Death Is Not An Option

Sometimes death is not an option
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The underlying rationale for home euthanasia is to provide a calm, anxiety-free EOL experience for the patient and their owner. Examples include limited space, poor lighting or ventilation, not having access to all support personnel, and other environmental disadvantages. However, the ultimate goal is to keep the patient and client comfortable and secure at this difficult time. The veterinarian may want to bring a technician or other personnel along to the home if they feel additional staff support may be needed to successfully complete the euthanasia procedure or for safety reasons.

Controlled substances should be kept in a secure place. Whatever medications are taken from the hospital need to be cataloged and recorded. A body stretcher and bag are also useful if a larger animal has to be transported back to the hospital for cremation.

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It is ideal to gather at a place in the home where the patient and client are most comfortable. This may include such places as a master bedroom or family or living room floor. An appropriate outdoor setting is also acceptable.

Whenever possible, the veterinary staff should be willing to attend the animal anywhere the client deems best. As with in-hospital euthanasia, preliminary sedation or anesthesia can be given before at-home euthanasia to minimize stress and anxiety. Euthanasia itself is usually performed by administration of an injectable euthanasia agent. Inhalant gases are rarely, if ever, used in the home procedure due to safety and logistical concerns associated with equipment transportation.

Each of the AVMA-approved injectable euthanasia methods can be accomplished as safely in the home as in the hospital. Even in a home setting, veterinary personnel in attendance should offer to excuse themselves after euthanasia has been administered in order to allow the owner privacy. Do animals remember the past? Do they anticipate the future? Are they capable of assessment of self? These questions have been under extensive scientific examination in recent decades, and the weight of the evidence indicates that many species of animals do possess some of these capabilities, in widely varying combinations and in different degrees of complexity.

Apply for AAHA membership. What is AAHA accreditation? Veterinary Management Groups. Practice Network Accreditation. End-of-Life Care accreditation. Behavior Management. Dental Care. Diabetes Management. End-of-Life Care. Fluid Therapy. Infection Control, Prevention, and Biosecurity. Nutritional Assessment. Pain Management.

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Why AAHA? Microchip Lookup Tool. Hospital Locator. AAHA positions and endorsements. Discipline of members. Strategic Alliance Program Members. Mission and vision. Download PDF. Euthanasia versus natural hospice-supported death Both euthanasia and hospice-supported natural death are medically and ethically acceptable options in veterinary EOL care and animal hospice.

The following guidelines will help the veterinary healthcare team to engage in ethical, collaborative EOL decisionmaking: Discuss all euthanasia and natural-death options with the pet owner do not exclude or minimize any single option. Describe EOL options to pet owners in language they can understand. Describe EOL options in a factual and non-judgmental manner, articulating pros and cons of each option. When an animal hospice patient is in the last hours of life, alleviating pain is a top priority and multimodal pain management strategies should be utilized.

To minimize anxiety, the client should be informed of every step of the euthanasia procedure. In-hospital euthanasia When euthanasia is to be performed at the veterinary hospital, it is possible and recommended to involve the entire healthcare team to make the experience as acceptable as possible to the client. Take-away points Never assume anything—it is important to adequately communicate to the client what to anticipate with the dying process as well as postmortem changes that may occur.

Never rush the process—clients want, and need, your undivided attention and you have an obligation to give it to them. End of Life Care-Home.

End-of-Life Care Task Force. If you raise the issue after receiving a terminal diagnosis, your physician may be less receptive. It is important to have this discussion with your physician in person. Do not ask their office staff, nurse, or assistant or leave a request on their voice mail. Under death with dignity laws your physician is not required to participate and may have valid reasons for declining. First, explain to your physician that you believe in being prepared, that you wish to avoid unnecessary suffering at the end of life, and that you would like to make sure that both of you would be on the same page in an end-of-life situation.

You may say something like:. If you will never be willing to honor my request for a medication to hasten my death according to state law, please tell me now, while I am able to make choices based on that knowledge. I have given lengthy consideration to hastening my inevitable death. If your physician seems reluctant to prescribe but seems unopposed to the concept , ask if the physician would be willing to participate as the consulting physician, i.

Right to die

Common responses from physicians and what they may indicate:. Every family is different, and many families have strained relations. However, even if there has been little communication for years, the months or weeks before death is a time when many people attempt to open up to each other. It is amazing how many families come around to reestablish communication, and offer support, as they learn what their relative is struggling with. It is truly in the best interest of those who will be left behind that you tell your family what you are planning, and give them the option to accept or reject it, or to work out personal past differences.

This helps those family members cope better after you die, as they have some good, positive memories.

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Even if your family cannot support you or what you are choosing to do, by starting the dialogue you have at least given them the chance to understand and grow. And most families rise to the occasion of help, support, and understanding. Death with dignity laws clearly outline the process by which qualified individuals may obtain life-ending medications.

It is up to eligible patients and their doctors to implement these laws on an individual basis; there are no government programs that will provide assistance.

Current Death with Dignity Laws

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Compliance protects you, your family members, and your physician from criminal prosecution. Participation in death with dignity laws is voluntary. No one is obligated to use these laws. The laws stipulate waiting period s. Generally, it may take at least weeks to go through the process from the first oral request to filling the prescription.

To legally obtain a prescription medication to end your life in a peaceful, humane, and dignified manner under physician-assisted dying statutes, you must first become a qualified patient, meeting a set of stringent requirements. You must also be able to self-administer and ingest the prescribed medication. All of these requirements must be met without exception. You will not qualify under aid-in-dying laws solely because of age or disability.

Two physicians must determine whether all these criteria have been met. Legal state residency is a requirement for accessing death with dignity laws. In California , Colorado , Hawaii , Oregon , and Washington , you may prove residency with any or a combination of the following:. In Vermont , the law does not specify how residency may be proven.

We recommend following the rules above. Likewise, the District of Columbia Death with Dignity Act does not stipulate ways to prove residency. However, the D. Department of Health has established rules for patients to prove residency, specifically by submitting any two 2 of the following original documents that include a valid address in the District of Columbia:. There is no minimum length-of-residency requirement. You must simply be able to prove you are a current, bona fide resident of one of these states or the District of Columbia.

You may make the initial oral request for medication under aid-in-dying laws at the time of your choosing; many people make the request when discussing their end-of-life options with their physician. Your attending physician must confirm you meet all of the eligibility criteria. Your physician must also inform you of alternatives, including palliative care, hospice and pain management options, and ask that you notify your next-of-kin of the prescription request. A second, consulting physician must confirm the diagnosis, prognosis, and your mental competence.