Oh, the humanity

The origins of the expression "Oh, the humanity" date back to the Hindenburg disaster in the 1930s.  But it has been playing on my mind frequently lately.  My father is ill.  He has had emphysema for many years.  He has had a number of heart attacks.  He has been diagnosed with kidney cancer and is currently in hospital receiving palliative care for end stage chronic obstructive pulmonary disease (COPD).  

Dad recently contracted a cold which turned very quickly into bronchitis and an acute hospital admission.  Dad has been told by his lung specialist that he is no longer  ridding his lungs of carbon dioxide effectively.  This is creating an acid environment in his blood and his, already stressed, kidneys are working hard to rectify the situation.  As a result of the emphysema, he experiences shortness of breath all day, every day.  For my Dad, it is painful to breathe and it is no longer possible to exhale in one breath.

The problem is, there are no guarantees with end stage COPD.  It is a particularly difficult disease to track or predict.  As such, the medical professionals cannot give any indications for the expected progress of Dad's condition.

Dad has expressed his wishes since his first heart attack over 3 years ago.  He does not want to live artificially and has a do not resuscitate (DNR) order.  Recently, a family meeting was called at the hospital where Dad made his wishes known to myself, my sister and my Mum.  I see this as an informal advanced care plan.

I am all for conscious living.  I like being around people that think about the choices they make in life rather than following the pack blindly, never considering whether the decisions they make are right for them.  For this reason, I respect my father's wishes and will do the best I can to support him.

One of the comments Dad made during the family meeting was that, as a society, we would not expect an animal other than a human to live like he is at the moment; in constant pain, with a terminal illness that no one has any chance of curing.  Euthanasia literally means "good death" in Ancient Greek.   


Dad's comment made me think about all the situations in which vets will euthanase animals.  Race horses are often put down after an accident.  Cows are terminated with severe infections.  There are instances where domestic pets are given a lethal injection because their owners cannot afford the surgery that would save their life and it is more humane to terminate the life of the animal than let the suffer as, without treatment, they would die.

Then, I came to think about how I feel about that.  While I believe firmly in saving lives wherever possible (and have been known to feed calves with a dropper in the hope that they will pull through scours), Dad's comment had me pondering at what point it is more humane to terminate a life than to progress with trying to keep it alive.  

The problem is that emotion gets in the way of a logical decision.  With livestock, pets and more so people, our ability to show true compassion is clouded by the fact that we have an attachment to the animal/human and we find it hard to let go.  Grief is one of the least commonly explored and discussed emotion.  I believe our society hides grief away.  Many people try to "protect" children in times of extreme sadness by keeping them out of the loop.  As such, we are not exposed to grief and the grieving process until later in life.  As a result, I believe that we are ill-equipped to deal with death.

Now, I concede that there are plenty of people out there studying the ethics of euthanasia and that I know relatively little about the intricacies of such things.  Admittedly, I am not keen to learn the details of something that my father would deem to be 'morbid'.  But I began to wonder what was done in "traditional" societies in instances where someone had a terminal disease.  So I turned to the tool that everyone trusts.  I did a Google search.

It turns out that it's not easy to find such information.  The only reference I found was that the Inuits would transport invalids to a sacred place, remove their clothing and expose them to the elements which would result in voluntary death by exposure.

To be honest, I have not come to any conclusion about euthanasia.  For humans or other animals.   I do believe in the first rule of medicine, however, being "Primum non nocere" or "first do no harm".  I wonder what this means in the case of the medical care for my father.  I question whether, with all the medications that Dad is on (and where he takes medications to deal with the side effects of other medications), his team of experts truly are doing no harm.