A square Quebec man has opted for assisted dying after a 4-day emergency hospital stay left him with a horrific bed sore.

On a Thursday in January, Normand Meunier arrived at the hospital in Saint-Jerome with a respiratory virus. A few weeks later, he presents with severe bed-sickness, which eventually forces him to seek medical assistance in dying (MAID).

Meunier, 66, was a truck driver until a spinal cord injury left him paralyzed in 2022.

Meunier spent four days in the emergency room on a stretcher before being admitted to an intensive care unit this winter with his third respiratory virus in three months.

Without access to a special mattress, Meigneur developed a large pressure ulcer on his buttocks that eventually deteriorated to the point where bone and muscle were exposed and visible — clouding his recovery and prognosis, according to his partner Sylvie Brosseau.

“You can't be on a stretcher for ninety-five hours,” Brosseau told Canadian Radio.

“Every time we go to the hospital, it's my job to tell them that Normand is a quadriplegic and needs a variable pressure mattress. . . . I don't understand how that's going to happen because a mattress is the most basic thing.”

Brosseau said that while she stood up for her partner, she said she needed to order a special bed.

“I don't want to be a burden”: Meunier

To prevent bedsores, the patient's position must be changed frequently without access to a mattress that can replace pressure points, says Jean-Pierre Beauchemin, a retired geriatrician and professor at the Faculty of Medicine at Université Laval.

“When you're always in the same position, there's hyper-pressure between the bone and the skin,” Beauchemin said.

“A head ulcer can open in less than 24 hours and then take a very long time to close.”

Buttocks, heels, elbows and knees are especially vulnerable.

According to a fact sheet from the Quebec Ministry of Health, a rotation schedule every two hours is usually necessary for a bedridden person.

Meunier had suffered from other bedsores in the past, most notably his heel, but none as disabling as the pressure ulcer he developed after his hospitalization at St. Jerome.

Speaking to Radio-Canada the day before his death, Meunier said he wanted to end his physical and psychological suffering by choosing medically assisted death.

According to the experts they consulted, he was told that the wound – an opening several centimeters in diameter – would take months at best to heal.

According to his partner, he underwent two debridements within a month – a treatment in which dead or infected tissue is scraped from wounds to help it heal.

“I don't want to be a burden. Anyway, medical advice says I won't be burdened for long; better to kick the can, as the old folks say,” Meunier said.

He died at home on March 29.

“A case of antitrust,” says the lawyer

“This whole incident is a shame,” said Stephen Laperriere, CEO. Regrouping activists joining Quebec (RAPLIQ), which supports people with disabilities.

“It's really unbelievable… What are we doing to help disabled or sick people live decent lives before they die decently?”

He says the health care facility was “negligent at the very least” and that getting a proper mattress is not like “launching a spaceship into orbit.”

“It's very simple… No one can convince me that the right mattress can't be found in a few hours,” said Laperriere.

“To me, it's a lack of professionalism,” Laperriere said, adding that if the staff had been truly professional about the matter, Meunier “would still be alive today.”

There are 145 variable pressure mattresses, the health authority said

In an email to the CBC, the local health authority, CISSS des Laurentides, said it was taking Meunier's case “very seriously.”

“An official investigation is being carried out to determine the incidents,” the report said.

The health authority confirmed that its facilities (including hospitals and long-term care facilities) have 450 therapeutic mattresses, including 145 variable pressure mattresses, and that the equipment is available if staff require it, Radio-Canada.

But adaptive mattresses and beds are not common in the ER, says Steve Desjardins, director of nursing at CISSS des Laurentides.

“The emergency room is not a good place for this type of mattress because the beds are not used in the emergency room, they are stretchers (and) there is no mattress that is really adapted (to wear) for a stretcher,” Desjardins said.

“The emergency room is a dangerous place for the fragile. That's why we actively work to get them access to an inpatient bed when necessary.”

“Very worrying,” says the health professor

Trudeau Lemmens says the situation is “a reflection of the problems in our health care system.”

According to the chair of the University of Toronto's School of Health Law and Policy, already vulnerable people feel like a burden on the system.

“Then the system says, 'You're going to get medical care and you're going to die,'” Lemmens said.

“Medical care in dying is easier and more permanent than some routine care.”

She said she often hears stories of people struggling in the system and turning to MAID.

“It's very disturbing,” he says.

With Brosseau Moelle epinière and motricité Quebec (MÉMO-Qc), an advocacy group for people with disabilities, is now demanding that the Quebec government conduct an independent investigation into Ménière's death. They believe the health department's internal investigation was insufficient.

MÉMO-Qc head Walter Zelaya said the investigation could be conducted by any agency outside the CISSS, such as the Crown or another commission.

“For many years, MÉMO-Qc has reported to various authorities in the health network major deficiencies in several regions of Quebec,” the statement said.

“It is unfortunate that there was a death and that the media had to report it so that the health authorities would listen.”

They are also asking for a meeting with Quebec Health Minister Christian Dubé to address the conditions and lack of care that led to Meunier's death, which is “unfortunately too common for people with disabilities.”

Dube told reporters on Friday that he would await the report of the CISSS investigation before deciding whether an independent investigation was necessary.

“We can say that this is an exception, but what happened is unacceptable,” he said.