Blue Juice: Euthanasia in Veterinary Medicine

5. Coping with Euthanasia: Emotion-Management Strategies

5 Coping with Euthanasia Emotion-Management Strategies A ll veterinary encounters are carefully negotiated, triangular interactions involving the veterinarian, the human client, and the animal patient. Because the animal is nonverbal and basically powerless to participate in any consultation, the client and veterinarian must determine the animal’s problem and negotiate an outcome for the patient.1 As both service providers to their human clients and medical professionals to their animal patients, the divided responsibilities can be difficult for veterinarians to balance, causing them difficult ethical dilemmas.2 As seen in Chapter 1, conflicts between veterinarians and their clients can occur for many reasons. For example, veterinarians may differ from their clients in personal values and opinions regarding the ethical treatment of animals. This chapter is concerned with emotional and moral stress associated with animal death and the practice of euthanasia. veterinary work causes distress for practitioners because it requires people who care strongly for animals to kill them, often when they are not sick enough to easily justify their death. The philosopher Bernard Rollin argues that animal-care professionals are exposed to a unique type of euthanasia-related moral stress.3 As described by Rollin, animal-care professionals typically enter their occupations because they want to help animals but then face a contradiction between what they believe they ought to be doing (e.g., protecting animals) and the reality of what they are asked to do (e.g., kill animals).4 Consistent with Rollin’s notion of moral Coping with Euthanasia 137 stress, Arnold Arluke uses the term caring-killing paradox to describe how animal-care professionals experience emotional stress when they are expected to euthanize animals for whom they have provided care and protection.5 In addition to this kind of euthanasia-related stress, veterinarians bear another conflicting responsibility related to end-of-life care, the duty to protect patients from unnecessary suffering and the obligation to continue life support as requested by pet owners. The veterinarian’s technical expertise and the client’s intimate attachment to the animal can lead them to different conclusions regarding the best interest of the animal. How do they do these tasks without abandoning a sense of themselves as people who work in the best interest of animals? How do veterinarians resolve challenging situations, manage ethical uncertainty, and deal with uncomfortable feelings? The stress literature identifies two basic types of coping strategies: problem focused and emotion focused.6 Problem-focused tactics involve mobilizing actions aimed to change the realities of the situation. The techniques veterinarians rely on to resolve disagreements with clients outlined in Chapter 1 are primarily problem-focused approaches. Emotion-focused tactics typically involve regulating one’s emotions linked to the stressful situation without necessarily changing the reality of that situation. Thus, the emotionfocused coping strategies outlined in this chapter are more concerned with adapting to stressors rather than changing them. While problem-focused coping would seem most effective because it directly addresses the cause of the distress, Susan Folkman and Richard Lazarus suggest both strategies may be necessary because overcoming problematic emotions is often related to overcoming the problem.7 The effectiveness of problem-focused coping, of course, depends on whether the stressor is controllable.8 Stressors associated with veterinary euthanasia involve both controllable and uncontrollable events. Whatever the level of stress my study’s participants experienced, which depended to some extent on personal values, all relied on both problem- and emotion -focused coping tactics. As outlined in Chapter 1, veterinarians use problem-focused strategies to negotiate disagreements with clients. However , these tactics do not always resolve the problem. In this chapter I first briefly outline the imperfections in problem-focused strategies before moving on to the emotion-focused strategies veterinarians use to manage their emotions and resolve ethical uncertainty. The chapter concludes by investigating problems implementing emotion-focused strategies, exploring why some people do not consistently use them and why they sometimes fail to resolve tensions. 138 Chapter 5 Imperfections in Problem-Focused Strategies Problem-focused strategies often helped veterinarians avoid stress related to euthanasia but did not always change the outcome for the animal, thus falling short for veterinarians. For example, the strategy of convincing pet owners to surrender their animals to local animal shelters could avoid euthanasia. However, dr. Spencer, as did many participants, feared that less-than-perfect animals would unhappily spend the remainder of their lives in crowed shelters and end up...