1.6 The Quality of Life and Euthanasia - Ray Butcher

The Quality of Life and EuthanasiaThe Quality of Life and Euthanasia

• Ray ButcherRay Butcher

• ICAWC, Prague Nov 2010ICAWC, Prague Nov 2010

Killing – an emotive subjectKilling – an emotive subject

Definition of ethics?Definition of ethics?

• “……………“……………..principles, or codes of conduct, ..principles, or codes of conduct, which specify what counts as acceptable and which specify what counts as acceptable and unacceptable treatment of others (and unacceptable treatment of others (and oneself)” oneself)”

• Kate Rawles in Veterinary Ethics (2000), Ed LegoodKate Rawles in Veterinary Ethics (2000), Ed Legood

Definition of ethics?Definition of ethics?

• Matter of opinionMatter of opinion• Cultural and religious differencesCultural and religious differences• Changes over time Changes over time

Medical EthicsMedical Ethics

• Campbell, Gillet and Campbell, Gillet and Jones (2001)Jones (2001)

Medical ethics – 4 foundations (1)Medical ethics – 4 foundations (1)

• (Medical practice) .. “should be governed by (Medical practice) .. “should be governed by an ethic that is committed to an ethic that is committed to restoring and restoring and repairingrepairing, as far as possible, the form and , as far as possible, the form and function of the human being”function of the human being”

• Compare to veterinary ethic: “Compare to veterinary ethic: “relief of relief of sufferingsuffering” ”

Medical Ethics: Medical Ethics: Foundation 2Foundation 2

• ““..treat patients as people, ..treat patients as people, involving them in those involving them in those significant decisions about significant decisions about their care that will affect their care that will affect their lives and well being” their lives and well being”

• ? Euthanasia? Euthanasia

Actions (or lack of them) have Actions (or lack of them) have consequencesconsequences

AimsAims• NOT to tell you what NOT to tell you what

is right or wrong is right or wrong

• Simply to present Simply to present options and consider options and consider the consequencesthe consequences

• Ultimately the Ultimately the decision is yoursdecision is yours

Veterinary Declaration Veterinary Declaration

• “…“….. I .. I promise abovepromise above allall that I will pursue the that I will pursue the work of my profession work of my profession with uprightness of with uprightness of conduct and that my conduct and that my constant endeavour will constant endeavour will be to be to ensure the welfare ensure the welfare of the animals committed of the animals committed to my careto my care”.”.

The Five FreedomsThe Five Freedoms

• Freedom from hunger and Freedom from hunger and thirstthirst

• Freedom from discomfortFreedom from discomfort• Freedom from pain, injury Freedom from pain, injury

and diseaseand disease• Freedom from fear and Freedom from fear and

distressdistress• Freedom to express Freedom to express

natural behaviournatural behaviour

Dilemma of the Dilemma of the “animal advocate”“animal advocate”

• Should we consider Should we consider killing to be an killing to be an integral part of a integral part of a population control population control programme?programme?

Old ageOld age

Quality of LifeQuality of LifeQuality of LifeQuality of Life• Is there a situation where the quality of an Is there a situation where the quality of an

animal’s life is below an acceptable level such animal’s life is below an acceptable level such that euthanasia is the preferred course of that euthanasia is the preferred course of action in the interest of action in the interest of that particularthat particular animal animal itself?itself?

Quality of LifeQuality of LifeQuality of LifeQuality of Life

• Is a poor quality of life equivalent to Is a poor quality of life equivalent to actual suffering?actual suffering?

““actual suffering”:actual suffering”:Legal implications of wordingLegal implications of wording

• Criminal offence to do Criminal offence to do something (or fail to do something (or fail to do something) that causes something) that causes actual sufferingactual suffering

• Veterinary Declaration: Veterinary Declaration: “…..constant endeavour “…..constant endeavour will be to will be to ensure the ensure the welfare of the animals welfare of the animals committed to my care.” committed to my care.” i.e: i.e: relief of sufferingrelief of suffering

Reasons for euthanasiaReasons for euthanasiaReasons for euthanasiaReasons for euthanasia

• Excessive and uncontrolled painExcessive and uncontrolled pain

• No longer enjoying lifeNo longer enjoying life

• No longer living with dignityNo longer living with dignity

• No longer in control of bodily functionsNo longer in control of bodily functions

• Liability rather than companion to the Liability rather than companion to the owner and re-homing is not feasibleowner and re-homing is not feasible

““Quality of life” Quality of life” ““Quality of life” Quality of life”

• Living with DignityLiving with Dignity• Enjoying lifeEnjoying life

EuthanasiaEuthanasiaEuthanasiaEuthanasia

• The method chosen should avoid as far The method chosen should avoid as far as possible any actions which might as possible any actions which might increase anxiety and awareness of the increase anxiety and awareness of the unusual. The animal must pass rapidly unusual. The animal must pass rapidly into a state of unconsciousnessinto a state of unconsciousness

Requirements of EuthanasiaRequirements of EuthanasiaRequirements of EuthanasiaRequirements of Euthanasia

• Competent personCompetent person• Minimum of physical or mental Minimum of physical or mental

sufferingsuffering• Immediate loss of consciousness or Immediate loss of consciousness or

deathdeath

ElectrocutionElectrocution

Humane methods – the “Link”Humane methods – the “Link”

Euthanasia and humane Euthanasia and humane selective cullingselective culling

• Euthanasia – “Mercy Euthanasia – “Mercy Killing”; performed for Killing”; performed for the sake of the the sake of the individual animal itselfindividual animal itself

• Selective culling – Selective culling – Killing in a humane way Killing in a humane way for the sake of the whole for the sake of the whole population or human population or human societysociety

