Palliative Care ≠ Murder
I talked yesterday about compassion fatigue, which often develops when caregivers focus primarily on others while ignoring their own needs. Sometimes, however, a caregiver’s negative emotions are a direct result of the words or actions of others.
I have found that stress seems to bring out the best or the worst in people. I am constantly amazed at how gracious and kind the great majority of my clients are when we are making end-of-life decisions regarding their pets. Of course, I’ve met a few bears too, but they are the exception that proves the rule.
I recently ran across a story about an especially egregious account of malice directed at a medical doctor. You can listen to the whole story at Colorado Matters, but here is an excerpt:
It was one of the darkest days of Daniel Matlock’s medical career. Dr. Matlock specializes in older patients and end-of-life care. He’d been summoned to the case of a woman who experienced a massive stroke. The woman had spelled out her wishes in an advance directive and she did not want any form of life support. Matlock saw the woman was getting intravenous hydration and asked that it be removed. That was when another doctor essentially accused him of murder. Turns out, this isn’t unusual. A recent report in the Journal of Palliative Care finds that one in four doctors who work with patients at the end-of-life have experienced accusations like these. Dr. Matlock, who’s a geriatrician at the University of Colorado, started blogging about his experience. It was picked up by the New York Times.
I’ve never had an owner or another veterinarian accuse me of "murder" when I’ve discussed palliative care, or even the euthanasia, of one of my patients, but I commonly come across very different points of view about what is appropriate treatment. I’ve dealt with a few clients who are morally opposed to the euthanasia of animals and in those cases we’ve developed a plan for hospice care that helps the animal die as peacefully as possible. Other people are adamant in their desire to prevent suffering and will request euthanasia at the first sign that a pet’s quality of life is starting to decline. Most owners fall somewhere in the middle, wanting to maximize the good times and minimize the bad. I work with each client on their own terms, always trying to be the animal’s advocate and remembering that there usually is more than one right way to handle a difficult situation.
The New York Times recently ran a group of editorials called One Sick Dog, One Steep Bill. In her commentary, Dr. Louise Murray, vice president of the ASPCA’s Bergh Memorial Animal Hospital in New York City stated:
In situations in which euthanasia would once have been the only option, pet owners may now need to make tough decisions about the best course of action for their pets and themselves … I reassure them that for an animal that is lucky enough to be a beloved pet, there are no wrong answers as long as the focus remains on minimizing suffering. In a world in which too many dogs and cats find themselves homeless, an animal in a loving home has already won the lottery. Beyond that, the choices become personal to each individual or family, and are not for others to judge.
Dr. Jennifer Coates