PRACTICE MANAGEMENT
But when a client asks a veterinarian for advice, what
do we do? Veterinarians usually choose from three
basic options when guiding clients on end-of-life decisions:
• We deflect: “It’s your decision. I can’t decide this
for you.”
• We give options: “You can try steroids …”,“I can
send you to hospice care …”, “You can elect amputation …”, “Humane euthanasia is not a bad option.”
• We tell them what to do: “Your pet is suffering.
You should euthanase.”
All of these can be the right way to handle the question depending upon the circumstances. For the client’s sake, and ultimately for our own, Colleran says
we must not try to solve the owner’s problems by
making decisions for them, rationalising their choices
or rescuing them. What becomes essential to assisting clients is our ability to educate, support, guide and
facilitate during this often-difficult time.
The emotional toll
On the one hand, euthanasia is a tough subject that
we face almost every day and don’t talk about enough.
Clients are stressed and emotional and looking to you
for guidance. In one study, more than one-third of
pet owners said that their major source of emotional
support was their veterinarian. Mental and emotional
stressors associated with euthanasia take their toll on
veterinarians as well. We have a saying at our clinic:
no one cries alone. I almost always cry at a euthanasia, even when I don’t know the clients very well.
Euthanasia is hard
• First, recognise the moral stressors involved in euthanasia that can affect you
• Convenience euthanasia. Euthanasia for reasons
we can’t accommodate in our minds (e.g. “My cat
doesn’t match my drapes”).
• Severed relationships. The client has ended
the mental and emotional relationship with the
pet before they have arrived, leaving nothing on
which to base decisions.
• Financial constraints. The ability to afford—or a
lack of desire to pay for—the care a pet needs
causes a client to choose euthanasia.
• Client guilt. Veterinarians often deal with client
guilt associated with euthanising too soon or
causing suffering by waiting too long.
• Technology zeal. Just because we can continue
to treat and diagnose doesn’t mean we should,
even if the client desires it.
• Inability to let go. Client won’t stop or won’t quit
seeking treatment even when the pet’s condition
cannot be cured or managed pain-free.
Second, realize you have little to no control over
these moral stressors, and take care of yourself mentally and emotionally.
• Take a time out.
•
•
Talk to someone who understands.
Learn mindfulness-based stress reduction techniques (i.e. breathing, meditation).
Uncertainty and grief
The strongest desire of highly attached pet owners
facing the loss of a beloved pet is to do what is best for
the animal. It is an elusive goal and one that requires
the owner’s interpretation of the animal’s state. There
is no easy answer, particularly because we advise our
clients based on proxy. As the pet’s proxy, the owner
makes the decision for euthanasia based on uncertain
anticipated events rather than what is known. Uncertainty makes the decision more difficult.
Also, highly attached owners who recognize that their
pets have a life-limiting medical condition that cannot be cured or managed pain-free experience