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Wednesday, August 28, 2013

Justifying Euthanasia

From death, to humor, back to death.  Some variety in the posts lately, eh?  Today's comes from a reader in Korea.

Hello! I am an aspiring veterinarian studying in Korea. Ever since I had to put down my dog after he got severely injured by a wild animal, the idea of becoming a vet just stuck in my head.
 However, what bothers me most about becoming a vet is how vets often have to perform euthanasia. Just by reading your blog I can get a good grasp of how many of those I have to go through each week. In no way am I suggesting that what you had to do was unreasonable, but the ethical issues regarding euthanasia bothers me to no end. I mean,
 So in what ways can euthanasia be justified? And does having to put down pets bother you much? 

Euthanizing animals isn't easy.  Doctors are trained how to preserve and extend life, sometimes through very extreme and heroic measures.  Our main motivation for becoming vets is to make sick and injured pets better.  So making the decision to end a life is often difficult.  And because it is an irreversible decision it isn't something to be done lightly.

I am 100% against "convenience" euthanasia.  Many times I have refused to euthanize a pet because a client couldn't keep it any more, was aggravated by it, was moving, and so on.  There are always other options for an unwanted pet and I'd rather an animal go to a shelter or foster home rather than be put to sleep.

To me euthanasia is completely justified when the animal is suffering and there aren't any other options.  It's a rather cold, sometimes depressing fact, but we can't fix everything.  There are some animals whose injuries are too severe for them to survive for long.  There are some diseases that we can treat and extend life, but at some point will be fatal, such as kidney failure and some forms of cancer.  The hardest cases are the ones that we're fairly certain we can help, but the clients cannot afford treatment.  Regardless of how it happens, there are pets that simply can't be helped and will die.

But most deaths aren't quick and quiet while sleeping.  Liver and kidney failure can cause a pet to linger for days or weeks, feeling sick and suffering the entire time.  Heart failure that leads to fluid in the lungs results in severe difficulty breathing.  Perhaps a dog is hit by a car and has multiple limb fractures that can only be fixed with surgery, but the client can't afford the procedure and their pet is screaming in pain.  I've seen many dogs who have such severe arthritis and joint disease that are generally healthy, but they literally cannot stand or walk and all attempts at pain relief have failed.

At these times we have to look at the best interests of the pet.  Is it the most humane, ethical thing to let them lay there, sick, painful, unmoving until they eventually die from thirst, starvation, or toxins?  I think most people would agree that this is not an ethical choice.  We want to stop suffering, not allow it to linger.  The pet can't make the decision or talk to us, so between the client and the animal we have to make the decision for them.  

When I agree to euthanize a pet, I make sure that there aren't other options.  I look at the case and think "What would happen to this pet and how would they feel or survive if we did nothing?"  If the answer is that the pet would die or suffer extensively I think the most ethical thing is to humanely end their life.  Then there is the quality of life question.  I'll ask the client if the pet is having more "good" days or more "bad" days.  If I know that the case will be terminal anyway and the bad days outnumber the good, why would I want the animal to suffer even more bad days before the inevitable outcome?

Yes, some cases bother me, but those are normally pets that I have seen for a long time and to which have become emotionally attached.  I've shed tears along with the client many times.  But the other cases don't bother me as much because I know that I'm ending their pain and suffering.  If I didn't have the assurance that I was fulfilling my oath to help illness and pain I wouldn't be able to do it.

I hope that explains some of the thoughts and justifications behind veterinary euthanasia.  As a would-be vet you'll be faced with these situations, and it might be a good idea to find a local vet and shadow them for a while to see these cases in the real world.

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