In response to my recent post, The Decision to Euthanize a Pet: A Vet's Perspective, BarbaraA recommended that I do a follow-up article on "how to combat a vet’s ‘objections’ to honoring a euthanasia request." She mentioned that she works with five people who have been talked into "last ditch" treatments, as well as experiencing it herself, and asks if this is a new philosophy that vets share.
Now, I can’t speak to those particular situations, of course, but scenarios like this do occur. Let’s look at a couple of reasons why and what can be done about it.
First of all, the answer to BarbarA’s question is "no." Vets aren’t in cahoots when we recommend that owners pursue treatment in the face of a poor prognosis. Veterinary medicine has simply come a long way in the last few decades, and we now have much more to offer in the face of serious disease.
Not too long ago, if your cat had cancer, for example, just about the only reasonable option we had was euthanasia. Now, advanced surgical techniques, chemotherapy, radiation treatment, and complementary therapies are all valid options. It is a veterinarian’s responsibility to put all of these choices on the table, and to strongly recommend any that might offer an animal a reasonable chance at an extended period of good quality of life. In this situation, the doctor’s role is to be an advocate for her patient’s best interests, not always to do what an owner wishes.
Problems arise even between people with good intentions because of the nebulous nature of the words "reasonable," "extended," and "good." What might seem reasonable to one person (e.g., $2000 for a 50 percent chance at four more months) might seem insane to another. When the vet is the former and the client is the latter, questions about motives often arise. But most veterinarians really are not looking to wring out a few more bucks from an owner before euthanizing a cherished family member.
What is the solution? Communication. It’s not a cure-all, but talking honestly about the situation goes a long way towards overcoming these pitfalls. If asked, a veterinarian should be able to present several options for dealing with most situations, and when confronting a terminal disease, euthanasia should always be one of them, in my opinion.
Everybody brings emotional baggage with them to this type of conversation, however. Maybe the veterinarian recently had an excellent outcome with the therapy she is recommending and is eager to try again. Or perhaps she has performed several difficult euthanasias already this week and is subconsciously trying to avoid another. Maybe the client went through an aggressive treatment regime that didn’t go well with a previous pet and is hesitant to enter into that scenario again. These are all reasonable points of view but can make a person’s stance seem irrational if they’re not understood.
So, if you ever find yourself in a situation where you are uncomfortable with a vet’s recommendation, ask "are there any other options available?" Be persistent and honest with your reasons for looking for an alternative. This is a lot to ask of an owner in the face of a crisis, but keeping the lines of communication open is the only way to make sure that your pet gets the best care possible.
Dr. Jennifer Coates