In Rural France, A Final Indignity
DOUAI, France — Sandra Lambryczak’s 80-year-old mother was terminally ill with breast cancer and was expected to die at home. But when she died early on a Saturday morning, Ms. Lambryczak encountered a growing problem in France: By law, the body could not be moved until the death was certified by a medical doctor.
“Madame, there’s nobody on weekends, there’s no doctor,” she was told when she called the emergency services. “I pleaded: ‘This can’t be true. We can’t leave a body until Monday morning.’ ”
Police officers came, but could not find a doctor. Half a day later, only after her mother’s nurse was able to locate her personal physician, was the body permitted to be taken to a funeral home. Ms. Lambryczak said, “Honestly, it was a nightmare.”
Such waits have been increasing in frequency around Douai, a city of 40,000 in northern France, and in other areas with a scarcity of physicians.
Mayors, police officers and other officials find themselves trying to help families find a doctor to certify a death.
Nurses, coroners and other officials can certify deaths in some countries. But in France, where a quarter of the population dies at home, the role is reserved for doctors, who must visit the home, verify the death was natural and note its cause. An acute shortage of doctors in some areas has created “medical deserts,” home to 8 percent of the population, according to the government, even as the overall number of doctors has risen. Physicians cluster in metropolitan areas, reinforcing the sense of a widening gap between a thriving France and a withering periphery.
“We’ve never had so many doctors in France, and yet we have medical deserts where families have to keep a cadaver at home, and where they’re abandoned in both life and death,” said Christophe Dietrich, the mayor of Laigneville, a 4,500-resident town where the last two doctors retired in 2017.
The town prohibited dying at home, trying to pressure authorities to place a physician in the region, with mixed results, Mr. Dietrich said. No doctor has arrived, but a telemedicine center was established.
Half of all French family doctors are over 55. Officials are bracing for a wave of retirements by eliminating a cap on the number of medical students. But the effects are not expected to be felt for a decade.
It is difficult to attract doctors to medical deserts, which lack other services, said Dr. Marc Vogel, the vice president of the French Medical Council in Nord, which includes Douai.
Overburdened, the remaining doctors do not feel obligated to go out of their way to certify the death of someone who was not a patient, some said. France pays a flat rate of 100 euros, or $110, to certify a death at night or on weekends and holidays, and in underserved regions.
Frédéric Deleplanque had to wait days for a doctor to certify the death of his father-in-law after finding him on a Saturday morning in Douai. Police officers and firefighters came, but were unable to help find a doctor. On Monday morning — by then the body had started to decompose — Mr. Deleplanque called the police again: “I told them, it’s simple. I’m taking my father-in-law and putting him in the middle of the street.”
Before he could carry out his threat, he found a physician who had treated his father-in-law years ago. The doctor came and signed the death certificate, and his father-inlaw was cremated the next day.
“We felt abandoned by the state,” Mr. Deleplanque said. “We were nothing.”
“I pleaded, ‘This can’t be true. We can’t leave a body until Monday morning.’ ”
SANDRA LAMBRYCZAK