How A Veterinarian’s Experience Influenced Her View On Assisted Suicide

shelley fitzgerald

Veterinarian Shelley Fitzgerald with her friends, Eddie and Jackie Parlee.

One of the most fascinating aspects of the debate over Question 2, the Massachusetts “Death With Dignity” ballot measure on assisted suicide, is the outpouring of personal stories about our encounters with death and dying that it has brought. We don’t like to talk about dying. But suddenly, we’re doing a lot more of it than usual.

The stories that have arrived in the comments section of this recent post are moving, sometimes heartbreaking, always thought-provoking. One particular recent comment prompted me to ask the writer to expand. She had written:

The issues raised by this ballot question are faced by veterinarians every day. I can only speak for myself but I can say I have never enjoyed euthanising a client’s pet. However, I am glad the option is available. The word euthanasia means ‘good death.’ Perhaps veterinarians’ experiences could provide some clarification.

That rang so true that I asked for more. But first, an emphatic preface: This is a veterinarian sharing her thoughts and experiences, but that by no means implies that she is equating putting a pet to sleep with physician assisted suicide in humans. So please hold those objections. She is, rather, offering an insider’s valuable perspective on hundreds of experiences in which families choose to hasten the end of a beloved pet’s life. And facing head-on an issue that vets don’t talk about much, either. Deepest thanks to Westford veterinarian Shelley Fitzgerald for sharing this:

Roxie was a friendly and exuberant two-year-old Afghan hound cross who came into our clinic in 2003 for a small swelling on her cheek. The most likely causes were an insect bite, an infection or trauma. However, the swelling increased in size despite being treated with antibiotics, antihistamines and steroids. Roxie continued to be happy and eat well, but we and her owners were dismayed.

Ultimately the cause of the swelling was determined to be an aggressive form of cancer. We all knew Roxie and her family well, and everyone in our clinic cried when Roxie was euthanized because she could no longer eat.

I have performed hundreds of euthanasias myself and witnessed many more. After nine years, the details of Roxie’s case are still clear and painful. Yet I would not have wanted to see her live in her condition. I was grateful then and still am now that the option to end Roxie’s suffering in a peaceful and painless way was available.

As a veterinarian with 21 years of clinical experience, I have been following the debate over Ballot Question Two — which allows terminally ill patients to request a prescription for life-ending medication — with great interest. Let me first be clear that I am not equating pet euthanasia with human assisted suicide. But there are some similarities between euthanasia in the veterinary profession and the procedure proposed in the ballot measure.

For vets, the clash between perceived ethical and unethical actions which concern some physicians is not as dramatic. In fact, euthanasia is an accepted part of practicing for most veterinarians. Additionally, our roles as both consultant and performer of the procedure place us at the center of the process, and usually alone. Despite the enormous responsibility involved, I believe my charge to prevent and relieve pets’ physical suffering and their owners’ emotional pain has given me a greater respect for life.

One of the startling realizations on my first day of practice was that I would be treating members of the pets’ human families. My roles as medical consultant, confidante and decision maker were barely hinted at during veterinary school. One thing we did learn was to discount the weight of anecdotal evidence. Despite beginning this post with the story of one dog, my advice to families is based on the existing medical knowledge and the majority of the cases I have seen. There are always exceptions. However, when advising an owner whose Bull Mastiff has bone cancer regarding the dog’s reduced lifespan and imminent pain, I hope to be giving them information that will help them make the best decision for their pet.

In the ideal situation, we will have time to discuss the actual euthanasia procedure and disposal of the pet’s body beforehand, if the family is comfortable with this. One of the important goals is to make sure everyone involved realizes that they do in fact have some control over a situation where the disease seems to be the paramount determining factor. Their pet’s life does not have to end in intractable pain. One hopes that the ultimate decision can bring some peace with it.

One of the reasons that the ethical issues surrounding euthanasia are not as critical is that there is less potential for abuse in the veterinary world. The veterinarian has to agree that the pet is terminally ill and/or has a condition which makes it impossible for the family to live with and enjoy their pet. A large elderly dog with incurable incontinence living in a household with a crawling infant would be an example. The evaluation of cui bono (who benefits) is rarely needed.

It is especially difficult to euthanize a pet that one has known and bonded with for years. This is when another of those painful realizations hits. It is not about us, the veterinarians. When I was first in practice, I wished that somehow I would not have to be the one when it came time to put down one of my favorite patients. When I had more confidence and a better understanding of the big picture, I wanted to be there for the pet and the family because I was their doctor and death was part of my role in that pet’s life.

I am glad that Question 2 is appearing on the ballot for a couple of reasons. One is that it has made me realize how taboo these issues are even for us veterinarians to discuss. The other is the opportunity to recall situations where, though the result has been the inevitable death of a beloved pet, I have been able to, by the standards of my profession, alleviate suffering and provide some comfort to the pet owners I have known.

I will be voting Yes on Question 2.

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  • http://www.facebook.com/mdamdaol Michael Achey

    I have been a physician in practice for 30 years. I would say that folks like those whose stories appear below truly understand what “death with dignity” means and something more simple which is ending suffering. The option of “assisted suicide” is only one of a range of suffering relieving options that families and physicians would be able to choose when freed from the legal threat of a murder conviction. I have seen compassionate “assisted suicide” in my families’ travails and I can only wish that all families and patients would have the OPTION (not obligation) to choose this route without fear of reprisal.

