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Thoughts on putting down elderly pets?

I am once again dumping my raw thoughts on Lemmy and asking your opinion on them.

My first dog (and pet in general) is nowhere near the age of me needing to think about putting her down, but having a dog has introduced me to the world of opinions on whether they should be put down when they get too old.

I've read a lot of very strong pro-euthanasia pet owner opinions, even going as far as accusing people refusing to put down their pets as "cruel" or actively wanting their pets to suffer. It really seems like a majority of pet owners, at least in the English speaking world, think putting their pets down is something you should always do when their bodies deteriorate past a certain point, and every time this is brought up you get a lot of emotional comments shaming anyone who doesn't subscribe to that philosophy.

The core argument being made seems to be that when their health conditions pile up past a point, it's not "worth" letting the pet live anymore, supposedly for their sake. But when I think about it further, I ask how can you be sure? All animals want to keep living, that's literally why animals evolved brains in the first place, to keep their bodies alive for as long as possible. How can you, who is not the pet, say for sure they would prefer to die than keep living? You can't ask them, and you can't get in their mind to determine how much they still appreciate being alive. Even the oldest, sickest pet will still make an effort to keep themselves alive however they can: eating, drinking water, moving out of the way of danger, etc. As far as I know, no animal (at least the animals we keep as pets) have an instinct to just give up and stop going through the motions of life past a certain age. Doesn't that imply they always want to live?

I consider the decision to no longer live past a certain age and certain number of health problems to be a uniquely human thing, and it doesn't feel right to impose that on a pet who probably doesn't have those thoughts. Even with humans, we refrain from making that decision for them. Someone who's in a coma isn't eligible for euthanasia just because they haven't expressed a desire to live, and the most their family can legally do is to stop actively keeping them alive with technology and let them die naturally. But if they don't die right after taking them off life support, you can't just straight up kill them, they need to die by themselves. Why isn't this philosophy applied to pets, who can never consent to euthanasia? You don't have to keep subjecting your pet to more and more invasive treatments just to extend their lives by a small amount, but at the same time, what gives you the moral right to unilaterally decide when they're done with living? Why is letting your pet die naturally in the comfort of their own home seen as cruel, while choosing for them when they should die is considered humane?

What do you think? I genuinely don't know how I feel about this but want to understand the problem and where I stand on it before my dog gets old enough for these things to apply.

88 comments
  • I'm not sure on the answer myself, but you did get one thing wrong.

    Even the oldest, sickest pet will still make an effort to keep themselves alive however they can: eating, drinking water, moving out of the way of danger, etc.

    No, they won't.

    Plenty of illnesses cause apathy, dehydration, or loss of appetite.

    Causes vary from pain so intense moving is unbearable, or nausea so severe food is inedible. It can be mental, physical, easily treated, or incurable and eventually lethal.

    Either way, pets can and absolutely do choose inaction when miserable enough.

    • I back this up. There is a state well studied in animals called hopelessness. Animals of diverse taxa can and will develop depression-related or depression-like behaviours and even self harm, not even necessarily at an old age. The same logic OP uses to question euthanasia is the one we use to understand them and make decisions. We know they will not communicate as humans, and we know we are directly responsible for their (pets) quality of life. This creates the consensus that we have to infer their emotional state and assume them capable of suffering based on their physiology. This (through studying their physiological and behavioural responses) is how we learn for example that dysplasia can be very painful, or that lack of certain standards of care can cause immense suffering. For humans we have the big problem of Christianity, that permeates western notions and confuses morals with ethics, stating that all life is sacred and god intended your suffering for some divine purpose. So much so that suicide was considered a crime and would ban you from heaven. But in more developed places the idea of self requested euthanasia is slowly being better understood.

      We don't have a "right" to do so, we have a "responsibility" to give them the best we can provide.

  • I work at a wildlife rehab clinic. Just a guess, but we probably euthanize more animals than any vet, since for people to be able to catch and bring us wild animals, they are typically much worse off than most domestic animals. A third of patients are dead by the time they get here, or shortly after. The next third, we will have to euthanize within a few hours or days. That's a lot.

    We don't do it because they are too hard to work on or anything like that. Our only goal is to return animals to the wild and have them survive. We try some far-out things sometimes to make that happen, and since most of us work for free, we do it because we love animals and want to see them survive.

