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March 20, 2008

When You Just Want to be Treated Like a Dog

In July of 2006, our beloved family dog Toby was put to sleep. Toby was a purebred cocker spaniel, and an amazing 19 years old. Over the years his hearing had mostly gone, and he'd developed cataracts in his eyes. His final year of life he developed arthritis, and walking was often painful for him. But we carried him up and down the stairs, gave him medications and painkillers, and could tell that the pain wasn't too bad; he still played, he still begged for attention and food, still stuck by my mother's side like he was glued there.

But in the spring of 2006, he developed a weeping sore behind his eye, and it abscessed, eating away the eye until there was just a bloody orb. The vets did their best to treat it, and my family paid the vet bills without thinking. At the time, my mother had just finished her best-chance round of chemo, and the very idea of having to make the decision to put Toby to sleep was one we wouldn't even discuss. "We don't believe in death" seems to be the motto of our house.

But when push came to shove, and it was clear that Toby's eye was gone and the infection raged on, when he stopped eating, stopped getting up, stopping trying to play, couldn't do much more than hobble carefully over to lay next to Mom for comfort, it was clear what it was time to do. It was hell, the sort of thing you don't want to do, but also the responsibility we take on when we have, and love, pets. Sometimes, it's time to allow them a quiet and pain-free death in the arms of those they love.

So that's what my father did, and it was a rough day. We lost Toby, we learned Mom's cancer was back. We had to start talking, then and more seriously, about how to treat Mom if and when her cancer progressed.

One of the first things I said to many people, when we found out Mom had stage four lung cancer, was that I was so very glad that my parents lived in Oregon. As a practicing Catholic, I didn't expect Mom to exercise the Oregon Death with Dignity Act, but that the option was there - I couldn't imagine having her hooked up to machines, existing in an in between state of life and death, fighting to die. That, if death was not swift in coming, if the pain became too much, if she could reconcile it with her own beliefs, there was a quiet and simple death available - it was mercy on the most emotional and basic level.

This is not, of course, the same as taking the family pet in to be put to sleep. That's active euthanasia - and given the lack of ability for Toby to take medications to end his own life, is understandable. But the fact that we have the option, at least in Oregon, for terminally ill patients to decide what and when is enough, when their quality of life is such that they would rather end it without further pain for themselves or others, and that we have not only the option but almost a social agreement that we it is the ultimate in compassion to put our animals to sleep when they are in pain, the story of Chantal Sebire is so sad, and so telling of how our priorities have become so out of line with our compassion.

Ms. Sebire had esthesioneuroblastoma, a terminal cancer that spawned multiple tumours in her face/sinuses. Bone tumours - disfiguring, emotionally difficult, and by all accounts, the worst sort of pain you can experience. She fought this terminal illness for nearly eight years, knowing it was a losing battle, and she finally had enough - she asked the French courts for help in dying, so that she could do it easily, well, without pain, without error.

The French courts said no. She appealed to the French president, who suggested that perhaps she get another opinion from other doctors. The French popular press rallied behind her, and many people began questioning Roman Catholic France's stance on assisted suicide - that they would be happy to place her in an artificial coma and let her then die over a period of weeks, without artificial nutrition and hydration, (a horrible option for her children and extended family) might not actually be as kind an option, or as moral, than letting her die a quick and conscious death.

Ultimately, the French courts didn't stop Ms. Sebire's death. They just prevented a guarantee of a peaceful and good death.

In at least one state, we've acknowledged that the terminally ill should have the right to decide when to die. And we have long acknowledged that it is our responsibility to ease the pain and suffering of our animals, to the point of ending their lives if that's what it takes. And yet, we still cannot extend that same compassion towards those who are dying in pain.

Normally, we consider treating someone like an animal to be derogatory, cruel. Yet in this case, it seems like it could have been the kindest thing to do.

-Kelly Hills


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Thanks for sharing your personal story and bringing the attention to Ms. Sebire. These are difficult issues for sure for any individual and family to face, with many subtle nuances. It is interesting that when discussing hastened death, some can talk about it as an act of kindness and love, and others see it as disrespectful and without any moral redemption.

I encourage anyone not familiar with the Oregon Death With Dignity Act to check out the annual reports to become familiar with it so that any arguments for or against can be made with some support of facts. the 2007 report just came out this week, and I posted a review of it over at Pallimed.

The use of the term 'active euthanasia' is not used in the medical literature any more, because of the confusion with the other term 'passive euthansasia.' Withholding or withdrawal of life support (ventilator, dialysis, etc.) has been historically mislabeled 'passive euthanasia' which is misleading since euthanasia is against the law in the US but the withdrawal of life support is allowable by law. So euthanasia is the introduction of medications by someone other than the patient with the intent of hastening death. the use of passive or active is unnecessary and more confusing. I hope that clarifies things a bit.

Yep - due to the international nature of the story, and the fact that a lot of the European outlets still seem to be talking in terms of active v. passive, I opted to keep that language. I dislike the word euthanasia, period, for the connotations it brings about - I'd prefer we simply talk in terms of letting people die,... which, I suspect, is simply too forthright for a lot of people to be comfortable with.

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