‘Dies Irae’ by Danièle Saint-Bois

Artist Alicia D. has struggled with cancer for the past two years and, when her doctor informs her that there are no further treatment avenues available, she decides that she wants to put an end to her suffering. Following a final, unsuccessful treatment attempt by her doctor, he agrees to help her end her life. Speaking directly to the reader throughout, Alicia D. recounts her experience of an assisted death, addressing the many doubts, hesitations and outright changes of mind that feature throughout her end-of-life journey. With Doc (her doctor) and S. (her nurse) at her bedside, Alicia closes her eyes for the final time, counting down, in the fashion of a pre-operative anaesthetic, to the moment where she will enter an eternal sleep. When she wakes up, however, Alicia is a disembodied spirit who speaks to the reader from the void of the afterlife, reminding them that the dead need the living, not the reverse. 

This fictional text seeks to engage with its reader by posing direct questions that invite them to reflect on the ethics of assisted dying. The first-person narration brings the reader into the narrator’s mind, providing emotive insights on her experiences of pain and suffering and offering a clear snapshot of the decision-making process that has led her to request her physician’s help in ending her life. There is a certain theatrical quality to the text, which frames the protagonist-narrator’s eventual death as an act of staging and casts the healthcare professionals that feature in the work in supporting roles. This quality of staging, coupled with the text’s title (a Latin requiem) and frequent engagement with questions of religion and spirituality, positions it in dialogue with the long-established tradition of the ars moriendi. In so doing, the text invites its reader to imaginatively consider what constitutes a ‘good death’ today.

Although Dies Irae has not been discussed widely in the media or in legal contexts, it remains an important text, particularly for the attention it draws to unofficial practices of assisted dying in France. The text probes the limits of acharnement thérapeutique – overzealous treatment – and the boundary between symptom relief and actively hastening death. Given that the text’s protagonist is a patient with no family support, the text also asks questions of the role of healthcare professionals in supporting an individual beyond the realms of established professional boundaries. The resulting entangled complexities and the medico-legal framework surrounding end-of-life care in France in the early 2000s are presented in all their ‘messiness’ and humanity in this short text.