    I just attended a conference talk about the topic of animal suffering. It wasn't specifically labeled as a talk about euthanasia, but it ended up being a large part of it, and attending made me feel a bit better about it.

    When we're treating animals, it's like a balancing scale. We have their health conditions, stress levels, etc on one side, and we have our treatments and stress mitigating factors on the other. Ideally, we can either balance the scales or tilt them positive. But as time goes on, and if things are not improving, or get worse, even if we can stack more and more positive responses on the other side, that is still a lot of weight on the scale. It wouldn't take a big nudge to make it crash. Or the negative side is stacking up and the positives have no chance to keep up or reverse things.

    All this time, the animal is not living the life it was meant to live. Out in the wild, hunting, mating, etc for my animals, or being a happy, lazy, snacking, sunbeam soaking friend to you that a domestic animal should. And animals hide pain as a survival reflex. If they are sick or injured, they are always hurting more than you know, because they don't want to be seen as that slowest wildebeest in the pack that the lions are chasing.

    And the point of the lecture was this: no matter how hopeless the stack of negatives is, there is one thing that is guaranteed to instantly alleviate that pain and suffering. Euthanasia is not a positive or negative, but should be looked at as neutral, a zero point. No points on the positive side of the scale, but the negative side is swept clean. If you can do nothing to help your animal, or if the treatment itself is making their life miserable, you have the ability to take that stress and pain away. When to do that is an ethical question with no concrete answer. We address each case on an individual basis and come to consensus as a group. With your pet, that is you and your family. Are you keeping them alive because the animal is still happy or because you aren't ready to let go to a hopeless cause?

    I've tried to treat my pets, 2 of which died of failing organs, and for my cat, it was clear the treatment was making her suffer, and for my dog, she eventually has a seizure. Those were where I had to say to myself that what I was continuing to do was only for my sake, and it wasn't helping me, and was certainly not going to help them. Looking back though, if I would have euthanized them a week or 2 sooner, I probably could have spared them days of pain, and I regret being what I consider to have been selfish acts.

    Especially with a dog (I was not a dog person, but the death of my 2 dogs both crushed me immensely due to that pack bond they have with you as opposed to more independent cats) it can be hard to make the call. But when you learn they are that sick and are likely going to crash soon, don't try to prolong that time, but do spoil the shit out of that dog. Take them on extra walks if they can. Take them to beautiful and smelly places like a state park or a sunset walk along water and walk extra slow so they can enjoy it in their dog ways. Feed them all the stuff they always wanted but wasn't good for them. And when they start to not enjoy even that spoiling anymore, know you gave them the best life they could have dreamed, and accept that ultimate responsibility you took when you committed yourself to that dog the day you brought it into your home and made it part of your pack.

    I hope that was helpful. I gave up having pets because it was hard to do that last step so many times. Now I work with wild animals and see death all the time, but it is less personal, so it is easier to see the positive/negative balance because it isn't clouded by an emotional bond. No one wants to say goodbye to a loved one, human or pet, but it is a certainty of life, and because we live life at a different scale than they do (unless you have parrots, tortoises, etc!) that time is never going to feel like enough, even if you could keep that dog alive for 50 years. The length of their healthy days we have no say over, but we can keep the sad days to a minimum.

  • We had to put down our 21 year old cat two years ago. Mentally she was fine, but her body was failing her. She was having a hard time controlling her body when walking, she would bump walls, fall off the back of the couch when trying to lay down.

    It was a very difficult decision to make.

  • I agree with legalizing assisted suicide for terminally ill humans. As such, if the pets quality of life at the end of life declines that much, then yes. Sometimes the treatments make things worse.

    For example, on the human side, people may not want to spend most of their last days in hospitals hearing machines beep and sleeping in an uncomfortable hospital bed. They want to go home, be comfortable, and die not in pain. Fair. In states where it’s legal, that sometimes means taking prescribed euthanasia on their terms, rather than letting the cancer do it. Sometimes it means just having the option close by as a reassurance while letting the cancer take them, but I digress.

    How much do our pets like the vet? Staying overnight? Considering that at the end, alongside pain, is something we have to weigh in these decisions. Unfortunately, unlike humans, our pets can’t make that decision for themselves. You’ll have to decide for them. When is enough enough? What’s the balance between their pain and your want to have them with you? None of us can tell you that answer.

