How to develop a sensible euthanasia policy

The author used a regretted, previous experience with three dachshunds to develop his current criteria before performing euthanasia. Photo: Bigstock/cynoclub Unlike our human medical counterparts, veterinarians are often called to end the life of a pet through the process called euthanasia. Euthanasia, meaning “well death” in Greek, is a way for us to end animal suffering. While this is often seen as a good thing, there is no question that taking a life, an innocent life, even if it’s done with the noble intention of ending suffering and hastening the inevitable, is painful for all the humans involved in the act. The emotional toll on pet owners dissipates with time, but with veterinarians and their staff that are involved with this activity on a regular basis, the emotions add up and can exact a greater toll as “forced death” is constantly with us. Our profession is currently dealing with a lot of emotional baggage. By our nature we are caregivers, but also many in our profession are particularly introspective, introverted, and somewhat antisocial. As a result, we rarely give our own emotional and physical well-being the attention they deserve, resulting in a bottling-up of emotions that at some point will explode externally, internally, or both. Forcing death upon a patient adds to the emotional baggage. All of us view euthanasia through our own personal lens. Is euthanasia an admission of failure? Did we properly diagnose and treat the pet? Did we do all that could be done for our patient? Did we give up prematurely, or did we fail to refer when help was a phone call away? Do we have our own fear of death, and does euthanasia bring us closer to our own mortality? Did we recently lose a loved one and possibly have guilt, anger, or unresolved feelings of loss? Are we and our staff simply worn out from death in our practices and in the world around us? Does all of this stuff lead us to feelings of depression and/or suicide? Looking back and ahead All of these questions must be addressed individually and as a healthcare team, and it is beyond the scope of this article to do so (maybe others will tackle that task?). I want to present my story and suggestions of why and how our evolving euthanasia policy came to be, and how incorporating some of these ideas might help your own situation. I learned many years ago from one of my mentors (and wrote as the topic for my first article for a veterinary publication) he only euthanized patients if two conditions were met: first, the animal could no longer enjoy the owner, and second, the owner could no longer enjoy the pet as the result of its physical ailment. A number of years ago I experienced the worst weekend of my life as a veterinarian based upon a horrible experience in my relatively new practice. As we were newly opened, I pretty much took any appointment as the practice needed the money. On a particularly slow Saturday morning, a new client came in asking me to euthanize his three healthy dogs. He stated all of these gorgeous and friendly dachshunds had “behavioral problems” that couldn’t be solved and he wanted them euthanized. I offered the option to refer him to a breed-related rescue group to rehome the dogs, and he declined saying he did not want another owner to have to deal with the pets’ behavior problems. Well, it was a slow morning, and I had made an attempt to spare the lives of these three dogs, and the practice needed the money, so I went ahead and agreed to the euthanasia, with the owner watching to confirm their deaths. For the next 48 hours of the weekend I barely slept or ate. Did I euthanize three healthy dogs just for the money? Why did this owner come to me for euthanasia rather than return to the veterinarian who had been treating the dogs? Did the dogs actually have any behavioral problems, or was the owner simply making up an excuse to kill his pets? Why didn’t I request medical records to confirm the “diagnosis?” After this horrible experience, I made the decision that no longer would I ever euthanize a pet simply because an owner requested this service. No, I instead developed a euthanasia policy that I and my staff could live with and allow us to minimize euthanasia in our practice. Here are the additional parts of our policy that allow us to achieve peace of mind whenever euthanasia was needed. 1) First, I agree to euthanasia only if I believe that is the only option to helping the pet. If I believe I can offer some help for the pet, then I refuse euthanasia and instead properly diagnose and treat the pet. If euthanasia is done, I know no treatment is available that might save the pet’s life. This means the pet owner must consent to a consultation and examination of the pet, and this visit must be paid for prior to euthanasia. 2) Another way I’ve diminished the role of euthanasia in my practice is to price it higher than basic treatment. This is something I began when I started treating exotic pets, as it is difficult to get some clients to make a financial commitment to treating some of these smaller pets that only cost a few dollars when acquired. In my practice, starting with the exotic patients but now extending to all pets, I’ve made it cheaper to attempt some form of treatment (that in most cases will give the pet a chance at life) and more expensive to end life. Doing so has reduced (essentially eliminated) convenience euthanasias. 3) As my practice has grown busier, we refuse to euthanize any pet that is not currently a patient (unless the new patient comes in for care but is obviously beyond all hope of recovery.) Therefore, anyone shopping for a euthanasia appointment is politely told to keep shopping! 4) Finally, I became a holistic/functional medicine doctor many years ago. As a result, it is extremely rare that I cannot offer some type of treatment, conventional or holistic, that fails to properly treat or cure the pet. Having numerous treatment options above and beyond conventional medicine has been a life-changing experience for my staff and my patients, and it is the rare patient that does not heal and/or requires euthanasia. As a side note, if euthanasia is needed, we always offer, as the first option, to suggest home euthanasia by one of the providers in our area. If the client wants us to do the euthanasia, we only offer this service at certain times of the week to minimize the number of clients in the hospital at the time of the euthanasia and reduce commotion to promote a peaceful visit for the family of the pet. Also, since we use a pet cemetery for disposal, we only offer euthanasia if the cemetery is available to pick up the body the same day as the euthanasia. All of these things have greatly diminished the number of euthanasias we now do. Prior to these policies, and prior to offering functional medicine, we probably averaged one to two euthanasias per month. Now we might do one to two per year, which reduces our emotional drain and enhances the overall positivity among the staff. I do not want you to think I’m intentionally “putting my problem” onto someone else based upon these policies. I’ve developed policies I can live with that work for me and my appreciative staff. Other personality types might find a calling for offering hospice and euthanasia, and I’m perfectly fine with each of us following our callings, living our strengths, and doing what we each do best to serve God, man, and creatures. For me, though, our euthanasia policies allow me to find that balance between saving lives and ending those for which ongoing care is not possible or feasible. I encourage you to consider some of the points I’ve made and work with your staff to create a sensible euthanasia policy that respects the concerns of your clients, needs of your patients (where euthanasia should be used rarely and only whenever all options, including “alternative therapies,” have been exhausted,) and emotional and mental concerns of yourself and your veterinary team. Shawn Messonnier, DVM, opened Paws & Claws Animal Hospital and Holistic Pet Center in Plano, Tex., in 1991. His special interests include holistic and functional medicine, exotic pets, dermatology, cancer, and internal medicine. In addition to serving clients, he has written for numerous veterinary and pet publications, and is also the author of several books, including the award-winning The Natural Health Bible for Dogs & Cats.

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How to develop a sensible euthanasia policy

The author used a painful lesson to determine his personal protocols

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