The End of Life Dilemma

Is Euthanasia a Dirty Word?  Perhaps for Humans.......

Our white boxer Deuce had two black spots on his head.  He also had one testicle.   I joked more than once that he should have been named "Ace".   Deuce and his littermate Howie had two very different personalities. While Howie seemed more calm and thoughtful, Deuce was always energetic and fun loving.  When Deuce began losing weight,  I took him to the vet for a checkup   I did not know it at the time, but this was the beginning of the end for Deuce. 

A month later, Deuce had received the best care available to aggressively treat a diagnosis of advanced Lyme's disease.   In spite of heavy daily medication and over a week at the veterinary hospital receiving intravenous medications, Deuce continued to lose weight.  Every time I broached the subject of euthanasia  with his veterinarian, he told me "if I was a dog, I'd want an owner like you - willing to do anything that you can to save your dog's life".  However, after a month of medication and weight loss, Deuce looked like a walking skeleton and was obviously feeling terrible.  I took him to the vet again, and was quickly shown to an examining room.  Deuce and I waited together for the vet.  I petted him, told him what a good boy he was, but I could tell he just felt miserable when he walked over and leaned his head in the corner and stood breathing shallowly on shaking legs.  The vet came in, and told me once again what a great owner I was.  However, the suffering I saw in Deuce prompted me to be more insistent.  "Doc", I said, "feel this lump behind his ear".   I saw the expression change in Dr. Dave's eyes as he felt the lump and said "I'm really sorry, but I have no doubt this is cancer .  Boxers, particularly white ones are prone to cancer and Lymes disease is often a precursor".

Ten minutes later, I was stroking Deuces head and telling him it would be OK while he lay on the on the examining table.  I tried not to look when the the vet-tech injected the chemicals that would end his life, but could not help myself.  With a diagnosis of cancer and the amount of his suffering, there was no question in my mind this was the right decision.  Yet I cried like crazy when Deuce took his last breath and softly exhaled - I did not want to see his life end.

Dr. Jack Kevorkian repeatedly made headlines when he assisted terminally ill humans to make their own end of life decisions.  While his actions eventually led to being thrown in jail, his hope was to shine a light on the indignities most terminally ill patients suffer when receiving end of life healthcare.  According to Medicare, one out of every four Medicare dollars is spent on the 5% of beneficiaries during the last year of life.  On average, more than 40% of patients in academic medical centers see 10 or more doctors in the last six months of life.  Speaking from personal experience, I watched my seventy-five year old grandmother that had been diagnosed with terminal cancer decline over a period of months.  She was medicated for pain to the point of unconsciousness in the final month of her life.  I would not have subjected Deuce to the suffering my grandmother endured.  Yet, I was forced to watch her as she became a pain-wracked, heavily drugged shadow of the person she had been.  The bills my grandfather received from the hospital were voluminous, and included dozens of needless tests and procedures - even including a pregnancy test.

The state of health care today in the U.S. forces hospitals to generate large amounts of revenue per patient to remain in the black.  End of life patients are primary revenue generators.  Trillions of health expense dollars annually are at play if we were to change policies on assisted suicide for those suffering in the last months of terminal illness.  It is no surprise then that the bulk of the medical community remained mute while the U.S. media painted Dr. Kevorkian  as an out of control, crazy doctor with a desire to commit murder.

Nearly half of terminally ill patients are likely to have their life savings wiped out, leaving nothing for their spouse or descendants.  Is another month or two of suffering with a terminal illness worth the emotional and financial cost?  I would advise you and your families to make your own decision on this subject, but legally you can't. I am glad  Deuce was not human and that I could choose to help end his suffering.  Today I remember his life as mostly filled with joy, with a minimal period of acute discomfort at its close.   I hope someday, if I am diagnosed with a terminal disease, that I might have painless options available to me to leave this life a little early and skip the intense suffering like our dog did. 

Opponents to assisted human suicide are quick to ask "where do we draw the line to avoid potential abuse?"   While the answer to this question is not readily apparent, it is clear that the line, such as it is, is currently drawn to ensure intense physical suffering and maximum financial charges are incurred by terminally ill human patients.  The abuse of our terminally ill loved ones is already occurring.  For now at least, the law still allows us to use our judgement regarding end of life decisions for our pets.