Stray dogs and cats:Stray dogs and cats:Dealing with the current problemDealing with the current problem

• Animal Protection Animal Protection Societies are faced Societies are faced with the problem of with the problem of coping with the coping with the current crisis with current crisis with limited resourceslimited resources

Animal protection Societies:Animal protection Societies:CharacteristicsCharacteristics

• Vary from large “professional Vary from large “professional charities” to small charities” to small independent groupsindependent groups

• Often volunteers motivated Often volunteers motivated by a genuine desire to save by a genuine desire to save animalsanimals

• May be little veterinary inputMay be little veterinary input• Local economy may restrict Local economy may restrict

the feasibility of re-homing the feasibility of re-homing • Limited resourcesLimited resources

““No Kill” PolicyNo Kill” Policy

• The “moral ideal” given The “moral ideal” given limitless resources of limitless resources of space manpower and space manpower and moneymoney

• Unrealistic in many Unrealistic in many practical situationspractical situations

• May lead to further May lead to further suffering as a direct resultsuffering as a direct result

• Shelter policy must be Shelter policy must be realisticrealistic

Realities of “No Kill” and Realities of “No Kill” and limited financelimited finance

• Relative overcrowding in poorly Relative overcrowding in poorly constructed and maintained constructed and maintained facilitiesfacilities

• Poor hygiene and sanitationPoor hygiene and sanitation• Reduced and unbalanced Reduced and unbalanced

nutritionnutrition• Lack of prophylactic medicationsLack of prophylactic medications• Inability to quarantine or isolateInability to quarantine or isolate• Lack therapeutic medications Lack therapeutic medications

The implications of infectious The implications of infectious diseasedisease

• Dogs in colony Dogs in colony susceptible to new susceptible to new infectious agent > infectious agent > epidemicepidemic

• New dog susceptible New dog susceptible to endemic disease to endemic disease in colonyin colony

• Risk of zoonosesRisk of zoonoses

Factors predisposing to the Factors predisposing to the outbreak of infectious enteric outbreak of infectious enteric

diseasedisease

• OvercrowdingOvercrowding• Poor hygiene and Poor hygiene and

sanitationsanitation• Continued contact Continued contact

exposure to infected exposure to infected animals animals

• Poor nutritionPoor nutrition• Inter-current diseaseInter-current disease• Lack of immunityLack of immunity

Realities of “No Kill” and Realities of “No Kill” and limited financelimited finance

• Relative overcrowding in poorly Relative overcrowding in poorly constructed and maintained constructed and maintained facilitiesfacilities

• Poor hygiene and sanitationPoor hygiene and sanitation• Reduced and unbalanced Reduced and unbalanced

nutritionnutrition• Lack of prophylactic medicationsLack of prophylactic medications• Inability to quarantine or isolateInability to quarantine or isolate• Lack therapeutic medications Lack therapeutic medications

The Five FreedomsThe Five Freedoms

• Freedom from hunger and Freedom from hunger and thirstthirst

• Freedom from discomfortFreedom from discomfort• Freedom from pain, injury Freedom from pain, injury

and diseaseand disease• Freedom from fear and Freedom from fear and

distressdistress• Freedom to express Freedom to express

natural behaviournatural behaviour

““No Kill” – Is it a practical with a No Kill” – Is it a practical with a poor economy? poor economy?

The new arrival – what should The new arrival – what should be done?be done?

The AssessmentThe Assessment

• Clinical examinationClinical examination• Laboratory testsLaboratory tests• Incubation periodsIncubation periods• Practical difficulties Practical difficulties

Classification of dog potentially Classification of dog potentially entering a shelterentering a shelter

• Dangerous to human healthDangerous to human health• Dangerous to the health of other dogs in shelterDangerous to the health of other dogs in shelter• Severe injury, disease that cannot be treatedSevere injury, disease that cannot be treated• Severe injury or disease that can be treated but at Severe injury or disease that can be treated but at

high costhigh cost• Minor injury or diseaseMinor injury or disease• Behaviour problemsBehaviour problems• Healthy with no apparent problemsHealthy with no apparent problems

Management policy decisionsManagement policy decisions

• What is the realistic What is the realistic capacity of the shelter?capacity of the shelter?

• What happens if this What happens if this capacity is exceeded?capacity is exceeded?

• If selective culling is If selective culling is performed – what are the performed – what are the criteria for choice?criteria for choice?

• What is the role of the What is the role of the Shelter?Shelter?

The role of animal shelters – The role of animal shelters – The Practical realityThe Practical reality

• To keep lost pets for a To keep lost pets for a sufficient time to allow sufficient time to allow collection by ownerscollection by owners

• To keep strays to enable To keep strays to enable them to be re-homedthem to be re-homed

• To keep strays for a To keep strays for a temporary period as part temporary period as part of neuter and release of neuter and release programmesprogrammes

Selection – one too many!Selection – one too many!

……. Can soon become 3 too . Can soon become 3 too many!many!

…………..and then 100 too many!..and then 100 too many!

““No Kill” PolicyNo Kill” Policy

• The “moral ideal” The “moral ideal” • Must work in the real Must work in the real

world – not suitable world – not suitable in all situationsin all situations

• However if we have However if we have an effective agreed an effective agreed strategy, we can work strategy, we can work towards this goal towards this goal

Humane Dog Control:Humane Dog Control:Interventions Interventions

• LegislationLegislation• Registration and Registration and

identificationidentification• Garbage controlGarbage control• Neutering Neutering • Control of breeders / sales Control of breeders / sales

outletsoutlets• EducationEducation