Futile Care: What a Difference a Species Makes
She's lived a long, healthy, happy, productive life, but now she's failing. Her eyesight is going, she can't get around as well as she used to, and she's started becoming incontinent from time to time. None of that changes your love for her, of course, so you help her get where she needs to go, and do what she needs you to do for her. You clean up after her as matter-of-factly as you can, so as not to embarrass her, because her company is as precious as it ever was.
But then you notice some blood, so you take her to the doctor. Not surprisingly, on the basis of age alone, she has a terminal illness. What happens next, though, depends on the quality of the doctors:
Are you told, "She needs an operation followed by some other treatments that are expensive, uncomfortable and may or may not prolong her life, but without treatment she will die," implying that of course you don't want her to die so this is what has to be done, or are you offered a compassionate discussion about comfort care and quality of life, allowing you the option of taking her home, making her comfortable and letting nature take its course?
AND: How much difference does it really make if we're talking about your aunt or your cat?
There was a time not all that long ago when the first option was the only one given for a person, and the second was the only option for a pet. To our credit, many physicians are coming around to recognizing the limitations of our wonderful craft, realizing that death is not the enemy and compassionately embracing palliative care. On the flip side, as veterinary medicine accelerates and catches up with human medicine in terms of what can be done, there are accusations of some young vets who begin to sound like old-fashioned human doctors: if we can do it, we should do it. After all, you don't want her to die, do you?
Here's the big question, though: Why is it only the veterinarians in this situation who are accused of being coldly calculating, money-grubbing scoundrels? Is it just because people actually have to pay vets for their animals' care, whereas Americans' dependence on the capitalistic system of medical payment brokerage (rendered in doublespeak as "insurance") has effectively allowed them to believe that medical care shouldn't cost anything? In the case of futile care, though, none of that ought to matter.
I am not saying that a human life is equivalent to that of an animal, nor am I espousing euthanasia for humans. But to the extent that ACLS is now an option for animals (despite the fact that cats, for example, don't get atherosclerosis so cardiac arrest is generally a terminal event) it seems that the line between futile care and heroic (ie care with a good outcome) is becoming as fuzzy in veterinary medicine as it is for humans.
Everyone needs to get together on the same page. Futile care is futile care, (edited to add: and shameless, money-grubbing appeals to guilt are, well, shameless) for man and for his best friends.