Death and Decision

Early in my veterinary years, I watched a dog suffer death of renal failure for weeks.  I watched as the owner visited daily for long periods of time.  She cried and prayed over her dog.  She wiped its mouth while the dog drooled copiously due to the necrotic tongue and oral ulcers.  She helped to clean the vomit resulting each time the pet tried to drink water.   She tried so desperately to convey her love to the dog as it slipped into a coma.  I became angry at the owner. How could she witness this suffering and not consider putting an end to it?

Euthanasia is a gift.  I have long felt this way.  It is an act of kindness.

So often I am told by my clients, "I always wanted to be a veterinarian, but I couldn't put cute little animals to sleep."  I understand what they are saying...but it always makes me cringe.


I once thought euthanasia was the hardest part of my job.  My heart would race and I would struggle with ethical role I took in this process.  I was troubled by my lack of knowledge about my client's personal beliefs on the subject.  I was troubled by my own belief.

I believe that I am accountable for the lives I take.  I want to be innocent in the end. 

As I grow more mature in this profession, I admit that euthanasia has become one of the hackneyed parts of my job.  It no longer affects me as it probably should.  There are many times I euthanize a pet and it deeply saddens me, for the pet and for the family.   These are the ones where owners have exhausted all the options or where the illness is far too destructive to the pet's quality of life.  But, sadly, there are many others that I euthanize and I simply feel numb.  These are mercy killings.  Pets who would go home and suffer death due to lack of preparedness on the owner's part or, often and worse, simple lack of caring.  "I'm not spending that when I can get another one for the kids at the pound for $60.  Just get rid of this one."

Will I be judged one day for these decisions I make?  Will the good I have done be greater than the harm?  Do you judge me?

For those of us who do perform this service routinely, we have learned the coping mechanisms.  We see the sadness and disappointment in the eyes of our staff.  We make those inappropriate jokes so that at least we can change the emotion that is felt. 

"How much euthasol are you drawing up doc," They will ask so it can be recorded in the controlled drug log.

"10 cc.  I know, I know...it's a 70 pound dog.  Overkill, right?".  Puh dum pum.  Silence. 

I have tried to imagine my own death from a terminal disease.  I imagine myself lying in a hospital bed.  I think of myself as having lived the life that would have pleased God and my family.  I want to believe that because I lived that life, my Maker will take me quietly, peacefully, painlessly.

I am a realist.  I have seen it happen this way, but more often, I have watched as good people and their family repeatedly hit the button on the pump that dispenses the morphine.  I have heard the family cry as they watch a frail body toil to breathe for days until a tired body gives up a mighty struggle.  I don't want this for myself.  I don't want my family to see this.  I want someone who loves me and my family to step up and, with a loving gentleness, comfort me as they administer my overdose.  I want my suffering to end and my eternal joy to begin.  I want to be able to chose this when my options are exhausted.  Will the laws someday change?

"Eternal joy?," you may be asking.  So perplexing is the dilemma of being a christian in favor of a suicide option for terminal patients.  I have read some arguments on both sides.  Many say that we commit murder and interfere with God's plans and the greater good to be gained from the situation.  Others argue that perhaps this is God's plan or that the modality of death matters not, only the state of the soul.  I teeter cautiously between the two and lean toward the latter.  I believe we have been given a great body of knowledge and resources.  We have been endowed with a vast responsibility to use it for the good.   I believe that suffering death is not good but that it is something God permits.  I also believe God allows us to make choices.  I feel we will be judged on the use of our ability to sort through the clutter, to make choices, to seek out love and that which is right and good.  I believe putting an end to the suffering of a terminal patient is a good choice.

As a young boy, I spent a lot of time with my grandparents while my sister was battling blindness brought on by congenital cataracts.  While my parents were comforting her in hospitals, my grandmother was building dirt roads around a great tree in her yard with me.  We spent hours under that tree racing hotwheels.  We went fishing together in the creek near her house.  We filled book after book full of color with our crayolas.  We grew close and remained so. 

I will never forget one particular day she sat me down and read to me from the Bible.  This was a common occurrence...but on this particular day, Mamaw wanted to show me all the suicides therein.  Why impart this particularly adult subject matter to a child?  My grandmother had experienced a deep hurt from people who knew about her father. 

"When I was a young girl," she once told me, "my daddy told me that I had beautiful hair and he hoped I'd never cut it."  That is exactly what she did.  She loved her father.  I used to love watching her wash her hair in the sink and then sit in a straight back chair in the sun and toss her hair out to dry on the porch.  I loved watching her comb it....for it seemed each stroke would go on forever.  Then she would braid it in two sections and wrap it around her head.  She was and is one of the most beautiful women I have ever known. 

Her father was plagued with headaches.  These were terrible headaches for which, at the time, there were no adequate treatment.  One day her father took his gun to the woodshed and shot himself.   It was an act that profoundly affected her.  She never offered an excuse or a reason why she thought he took his own life.  The only thing I heard her say was that he had headaches. 

Over the years, as a preacher's wife, I don't doubt that she wrestled with the christian theories regarding suicide.  I never asked her opinion of whether she felt she'd see her father in heaven.  I didn't need to ask, because one day she sat me down with the Bible to show me every suicide it contained.  She showed me that Moses, Jonah, and Elijah wished to die rather than live, but did not act on it.  She showed me that Samson was a mightier conqueror in his self-inflicted death than he had been in his life.   She shared with me the assisted suicide of Saul, the Lord's own anointed. We read several passages that day, but we savoured Saul.  There seemed to be no moral dilemma, but a simple decision for these tragic characters.

She had been hurt by the words people had spoken and their opinions of her father's soul.  She loved me and was trying to spare me pain.  She took comfort  in these words.  On this day the root of my own belief took hold and began to grow. 

Thinking back to the owner of the dog in renal failure, I renew a familiar struggle with the issues of euthanasia and assisted suicide.  You see, she couldn't bring herself to euthanize her dog because she too had been in renal failure.  Only months prior she had been lying in a critical state in a hospital bed awaiting a transplant.  Though she had experienced the benefit of dialysis for years, she too had faced this very familiar death struggle.  Was she trying to be the comforter for this dog that she desired for herself?  She would not be offered the option of assisted suicide.  Was she watching her own demise in the form of her beloved friend?  Was she educating herself for her own future by permitting the disease to rage against the pet's life?  Was she hanging on to a belief that this dog, or she herself, had been good and long suffering would not be permitted?  Were we or was she a beneficiary of the greater good of this illness?  After her disclosure, I simply could not ask her reasons. 

I will not judge this owner for her decision.  The dog slipped away within a day of going into a coma, to the relief of all who were attending to her needs.  The owner was grateful for the care she and her pet had received, even though there had been glares from the caregivers and pleas from the doctors. 

We are all given choices.  From the abundance of our heart and breadth of our knowledge we will make our decisions.  We and our pets will live and die by these choices.  Perhaps we will love and be kind with these choices.  We must acknowledge that doing nothing is also a choice...and not the absence of one.  When it comes time to chose between two types of death, which will you chose...and will you have an option?