Can we judge suffering and do we have the right?

A British High Court recently deliberated that life the support system should be withdrawn from a 9 month old child whose brain, due to a birthing crisis, was nothing but liquid. Many highly-qualified doctors had concluded that the child was suffering unimaginable pain. The parents strongly disagreed saying that the ‘spasms’ shown by the child were simply reflex movements. How can ‘liquid’ feel pain? Who had the right to judge? The loving parents? The professional medical teams or the judiciary?

I don’t know, and coward that I am, I am glad I have not been asked to decide.

Who is to judge suffering?

Suffering comes in many forms — physical, emotional, mental and, at times, indefinable. For many years I practised as a veterinary general practitioner specialising in small animal surgery and, as such, I witnessed suffering every working day of my professional life. As veterinary surgeons we are both blessed, and cursed, by the availability of the ultimate weapon — I hesitate to call it a cure — of euthanasia.

A widow who had been alone for the previous eight years since her husband died, but for the companionship of her 12 year old black Labrador, Windsor. She brought him in to my surgery one morning because he was off his food and listless. The first symptom I noticed was the colour of his eyes — they were a lemon yellow. His lungs were clear and his heart beat was sound but simple palpation of his tummy told me that his liver was enlarged. He had jaundice which depresses the appetite. The lady was living on a small pension and the original insurance policy had lapsed beyond the age of 8. X-rays, ultrasound scans and blood tests would have confirmed my provisional diagnosis of a liver tumour but would have cost her too much money.

Windsor was the last link to her late husband and her only child had emigrated to Australia. Specific blood tests were the cheapest way of confirming my diagnosis and I visited her at home the next day with the results. The cancer was inoperable. Her one remaining companion was not only dying, but suffering. It took her another three weeks before she asked me to visit and perform the final kindness. Was she right to prolong that suffering? I don’t know.

As veterinary surgeons we are both blessed, and cursed, by the availability of the ultimate weapon — I hesitate to call it a cure — of euthanasia.

Two years earlier a middle-aged aged couple, the Robinsons, had brought in their beagle, Sally. This dog had suffered glaucoma in the left eye and, at that time, the late 80s, the only remedy was to remove the eye. This was no problem as many animals can live an enjoyable life with only one eye. Unfortunately certain breeds of dog are more prone to glaucoma than others and once glaucoma had been diagnosed in one eye it was often only a matter of time before it developed in the other eye — and this was the case with Sally. Her right eye was painfully swollen with glaucoma and my considered advice, at the time, was that euthanasia was the kindest option. The owners were horrified at my suggestion and a ‘lively’ discussion followed.

“Why can’t you remove her second eye?”

“Surely, you cannot ask me to do that. She will suffer unnecessarily.”

“Please give her a chance.”

It ended by the owners agreeing to sign a letter of authorisation which stated that if, if in my opinion, and mine alone, I considered the dog to be suffering within three months I had their permission to put her down.

With great reluctance, and the disapproval of many of the surgery staff, I removed the second eye. I could not wait the full three months and after 10 weeks I arrived unannounced at their front door. Mrs Robinson opened the opened the door and beamed a huge smile at me which rather took me by surprise.

“”Sally! Look who’s here.”

The beagle came racing round the corridor, banged into my legs and jumped up with her tails going furiously. To say I was gobsmacked would have been one of the understatements of the year.

“Come in,” said Mrs Robinson. “Shall we show Mr Arnold, our game?”

She led me through to the dining room — there were dining rooms in those days! — picked a tennis ball off the sideboard and tossed it into the wooden jungle of chair and table legs. Sally dived in, hardly missing an obstacle, and brought the ball back within a minute or two.

“I am amazed,” I said.

“Oh, no! That’s not the game,” said the lady. “Give me a hand will you?” and we turned the whole dining room suite through 90 degrees, while Sally pounded her feet on the carpet in her excitement. I was then given the ball and asked to throw it into the new configuration of wooden legs. I don’t know which part of Sally’s body hit the wooden legs most; it was a close run thing between the head and her tail. She was having a ball — in many more words than one.

Within five or ten minutes Sally had worked out the new geography of the dining room and, after a welcome cup of tea, I left the house feeling rather small.

Who is to judge suffering?

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Adrian Arnold

Adrian Arnold

Retired veterinary surgeon now a collector of trivia. Married to a wonderful wife, four children and four grandchildren. Author of A Veterinary Life on Amazon.