The recent Supreme Court of Canada ruling on assisted death has opened the door for legislation and sparked dialogue about what assisted dying should look like in this country.
As we grapple with these difficult questions surrounding assisted death, it may be pertinent to consult those in our society with considerable experience.
Veterinarians are frequently asked to euthanize their patients.
Euthanasia literally means “a good death,” which includes a quick, humane method resulting in minimal anxiety and pain.
Veterinarians are ethically obliged to alleviate suffering of animals placed in their care and frequently provide this compassionate service for patients.
Compared to euthanasia, natural death in many circumstances is cruel, painful and inhumane.
There are many important differences between end-of-life decisions in people and animals, but some aspects are comparable.
People and animals both suffer from similar, chronic debilitating diseases such as cancer. As well, many pet owners consider their animals to be members of their families, so I would argue veterinarians deal with assisted death of family members all the time.
As such, veterinarians are experienced with sensitive and frank discussions with owners regarding compassionate euthanasia for their animals.
Their role in these conversations is two-fold:
- Veterinarians diagnose disease, provide treatment options and prognoses, assess pain and carefully consider the needs of the animal.
- They offer guidance to families about end-of-life decisions and receive training and garner hours of experience in this aspect of practice. Having that difficult conversation with a family about suffering, end of life care and ultimately when to say goodbye is not easy. Physicians will face similar challenges as they directly council patients and their families about euthanasia options.
Terminal illness raises similar quality of life concerns in people and animals. Pain control, appetite, interest in normal activities and control of bodily functions are common themes that need be thought about and discussed.
A key difference is choice. People will decide for themselves whether euthanasia is an option for them, while animals cannot decide.
As a result, people who care for them must make the decision to euthanize when treatments are no longer effective and prolonging life would cause pain and suffering.
The cost of care is another key difference. Decisions to euthanize animals can be dictated by treatment cost, but this is not an immediate issue in the Canadian health-care system.
The procedure is usually straight-forward and handled with great care and sensitivity by the veterinary team once the decision is made to euthanize an animal. Pets are first sedated and an intravenous catheter is placed, usually in the presence of their family.
An anesthetic agent is injected that makes the animal unconscious before it stops the heart and breathing. As pets die in this way, their bodies soften and they pass in peace and with dignity.
For everyone involved, euthanasia requires a fundamental shift in thinking about the goals of treatment from one of prolonging life at all possible cost to considering quality of life.
This is difficult, but the approach also recognizes that prolonging life would result in unnecessary suffering.
Choosing euthanasia is the final admission that there is no more hope, which can exact a professional and emotional toll. In my own experience, I try to mentally partition this aspect of practice as an end of suffering.
Veterinarians have been dealing with the professional consequences of euthanasia for years, and although they may not have all the answers, perhaps physicians and veterinarians can learn from each other.
Veterinarians could serve society by actively participating in the consultation process and public de-bate.
But also, health care providers and those involved in creating legislation would do well to seek out and em-brace this wealth of veterinary experience with assisted death.