To ask why we apply end of life compassion logic to dogs but not humans

[NorthernRosie]

It struck me again today (whilst reading Tim Dowling's Guardian column!) that many people seem happy enough to believe that it's kinder to put down animals at the end of their lives to end suffering but when it comes to our own species the majority argue against people's right to make that decision.

After all an animal can't actually make the decision but a competent human adult can.

Why is this?

One reason I have heard is that once you declare something a right, the State has a responsibility to uphold that right for their citizens. If there is a 'Right to die', the government must make sure that people are able to die if they need it.

If you have a very sick patient, who has no family and is perhaps not able to communicate, the State will have the responsibility to make the decision on whether to kill them. How can you be sure they're making the correct decision? Or could they overrule the decision of the family in order to protect the person's right to die, even if they've not been able to communicate that that is their wish?

I assume it also means that if someone was suicidal you could not section them.

I do think we should have euthanasia however.

Putting a dog to sleep and doing so for a human is completely different, because a human may be in fear of what's coming, and a dog will be oblivious.

But if the human has made the decision themselves then surely the fear of being helped to die is, for them, less than the fear of being made to carry on the potentially long journey towards a painful and distressing death. This argument makes no sense

Exactly babyroobs. That is how siblings and I felt watching my dad die. It was really awful, distressing for him and for us.

I am pro elective euthanasia (e.g. I choose my end.). It is not illegal in many places, and actually legal in a few. As is assisted suicide.
Those places have strict codes of conduct. The policies seem to work by and large.

en.wikipedia.org/wiki/Assisted_suicide

My DM is not dying, but there is no way I would want to end up the way she is now (completely incapacitated by dementia, cannot move, cannot do anything at all independently). I would far rather be put out of my misery than 'live' like that. How we deal with that raises so many difficult questions though...

I think it's a combination of several things. There's the Christian view, that God chooses when we die, and there are Bishops in the House of Lords who (I assume!) would oppose assisted suicide.

There's the concern that elderly people will feel pressured to 'go' in order not to be a financial or emotional drain.

And then there's the ethics of the medical profession - how many doctors would be happy to end a human life? Though I'm sure that there have been plenty of doctors prescribing large doses of morphine, but ethically that's squared away as 'pain relief.' Though since Shipman I suspect that's now far less common.

We can legally commit suicide. The problem is we may lack ability to do it when the time comes. That is where the grey area is.

My Mum has dementia she is no longer able to make that choice.

I can very easily imagine people, especially the elderly, being persuaded into taking that option because it releases cash, a large house maybe - and frees the younger generation who have their own lives and children from the burden and expense of "caring".

A written legal document stating your wishes and plans in place before you get old or just in place anyway would be a good place to start if that is what you believe.

We cannot decide for others but we can persuade others to put this in place now - much like the organ donor scheme - so that should the worst happen we are in a better position to make our choice.

If it became commonplace it would be so much easier than it is now when someone has to play an active role to end someone else's life without being completely sure that the person so chose.

Not foolproof but it would be a start.

Because we are idiots. Because we are afraid to die. Because we don't want to think about it until it is too late.

That people have to travel abroad to end their lives with some modicum of dignity is appalling. Other jurisdictions manage it without everyone forcing their elderly relatives to kill themselves. We will manage it too. Just a shame it is so long coming.

Are there currently many cases of elderly people killing themselves in order not to be a burden on their families?

This is commonly stated as an argument against assisted dying, but I would have thought that families who would badger an elderly person into killing themselves would be doing this already - at least with assisted dying there would be (one would hope) close scrutiny of anyone who might seem to be trying to influence the decision of the person stating they wanted to die.

I think the human instinct to live, almost at all cost, is hugely underestimated in these arguments. It takes a lot to get to the point where you feel you've really had enough, and once the appropriate measures in terms of investigation of palliative treatments have been made, I do think we should believe people who express this as their wish.

Because it is expensive and time consuming to give a dog the care and medication which would allow it to die naturally without pain and in comfort and because we see dogs as less important than humans so we can dispose of them once they start getting too expensive and inconvenient to care for.

In a minority of cases a human may decide that assisted suicide would be preferable to a natural death. There are arguments for and against this.

But most human deaths are not like this and can be managed with good quality care and pain relief. Do you really think we should top everyone once they are on this path?

Theres a difference between me making the decision for myself and someone else making it on my behalf without my consent.

Also, what about people who have progressive degenerative conditions like Huntingdons? Shouldnt they have the right to die comfortably?

It's not always easy to tell when someone is dying. Several times I have known people to be 'dying' one day and say up eating breakfast and reading a newspaper 3 days later. Even very experienced professionals don't know, sometimes.

As this is a serious subject, Zombie will step out of character and speak properly.

This is a subject I've thought about a lot. As many of you will know, I have Stage 4 breast cancer. I had metatases on my liver which were surgically removed 9 weeks ago and I resumed chemo 10 days ago. Previously I was admitted to hospital at the end of last April with pneumonia. I had numerous complications and quite frankly it was very much up in the air as to whether I would survive.

I will face two critical decisions at some point.

Decision one will be if and when to decline further treatment. I'm very fortunate in many ways. New treatments are coming on line. I tolerate my current chemo pretty well. Once we got the dosage right the only real side effect I suffer is a few days of aches and pains. Those aches and pains can be severe. I always start medicating with paracetamol but on the bad days I also need to take morphine or codeine. One day my current chemo will no longer be effective. At that point my oncologist will recommend what she considers the best alternative for me to try next. Assuming I still have what I believe to be a good quality of life, I will then begin the new treatment. But the day will come when either there is nothing left to offer me or I will feel that the effect of the treatment on my quality of life is more than I can continue with.

