Jane Hunter

Background

Euthanasia and death has been with me since the age of twelve when I comforted our dying cat and the vet came and took her away. I didn’t want to lose her but I did not want her to suffer. What I witnessed during my formative veterinary years has stayed with me – that it is the quality of life which is important. This is what an owner and vet have to decide; is it better for the animal that its life is ended? But I am aware that when a person is suffering and repeatedly requesting assistance to die there is no procedure in place to allow that to happen, even if they are of sound mind and there is no hope of betterment in their condition.

Veterinary opinion on euthanasia and guidelines

The Royal College of Veterinary Surgeons Guide to Professional Conduct states that a vet must treat all patients with respect and attention to their welfare. Welfare can be assessed in relation to the ‘Five Freedoms’ : freedom from hunger and thirst; freedom from pain, injury and disease; freedom from discomfort; freedom to express normal behaviour and freedom from fear and distress. A veterinary surgeon must not cause any animal under their care to suffer, by failing to maintain adequate pain control.

Present situation

As a veterinary surgeon, owners often comment when their pet has been euthanased that they wished people were allowed the same respect, compassion and assistance to end their own life peacefully. A friend of mine, who was suffering uncontrollable pain and paralysis due to a spinal tumour, believed, as Margo MacDonald MSP has stated, that “a person has the right to make end of life choices unrestricted by the moral, cultural, religious or personal beliefs of others”. He knew that if he was a dog he could be put to sleep and only wanted the comfort of knowing, that should the day come when he had had enough, he could be afforded the same dignity.

Quality of life and pain control

One-third of the UK population die from cancer, with 80% experiencing severe pain during the final year. Pain control with reliance on opiates is usually helpful, with morphine used for moderate to severe pain. However, around a quarter of patients who receive morphine fail to obtain adequate relief or experience unacceptable side effects.

I witnessed the effects that post-operative morphine had on my mother after surgery for bowel cancer. She was hallucinating and convinced that I was lying dead in the next bed and that the nurses were trying to kill her. Later she was deeply troubled by her behaviour; she remembered every detail and considered the mental distress she had experienced far worse than any physical pain. A friend who also died from bowel cancer recollected his father hallucinating with the effects of morphine and was terrified the same might happen to him. Where terminal sedation is the only option for people, why can they not be allowed to receive help to hasten their death?

A few months later, my mother died peacefully having experienced little pain. She was unconscious for five days, a fan by her bedside trying to dispel the smell of ketones on her breath as her body degraded. I was aware that an animal would not have been kept alive in that condition.

A professor of veterinary pharmacology wrote of the experience of watching his wife die slowly from pancreatic cancer and concluded, “it is not death that most people fear, but the circumstances of death. We cannot control the length of our life or the cause of our death but we should be allowed, as far as possible, to control the circumstances”. He had to stand by as the side effects of medicine prolonged the suffering associated with his wife’s disease; as she was reduced to a passive body in nappies unable to communicate, in pain which was sometimes uncontrollable, confused and semi-comatose. “The law did not allow the tortured semi-coma to be eased into permanent peace [unlike their dog], despite the absolute certainty that no form of recovery was feasible”. He agreed with people who say we put a higher value on human life than animal life. But stated “that is exactly why we should no longer tolerate the obligation to impose greater cruelty in the clinical management of death for human beings than we would accept for any other species. The Home Office would prosecute those responsible if laboratory animals experienced similar deaths and protesters would be out in force”. He asks “why can painkillers only be used to postpone the inevitable instead of ushering it in with tenderness and dignity?”

Veterinary euthanasia

On a veterinary practice website the process of euthanasia is described as a final act of kindness and “in a strange way the beauty of veterinary medicine over human medicine is that we ensure quality of life, rather than extending the life no matter what the quality”. It is very much the owner’s decision with the support of the vet and they are advised to plan ahead as to where and when the euthanasia is to be carried out. A consent form is signed and the owner decides whether to be present. The procedure is explained and is simple and quick, where an overdose of anaesthetic is injected directly into the bloodstream

As a vet I aim to be compassionate to both the animal and owner and I cannot imagine how I would cope seeing a loved one suffer and for them to be denied a compassionate release. As a vet I have to provide care for an animal throughout life from birth to death. Why should we stop short of that for people?

The way forward

Whether or not to provide end of life assistance is an ethical question for our society. The End of Life Assistance (Scotland) Bill was rejected in 2011 by 85 MSP votes to 16 but we now have a new Bill. With a new set of politicians in place, it is time for us to speak up and enlist the support of friends and colleagues if we want to change the law. We need to decide as a society – do we go on turning a blind eye and keep things as they are -- or do we change them for the better?

I believe that Scotland can bring about that change. We should not leave desperately unwell people to struggle off to Switzerland to end their lives prematurely, for fear that if they wait they will not be able to make the journey. Will we face the truth now and be brave and compassionate enough to allow assisted suicide as an option for the small minority of the citizens of this country who will request it?

If we truly care for those around us we have a moral duty to allow that last kindness.

What can we do?

If we want to help ensure the Assisted Suicide (Scotland) Bill 2013 is passed we need to make our voices heard. We must press our politicians to support a change in the law andjoin the campaign “My Life, My Death, My Choice” in support of assisted suicide (www.lifedeathchoice.org.uk). We must encourage others to join the campaign by signing the petition; contacting MSPs; getting people talking and writing about their experiences and thoughts; organising discussion meetings and engaging with the wider public.


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