by Stacy Bremner, MA, RP
Recently, I found myself having several conversations about Medical Assistance in Dying (MAID). Some conversations were with friends. Some were with clients. Some conversations unfolded over months, while others surfaced briefly during a therapy session.
With all of these conversations happening within a relatively short period of time, I couldn’t help but notice that more and more people seem to be experiencing the loss of a loved one whose death comes with some notice and preparation.
What struck me was the complexity.
I became curious about the emotional experience of those left behind and the unique challenges that can arise when a loved one chooses the timing of their own death.
When Someone Chooses to Leave Early
We all understand that aging eventually leads to death. We expect grandparents and elderly parents to decline over time. We may not like it, but there is a perceived natural order to things.
At the same time, most humans are remarkably invested in staying alive. We endure difficult surgeries, demanding treatments, and exhausting rounds of chemotherapy because there is a powerful instinct to keep going for as long as possible.
So when someone chooses MAID, family members may find themselves wrestling with difficult thoughts and feelings.
- Why are you leaving sooner than you have to?
- Don’t we have more time together?
- Should I support this decision?
- Should I challenge it?
- If I support it, will they think I don’t care whether they live or die?
- If I oppose it, am I respecting their wishes?
Love, grief, fear, respect, and confusion can all arrive at the same time.
The person choosing MAID may feel at peace with their decision, while family members struggle to know how best to show their love.
The Gift of Time and a More Intentional Goodbye
One potential gift of a planned death is the opportunity to prepare.
Many people have shared with me the sadness of never getting a proper goodbye. A sudden accident. An unexpected heart attack. Arriving at the hospital too late. Wondering forever what they would have said if given one more conversation.
MAID can create a different possibility.
Families may have time to gather, revisit memories, express love, and say what matters.
I experienced this myself when my father was nearing the end of his long battle with cancer. Knowing his time was limited, I tried to have one of those deeper conversations about life, death, and what it all meant.
I’ll never forget his response.
“Stacy, I’m just not that deep.”
Seventeen years later, that memory still makes me smile.
We didn’t have a profound discussion, but we did have an “I love you” and what become our final hug.
Looking back, I realize that meaningful goodbyes do not always look the way we imagine they should. Sometimes there are tears, apologies, forgiveness, and heartfelt conversations. Sometimes there is simply the gift of being together and sharing a moment that feels true to the relationship.
One of the unique aspects of MAID is that it can create an opportunity that many families never receive: the opportunity to be intentional. To gather. To express love. To ask questions. To say what matters. Or sometimes, to simply sit together and be present.
A planned death does not guarantee a meaningful goodbye. Longstanding family dynamics do not magically disappear, and unresolved hurts may remain unresolved.
Still, for some families, the opportunity to prepare and say goodbye is a profound gift.
Not Every Community Is Equally Prepared
Something else I have noticed is that support for families can vary widely.
I have heard stories of beautiful settings where loved ones gather, celebrate a life, share memories, and receive support before and after the procedure. Staff members check in on family members and recognize that this is not only a medical event but also a deeply emotional one.
I have also heard stories suggesting not every family receives this level of care and support.
As MAID becomes more common, it is important to consider not only the needs of the person receiving MAID, but also the needs of those who love them. Being present at the deathbed of a loved one is an experience that can remain with people for the rest of their lives, and thoughtful preparation matters.
If those supports are not built into the process, families may wish to seek them out themselves. Having a therapist, death doula, spiritual care provider, or other trusted guide available before, during, and after the procedure may help loved ones feel more supported as they navigate a profoundly emotional experience.
Every Family Member Experiences It Differently
There is no single experience. No two family members experience the loss in exactly the same way.
The age of the person about to cross over, does not necessarily simplify the process either.
Whether the person choosing MAID is 36 or 96, loved ones may still struggle with loss, timing, and acceptance.
Each person’s feelings are influenced by the relationship they had with the deceased, their beliefs about suffering, and their views about MAID itself, and more….
Even within the same family, one person may feel relief that suffering is ending while another feels devastated that more time is not being pursued.
All experiences are valid.
What Do We Believe Happens Next?
Another layer of complexity involves something that is rarely discussed and deeply personal: our beliefs about death itself.
Families are not only responding to a loved one’s decision. They are also responding to what they believe death means.
Some view death as a transition, believing that the spirit continues on in another form. Others see death as the end of an individual’s existence. Some feel certain in their beliefs. Others live comfortably with mystery and simply acknowledge that none of us can truly know until our own time comes.
These beliefs matter.
Two family members sitting beside the same bed may be witnessing the same event while understanding its meaning in very different ways.
Questions naturally arise:
- Are they afraid?
- Are they ready?
- Are they at peace?
- Is death a doorway or an ending?
- Will I see them again?
- What happens next?
For some people, these beliefs may make the decision easier to accept. For others, they may make it more difficult.
The Grief That Comes After
When someone dies naturally, survivors have plenty to process. When MAID is involved, there may be additional complexity.
One daughter shared how she felt panic, and said, “I felt like I was walking her to her death.” Another daughter said she thought her mother could have had 5 more years if they had chosen a better long-term care facility.
We may wonder:
- Could something have been done differently?
- Did the facility provide the best possible care?
- Might they have lived longer under different circumstances?
- Did we make the right decisions?
These questions may arise even when everyone involved genuinely believed they were acting with love and good intentions.
The human mind naturally revisits important events, searching for understanding.
The Last Breath
Being present for a person’s final breath is not all that common for the average person, and is an experience many people never forget.
For some, it becomes a peaceful memory, for others less so.
Either way, those final moments often leave a lasting imprint.
A Compassionate Complexity
When I listen to stories about MAID, I do not hear simplicity.
I hear love, grief, uncertainty, relief, guilt, gratitude, anger, sadness, frustration. I hear most everything under the sun.
I hear families doing their best to navigate a complex situation, with one of life’s most profound transitions.
MAID may be a blessing for some people and families. It may also add layers of complexity to the grieving process that deserve acknowledgment, compassion, and support.
Perhaps the deeper question is not simply what we think about MAID.
Perhaps it is what we believe makes for a good death, a meaningful goodbye, and a compassionate way to accompany someone we love through their final chapter.
I am curious whether you have had personal experience with MAID, either directly or through someone you care about, like a close friend who lost a loved one. What emotions, questions, or reflections did it bring up for you?
After the Goodbye
If grief is a topic you are currently navigating, you may also find value in my earlier article on grief and the many ways people process loss.
Death has a way of bringing unfinished feelings to the surface. Whether your experience with MAID brought peace, relief, confusion, guilt, gratitude, heartbreak, or some combination of all of the above, please be gentle with yourself. Grief is not a problem to solve. It is a process of making space for both love and loss.
What I noticed the other day… is that healing begins with kindness. This space offers food for thought — and food is love. ❤️
