euthanasia

Human euthanasia

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This is a personal blog, filled with personal opinions, and it’s not that funny. Skip to the one about CPD if you fancy a chuckle, and, as ever, if you strongly object to an opinion of mine, bear in mind it was probably implanted by space aliens, so it’s not my fault.

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euthanasia
“Humans suffer as much, arguably more, than most of the animals we deal with, including when the time comes to die.” Image © Dan Race / Fotolia.

“We’re so lucky to have this,” the elderly woman says as she signs the form, trying to smile. “I had to watch my mother…”

She pauses, because she doesn’t want to think about that any more. She ruffles the fur on her companion’s head, and gives in to the tears.

“Not for you,” she says, looking down. “We won’t let you suffer any more.”

Variations on a theme

I wonder how many of you have heard variations on this during a euthanasia consultation? I find it happens often – so many people have lost relatives or friends in clearly upsetting ways. I know I’ve watched someone fade away, and it’s something I’ll never forget.

A large number of people spontaneously offer the sentiment above – that we’re lucky to be able to end suffering in the way we can with our pets.

Now, it’s true they’re a self-selecting population – by definition, people coming to have their pets euthanised are people who don’t object to euthanasia on ethical grounds. But agreeing with the principle of pet euthanasia doesn’t mean people should automatically agree with the principle of human euthanasia, although I would say (subjectively) the majority of them do. How many of you have had people whisper to you conspiratorially in the aftermath, for example: “I wish we had this for us, too?”

Unique

For what it’s worth, here’s what I feel: sometimes, there’s nothing left in life but to suffer and die. It’s not pretty, but it’s true, and it applies to humans as well as animals – this is because we, too, are animals.

We’re unique among the animals in a number of ways, mainly because of our large brains. One of these ways is, arguably, our capacity to suffer. If someone tells us our death is imminent and inevitable, and that we’re going to suffer every moment until then, our overactive imaginations will furnish us with a good idea of exactly what that will be like, adding a new dimension to the misery.

Another way we are unique is we can agree we do not wish to suffer in that way, and can ask for it to be brought to an end, although this is not something that can be done for humans in this country (both active euthanasia and assisted suicide are illegal under English law). Many of our patients will have a better end to their lives than you or I will.

It’s complicated

Now, I’m not entirely naive. Human euthanasia isn’t nearly as simple as pet euthanasia, for various reasons:

  • Other animals don’t suffer from suicidal tendencies.
  • Nobody is going to inherit a fortune if they convince a vet their pet needs to be euthanised.
  • It’s unlikely (although not impossible, especially in divorce cases or similar) people will want animals euthanised out of spite or hatred (and when they do, it’s usually to spite another human).
  • Religion is rarely brought up when animals are euthanised.

The sheer complexity of our lives means human euthanasia brings with it a whole range of ethical issues that muddy the waters. I acknowledge that, and understand it, but complexity is no reason to sidestep the issue.

He who suffers more

hospital
“Many of our patients will have a better end to their lives than you or I will,” says Nick Marsh. Image © Photographee.eu / fotolia.

As ever with me, it comes down to suffering.

I have dedicated my life (or, at least, the part of it that doesn’t play games, read books or watch TV) to relieving suffering, in any way I can. Humans suffer as much, arguably more, than most of the animals I deal with, including when the time comes to die.

I hear a lot about the “sanctity of human life” when I look into these issues, but this is a confusing phrase to me. Firstly, it’s often inconsistently applied, because some human lives appear much more sacred than others. Secondly, I can’t see why human life is more sacred than any other, except I happen to be human and have something of a vested interest in it being so.

Regardless, nothing – absolutely nothing – is sacred to me about pain, fear, misery and death.

Enquiring within

I suppose I have to ask myself a hard question, given the possibility for abuse of human euthanasia: what if someone is euthanised who would have recovered?

That’s a tricky one for me. I use the same argument in reverse for my opposition to the death penalty – what if someone is executed who wasn’t guilty? History shows this is what happens with executions, and there’s no reason to suspect that, every so often, someone would be euthanised who wouldn’t have died otherwise, and may have had many years of happy life ahead of them.

