Saturday, January 28, 2012

A Funny Thing Happened in Oregon...

     Oregon is the only state in our nation that has legalized Physician Assisted Suicide.  On September 27, 1997, Oregon's legislature enacted the Death with Dignity Act which allows patients to self-administer a lethal dose of prescription medication, prescribed for that purpose by a physician.  The person must be at least 18 years old, suffering from a terminal illness and informed of the opportunity for palliative and hospice care as well as counseling.  Being elderly or having special needs does not qualify unless also combined with a terminal illness.  Two doctors must agree on the diagnosis and there is a 15 day waiting period between the written request and the prescription.

     I cannot count the number of times people have said, "If I had X,Y, Z Disease, I would want to die rather than suffer to the end" and "I am so grateful we are able to give the gift of euthanasia to our animals and can't believe we don't have the same right for people."

     But here is the interesting thing, according to the most recent statistics available (for the period from 1998-2010), after thirteen years only 525 people in total  had in fact used the Act to commit suicide.  In 2010, there were 65 deaths under the Act, representing 20.9 deaths under the Act per 10,000 deaths -- or 0.00209%.

     The most recent comprehensive report issued by the Oregon Department of Human Services (2005) indicates that in the first 8 years the Act had been in effect, a total of 246 people committed suicide under the Act as compared to 76,947  people who died in the same period of the same underlying diseases.  In other words, only 0.003% of people who could have elected assisted suicide chose to do so.

     This does not surprise me.  Those of us working in hospice see people dying every day who suffer in innumerable ways, lose the autonomy and dignity that are most often cited as the reasons for electing assisted suicide, and yet fight to stay alive as long as possible.  It's easy to say, and easy to believe, that we would want to die in that situation, but the reality is that when it happens most people do not.  The vast majority want to live.

     So what does this have to do with animal hospice?  

     I live in a state where physician assisted suicide is not legal for humans and euthanasia is expected for animals.  A perplexing situation for many.  If euthanasia is the most compassionate choice for our animals, shouldn't it also be true for our human family members?  If assisted suicide is morally wrong for humans, why is it the kindest gift for our animals who do not have the ability to express an opinion or make a choice?  Is there something fundamentally different about a dying animal and a dying human?  If so, what is it?  Is it a qualitative difference or a quantitative one?

     Although I am a big believer in our ability to sense  what our animals need and want, we do not have the ability to ask them what they want and have them respond in clear words for all to understand.  Research in the last 10 years has shown, however, that animals perceive and experience pain in very similar ways as humans do.  The leading thinkers in animal pain management today tell us to expect that anything which would cause us pain or discomfort will similarly cause pain and discomfort in our animals.

     Is it such a leap to suggest that if most people want to live as long as possible, most animals do also?  That if the vast majority of people given the opportunity to elect painless, simple, legal euthanasia when facing a terminal illness do not choose it, perhaps some (many? most?) animals would prefer to die in their own time, in their own home, with their pain controlled and their family at their side?

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