There are two views about a doctor’s role in death in our country, and they couldn’t be more diametrically opposed.
If you are an MD, you live and work in a world where natural death is the norm. Assisted suicide is still an option in its infancy, legal in only four states up to this week, when California became the fifth. The role of the doctor is to preserve life at all cost, even, some might say, at the expense of its quality. Helping a patient end his or her life is, many say, cruel and unnatural.
But as a veterinarian, euthanasia is the norm. It is so far in the opposite direction that I have read some of the most well-respected names in the field state publicly that no pet should ever experience a natural death. The role of the doctor here is to preserve quality of life at all cost, even its length. Prolonging a suffering pet’s life is, many say, cruel and unnatural.
So who’s right?
The answer, of course, is neither and both. Where MDs and DVMs once stood at opposite ends of the rope, both sides are now moving towards the middle. While coroners in Los Angeles were shaking their heads at the role physicians may now play in the death of a patient, I was sitting in a packed lecture hall at the International Association of Animal Hospice and Palliative Care listening to a veterinarian discuss how she supports clients who wish their pets to have a natural death.
Up till now, many clients who do not want euthanasia for any number of reasons were given one of two options: accept it and all the moral discomfort that may accompany it; or go home and let the pet die on his or her own, with little palliative support from the veterinarian.
When veterinarians talk about the cruelty of a natural death, we’re thinking of a situation where there is no support whatsoever. Dying, despite what some people may tell you, can be a messy business. Yes, some living beings may drift off gently into that good night. On the other hand, they may suffer from tremendous nausea, gut-wrenching pain, soiling oneself, the agony of trouble breathing.
Fortunately for us, we have a great model on how to manage all of that: human hospice. A hospice-supported natural death is kind of the opposite of doing nothing; it can be intense. Parenteral fluids. Tube feeding. Round the clock nursing care. Meticulous observation of pain symptoms. It is not an easy path to walk, and many clients who elect to try for a natural death in their pets eventually choose euthanasia. But at least they do so with a clear heart.
And those who do not, have done their duty in providing an ethical death for their pets.
I live for the day when the conversations we have are open and honest enough to determine what is right for each patient and each family, the day when the death of a pet and the death of a person are not so very different. The day we all can make educated choices rationally, and feel, if not good about it, at least at peace.
Because we sure aren’t there yet. But we are on our way.
Dr. Jessica Vogelsang