she plans to decide “one day at a time” how, and especially with whom, to celebrate the last December 25 of his mother.

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