Admittedly that title is provocative. In a sense, both the late Dr. Jack Kevorkian and I could be considered to be in the business of euthanasia (though I hope I will someday be remembered for far more), but the species of our patients differs. And that, as they say, makes all the difference in the world.
A few weeks ago, I reflected upon how euthanasia of my animal patients offers a glimpse into the debate over human euthanasia, and what trends may be portended by this ethically-accepted practice for animals if starts to become more widely-accepted when applied to humans. But why the distinction? Why do we look at this difficult but necessary part of a veterinarian’s work as a genuinely humane way to end animal pain and suffering but have such qualms about applying it to people? Perhaps it could be found in Leon Kass’s “moral wisdom of repugnance” or good old natural law? A few of my thoughts.
First, even the most strident of animal rights advocates could find that the technological and logical capabilities of human beings compel them to exert some superiority over non-human animals, if only to relieve pain when we see it. If animals have rights, others (specifically humans, who have the wherewithal to act upon them) have responsibilities to those animals. Even those like me, who find little practical use in using the language of rights for animals, can recognize the awesome powers human beings have for good and evil over the natural world, and thereby derive a responsibility to tend to the pain of those animals that cannot provide for themselves. Intellectually we have a hard time believing that we can legally take the lives of healthy animals for food or clothing (even if vegetarians dislike its practice) and yet have no authority to euthanize the gravely ill and dying. While the acceptable criteria for animal euthanasia may well differ (some veterinarians will not euthanize pets that have behavioral problems but are otherwise healthy, for example, whereas others will do so if a pet owner is just “tired of” their pet—that’s a subject for another time), it is well-respected as part of the veterinarian’s principal duty to “relieve animal suffering” as our oath states, and appears well within the ethical bounds of being a good and moral person. I read a piece by another veterinarian today that felt like our oath should well be extended to state “relief of animal AND HUMAN suffering,” as the process of slow pet death can be so poisonous to the human family enduring it. There is a certain restoration of wholeness that comes from the removal of that pain and perceived suffering in a creature that cannot understand it nor benefit from it (see my comments below). When people are given the freedom to address their pet’s AND their family’s quality of life issues, the relief is palpable. Though not ultimately my decision, I can ethically apply the “best interests” standard to both my patients and the human family and recommend euthanasia based on all applicable factors. For a physician to apply those same standards would be alarming.
Second, and obviously, I am not a “people doctor.” The medicine certainly overlaps substantially, but I have heard no one who realistically wishes to merge the professions. I’ve mentioned before that the Hippocratic Oath is primarily focused on healing disease, not relieving suffering, and euthanasia directly violates that. It is a primary reason (though not the only one) that the Oath is under such assault now. Whether we look at the Judeo-Christian view of anthropology as humanity made in the image of God or the secular idea that our species is distinguished by higher capacities than other species, there is an inarguable “otherness” to human beings. We have courts to help ensure justice, but certainly do not expect even brainy animals like dolphins and chimpanzees to do the same. Our fearsome capabilities to exert justice on one another limit, in civilized society at least, the role for taking the lives of other human beings to the domain of the state. As a veterinarian, I don’t need the courts to help me decide if the patient’s “time” has come, because I am acting entirely within ethical bounds and my own professional oath. For a physician, charged with doing all she can to heal disease in a patient, to usurp the role that legitimately belongs to the government and work to end a life is a horror, regardless of whether or not it is carried out in the name of compassion.
Third, the “otherness” of humans carries into the dying process itself. While facing the approach of death can, perhaps counter-intuitively, be a time of growth and transformation for human beings, a time to heal relationships and face eternity, there is nothing to suggest that such things happen in animals. I can find no redemptive purpose in prolongation of life in a moribund pet for the animal itself, but have observed that very thing in the death of a relative of mine, albeit a rather distant relative and as viewed via Facebook, as he very slowly died from cancer. His bad days were bad indeed, but his good days offered him and his family great joy as they treasured the sunsets and the breezes, enjoying the few days left on this Earth and gathering in what it meant for life after death. The privilege of dying with his family surrounding him, to themselves be able to impute his brave submission to a death that they might someday face, would have disappeared had a physician helped to sacrifice his life on an altar of compassion. That’s part of why our oaths are different, and why I can be a hero and why Dr. Kevorkian was decidedly not, even as we ostensibly carry out the same task.