'Moral Distress' Among Veterinarians

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One of the downsides of owning a pet , in a lot of cases, you have to have it killed. This article looks at it from a veterinarians perspective.

NPR Choice page
 
One of the downsides of owning a pet , in a lot of cases, you have to have it killed. This article looks at it from a veterinarians perspective.

NPR Choice page

I cannot access the link. :(From my own personnel experience and also further to other peoples', it would seem that having to put pets down, is a 'part of the job' to most of them.
When I had to take my pet for the dreaded injection, it was one of the most awful moments ever.

It will be her 2 year anniversary tomorrow when she passed and I still have vivid memories of the dreaded moment.
 
I have already had the conversation with my vet about Ben. I don’t think it will be an issue in this case. We’ve been treating him since February 10 with no improvement.

We have an appointment this evening to check his weight loss and fluid in the abdomen. He is still running fever of 104. I am trusting her judgment as to whether or not he comes home with me tonight or if we say our goodbyes. I’ve been stressing it all weekend. It’s so hard to tell how miserable he is. He definitely looks sad. He barely moves other to nibble on food or use the litter. I used to use eating and toileting as signs to keep them with me but he’s become so frail. I just don’t want to make the decision as to when it’s time based on my not wanting to let him go or on the flip side, my inability to keep watching him decline. I’m not really good with this kind of thing. But then who is.

I saw a really good article on FB about this. I’m going to see if I can find it.
 
I have already had the conversation with my vet about Ben. I don’t think it will be an issue in this case. We’ve been treating him since February 10 with no improvement.

We have an appointment this evening to check his weight loss and fluid in the abdomen. He is still running fever of 104. I am trusting her judgment as to whether or not he comes home with me tonight or if we say our goodbyes. I’ve been stressing it all weekend. It’s so hard to tell how miserable he is. He definitely looks sad. He barely moves other to nibble on food or use the litter. I used to use eating and toileting as signs to keep them with me but he’s become so frail. I just don’t want to make the decision as to when it’s time based on my not wanting to let him go or on the flip side, my inability to keep watching him decline. I’m not really good with this kind of thing. But then who is.

I saw a really good article on FB about this. I’m going to see if I can find it.

How I feel for both of you. It's one of the most awful moments ever. You don't want to let your pet go and then you don't won't to let the mite suffer.

:hug:
 
I have already had the conversation with my vet about Ben. I don’t think it will be an issue in this case. We’ve been treating him since February 10 with no improvement.

We have an appointment this evening to check his weight loss and fluid in the abdomen. He is still running fever of 104. I am trusting her judgment as to whether or not he comes home with me tonight or if we say our goodbyes. I’ve been stressing it all weekend. It’s so hard to tell how miserable he is. He definitely looks sad. He barely moves other to nibble on food or use the litter. I used to use eating and toileting as signs to keep them with me but he’s become so frail. I just don’t want to make the decision as to when it’s time based on my not wanting to let him go or on the flip side, my inability to keep watching him decline. I’m not really good with this kind of thing. But then who is.

I saw a really good article on FB about this. I’m going to see if I can find it.
Omg, i'm so sorry about Ben.:sob: One of my former kitties (her name was Lucy, too) was too ill. And those crazy dudes (so-called doctors) decided to perform eutanasia on her without asking me! (Because they saw that i'm poor, and the treatment was very expensive and obviously useless,- her liver had almost decomposed because of cancer). They made one more suspicious injection which i didn't expect,- when i asked them what it was, they said those were "vitamins". Then Lucy died on my hands, and i was absolutely helpless. ...I can't even blame them, as they did it out of mercy to me (though it was definitely illegal). The woman who was sitting next to me with her sick doggy, saw the whole "procedure" of eutanasia, and she started crying so badly, that i couldn't calm her down. The vets didn't take any money from me (they even didn't take the money for the previous droplet), then they said where i could bury her, but i said we had a "cemetery" for our dead animals behind our garage.
So, it's a very tough dicision that you're going to make, no matter if there's no other choice.:sniff: I understand. We're here for you.:hug:
 
I was at the vet recently and I was talking to one of the vets that took care of my dog when he was very ill on the drip last year. She said the first time he ate some chicken from her hand she burst into tears.

