Saturday, December 24, 2011

A Lethal Injection

I entered the exam room as an intravenous catheter was being inserted expertly. The procedure had been explained to me. I wanted to be there to comfort my friend in his last moments. Life had been getting difficult and the infirmities and pain too severe. The doctor entered the room with an appropriate look of sympathy on his face and reviewed the case agreeing that my friend's quality of life was severely impaired.

The sodium pentothal was slowly injected IV. I saw a questioning look on my friend's face, he then slumped to the table and died. Being unconscious, his breathing almost immediately stopped, then the heart beat ceased a few minutes later. It seemed so fast.

I loved my friend, my companion, my dog. We walked in the park or on the beach every morning. He greeted me, my wife, my children, and my grandchildren each day like long lost friends. His goal in the yard (thus in life) was to be protective seemingly at all costs.

Today we grieve, but not like when I lost my mother or father, or when I lost a patient. It's a mixture of sadness for our loss, but contentment that he didn't suffer and could have a peaceful end.

Many patients over the years asked me for a peaceful painless end. Before hospice and palliative care, a patient would often sense abandonment or a loss of control at the end saying, "Doctor, my dog was treated more humanely at the end than my father was." Ironically, my experience today has brought me to question how humane we humans really are in our treatment of each other at the end. Do we have lessons to learn?

5 comments:

  1. I'm sorry for your loss. I am a veterinarian. More than one client has asked me in jocular fashion if I could put THEM to sleep as they have neared the end of their useful chemotherapy or whatever. From their responses when I have declined to do so, I don't think they were all kidding.

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  2. Merry Christmas & new year! I too have had the experience of eurhanizing a dog. As a physician myself I am of the opinion that ( in all aspects of medicine ) the primary goal should be thr relief of suffering - both physical and emotional. This does NOT necessarily equate with euthanasia but may of necessity result in death whilst providing relief from suffering. With the mindset and goal of achieving relief from suffering through use of standard methods and always following legally acceptable procedures,, I think that many dilemmas can be resolved with a clear conscience.

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  3. Tory@allthingscaregiverDecember 26, 2011 at 1:48 PM

    I am very sorry for your loss. This was often a topic of discussion among my family as my mother suffered from cancer. Both my mother and one of our dogs had cancer mets in their bones. When the time finally came, we were able to euthanize Austin (sweet dog), and end his suffering, while mom continued to allow " life" to run it's course.

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  4. Boy, has entering hospice caused me to question my views on this.

    I have always believed that euthanasia should be an option and have come to agree with Byock that suicidal ideation during a terminal illness is generally a matter of people being frightened that their symptoms won't be controlled. I have seen this wish diminish as intractable n/v have been stopped, excruciating pain conquered....

    Tonight I attended a man with terminal agitation. The family is distraught, he is miserable - hallucinating, crying out - and none of our interventions are working. His death is going to drag on for at least another week. He is suffering. I can't help enough.

    I am so sorry for the loss of your friend and companion. At least you could give him the gift of a peaceful release from pain.

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  5. I have discussed this subject with my vet on more than one occasion. i am a nurse who works with elderly people at home (sometimes also receiving hospice care, often not actively dying.) Fear of death is much less than fear of disability and loss of dignity (control). Our medical system in US does a lousy job of getting folks into hospice care so the focus is on comfort. Even elders who are not actively dying don't want to run around and see a different specialist for every ailment. My vet is great about doing labs and a good exam and maybe an xray, then making an educated guess as to the most likely cause of the problem, and treatment options. My own doc practices this way, and it just makes sense. Life is generally a chronic condition that eventually becomes fatal, for all of us. (or we die young, which is worse).

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