    The only real advice I can give you is to listen to them, really listen to them, and don’t allow your personal pain drown out their voice. Humans or animals.

  • You've missed a few critical elements.

    Firstly, pets can't reason, don't understand what's happening to them, and the worst part - aren't able to minimise their own suffering. For example, I lived with a dog that had quite advanced cancer in one leg. Every time he got up he would hurt himself. The leg just couldn't support his weight but he couldn't not put it down. He had cancer in other parts of his body as well.

    Secondly, lots of people are just unable to provide the high level of end of life care that an animal like that needs. Like, if you need to go to work every day, you just can't be there to carry your dog every where they need to go, and make sure they don't hurt themselves. There's no social security for pets, they haven't worked hard and saved up for their end of life care. The vast majority of pet-owners can't afford indefinite high level care.

    Every day you own a pet, you are making decisions on their behalf. Yes they can't choose euthanasia themselves, and you have to make that decision as their guardian. Ask yourself, what would this creature choose to do if they could reason and if they were aware of the relevant considerations.

    Obviously that's not an easy decision. I haven't had a pet for the last 15 years because I don't want to have to make this kind of decision.

  • Let me share my personal story. Trigger warning for anybody reading this, there's a lot of details.

    My spouse and I had a beloved cat who was amazing. Rescued her as a kitten, the runt of her litter. She was born sickly and got worse for a while, we thought she wouldn't make it for several weeks.

    But we nursed her back to health and she started to thrive. She never got big, even fully grown, she was 6.5 lbs. Most people thought she was still a kitten, but she had 60 lbs of attitude lol.

    She was a wonderful cat, full of life, playful, fierce, super smart, my spouse and I were totally in love with her.

    Then one day, she stopped eating and started acting really lethargic. We went through all the typical potential causes. Tooth pain, upset stomach, constipation, UTI, etc.

    Took her to the vet several times. After almost 2 weeks of us barely able to get her to eat more than a few bites of her usual favorite treats per day, we had them scan her for potential blockages or other stomach issues.

    Vet came back with the results, it was cancer, her entire abdomen was filled with large tumors. 100% terminal, the vet said that there was no way to remove it all without killing her from the internal trauma because the cancer had spread so far and was completely surrounding many of her organs.

    We were absolutely devastated. She was only about 3 and a half years old. The vet said it was just bad luck, it was rare to see this kind of cancer in a young otherwise healthy cat, but it did sometimes happen.

    Even still, we asked about chemotherapy, (yes they do that for pets sometimes). The vet said that at best, it would only give us 1-3 more months if we were lucky, and she would be drugged up so much that she would basically be in a state of dillusion the whole time. Plus it would have cost between $4,000- and $8,000. Which was far beyond anything we could afford.

    My spouse and I went home, cried our eyes out for the next 2 days, and talked about end of life care. Our primary vet had given us a pamphlet about in-home euthanasia. They come to your home, you can lay down and cuddle with your pet, play music or talk to them. The vet administers a shot, and after about 10-15 minutes, they fall asleep and then...they're gone.

    We chose that option and it was as positive of an experience as it can be, when doing something so sad.

    We laid down on both sides of her, placed her on her favorite blanket, and just gently pet her, kissed her, and quietly told her what a brave girl she was and how much we loved her. Our vet was super calm and respectful. After she administered the shot, she let us be with her, and checked her pulse every 5 minutes or so. After the third time, she quietly told us, "Alright, she's passed. Take all the time you need. When you're ready, I'll take her back with me."

    The vet handled the cremation and a week or two later my spouse and I got our cat's ashes delivered to us in a little urn, with a clipping of her hair and a little paw print in clay. There was a hand-written note from the vet with her condolences, signed by a bunch of the vet techs, it was very sweet.

    It's a brutally hard choice to make, but I think it's the right one. Our cat was in so much pain, she was malnourished, exhausted, dehydrated, she had lost all the joy that a healthy life provided her. Looking into her eyes and seeing her in so much pain, that's what convinced me and my spouse to do it. I think it would have been selfish for us to keep her alive in that state waiting for her to die "naturally" or forcing a massive cocktail of drugs into her just so we could get a few more days or weeks with her.