With luck at that point I will still have a few months during which I can live my life to the fullest extent possible. Inevitably I will begin the final decline.

Decision two will be at what point during that decline might I decide that I don't want to go through the rest of that decline. When will I have had enough? I won't know until I get there. But when I do get there I want the right to request as painless and dignified a death as possible and for it to be possible for that request to be granted.

I've had an interesting life. Parts have been painful almost beyond belief. Parts have been more joyous than I could ever have dreamt. Most have been bumbling along day to day.

But most human deaths are not like this and can be managed with good quality care and pain relief. Do you really think we should top everyone once they are on this path?

In my experience, this is bullshit. The deaths I have known and the deaths my friends have told me about were NOT 'managed by good quality care and pain relief'.

My friend had to watch her father die over seven agonising days. She is still traumatised by it. She said - quite rightly - that if she had allowed an animal to suffer the way her dad did, she would have been prosecuted for cruelty.

Luckily my mum died quickly before things got much worse, but she spent her last few weeks in pain and it wasn't 'managed'.

Zombie - I hope you get to chose how you bring your life to a close. That you should have to linger and suffer because another person doesn't have the courage to face what you face makes me just want to scream and be sick. I too may face cancer coming back. I know that I won't be able to endure any more treatment. I would want to end my life with dignity. And for it to be MY choice.

Many doctors are too scared to give the necessary amounts of pain relief for fear of being accused of doing a Harold Shipman by some idiot.

It is not always managed as well as it should be,

I'll tell you what is really difficult to watch and something that makes me very angry.

Relatives insisting upon treatment of very frail, elderly folk who are suffering and in pain. Endless courses of antibiotics and being fed tasteless goo just so they can tell people their parent is still alive and make themselves feel better

Oh yes, and I've seen relatives insist that the terminally ill person isn't given morphine because it makes them sleepy and they then can't eat or drink.

Since when did it become a good idea for relatives to be able to make these decisions?

Be extremely careful about who you allow to make decisions on your behalf should you become incapacitated.

Make an advance decision in writing and lodge it with your GP and hospital medical records if you have them.

I work has a veterinary nurse, and so I deal with euthanasia of animals myself. I know what you mean, I've often uttered the same when I see an awful story of human suffering through illness.

However, I also see the impact it can have on the humans carrying out the euthanasia, and to an extent, felt it myself (although I only assist, I don't actually practice it myself). The veterinary profession has one of the highest rates of suicide and dealing with the emotional impact of euthanasia is often cited as one of the reasons. So I wonder if, in part, the reason it is not legal in this country is due to the ethical considerations of those left behind?

Then Tanni Grey-Thompson doesn't have to chose it.

I am disabled. She doesn't speak for me. She makes her own choice. Removing choice from the disabled doesn't actually make them any more protected against the perverse paternalism of the able bodied you know.

In fact I would say it does the opposite - you make disabled people again an amorphous lump whose fate is decided by others.

I gloss over the irony that you can't even be bothered to google her to make sure you have spelled her name as she would wish it.

The simple fact remains that I could kill myself right now if I wanted, so long as my disability extends to my leg and not my arms. But the moment I cannot end my life due to physically being unable to carry out suicide,I am left at the whims of my able bodied carers. This is a terrifying prospect - as Tony Nicklinson knew so horribly well.

I'm with Zombie so well put and so dignified. On another point I do not wish for any money I could leave the dc to be wasted on keeping me going day after miserable day. Also being blunt the nhs, social care etc is going to hell in a wheelbarrow we can't afford to care for all those ill elderly people so I would rather get out when I can rather than suffer budget cuts and scrimped care.

The media has a lot to answer for, truly. All the coverage of the Liverpool Care Pathway and they didn't seem to care about the truth, about seeking proper information, as long as they got their sensationalist headlines.

Down in the South, now, we don't have the LCP. It couldn't survive after the media onslaught. We have 'Achieving Priorities of Care' (APOC). The key with APOC is that it is used in the last days and hours of life, which means that somebody has to recognise that a person is in those last days/hours of life.

APOC is a document which provides a care plan to focus care on the comfort of the patient. Medical monitoring is removed (e.g. there is no point measuring a blood pressure if you aren't going to treat any abnormality -it's just an activity that makes a nurse feel like they are doing something). The patient is given food/drink only if they desire it, instead of forcing food and drink and keeping food charts. The patient is checked every 2 hours (if they haven't needed attention before that time) to make sure they are comfortable, but not subjected to unnecessary interventions. Medication is optimised -it is perfectly acceptable, legally, for as much medication to be given to control pain as necessary, even if the side effect is to hasten death. It's only illegal to prescribe medicines with the primary intention of hastening death.

Death is a process and we don't always get it right, but I don't know a single person that doesn't try their hardest to give their patient the best death possible.

I'm not against euthanasia in the right circumstances at all.

But I don't think you can use our ability to put pets down as an argument for it.

Yes, many pets are put down because they are suffering and there is no way they are going to survive.
But many others are put down because, in order to get better, they require complicated and prohibitively expensive treatment that is not necessarily going to extend their life that much longer.

In the second situation a human should not die, surely? I think we would easily end up in a position where it might be technically the person's 'choice' but in reality they would be thinking about the financial, emotional and practical burden on those they care about and 'deciding' to die rather than put others through that. Which I do think is wrong. Especially when those most likely to face those 'decisions' are the elderly and disabled.