Physician-assisted death: how veterinarians can contribute to the conversation

JRothenburgerJamie L. Rothenburger is a veterinarian and researcher in the Department of Pathobiology at the Ontario Veterinary College in Guelph, Ontario

 

 

Editor’s note: This article was originally published on February 26, 2015, in The Western Producer.

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 the suffering of animals placed in their care and frequently provide this compassionate service for patients. Compared with euthanasia, in many circumstances natural death is cruel, painful and inhumane.

There are certainly many important differences between end-of-life decisions for people and animals, but some aspects are comparable. People and animals both suffer from similar, chronic debilitating diseases such as cancer. Terminal illness raises similar quality-of-life concerns for humans and animals. Pain control, appetite, interest in normal activities and control of bodily functions are common themes that need be thought about and discussed. In addition, many pet owners consider their animals to be members of their families; thus, I would argue that veterinarians deal with the assisted death of family members all the time. Veterinarians are experienced in having sensitive and frank discussions with such pet owners regarding compassionate euthanasia for their animals.

The role of veterinarians in these conversations is two-fold: they 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, 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 when to say a final goodbye is not easy. Physicians will face similar challenges as they directly council patients and their families about euthanasia options.

A key difference between the two groups is choice. People will decide for themselves whether euthanasia is an option for them, whereas animals cannot. As a result, the people who care for the animal must make the decision to euthanize when treatments are no longer effective and prolonging life would cause pain and suffering. A second important difference is the cost of. Decisions to euthanize animals might be dictated by the cost of treatment, but this is not an immediate issue in the Canadian health care system.

The procedure is usually straightforward 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 renders the animal unconscious before the heart and breathing stop. 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 prolonging life at all possible cost to considering its quality. This shift 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 we may not have all the answers, perhaps physicians and veterinarians can each learn from one another.

Veterinarians could serve society by actively participating in the consultation process and public debate. Health care providers and the people involved in creating legislation would do well to seek out and embrace this wealth of veterinary experience with assisted death.

One thought on “Physician-assisted death: how veterinarians can contribute to the conversation

  1. Harold Fast DVM

    I commend Dr Rothenburger for offering a Veterinary view point on this important topic. As Veterinarians, we are very sensitive to patient suffering, in fact to leave an animal to suffer when recovery is not an option, is an illegal act.

    Reply

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