Quality of life, suffering and decisions

We have a cat.  He’s fifteen years old and has a lovely relaxed nature.  He loves being fussed, and sunning himself.  He’s a lot slower now than he used to be, but even in the spring he was able to catch a bird in the garden, and until last year was fairly regularly bringing the odd mouse in.

Palin relaxing

He’s not well, hasn’t been eating and when he does he’s sick very quickly.  We’re treating that medically but it really looks as if that’s not having any significant effect.  It’s possible a surgical intervention might have an effect, but at his age there are big risks around giving him a general anaesthetic. He’s listless and clearly in pain, but still walking around, making his way up and down the stairs, and responding to being talked to or fussed.

We have a decision to make, and at the moment that decision is when we take him on his final journey to the vet.  There is a possibility that his heart will give out before we do that, and in some ways that would be best for him, as he hates being in the car.

As a Buddhist, it’s a difficult decision to make: the taking of life, or being responsible for the taking of life, is itself something that one should avoid.  I tend to take a western view of these principles though; rather than the fairly simple ”reincarnation” concept, lifetime to lifetime, we experience our world moment to moment.  Each of our experiences is the moment of rebirth, influenced by what has gone before.  That has parallels with modern thinking around physics at both the macro and micro scales.

So what is my intent around this life that I have had some influence over?  He looks to us for food and shelter, although he’s demonstrated himself capable of doing both for himself over his life.  I do feel some responsibility for him now, perhaps there was something that I missed and we could have had some form of intervention, whether medical or surgical, earlier.  Perhaps that would have given him a little longer.  It would be easy to play virtual histories, I don’t know now whether we could have done anything, or perhaps an intervention would have brought this moment forward.

The intent is to find the point where his quality of life isn’t sufficient, to find a point where his pain makes him more miserable.  With one of my pet rats I left it too long, and she suffered to assuage my guilt about taking her to the vet.  Again as a Buddhist, I know the effect the choice will have on me; I carry that forward into my next moments, each of which become an aggregate of our decisions and choices, the interplay between them.

I am very glad that it is a decision that we are able to make. We’re driven to think about his quality of life, not his length of life.  As an animal, the end of his suffering has more dignity than a human.

I compare the way we treat pets with the inhumane way we deal with people suffering in similar ways.  Friends have died of cancer, with the associated loss of dignity as they approach their final weeks; friends and family who suffer dementia with an ever increasing reliance on others for help with the most basic of functions.  In the former case there is an opportunity to make a choice, in the latter the opportunity for choice is long gone and with it one’s dignity as  human.

In a liberal society, surely the individual should have a choice over their end of life?  The ability to identify the conditions of the choice, and what triggers should be put in place for others to act if that choice cannot be exercised.

I’m conscious that I’m exposing a dichotomy: our cat is unable to make the choice, so we do, yet I want the same opportunity for myself.  We can’t speculate as to whether a pet would make the choice, and communicate it to us should he have the language.  They communicate with us, but they don’t have the cognitive abilities to make that decision.  They clearly make choices, but they’ve learned the consequences of these through experience.  We can make the decision for ourselves, we know the consequences of ending our life, we should be allowed to do so.

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