Dying like a dog: the convergence of concepts of a good death in human and veterinary medicine

Abstract

Standard views of good death in human and veterinary medicine considerably differ from one another. Whereas the good death ideal in palliative medicine emphasizes the positive aspects of non-induced dying, veterinarians typically promote a quick and painless killing with the aim to end suffering. Recent developments suggest a convergence of both professions and professional attitudes, however. Palliative physicians are confronted with patients wishing to be ‘put to sleep’, while veterinarians have begun to integrate principles and practices from hospice care. We will argue that the discourses on good human and animal deaths are not distinct, but that they interact and influence each other. On the one hand, veterinary medicine adapts techniques like chemotherapy or sedation from palliative end-of-life care. On the other hand, philosophers, veterinarians, pet owners, patients and the general public alike make certain assumptions about the (dis)analogy of human and animal dying or killing. Unfortunately, these interactions have only scarcely been reflected normatively, especially on the part of human medicine. Conflicts and misattributions with potential serious negative consequences for the (animal and human) patients’ wellbeing are provoked. For these reasons, palliative physicians and veterinarians are invited to engage in the debate around human and animal end-of-life care.

Veterinarian’s perceptions of animal euthanasia and the relation to their own mental health

“…Virtually all participants stated that they had already had in their attributions the need to perform animal euthanasia, and almost half said they performed the procedure at least once a month, which configures a high frequency, as it does not represent the conventional clinical routine. Euthanasia is a tool used in livestock operations to alleviate animal suffering (SIMPSON et al, 2020), and it also provides welfare to companion animals (MEEHAN & BRADLEY, 2007;NETT et al, 2015;SELTER et al, 2022). It is known that carrying out this on a large scale can cause so-called moral stress, and if not adequately controlled, it can cause damage to mental and physical health and well-being, which can lead to the abuse of psychotropic drugs and even suicide (ROLLIN, 2011;NETT et al, 2015;EDWARDS-CALLAWAY et al, 2020).…”

“…The insecurity experienced by veterinarians should not result in an extension of the patient's suffering, as, unlike humans, animals do not have the same understanding of future life or the end of life. In other words, they do not have the insight that enduring negative short-term experiences can lead to the achievement of future goals (ROLLIN, 2011;SELTER et al, 2022).…”

“…Veterinary medicine is the only area of health where professionals can recommend and perform the euthanasia of their patients. The practice of animal euthanasia is a veterinarian's sole responsibility and is regulated according to the Brazilian Constitution via Resolution Nº.1000, of May 11, 2012(CFMV, 2012, being indicated when the quality of life of an animal becomes compromised to the point that its death is preferable: quick, painless and without suffering (SELTER et al, 2022), or even in situations of risk to public health (CFMV, 2016). Therefore, as it is fundamental to animal health and welfare, decision-making and recommendations related to euthanasia should be the exclusive responsibility of the veterinarian.…”

“…Although studies involving the euthanasia impact on companion animals are common (MEEHAN & BRADLEY, 2007;NETT et al, 2015;SELTER et al, 2022), recent studies have also given importance to the euthanasia of large animals and production animals, and showing displeasure and psychological impact also to veterinarians in these areas (EDWARDS-CALLAWAY et al, 2020;SIMPSON et al, 2020;WAGNER et al, 2020). Emotional issues and dilemmas experienced by veterinarians have been the subject of studies (PLATT et al, 2012;GYLES, 2014;NETT et al, 2015;MOISÉS et al, 2018;BEST et al, 2020;ZANI et al, 2020), given the concern on mental health.…”

Killing Kira, Letting Tom Go?—An Empirical Study on Intuitions Regarding End-of-Life Decisions in Companion Animals and Humans

“…Individual pain therapy, sedation but also spiritual counselling frame the final phase in palliative and hospice care. However, recent research findings suggest parallels or even convergences between EOLD in veterinary and human medical practice, such as the role of relatives, the importance of the individual patient’s preferences, challenges in communication, preferred circumstances of the final phase [ 3 ] and death ideals [ 4 ]. Habituated to legal constraints and common practice, human and veterinary medical professionals may not be used to challenging their own thoughts on their decision-making criteria [ 5 ], and much less on those of the respective other profession.…”