On March 1, I took my dog, Bentley, a 13-year-old Cairn Terrier, to my veterinarian to be euthanized. Bentley had metastatic oral melanoma. His primary tumor was in his mouth but the cancer spread to his lymph nodes and lungs. He had undergone radiation therapy, a series of oral melanoma vaccinations, and chemotherapy. While the first round of chemo yielded partial remission, he soon went out of remission and the tumors grew in size and spread to his lungs. The day prior to taking him to be "put to sleep," I took him to his oncologist. A chest x-ray revealed that the tumors in Bentley's lungs had grown substantially larger in the course of one week. His breathing was loud and rapid, but his gums were pink, suggesting that he was still receiving sufficient oxygen. The vet gave him one week to live. She told me she could euthanize him but I opted instead for a cortisone injection and an anti-vomiting injection in the hope that these would give him a few days of qualitative life--a hope that, unfortunately, didn't come true.
Bentley had not eaten for over a week, and while he had been consuming large amounts of water, he was now unable to hold down water and began to vomit each time he drank. Only able to walk small distances, he refused to go out to urinate. Still, his mental capacity remained intact and he was cognitively the same very intelligent Cairn Terrier I knew and loved.
It is only half true that I had Bentley "put to sleep." The whole truth is much more painful to speak. The first injection did truly put him into a deep sleep. The second, however, was a lethal dosage of a barbiturate.
Since that day, I have thought about what I had done, not merely as a bereaved pet owner, but also as an ethicist. Was it ethical to have put to death this faithful companion of mine with whom I had shared so much for the past thirteen years?
"Of course, it was ethical. He was suffering." This is the most obvious rejoinder, and in fact the one I have most often heard from others when I have raised the ethical question. As a bereaved pet owner, this answer is consoling; so too is the response that I had done everything I could to try to save him. Yet, as an ethicist, this is not satisfactory.
I would estimate that Bentley had the intellect of a very intelligent two-year-old human, which is quite intelligent indeed. But, had Bentley been a two-year-old human instead of a dog, euthanasia would not have been a legal option. In fact, euthanasia would not have been a legal option even if he were an adult human. (I am not here addressing physician assisted suicide, which is presently legal in at least two states.)
Typically, proposals to legalize euthanasia for humans restrict legalization to adults. The idea of euthanizing a two-year-old child is not one likely to gain acceptance, at least not here in the states. Why not? Because a two-year-old child is not, nor never was, capable of providing competent consent.
Here then is an ethical argument not captured by the argument in terms of alleviation of pain and suffering. If euthanasia is justified at all, it is justified only if we have the patient's competent consent. But small children are incapable of giving competent consent; so if euthanasia is justified at all, it is definitely not justified in the case of small children. True, we could argue about the age an individual must be to provide competent consent. Thus, in the Netherlands, which has legalized euthanasia, a patient must be at least twelve years old to consent to euthanasia and the parent or legal guardian must also provide consent. But, no one would argue that a two-year-old is capable of giving competent consent.
Indeed, most of us would not even consider euthanizing a very young, terminally ill, human child; yet most of us would not apply the same standard to a dog (or other animal) of comparable intelligence. Perhaps this is because most of us think that human life is special in a way that nonhuman life is not. But, unless we can find some distinction that transcends our desire to prefer our own species to others, we run the risk of falling into "specism"-the discriminatory practice of making a special exception for one's own species. Some, I know, would make the distinction on religious grounds; but this is not likely to convince those who do not share the same religious perspective. In any event, I am seeking a rational argument, not one based on faith.
So, if, on rational grounds, we would be unwilling to accept any euthanasia policy that condoned killing a very young, terminally ill, human being, we are left with the problem of trying to justify such a policy regarding other animals of equal intelligence.
I am not saying that the justification for euthanasia in terms of ending pain and suffering is not a rational argument. What I am saying is that there is also another rational argument that cuts in the opposite direction. When I tell myself that I have done the most merciful thing for Bentley by having ended his suffering, I can see the force of what I am telling myself. However, when I conceive of him as the equivalent of a baby-a dependent, incapable of giving competent consent-I feel very uneasy about my decision.
I have often written about the importance of avoiding dilemma thinking-the sort of thinking that says you are damned if you do and damned if you don't. But I do recognize that there are some true dilemmas, that is, cases in which there really isn't any way to avoid the untoward consequences of casting a decision one way or the other.
The decision a devoted pet owner faces when deciding whether to euthanize a beloved pet can be such a decision. If you do not euthanize, then the pet who is suffering continues to suffer even longer. If you do euthanize, then the suffering ends but you affectively end the life of a dependent of yours who has the mental capacity of a small child and is therefore incapable of giving competent consent.
It appears that the only way to avoid the bad consequences of both horns of this dilemma is to find a palliative solution, that is, one that relieves pain and suffering and, at the same time, avoids having to euthanize the pet. In Bentley's case, I had tried a cortisone injection and an anti-vomiting injection as a last resort, but to no avail as the cancer continued to grow and diminish his lung capacity. Orally administered pain medications were no longer an option. I might have rendered him unconscious; but then what would the point have been to keeping him alive, except for not having had to euthanize him? The limited nature of available options was daunting.
My intent here is not to say which decision (to euthanize or not to euthanize) is "the correct" decision. Indeed, my point is that there is a rational argument both for and against each of these options. I know there are many who would see the suffering of the pet as their primary, overriding consideration; and still others who would find some way to explain away, ignore, or otherwise dismiss the argument against euthanizing. Yet, as an ethicist, I cannot discount the force of the rational argument against my decision to euthanize my dog. I wouldn't request euthanasia for a two-year-old, terminally ill, human child; so why Bentley?
To me he was not "just a dog." Like a human child, his life was inherently valuable, unlike an object that could be discarded or replaced. Like a human child, he depended on me for fulfillment of his basic needs, and had the capacity to make demands on me, and to give and receive love. He could perform intelligent acts including greeting me regularly at the door with a vocalization that sounded very much like "hello" (he had to contort his mouth in order to make the sound). He understood and responded intelligently to many commands; he could be stubborn but also aimed to please. Clearly, he had a range of cognitive and emotive capacities that marked him out as a distinct and very special individual.
So my having him "put down" (the words my vet used) was, in many respects, akin to "putting down" one's small child. Doing such a thing to this precious little loved one, even out of love, was for me almost unthinkable.
I have experienced great remorse, including guilt. This isn't to say that I am not now in the process of working through my grief. To the contrary, the process of working through starts with understanding. In my case, this involves coming to understand why, in the first place, I have experienced such painful emotions over having euthanized my dog. This means clarifying the ethical conflict underlying my decision, which is precisely what I have undertaken to do in writing this blog. Hopefully what I have had to say will resonate with and help some of my readers who have experienced a similar conflict regarding the euthanizing of a pet.
Sadly, most often, our family pets grow old and die before we do. Yet, even in their advanced years and on their death beds, they remain our babies, depending on us for their nurture. This is the existential plight we confront when we come to love and be loved by these wonderful creatures.