    I don't condemn people for putting it off, I get it, it was one of the hardest decicions I've had to make as an adult. I wept like a baby before and after it for many days. If you haven't seen it before, I can't describe it. But there is a certain "look" an animal gets when it's near the end. They know, they are smart, they have a soul of some kind I think, they can sense it. As somebody who is an animal lover and has had pets all my life, you learn what it looks like. It's a look of pain and pleading, a look that says, "I'm in pain, and I'm tired, it's time for me to go."

    Some people say that pets can't tell you if they want to be done, but I think they can, it's that look in their eyes of desperation, and when you're my age and you've had to say goodbye to numerous pets over the years, you learn what it looks like.

  • Don't listen to anyone trying to shame you into agreeing with their view about something so profound. You are entitled to your own philosophy on the matter.

  • I don’t know about dogs, but since the prompt states “pets”, I will point out that cats may leave (or hide if they are not allowed out) to die alone if they sense it.

    My oldest tried to leave, but he returned a week after we gave up the hunt and was diagnosed with an aggressive tumor when we had him checked out. Inoperable. Put him down after it broke through the skin and literally started rotting. Only one who tried to leave. Second had a brain tumor, would not have been able to find his way out. Third had jaw cancer, put him down to avoid removing half his face. Fourth died of natural causes: a horrifying seizure. I would not recommend waiting for natural causes.

  • We made the call when our dog had cancer and couldn't walk anymore. It was the right call. We wanted to maximise his good life and minimise his suffering. From his point of view, he got lots of pats and treats and then peacefully went to sleep. There was no pain or panic. He lived a good life.

  • I waited too long for my little lady, she didn't need to suffer as long as she did. It sucks either way.

  • All animals want to keep living, that's literally why animals evolved brains in the first place, to keep their bodies alive for as long as possible.

    Absolutely not. Brains evolved because it gave an evolutionary advantage. They developed from just sensing light, giving an adavtange to finding food, into more complex forms, but every stage is just because it allowed them to survive long enough to reproduce usually, and, for most animals, not much longer. Most animals don't have an advantage to keeping elderly populations alive. At best, they're a drain on resources and can't contribute with fighting, hunting, foraging, or whatever else. Humans are special in that we can pass down information, and elderly people have amassed a lifetime of information. Animals in nature don't really survive that long, so there is not an evolutionary pressure for what you're claiming. Their bodies failing is literally evidence to the contrary.

    As far as I know, no animal (at least the animals we keep as pets) have an instinct to just give up and stop going through the motions of life past a certain age. Doesn't that imply they always want to live?

    This isn't totally true. Some things will cause them to stop going through the motions that keep them alive. Regardless, performing the actions that are baked into us evolutionarily does not equal a conscious choice. We (animals) will almost always eat, drink, sleep, etc. even if we want to die. If not, suicidal people would just decide to stop, instead of having to do more extreme things. Evolution has baked behaviors into us that are hard to overcome, even if we're conscious of it.

    I consider the decision to no longer live past a certain age and certain number of health problems to be a uniquely human thing...

    I find this weird. It may be (unprovable either way), but you're ascribing so many human traits to these animals, but then refusing to entertain the idea that they may want to die in order to stop being in pain. Why? I feel like you're showing some biases here, and if you really want to understand your opinion you need to figure out what that is.

    But if they don't die right after taking them off life support, you can't just straight up kill them, they need to die by themselves. Why isn't this philosophy applied to pets, who can never consent to euthanasia?

    The difference is the pet will never be able to consent. I assume the rule of taking them off life support exists to require it to take time. This way they have a small window where they could come to. I don't know though. It could also be a morality thing of not wanting to actively take a person's "life" (if you can call it that). I suspect this could change in the future, with increasing acceptance of assisted suicide, for example. Making them die from (presumably) dehydration seems much more cruel to me if they can feel anything.

    I don't have a strong opinion either way. Do what you think is right for your pet. In my opinion though, suffering is something that should be minimized. That's true for raising animals for food, for humans, for pets, etc. It depends on the pet, but if they are in constant pain and can't really live life on their own (which would cause them to die in nature) then I'd consider euthanasia. I would at least not consider doing any expensive or invasive healthcare to keep them alive.

  • It's hard as hell, but for me it comes down to this: we have to decide if they're suffering so much that death would be a relief for them. Since we don't have a common language, all we can do is go by what other signs and indicators are available. I don't entirely trust veterinarians to make that decision, because in the past it has seemed to me that they tend to err on the side of euthanasia.