Statistically, given the number of animal patients I have euthanised, it’s likely some of them would have recovered, too.

Playing God

The look in people’s eyes when they say they’ve “had to watch” a relative die always leads me to think about my own experience. I think of all the suffering out there, the terrible ends to otherwise wonderful lives, and can only say that yes, I believe it would be worth losing a small percentage of people, who otherwise would have lived, to end the suffering of thousands more.

We’re very quick to say we have no right to “play God”, but we don’t seem to have the same compunction about going to war, which strikes me as a very similar thing.

My patients have the right to die without suffering. Why don’t we?


Comments

6 responses to “Human euthanasia”

  1. Hi Nick, thanks for writing this piece. Human euthanasia has been much on my mind recently as a very close friend of my sister’s was euthanased in Holland recently, where it is legal. I must say I was very torn about it – I think there exists a very real danger- particularly with elderly people, who feel that they are a burden – and maybe encouraged by relatives to think so (by benign neglect) – to make this choice, when maybe it’s not what they really want. So in principle, I think I would prefer not to see it legalised here, even though for animals I absolutely believe in it for the reasons you’ve outlined above. In my sister’s case, she was there at the end with her friend at his euthanasia having spent weeks helping with some other friends to nurse him (he had a very sharp decline from cancer). She believes in euthanasia for people. But she felt a very great burden – the euthanasia legal process appears to be slow – though I have only my sister’s experience to go on – there have to be two doctors involved in the sign off, your own GP and another doctor who goes around seeing patients and making the final decision – there’s a dutch name for them but I can’t remember it. This is their entire job. There is inevitable waiting involved for appointments and people to be available as it doesn’t all happen together. My sister’s friend suffered for much longer than he had wanted to or any of them had envisioned because of this waiting, and in the end, my sister and her friends had to actively petition the second doctor to sign off his euthanasia as by the time she visited, she claimed she saw ‘a peaceful deathbed’ and wasn’t going to give permission. She was only seeing a snapshot as my sister’s friend had periods where he was awake and suffering greatly. Arguing and trying to persuade the second doctor to sign off the euthanasia , because that is absolutely what her friend wanted, left her feeling very conflicted and upset – here was her friend she loved and didn’t want to lose and she was asking someone to sign a death warrant. In the end the second doctor consented, but then another two days passed while they waited for the first doctor ( the GP) to come back with a colleague and perform the euthanasia. That, I believe, did not go altogether smoothly and my sister cannot bring herself to talk about it. She’s been left very traumatised by the whole thing and is left with what will be no doubt a very complicated grieving process.
    I suppose what I’m saying is that, even in cases where it is a legal thing, it’s not straightforward. My sister’s experience might be unusual though, I don’t know.. But in the end, it was not as her friend wished for his final days, nor she either.
    But thanks for your blog Nick, it was very thought -provoking.

    1. Hi Libby, thanks so much for your input about a very sad and difficult situation. It’s interesting to hear the complexities of the situation – I suppose the huge amount of red tape is in place to try to prevent, or at least reduce, the risk of the ‘burden’ situation that you mention in the first part of your reply, and I think that’s inevitable; our relatively simple system of signing a consent form just can’t hope to cover the complexities of human euthanasia.

      Hearing all of that doesn’t change my thoughts on human euthanasia, however; it sounds like your sister’s friend had an awful, dreadful time while he was waiting, but in this country he would have had no alternative at all but simply to continue until his body stopped working, and I struggle to think that this is a better way round. I absolutely understand the risks of people being pushed into it, but personally I wonder how much that happens on a less extravagant scale anyway with our current system, where older people are sidelined and quietly, respectfully, fade away in nursing homes – read Alan Bennet’s excellent ‘Telling Tales’ for some insights here.

      Thank you again for your comments and openness. It’s very much appreciated and I’m glad sensible discussion can occur even in difficult areas like this.

