NOTHING focuses the mind quite so effectively on the wasteful passage of time as the death of a friend or loved one. As one grows older, this seems to take place with depressing frequency and it’s easy to forget that, for the older members of our population, the roll call of the departed far exceeds the list of friends and family who are still with us.
Where modern medicine excels is in its huge range of capability both in terms of diagnosis and in the application of its enormous pharmaceutical armamentarium.
Where it might be said to have fallen down is in the degree of handson capability of many GPs, their ability to reassure patients constructively and to manage both the decline and the end of life for those patients under their care.
As a friend said recently, GPs rarely see anyone dying nowadays, that rôle falls to nurses, most specifically, and to an overstretched hospital staff in general.
One should resist the temptation to cite personal experience but, based on a tally of two fairly recent, tragic events in my own life, I think I could reasonably claim that veterinary staff would have handled this better, with more empathy and with far more anticipation of the patient’s needs and of those who would be with them until the end.
For more than 20 years now, most veterinary practices have put in place a considerate routine to help pet owners deal with the end of life issues experienced when a pet dies or is put to sleep. Wherever possible, veterinary practices allow a recently bereaved owner to exit with dignity via a different route rather than having to confront a waiting room full of joyous owners with happy, healthy pets.
Contrast this with oncology clinics in both NHS and private hospitals where stunned and shaken patients, just a few minutes into a shattering realisation, have to parade past other anxious and emotional patients as they leave the clinic. Not only has the veterinary world thought through the end of life issues in practical terms, it has everyday experience of putting each component of these issues into practice.
Early release
Most of us, if we think about it at all, believe that within a decade or two our society will have to contend with coming to terms with granting early release to those whose pain and suffering is intractable.
Today, the problem is fraught with issues of conscience, ethics and faith; society appears polarised by the two extremes of belief and even the terminology can be seen to accentuate this polarisation.
The word “euthanasia”, when used in the context of terminating human life, carries huge emotive connotations and would never be accepted by the broad church of public opinion. However, as populations in the western world grow older and the axis of work and dependency shifts towards the few supporting the many, we fool ourselves if we think that this issue will go away.
Of course there need to be safeguards in place before the public would be willing to accept the debate with an open mind but one suspects that, even without a cogent debate, a significant sector of today’s society would favour the principle of granting humans the dignity of early release that we afford our pets.
The veterinary profession has learned to see this issue in a balanced way but no one would suggest that this is an easy issue. Years ago, a young, talented veterinary surgeon from one of the charities applied for a job outside practice and when I interviewed her I asked why she wanted to leave practice.
Her response was that she was “weary of playing God, in deciding which animals should live and which should not”. Twenty years later you will find her back in practice as a superb clinician and more able to rationalise an issue that clearly brought her heartache. I doubt, however, that she will ever euthanase an animal without the pang of sorrow that it involves for her, as a clinician dealing with both the pet and its owner.
This is exactly as it ought to be and, for those among us who are not qualified veterinary surgeons, this empathy will simply be assumed to be the case on every occasion.
One can only hope that, when the time comes for Parliament to debate this issue again, our political masters will choose to involve this profession in giving such balanced advice to those seeking to be properly informed.