    I've done it both ways. Either way, it hurts.

  • It's too case by case to make a sweeping statement. Sometimes a pet's quality of life is extremely bad, sometimes an animal's instincts will tell it to stop eating, sometimes you could have an old pet that does that and think that they're going but then it turns out they have a totally treatable kidney issue and go on to live five more years after two weeks of pills. That last one happened to me with my thirteen year old cat who went on to live until eighteen.

    I wouldn't put down an animal unless they were suffering and an expert told me there was no way out of it - but of course that's easy to say in isolation, when in the real world vet visits cost money. I guess what I'm saying is that I wouldn't judge someone on the decision they made for their pet unless it seemed that they were acting without compassion and didn't consider all alternatives.

  • All animals want to keep living, that's literally why animals evolved brains in the first place, to keep their bodies alive for as long as possible. How can you, who is not the pet, say for sure they would prefer to die than keep living? You can't ask them, and you can't get in their mind to determine how much they still appreciate being alive. Even the oldest, sickest pet will still make an effort to keep themselves alive however they can: eating, drinking water, moving out of the way of danger, etc. As far as I know, no animal (at least the animals we keep as pets) have an instinct to just give up and stop going through the motions of life past a certain age.

    While it's not an instinct, I've known friends and family members who have had dogs and cats who stopped putting in the effort to eat and drink at the very end. At that stage, you know that it's over...

  • Humans are already imposing upon our pets and depriving them of their autonomy, simply by keeping them in captivity. Any argument against merciful euthanasia grounded in concerns about how it is imposing are moot.

    As for pulling human euthanasia into this context, do yourself a favor and don't. You might be surprised at how common euthanasia is in humans. At least in my part of the world, it's largely a wink-wink nudge-nudge situation, but it does happen with some regularity. Also for people who are actually suffering in decline, there are all kinds of supportive care options being provided that simply aren't feasible or economical for pets. There's also not really the potential for the same kinds of perverse intentions with pets as there might be for people. Like, the list goes on.

    So, basically from either of those two perspectives, let alone the fact that both apply, the argument against euthanizing pets that you've presented fall apart.

    Having said that, this is often not a simple and straightforward decision. But since we've already established that we're imposing upon them one way or the other, it really comes down to what kind of imposition do you want? The animal is going to die soon one way or the other. You can impose upon it and force it to experience the pain and fear and discomfort of its body naturally shutting down over the course of days, weeks, or months. You could impose upon it and decide to euthanize. What can you live with?

    On a more personal note, I've had to have 2 pets euthanized.

    One was a cat who managed to escape outside, it got hit by a car and then a neighbor's dog mauled it. Literally pieces of broken rib and punctured lung exposed as well as untold other injuries. No hope of recovery. The idea of letting it suffer another moment was not something I could live with and it was going to die anyway.

    The other was a dog with congestive heart failure. There comes a point where there are no more medications and no higher doses that are effective. The animal literally is experiencing the sensation of drowning. They're terrified and in pain, exhausted, and suffering. The vet might be able to alleviate it a few hours or even a couple of days with a procedure to manually remove the fluid, but then you're just going to put the animal through this again and soon. I could not live with myself forcing the dog to endure that knowing there was another option.

    Plus, I have seen the pet owner that refused euthanasia and wanted their pet to die a natural death. The dog had cancer. I'm honestly broken up enough just thinking about what I witnessed that I can't even bring myself to type it out. So I'll stop there other than to say I've seen people dying of cancer in their final hours -- there is a world of difference in those things, at least in modern times. The pet was clearly distressed, in pain, and suffering. The people are being made comfortable with drugs and medical care.

  • All I know is that if I were in constant pain and shitting myself because I had no more bowel control and had no ability or freedom to move myself anymore, and I could no longer do anything I enjoyed like hobbies and I was confined to sleeping 95% of the day away...

    I would put myself down.

  • I've had a few creatures put down. My grandmother's dog was in such bad heart health she couldn't really move around anymore. When the creature shakes and whimpers under the strain of standing up, and sometimes just randomly screams in pain, it's about time to make that difficult trip to the vet.

    My old cat Spice lived to the ripe old age of 18, and then she had a saddle thrombus. Essentially a blood clot blocked her aorta where it forks to her back legs. Her back beans turned cold and blue, she couldn't walk right, she was obviously in distress, so we rushed her to the emergency vet where we were told at her age she probably wasn't going to survive any treatment, and that she probably had about 3 more horribly painful hours to live. She was actively dying, it was a question of how long do we let her lay there gasping?