  • T H

    It looks like our society is not becoming more compassionate toward our pets but rather less compassionate toward human beings. Why else would we consider assisted suicide before all other options are tried: palliative care, mental health counseling, etc.

    Question 2 just skips that: no psychological tests required, no family needed be told, no palliative care specialists need be consulted. We’ll have the compassion shown those dogs and cats!

    • gentlewomanfarmer

      Death with dignity is one of many options available to the dying person, but not the only one, and certainly not to the exclusion of the options you list. The question is “Who decides?” So I suggest that you rethink your analysis by putting yourself in the position of the dying person. You might wish the state and other strangers to become involved in your decision making process – requiring you to jump through various testing hoops, psychological and otherwise – but I bet you won’t when the time comes.

  • Maria

    It’s just disgusting that it’s considered ok to euthanize a pet for having, say, incontinence, because the family will no longer be able to enjoy this pet. (And it’s sad to read the thoughts of a veterinarian who talks about this so callously). On the other hand, might death be less traumatic than living with a family that “no longer enjoys you” and perhaps neglects or abuses you? Humans face a similar problem when they lose function. Neglect and abuse of elders is all too common both in families and institutions. Those who oppose letting terminally ill and elderly patients take charge of how their journey ends need to start thinking hard about how we can better protect our sick & elderly wholap end their last years powerlessly suffering at the mercy of others. With humans as with other animals, quality of life often declines dramatically once your family “no longer enjoys you.”

  • Tall_and_Sweet

    Another key difference between Question 2 and veterinary euthanasia is that the former does not provide for a trusted and long-time family doctor to assist. Animals still have it better! So to me, Question 2: good intentions, poorly written. Serious, unintended consequences.

  • jmlorimer

    I agree with vito33. A few years ago I had my 1/2 Arabian mare, whom I had bought at the age of 6 weeks, humanely euthanized at the age of 31. She was arthritic to the point where she would lie down and have trouble getting up. One day she went down in her stall and had to be dragged out on the Fire Department’s rescue sled. After that she just stopped eating. A good friend offered me a burial spot in her large pasture, so the vet met us there. She gave my old friend a sedative first, and then the euthanasia mixture. She quietly crumpled to the ground and breathed her last. Should I have waited and let her die of natural causes? Of course not. She would have slowly starved to death, or gone down and would not have been able to get up at all. She had given me 30 + years of pleasure and companionship, as well as thousands of miles on the trails. I owed her a peaceful and painless exit. I would wish the same option for myself.

  • vito33

    The unfortunate takeaway from this story is that many times we treat our pets with more compassion than we do each other.

    Anyone with an incurable disease, in intractable pain, and facing a horrible slog to the end, has every right to choose to die with dignity on his own terms.

  • Itapipoca

    I cared for my father in his last days when he came home for “hospice care”. That “care” meant that we were not allowed to give him more than spoonfuls of water and he could eat no food. My father, in effect, died of dehydration as well as the cancer that ravaged his body after 10 days at home. He clutched my hand as I gave him eye droppers of water.

    We were told that his death would be horrible if he were “full of water”. Is death by dehydration a kinder death? I gave him far more of the pain killer prescribed than was directed, and have hoped that I helped end the suffering of my gentle, patient, and still cognizant, father. I will vote yes on the question of assisted suicide.

  • InsightAtNight

    The veterinarian starts off claiming she doesn’t mean to equate pet euthanasia with assisted suicide of a person, but then she does just that.

    The standards of the medical profession are very different from those of the veterinary profession, as well they should be.

  • MargaretDore

    Pets don’t get to choose, the owner does. Ballot Question 2 is a recipe for elder abuse: see.www.massagainstassistedsuicide.org

    • Yoshi

      This is frankly bull (no pun intended). A basic tenet of the proposal is, as in Oregon, that no one will be given the prescription who is not of sound mind to request it and able to administer it unassisted to herself/himself. Question 2 is no more a recipe for elder abuse than nursing homes and other full-time care sites are kennels, and no ‘owner’ is threatening to euthanize the elderly – or anyone – without their consent. I also think that advertising your group’s website as a reference site without acknowledging your vested interest in it is dodgy dealings at best.

      • MargaretDore

        What about the greedy kids? Inheritance time. Read the bill. Once the lethal dose is issued by the pharmacy, there is no oversight. Someone could administer it to you while you’re sleeping (it’s water soluble and therefore injectible). Even if you struggled, who would know?

        As for my “vested interest,” I live in Washington state where assisted suicide was legalized in 2009. We have already had newspaper articles suggesting that we expand our law to direct euthanasia of non-terminal people. More disturbing was a column in the Seattle Times casually suggesting euthanasia as a solution for people who can’t afford their own care, which would be involuntary euthanasia.

        For more information, see my website at http://www.massagainstassistedsuicide.org/2012/10/ballot-question-2-whose-choice.html

        Be careful what you vote for.
        Margaret Dore
        http://www.margaretdore.com
        http://www.choiceillusion.org