      Nick

  2. Thank you for this blog, Nick. It is a very difficult subject, and you addressed well the problems that can arise when deciding whether a person will be euthanised or not. However, there are cases where it is only a matter of hours and people die slowly and in immense pain. Often, their families are left alone with this burden. A German friend of mine experienced this with her 88-year old mother, she held the dying woman in her arms for the entire night, watching her suffocate painfully. The doctor was willing to let her starve to death, which is legal in Germany, but it is illegal to put a quick end to a patient’s life. He was not at the deathbed, my friend was completely alone. After this experience, she wants to kill herself as soon as she receives the diagnosis of dementia, giving up time she could live happily to make sure that she won’t suffer in the end. There are many people doing that, some starving to death cruelly, just to put an end to their suffering, when society isn’t willing to discuss an important matter.

    Whether you are pro or against euthanasia in humans, society must begin to think about it. We have the power to prolong life (playing god, in a way, by keeping people from dying), so we have to face the responsibility of the consequences for the patient. Right now, too many people aren’t even willing to participate in a thoughtful discussion about it, closing their eyes from the suffering of others. Thanks for adding to this discussion!

    1. And thank you very much for you comments! Your awful story is mirrored, I think, across many people, but the quiet suffering and death of someone at the end of their lives doesn’t make many headlines, even though it is a fate that will await many of us. I’ve never understood the ‘playing God’ argument, myself – it seems to me to be inconsistently applied to whatever makes people feel uncomfortable (for instance, genetic manipulation of an embryo is ‘playing god’, but killing 100,000 or more civilians in a war, using antibiotics or wearing a condom isn’t (depending on your religion, of course) and you’re absolutely right. Nobody really wants to think, much less talk, about their own death – I suspect, on some subconscious level, we all secretly feel that it might not actually happen to us until we’re confronted with irrevocable proof that it is coming. The sad consequence of this cultural blind spot is that most of us will suffer as the mother of your friend did when our time comes.

  3. Ruth Eyre-Pugh Avatar
    Ruth Eyre-Pugh

    Hi Nick, only just found this blog today. I am looking for a vet who shares my beliefs about human euthanasia. Could you please contact me direct re an academic paper. Thanks so much, Ruth.

  4. Will Easson Avatar
    Will Easson

    Hi Nick,
    I wrote my Masters (Law) dissertation on human euthanasia two years ago. I found that while it’s a ‘paternalistic’ policy in this country (i.e. the Authorities are making the judgement that euthanasia is/is not in your best interests, and the patient has no say), it’s there because there is so much doubt about whether a patient is making the request ‘in sound mind’.

    If a patient is in unremitting pain then the law is quite clear; if you happen to die after receiving a large dose of (justified) analgesia, the doctor is protected by the ‘doctrine of double-effect’, and thusly it can be said that death happened as an unintentional but unavoidable consequence. What the patient mustn’t do though is ask for death. For someone to act intending death is murder, and asking for death could make a subsequent inquiry or investigator suspect that death was intentional. It can be tricky and detailed and pedantic to decide what was intentional and what was ‘double effect’!

    The really horrible situation though is where patients aren’t in pain, but know they are going to die – like some cases of motor neurone disease, where the patient is progressively paralysed and may drown or asphyxiate. I think I would rather die from a slow steady pentobarbitone injection than drown in my own spit.

    There are many concerns about making euthanasia requests fully legal – that people my die before errors or loopholes in law are spotted and closed, or that people may request euthanasia because of considerations other than their suffering e.g. a person feeling a burden on their family. This is further complicated by the thought that people of particular gender or personality types may be more susceptible to this thinking. Also in case law it has been noted that people who are depressed are mentally ‘capable’ enough to make decisions and can have their autonomy and decisions overruled by the courts. Many people with a terminal diagnosis are depressed (60-80% apparently).

    So I am totally with you – I think it should be an aim to make it legal (as it is in some US states, and some European countries), I can see why it isn’t, but that with care, consultation, and forethought it could become legal.

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