    I let it get about that grim before it becomes an option.

  • Do you put down your elderly family members? It's really that simple...

  • I see a lot of good reasoning here but I can't get over the fact that I wouldn't choose the same for myself. If I can't see myself choosing death why force it on my friend? I have never judged someone for choosing to kill their pet who is in a terrible condition dommed to get worse however.

    I just can't do what I wouldn't want done to me.

    • Please don't take any of this as being directed at you personally, I think your opinion is 100% valid, but you're the only one I saw with this stance.

      I think this is something very important to consider when it comes to things like living wills and just how we as a society feel that a medical system should operate, preserving life at all costs vs preserving quality of life.

      I won't go deep into details, but I have been there to witness the passing of both my wife's parents in the last 2 years. Both were normal for their age and overall health conditions up to the very days they died. Both died suddenly, though not immediately, and one was upset they called the ambulance because they said they were fine, both those ended up being last words.

      Both became unrecoverable very soon after being admitted to the hospital, as in less than 12 hours. The family made the decision to take them off the life support stuff, as there was nothing treatable. A fair decision. But what I witnessed afterwards was the cruelest stuff I have ever seen. It isn't like on tv where they turn the stuff off and in a couple seconds it's over. The sights and sounds of suffering were horrific, and all of us who were there just had to sit for hours, watching our loved ones in total unconscious agony while we were all just wishing for it to be over.

      After I saw firsthand what natural death can look like, I thought it was a sin that with all the equipment and medicine in that hospital, that no one was allowed to end the suffering, either for the dying, or for the living. It looked and sounded like physical torture, it was undignified, and I sat there the whole time saying we would not leave an animal to suffer like this, so why are we letting it happen to our family?

      It really solidified my thoughts on assisted suicide and the concept of keeping someone "alive" at all cost.

      I get if you want to be in your own home instead of hospice someday, or that you shouldn't have all your freedoms as long as you're not a danger, but we don't all get the luxury to die in a brief moment in our sleep. For a lot of us, it will be a long processes, and it won't always be us conscious or able to make determinations on that process.

      Again, just sharing my personal experience, nothing to argue against you in particular. I just find myself able to consider and discuss death more than most people around me seem comfortable doing.

    • No idea of why you got down voted. You are simply saying you couldn’t do it but wouldn’t judge others for doing it.

      Down vote here seems strange

  • I can’t sit my pets down and explain to them what chemo is or that they’re going to have an invasive surgery and may get better afterwards. All they know is that they love me, but they’re in pain. You may question it for a long time afterwards, but if they’re miserable and don’t understand why then keeping them around is more for your benefit than theirs.

    I’ve spent way too much money getting care for a sick, young cat because I knew the pain would be temporary and they could get back to their bonded half and recover quickly and I’ve had to put down a dog that could have lived a few more years because their dementia had become so bad they were confused and lost constantly, even when in the same room as I was.

    Compassion and love are always important, but you can’t explain to them why they’re in pain, only save them from needless suffering.

  • Perhaps euthanasia is cruel, but the alternative must also be considered.

    My cat died from some sort of cancer. We noticed blue welts growing from her face years ago, but the vet said that they were harmless, some sort of allergic reaction. They got bigger over time, and more started to appear. Tests were done, but the vets still said that it was nothing to worry about.

    Over time, her personality changed. She was never really extraverted, but she still liked attention. Over time, she started hiding from people. She only came out to eat, then went back to hide again. We never saw her walking around like she did in the past.

    The night when she died, she pulled herself to visit the bedroom, then crawled back out into the living room and curled up onto the sofa and waited to die there. We knew something was wrong when we woke up the next day because she left a trail of blood that led us to her. At that point, it was already too late.

    In hindsight, it was clear - she was in constant pain for years. It was why she was hiding from people, why she seemed to start avoiding attention, why she stopped doing anything that she enjoyed. That night, she knew she was going to die, and she paid everyone a final visit before resigning herself to die on the sofa. It was an undignified, likely painful and slow death, that was preceded by years of debilitating pain. If she were given the choice, would she have chosen euthanasia? I'm not sure, but it feels clear to me that she knew she was going to die and was suffering for years.

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