Since I started researching and writing my book The Last Walk about end of life care for animals, I have taken every opportunity to talk to people about their experiences and hear their stories about the death of a beloved pet. And I have talked to many veterinarians who routinely perform euthanasia on ill and dying animals. The vast majority embrace euthanasia as a compassionate and ethically appropriate way to release animals from suffering at the end of life.
People are eager to talk about the choices they have made at the end of their animal's life. Sometimes I ask, but more often people say without provocation something like this: "I just wish we could be so compassionate with people." Many have had the experience of watching a (human) loved one die a protracted and ugly death. Almost everyone I talked to—above all the veterinarians—spoke in favor of assisted dying for humans. "There should be a way out," people say. If we can do this for our pets, why can't we show the same compassion for our human loved ones?
It makes me wonder: Does deciding to euthanize an ailing or dying animal make one more open to euthanasia in general? Does being a vet have a similar effect on one's attitude toward euthanasia?
It is interesting to observe that human physicians, at least when they are surveyed by academicians, are generally opposed to human euthanasia. A recent survey of U.S. physicians found that 69 percent object to physician assisted suicide or PAS (which is close as we come to euthanasia), and fully 18 percent object to terminal sedation and 5 percent to withdrawal of life support. The primary arguments given against PAS are these: pain medication is good enough that there is no reason for a patient to be in intractable pain (thus there is no reason that they should desire to die); physicians might incorrectly diagnose terminal illness; PAS violates role of physician as healer; and finally, we have what is known in bioethics as a "camel's nose under the tent" argument: if we allow PAS for some patients, this will lead ineluctably to the killing of patients who do not want to die.
Professor of Veterinary Ethics Jerrold Tannenbaum observes in his book Veterinary Ethics that discussions of euthanasia by medical ethicists fail to mention veterinary medicine or the euthanasia of veterinary patients. "This apparent lack of interest is startling," he writes, "because many objections to euthanasia in human medicine stem from the fact that human medicine has had little experience with it." He goes on: "There is a healing profession with extensive experience relating to the euthanasia of its patients. These doctors have long had to worry about when (if at all) euthanasia is justified, how to perform it, and what effects it can have on those close to the patient." Some cross-disciplinary discussion would be enlightening for both sides.
Tannenbaum's reflections on veterinary euthanasia paint a mixed picture. The experience of veterinary medicine shows that a profession allowed by law, its own official ethical standards, and societal attitudes, to kill its patients may well kill too many. Fears in human medicine about who might be responsible for overutilization of euthanasia could be misplaced: it is the clients, not the vets, who ask for euthanasia. Practitioner-induced euthanasia is not inevitably associated with disrespect and devaluation of the patient. There is a link between the value people place on a being (or kind of being) and their willingness to choose euthanasia for it. And finally, money is a significant motivation for euthanasia.
I am not arguing in favor of human euthanasia, nor am I justifying the widespread practice of euthanizing animals. Instead, I am simply wondering why we have such vastly different approaches to "compassionate" end of life care: Why is euthanasia almost always considered the appropriate end point for our animal companions, but not for our human loved ones? The answer people may give is that humans are not the same as animals, and shouldn't be treated like animals. This implies either that humans are not animals or what we do to animals would be morally innappropriate, if done to people.
I may be breaking an unspoken taboo in drawing a comparison between animals and humans, but I think the comparison raises important questions. Should we be more open to euthanasia in the human realm? Should we, on the other hand, be a little more circumspect in how easily we apply euthanasia to our animal companions?