Saturday, May 14, 2011

Quality of Life and Selfishness

     Whenever I talk about end of life care for animals, two things inevitably come up right away:

          (1)  The animal's "Quality of Life"; and
          (2)  The concept that "keeping" an animal alive is done only for the benefit of the human and is therefore selfish.

     Frankly, I think both concepts get in the way of providing the best care we can for our animals and hamper our ability to do the right thing for them.  Here's why:

     Let's tackle the first and trickiest one - quality of life.  It almost goes without saying that no one wants to live without a certain quality of life, that quality is more important than quantity and that at some point we would rather die than persist in life.  But really, what does that mean and when it comes to our animals, how do we know?  And often more perplexing still, who are we to judge and how will we make that decision?

     The question of quality of life usually includes factors such as:

          - is your animal playful and interactive?
          - is your animal eating and appearing to enjoy food?
          - is your animal losing weight regardless of how much they are eating?
          - does your animal sleep a great deal?
          - does your animal appear to be in physical pain?
          - does your animal appear to be happy?
          - if you were your animal, would you want to continue living in this state?

     But here's the problem - many of those factors are indicators of aging and dying in the normal progression of life.  To label them "abnormal" or a reason for euthanasia only further perpetuates our unwillingness to be present during death and dying.  Dying can be difficult to watch and it is easy to project unacceptable suffering onto a being because of our own discomfort observing the process.

      Let us be clear: physical pain must always be addressed and alleviated, illness and injury treated to the very best of our abilities and kindness and compassion always infused in all of our care.  The decision of whether and when to euthanize is a complicated and personal one.  It is a decision not to be taken lightly or made from a place of fear or guilt.  When the decision comes in connection with the normal aging process or in connection with the end stage of an illness, the decision to euthanize is not an emergency and does not require a quick decision.

     At New England Pet Hospice, we are asked all the time, "How will I know when it's time?  How do I make that decision?"

     To us, the answer lies within your relationship with your animal.  Take the time to shut everything else out.  Stop listening to what the world thinks you should do.  BE with your animal.  Look in his or her eyes and trust that the feeling in your gut which tells you which way to go.  And if you hear nothing - wait.  When you animal wants to leave this world, you will know.  Trust us.

     An elderly or terminally ill animal, just like an elderly or terminally ill person, is on his or her own journey through life and into whatever comes next.  Aging is not a failure or a flaw.  Death is normal and natural.  Just as birthing is messy, complicated, often not pretty and sometimes frightening, so is dying.  We may sometimes need to deliver a new life through Cesarean section, but we do this not to avoid the messiness of birth or our own discomfort watching it.  The same is true for euthanasia: it is sometimes necessary, but is not (or at least in our view, should not be) a foregone conclusion in every case.

     It may help you to imagine your animal is your beloved grandmother or grandfather.  If all your grandmother could do was sit in a bed in the family room, watching the comings and goings of the family, comfortable and not in pain, but without interest in food or going out to play ball with you - would that be enough? If she had no pain, complaint or agitation, would you feel her suffering to be so great that you were morally obligated to end her life (assuming, of course, that it were legal to do so)?

     We are not opposed to euthanasia.  We are opposed to making life and death, irreversible decisions based on fear or innocence, pressure or confusion, lack of information or inexperience with aging and dying.  Remember, aging is not the same as suffering, dying is not the same as failure, and most beings would chose a certain reduction in quality of life over death.

 Next time, we will write about the persistent myth that failing to euthanize your animal on the schedule prescribed by someone else is somehow unfair or selfish.  


  1. I think some people resist considering this way of looking at euthanasia decisions because of guilt over past decisions made based on older ways of thinking. I know that's been true for me.

    Thank you for continuing to encourage us to open our minds -- and hearts -- to new ways of looking at this.

  2. Excellent point, Marcella.

    We are not here to judge anyone. We believe with all our hearts that loving animal caretakers make the best decisions they can at the time with the information and resources available to them. Regret and guilt are destructive emotions that impair our ability to live a full and rich life now and make good decisions in the future.

    If this post, or any other, raises feelings of guilt or regret for you, allow yourself to feel those feelings, then let them go. Be gentle and compassionate with yourself. You loved your animal and you did what you thought was right at the time. No one can ask any more of you. Your heart was in the right place and you acted out of love. There is nothing to be ashamed of or feel guilty about.

    - Heather
    Founder and Team Leader
    New England Pet Hospice

  3. Great post Heather - the line that really struck me is "Remember, aging is not the same as suffering, dying is not the same as failure, and most beings would chose a certain reduction in quality of life over death".

    It's such a difficult decision to make, and guilt plays such a huge role.

  4. I wish I had read this before I had my cat euthanized. I'm guilty of just about everything -- panic, lack of information, fear, confusion, and total loss of perspective. I hope she forgives me. I miss her and can't stop thinking about my poor decision.

  5. I'm so sorry for your struggles, OwlWatcher. I am certain your cat forgives you and knows you have done everything from a place of love, wanting to do what is best for her. Very difficult decisions under very difficult circumstances. I would be pleased to send you some supportive materials.Please e-mail me at heather @ NewEnglandPetHospice . com and I will get them right out to you.

    I hold you and your cat in my heart and wish you PEACE. There are no perfect decisions in this case, only the best ones we can make at the time with the information and resources we have available to us.

    With sincere condolences and warmest wishes,

    Heather Merrill, CT
    Founder and Director
    Certified in Thanatology: Death, Dying and Bereavement
    New England Pet Hospice & Home Care