Monday afternoon my wife and I will kill a dear member of our family.

Mercy killing, a difficult concept.  What do you do when the body fails, there is no hope for recovery and only a lingering and painful death will be the result?

We have a 17 year old cat that has come to the end of her life with multiple organ system problems and a ping pong ball size tumer in her lung.  She is in considerable pain, only partly managed with drugs, and has no quality of life or prospects for an easier time.

She and my wife have a quite profound bond.  She came to us as a very young feral animal that came onto our deck when we were sitting out enjoying the day.  She was a mess. Very skinny and frail and clearly afraid.  She watched us for a time, then went slowly to my wife and crawled into her lap.. They looked at each other for some time, then she curled up and went to sleep.  She adopted us and has been my wife's companion ever since. She turned out to be a very nice animal to be around and has added much to our lives.

What an odd thing to write about don't you think? The reason is that having looked at the prospect of my own death twice now I am disquieted by how we handle end of life for many people.  I lost my parents in the last decade of so and both of them had a very difficult time in the last days.  Our practice, as a society, is to warehouse terminally ill patients, keep the body going with drugs and machine long after there is any hope of recovery.  I'm OK with that if people have chosen that course.  Hope for a miracle lives in many and sometimes people do recover against all odds.  Mostly, though, dying is hard and the patient may be so drugged and sick as to be unaware of what is happening.

When you are lying in the hospital with nothing to occupy your mind, it is not possible to avoid thinking about the possible end. Last year I had a genuine crisis which could have gone badly but didn't but it certainly focused my mind for a time on the question of how to die.

I do understand the imperative to value life that is a core tenet of our philosophy and I believe in that but I still wonder at what price.  We have adopted the legal strategy that any artificial termination of life is murder.  A very absolute standard which avoids the grey area of who decides and how and is that really the patient's wish. The potential for abuse is clear, but the price paid by the dying can be horrendous and I wonder about the morality of that as well..

I looked at this for my own life and, like most, I guess I end up of two minds. I don't wish to endure when there is no hope and no surcease, However, having looked that old girl in the eye before, I can't help but imagine what if.  We see liver patients within hours of dying after years of suffering who manage to get a transplant and go on to fruitful lives.  Miracles do happen sometimes.  What would you go through to have the chance?

I'm not on a crusade here, but each of you will face your end of life.  It might be worth considering what you want.