Low and No-Contact Euthanasia: Associated Ethical Challenges Experienced by Veterinary Team Members during the Early Months of the COVID-19 Pandemic

Abstract

Background: During the ongoing COVID-19 pandemic, many veterinary practices around the world have shifted to a low or no-contact consultation model to ensure the safety of their team members and clients, and comply with public health orders, while continuing to provide veterinary care. Methods: We performed reflexive thematic analysis on a subset of data collected using a mixed-methods survey of veterinary team members globally. Results: There were 540 valid responses available for analysis. Low and no-contact euthanasia we raised as a common and/or stressful ethical challenge for 22.8% of respondents. We identified five key themes: no-contact euthanasia as a unique ethical challenge; balancing veterinary team safety with the emotional needs of clients; low and no-contact protocols may cause or exacerbate fear, anxiety and distress in veterinary patients; physical distancing was more challenging during euthanasia consultations; and biosecurity measures complicated communication around euthanasia and end-of-life decision making. Recommendations: In light of concerns highlighted by respondents, we recommend the development of a toolkit of protocols that will assist veterinary team members in performing low-contact euthanasia in a range of circumstances, in alignment with their values and professional ethical codes. Professional bodies may be involved in developing, updating and disseminating this information, and ensuring a continuous supply chain of PPE.

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“…For the purposes of this discussion, we have used the term “financial euthanasia,” however, some authors may argue that a more appropriate term would be “humane killing” ( 82 ). During the COVID-19 pandemic, many clinics implemented protocols to reduce client contact resulting in non-contact euthanasia, further exposing veterinary team members to greater ethically challenging situations ( 83 ).…”

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“…Finally, it is important to note that the time period about which respondents were surveyed overlapped at times with COVID-19-associated public health orders, including physical distancing requirements in which euthanasia practices may have been altered. For example, due to the public health orders requiring physical distancing, low and no contact euthanasia practices were utilised in many practices to minimise the risk of SARS-CoV-2 transmission between clients and veterinarians [ 54 ]. It may be, for example, that premedication or sedation were administered to facilitate placement of an IV catheter and long extension set so that a veterinarian could administer sodium pentobarbitone IV while physically distancing from the client as they held the animal in their final moments.…”

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“…This study was conducted during the COVID-19 pandemic (February to June 2022); hence, the euthanasia experiences that the respondents recalled would be within the period from February 2021 to June 2022. It is possible that during this time, to facilitate physical distancing and comply with public health orders, some veterinarians modified their euthanasia practices, performing low-or no-contact euthanasia [73]. For example, premedication or sedation may have been used to facilitate the placement of an intravenous catheter and an extension set so that pentobarbitone could be administered at a distance from the cat being held by the owner.…”