5 questions on the most difficult decision


5 questions on the most difficult decision

Sep 01, 2006
By dvm360.com staff

Editor's Note: DVM Newsmagazine asked Cheryl Weber, a grief counselor from the University of Illinois, to share her expertise and advice when a doctor is asked to euthanize a sick animal.

DVM: What should every veterinarian understand about the subject of euthanasia?

Weber: Learn to do it well. Done with skill and compassion, clients will loyally return and tell their friends. Done poorly, euthanasia can result in you losing business or facing complaints or possibly a lawsuit.

First, a young veterinarian needs to become technically competent at humane euthanasia. One memorable story I've heard is how a dog chewed out of its cadaver bag in the cooler because it wasn't dead. Learn from the mistakes of others.

Second, expect that euthanasia will be incredibly emotional. Be prepared to respond to each individual's emotions with empathy and compassion. Give yourself permission to grieve. Work through your own emotions and maintain a perspective about the good that you're doing.

Third, communicate, communicate, communicate! Continually educate clients about what's going on, before, during an after the euthanasia. Empower them with knowledge and choices. Be respectful. Show them you care.

What do clients look for in a veterinarian? The May 1999 Executive Summary of the KPMG Market Study (online at http://www.avma.org/) found clients said they wanted a veterinarian who is "kind and gentle." It is never more important than when you are euthanizing a companion animal.

Remember this quote: "People may not remember exactly what you did or what you said, but they will always remember how you made them feel." (-Author unknown)

DVM: What are healthy ways to approach clients about the subject of euthanasia?

Weber: Bring it up when you see it as a treatment option. Put it in the context of the diagnosis and prognosis, quality of life, pain and suffering.

Be honest. Be truthful with clients, especially when you have bad news to deliver.

Clients never want to hear bad news. It's hard for them. I've seen clients sob, scream, swear, wail, vomit, pass out and talk about suicide. Show sensitivity for their distress. Walk with them through the emotional times. Recommend resources to them if they need more help coping than you can provide.

What's not helpful? Practicing avoidance, offering false hope or communicating with too much medicalese, in other words talking beyond a client's understanding.

It's neither healthy nor helpful to avoid telling a client that his or her animal is dying because you think he or she will be upset.

It's not healthy to give false hope or set unrealistic expectations to surgical or therapeutic intervention. It might come back to bite you.

It's estimated that veterinarians deal with death five times more often than physicians. Become skilled at delivering bad news and bringing up euthanasia in an honest, sensitive and compassionate way.

DVM: What are your recommendations to veterinarians following euthanasia?

Weber: Several things you can do if the owner was present:

  • Pronounce the animal dead.
  • Stand or sit silently while the owner reacts. Be present.
  • Listen. Don't nervously chatter to fill the silence.
  • Offer tissues if there are tears.
  • Acknowledge the client's emotion, i.e. "I can see how painful his death is for your family."
  • Normalize the client's grief by saying something like: "It's normal to be upset when you're saying good-bye to such a special girl."
  • Gently touch the animal and use its name.
  • Offer the client time alone with the body (some people want that and some don't).
  • If you have some time, listen if they want to reminisce.
  • Support the client's decision if appropriate.
  • Offer pet loss information.
  • Prepare the body for transport if they're taking it home.
  • Get payment if that wasn't done ahead of time or will not be billed.
  • Walk the client to the door.