A veterinarian I know told me a story recently. She had given a presentation at a veterinary meeting about the process of caring for a terminally ill cat whosecaregiver did not want to euthanize, but instead wanted to allow the cat the natural death. My friend had talked to the audience of fellow veterinarians aboutmanagement of symptoms, treatment of pain, and attention to the complexities of palliative care for beings who cannot verbalize their wishes or their suffering in ways we can readily hear. A few days later, she received a long letter from a prominent veterinarian who had been in her audience. He derided her for her failure to properly care for the cat and told her that she was spreading dangerous ideas. “No animal should ever die a natural death,” he wrote. “No vet should ever see a natural death.”
But why not? Why is natural death wrong for our companion animals? Why is it a dangerous idea that animals could be—at least in some circumstances—kept comfortable and shielded from significant suffering as they live out their last days? And to turn the question backwards, why is euthanasia the unchallenged imperative in veterinary medicine?
There has been surprisingly little critical reflection on animal euthanasia. For a “procedure” of such profound importance, it is simply not given proper moral attention. Consider the fact that there are no books—not a single one—dedicated to exploring the moral terrain of euthanasia in veterinary medicine. There is one very interesting ethnographic study of veterinary euthanasia (called Blue Juice), but nothing about ethics. Yet euthanasia is arguably the most ethically fraught “procedure” in veterinary medicine; it is certainly one of the most significant, in terms of its end-point for animals and in its potential for emotional fall-out among caregivers and professionals.
Nor have I been able to find any discussion of the historical development of the practice of euthanizing animals. One of the only references to euthanasia’s history in veterinary medicine is in Lagoni, Butler, and Hetts’s excellent book The Human-Animal Bond andGrief. They say simply, “it has just always been there” and that’s about as much history as we have.
Nor has there been a consideration of the relationship between euthanasia of companion animals and physician aid in dying for human loved-ones, despite obvious similarities and glaring differences.
Just how established is the preference for euthanasia? A search through the Veterinary Information Network database is revealing. There are close to 5000 entries for “euthanasia,” and a mere 186 for “hospice.” Even “quality of life” only generates 674 entries. “Palliative” gives us 305; “palliative sedation” is never mentioned in the context of veterinary care. Unless I’ve missed something, none of the 5000 entries on euthanasia gives an account of the historical development of this practice (why do we kill the animals under our care?). The vast majority have to do with technique, or with the practical application of the technique in various settings. A handful of entries relate to ethics and euthanasia, but each and every one of these is focused on a particular “hard case” (e.g. the pet owner who refuses to euthanize a sick cat; the dreaded “convenience euthanasia”).
I’m not sure how widespread is the sentiment expressed by the letter-writer in my opening story—that euthanasia is an ethical imperative, and that allowing an animal to die a natural death, under any circumstances, is cruel. But anecdotally, I’ve heard it expressed on a number of occasions, not only by veterinarians, but also by pet owners and animal welfare advocates.
It is time to challenge the euthanasia imperative. I am not arguing that euthanizing an animal who is suffering is wrong; it can be an ethically justifiable choice, in my opinion. But we desperately need more open discussion of when euthanasia is ethically appropriate and when not—and a greater moral resistance to those situations in which it is not (such as the pet owner who wants to dispose of a healthy animal) and more nuanced discussion of those situations in which there really are viable alternatives to euthanasia, such as hospice and palliative care and veterinary-assisted natural death. Allowing an animal to die naturally—with appropriate support—is not a dangerous idea.
(P.S. If you know of any careful ethical examination of animal euthanasia, or any history of how the procedure came to occupy such a central place in veterinary medicine, please let me know.)