Around 10:45 on the morning of Feb. 25, Lee Goguen asked her father if he had any last requests.
The death that was coming to 70-year-old Gerald Goguen was the death he had chosen weeks in advance and his wife of 41 years had chosen to go with him.
Diagnosed with prostate cancer in 2008, Gerald’s health had started to deteriorate sharply in the months leading up to Christmas. Coby Goguen, 62, also had cancer that had spread and eaten into her bones. Both were racked with pain and wanted out.
Lee said she wanted to see her parents relieved of their suffering and was grateful they had the option to end their lives on their own terms.
“I got a lot of closure from it,” Lee said. “It gave me the encouragement to say the things that might have gone unsaid.”
Medical assistance in dying now accounts for about one in 20 deaths in Canada, and demand in New Brunswick has been climbing year over year.
Lee said she wasn’t so sure about MAID when the procedure became legal in 2016, but her parents helped change her mind. In their final days in hospital, Lee asked their permission to speak publicly about it.
With minutes to go before a sedative would put them to sleep and a second medication would induce a coma, Gerald asked to hear I Love You by the Climax Blues Band, a tune that was played on his wedding day. The vinyl record was back on the shelf in the Goguens’ home on Saint John’s east side, but Lee had downloaded it to her phone and she played it for them.
“My mom said, ‘I haven’t heard that in forever,'” Lee said.
It had been a hit in 1981, before Gerald married the most beautiful woman he said he’d ever seen. Lee is convinced that’s still how Gerald saw Coby as he gazed at his wife lying next to him in her hospital bed.
Lee Goguen’s parents died together, holding hands.
“Mom just leaned back and listened to the music,” Lee said. “And Dad, he didn’t stop looking at her. He was just so in love.”
New Brunswick’s two health networks have reported a slow but steady increase in MAID applications over the past five years. The Vitalité Health Network says requests for MAID more than doubled, from 105 requests in 2020 to 216 in 2024.
“It’s just been a continual increase in demand,” said Horizon’s palliative care physician Dr. Julia Wildish.
“I think initially everyone was a bit leery of the idea. It was sort of a new concept to people and kind of creepy maybe. But I think over time, people are more familiar with it. They know someone who’s had it. They’ve had time to wrap their heads around the whole idea, and it’s just not as scary.”
While Lee was one of the early skeptics, her mother was not, having watched her own father suffer for about a decade with an illness that left him unable to recognize his family.
“Mom always told us, if I ever get like that, pull the plug,” Lee said. “Because back then, there was no option for medical assistance in dying.”
Lee said her parents were thoroughly assessed as candidates for MAID before they got approval.
Canadian law requires two independent medical practitioners — they can be physicians or nurse practitioners — to assess patients over a minimum period of 90 days.
That period can be shortened in specific circumstances where both assessors agree the patient is at imminent risk of losing capacity to consent.
“You have to be in an advanced state of functional decline, and you have to have intolerable suffering that can’t be relieved by any means acceptable to the patient,” Wildish said.
Since 2021, the law in Canada has allowed for two tracks of MAID patients.
Track one patients have a reasonably foreseeable natural death. Often this means the health-care providers consider death to be imminent. These patients can waive final consent, which means MAID can proceed on or before their chosen date, even if they do not have the capacity to consent at the time of the MAID procedure.
Track two patients include people who suffer intolerably but whose death is not reasonably foreseeable. They can access MAID, but they cannot waive their final consent.
Canadian law will also allow patients to receive MAID if their sole underlying medical condition is a mental illness. That eligibility goes into effect March 17, 2027.
Chantale Arseneault, a regional MAID co-ordinator for Horizon, said helping families with MAID is the most rewarding job of her nursing career, and she wouldn’t trade it for the world.
“Most people will say, ‘Oh, my goodness, how can you do this type of work?’ Arseneault said. “And I challenge that, because most of our patients are extremely grateful to not only tell us their story, but they become vulnerable with us and we make connections, deep connections.”
Part of her role is helping patients plan their last living day.
“I ask, what does a good death mean to you … what does it look like? Who is there?'”
Lee said hospital staff made it possible for her parents to be in hospital beds side by side, and when they died together, it was merciful and peaceful.
“I have never experienced a death where I have had this much closure,” she said.
“Mom and Dad were holding hands and looking at each other. The entire time the procedure was happening, they were holding hands.”