10 Apr Euthanasia: The Most Painful Decision
by Moira Anderson Allen, M.Ed.
Many think of bereavement as beginning after loss. For many, however, grief can begin much earlier. Often, it begins the day you realize that your pet is approaching the end of its life — even though the final loss of that pet may still be many months distant.
This stage of grief is especially difficult, because it is without closure. You can’t make an effort to “get over it” or “feel better,” because the loss itself has not occurred. Thus, no matter how bad you feel, you know that things are just going to get worse. It can be difficult to find comfort during this stage, for even people who understand the pain of bereavement may wonder why you are grieving before your cat has actually died.
Grief for impending loss is complicated by the need to make difficult, painful decisions. How much treatment should you pursue? At what point will treatment cause more trauma than relief? Can you provide the care needed to keep your pet comfortable — and will your cat reach a point where no amount of care can do this? At what point, if any, should you consider euthanasia?
Sometimes circumstances don’t give you time to ask such questions. An unexpected illness might give you days (or at most, weeks) to consider these issues; an accident or injury might leave you with hours, or even minutes. Whenever possible, however, it’s best to develop a plan, taking into consideration three basic issues:
1) When should you consider euthanasia? When your pet is ill, this may be the last question you want to think about. Yet it is the most important question you may need to answer.
Start by asking your veterinarian what types of symptoms to expect as your pet’s illness progresses. What stages will the disease take? How long before kidney disease produces incontinence or renal failure? How long before tumor cells invade the lungs or other organs? How long before symptoms become medically unmanageable, before pain becomes severe and untreatable? At what point will your pet become unable to function normally; at what point will its suffering become extreme?
This information can help you form your plan. For example, you may decide to seriously consider euthanasia when your pet can no longer breathe easily, or eat or drink, or find a comfortable position in which to sleep, or when it seems to find your touch painful. By defining a “decision point” in advance, you place boundaries on the suffering your pet is likely to endure.
2) Will you be there? Many people feel it is important to be present during euthanasia. Many others feel unable to handle this traumatic event. And make no mistake: Witnessing the euthanasia of your beloved companion IS traumatic (though it can also help allay fears that your companion suffered). This is not a decision to be made lightly, or based on someone else’s choices.
Most feel that the pet’s well-being is the most important consideration. If you believe your pet will feel more comfortable or secure in your presence, you’ll probably want to stay, no matter how difficult it will be. On the other hand, if you’re concerned that your own reaction and grief may disturb the pet more than the process itself, you may prefer to stay away.
If you choose not to be present, don’t simply leave your pet with the veterinarian. Some clinics hold “to-be-euthanized” pets until after clinic hours, which simply adds to an animal’s trauma. Make sure that your pet is going to be euthanized immediately, while you wait in the waiting room or car.
3) What will you do next? The worst time to decide what to do with your pet’s remains is at the last minute. It’s far better to begin discussing options weeks in advance. Indeed, even the owner of a perfectly healthy pet can begin considering the answer to this question at any time, particularly if you want to make special funeral or private cremation arrangements, or want a particular type of funerary product (such as a special urn or casket).
For many, this decision involves both physical and spiritual issues. How do you (and your family) distinguish between body and soul? Do you feel that your pet will be “closer” to you spiritually if its remains are close to you physically (e.g., in a cremation urn)? Do you feel that your pet’s spirit will be happier if it is interred in a familiar, beloved location? Or do you feel that your pet’s soul and personality are not associated with its physical remains, which you’re quite happy to leave with the veterinarian? There’s nothing foolish about such considerations. For many, the certainty that they have provided for their cat’s spiritual needs can go a long way toward healing the spiritual wounds of the owner.
Myths About Euthanasia
Many people have mixed feelings about euthanasia, for good reason. No matter how well-intentioned we may be, this act feels like murder to many of us, and guilt may often haunt us long after the act.
Even when we know intellectually that euthanasia may be the “best” or “most merciful” choice, that means little when we face the decision itself. Many pet owners cling to misperceptions that provide apparent justification for postponing this decision — often at the expense of the pet itself. Three common misperceptions include:
1) Euthanasia isn’t nature’s way. Some pet owners reject euthanasia as “unnatural.” Nature, some say, has a timetable for every life, and by artificially ending a life, we’re disrupting nature’s plan. While charming, this belief overlooks the fact that by providing treatment, surgery, medication, or any other form of care for a sick (or injured) pet, we are already extending that pet’s life far beyond what would occur if matters were left in the not-so-tender hands of “nature.” Euthanasia is often not so much a question of “artificially ending” a life, but of determining when to cease artificially extending that life.
2) Euthanasia is selfish. One of the commonest sources of guilt is the belief that one has euthanized a pet “too soon” or for “selfish” reasons. “I should have tried harder,” many tell themselves. “I should have been willing to do more, spend more, get a second opinion, stay up all night to take care of her.” Yet the person who worries most about not having “done enough” is often a person who has already gone to superhuman efforts to care for that pet. A far more dangerous form of selfishness is to prolong a pet’s suffering simply to postpone one’s own.
3) My pet will tell me when it’s “time.” Many of us have heard of pets who allegedly offered some indication of acceptance of death, of being “ready to move on.” And who among us would not welcome that sense of being granted “permission” to end a pet’s life? Such a “signal” would remove the dreadful burden of having to make that decision on our own. Unfortunately, for many that signal never comes. By convincing ourselves that our pets will “tell us” when it is time to die, we risk two hazards: Prolonging a pet’s suffering by waiting for a sign that never comes, or torturing ourselves with guilt for acting “too soon.”
The painful truth is that if your pet is terminally ill, and especially if it is suffering and unable to function, it will die; the decision you must make is not whether its life will end, but how, and how much discomfort you are willing to allow it to endure. Stefanie Schwartz, DVM, sums up the issue in one vital question in her book, Canine and Feline Behavior Problems: “Which choice will bring you the least cause for regret after the pet is gone?” Unfortunately, “no regret” is often not an option.