End of life issues: what's best? What is most humane?
Last September, I experienced the death of a dear uncle. George had advanced pancreatic cancer that had spread to his liver and lymph nodes, and his doctors advised against treatment, which they said, would only make him suffer more. George's partner, and one of my sisters and I arranged to bring George home for hospice care.
George's healthcare directive clearly stipulated that, if he were ever unable to make medical decisions for himself and had no hope of recovery, he wanted to die without any life-prolonging measures--not even fluids or intravenous feeding. Medication to keep him out of pain was the only thing he wished.
We brought George home on a Friday, and hired a live-in nursing assistant to help us care for him. Since it was a holiday weekend, we were put on a waiting list for an "intake" from a local hospice; anxious, we had to wait several days for the hospice workers to come to the house to help us do everything we could for George. We were able to talk to the on-call hospice nurse over the weekend, and she provided lots of support and practical advice over the phone, but wouldn't be able to come to George's home until Tuesday.
As we made George as comfortable as we could, I couldn't help thinking about the deaths I had experienced firsthand. All were with animals; I was never present with a person who was near death. And all the deaths I attended--of a number of dogs and cats, a horse, and a dairy cow whom I had hand-milked for several years--were hastened by euthanasia medications. Never had I been present for a natural death; in each instance, I had opted to preemptively end the suffering of my animals.
As I watched George advance through the stages of dying, I found myself wondering: Is this kind? Is this humane? And I concluded that, yes, it was the kindest thing we could do for him. If he had been a dog, I almost surely would have arranged for a vet to come to my home to "put him to sleep," to "end his suffering." But thanks to pain medication, George did not suffer. He was home, with his partner at his side and his 20-year-old cat on her bed by his bedside. Those of us who loved George surely suffered, watching him fade from this world, but I know he did not.
On Saturday, George stopped taking the small bites of food he had accepted earlier in the week, and took only enough water to wet his mouth. By Sunday morning, he stopped speaking, though he was still responsive to us. On Monday he ceased to respond, and he passed away quietly that evening.
I used to think it is cruel that euthanasia is not available to people who are dying, the way it is for our animals companions. I used to think that a hastened end to my dying animals' lives was the most "humane" gift I could give them. I'm unsure about this now. What if the dying take an important spiritual journey as they pass from this life? And should our discomfort with death provoke us to speed it along?
"Hospice How-To" (page 19) will help anyone who is considering providing hospice care for an aged animal companion, or one with a terminal illness.
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|Title Annotation:||EDITOR'S NOTE|
|Publication:||Whole Dog Journal|
|Date:||Apr 1, 2006|
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