We have an appointment this evening to check his weight loss and fluid in the abdomen. He is still running fever of 104. I am trusting her judgment as to whether or not he comes home with me tonight or if we say our goodbyes. I’ve been stressing it all weekend. It’s so hard to tell how miserable he is. He definitely looks sad. He barely moves other to nibble on food or use the litter. I used to use eating and toileting as signs to keep them with me but he’s become so frail. I just don’t want to make the decision as to when it’s time based on my not wanting to let him go or on the flip side, my inability to keep watching him decline. I’m not really good with this kind of thing. But then who is.

:hug:

Someone said to me that euthanasia is the final act of kindness you can show your animals.
 
I was at the vet recently and I was talking to one of the vets that took care of my dog when he was very ill on the drip last year. She said the first time he ate some chicken from her hand she burst into tears.



:hug:

Someone said to me that euthanasia is the final act of kindness you can show your animals.

Very difficult but you are right.
 
I cannot access the link. :(From my own personnel experience and also further to other peoples', it would seem that having to put pets down, is a 'part of the job' to most of them.
When I had to take my pet for the dreaded injection, it was one of the most awful moments ever.

It will be her 2 year anniversary tomorrow when she passed and I still have vivid memories of the dreaded moment.
n some ways, it can be harder to be a doctor of animals than a doctor of humans.

"We are in the really unenviable, and really difficult, position of caring for patients maybe for their entire lives, developing our own relationships with those animals — and then being asked to kill them," says Dr. Lisa Moses, a veterinarian at the Massachusetts Society for the Prevention of Cruelty to Animals-Angell Animal Medical Center and a bioethicist at Harvard Medical School.

She's the lead author of a study published Monday in the Journal of Veterinary Internal Medicine about "moral distress" among veterinarians. The survey of more than 800 vets found that most feel ethical qualms — at least sometimes — about what pet owners ask them to do. And that takes a toll on their mental health.

Dr. Virginia Sinnott-Stutzman is all too familiar with the results. As a senior staff veterinarian in emergency and critical care at Angell, she sees a lot of very sick animals — and quite a few decisions by owners that trouble her.

The study's senior author, Cambridge Health Alliance psychiatrist and Harvard bioethicist J. Wesley Boyd, sees a connection between the study's findings and daunting statistics about veterinarians' suicide rates: "My assumption," he says, "is that the findings from our survey are definitely part of, or even the majority of, the reason why veterinarians have higher-than-average suicide rates."

And Moses says that while euthanizing an animal is often the right thing to do to end suffering, that doesn't make it easy.

"I want to make a plea to the pet-owning public to understand that, no matter what you think, odds are the person who's trying to help you take care of your animal has pretty strong feelings about how important that is," she says. "And they feel it."

The study's authors are calling for better training — in veterinary school and beyond — on self-care and how to cope with moral distress and ethical conflict.

Sinnott-Stutzman defines moral distress as the feeling when the vet determines an optimal treatment course but is blocked from carrying it out — whether because of money, or an owner's beliefs, or rules about, say, dogs that bite.


SHOTS - HEALTH NEWS
For Veterinarians, Caring For Sick Pets And Grieving Owners Takes A Toll

"The most poignant example is when a young dog has a fracture — so a totally fixable, non-life-threatening problem," she says. But an owner neither wants to pay for a proper fix nor have a three-legged dog, and opts for euthanasia instead.

"That's a really tough thing to go through," she says. It's also particularly hard, she says, when owners, caught up in their grief, project their anger onto the vet. "So in this example," she says, they might say, " 'We have to kill our dog because you're all about the money,' which is of course not the case."
 
@Val I can't say how sorry I am about your experience. I appreciate they didn't ask you for any money at the end, and there was probably nothing more they could have done for Lucy; animals with advanced cancer have even fewer options for treatment than humans do- and humans don't have many at all!

I just wish there was hospice care for terminally ill pets.

ETA: Oops- I posted the wrong link from memory: www.pethospice.org

I originally posted this one, which is relevant to our discussion, but isn't about veterinary hospice:

www.petloss.com
 
@Val I can't say how sorry I am about your experience. I appreciate they didn't ask you for any money at the end, and there was probably nothing more they could have done for Lucy; animals with advanced cancer have even fewer options for treatment than humans do- and humans don't have many at all!
That's right, it was obvious that she was dying, and that nothing could help her. It's not a coincidence, that a half month before Lucy's cancer broke out,- our another cat, Pussy (yes, my parents really had named her Pussy), died too. They both died because of the curse and bad eye. It happens, and it's not fairytales. That was a gloomy time. I knew that Lucy would die soon, and i asked Sumerian gods to make a copy. I saw them do it in my dream. I wanted them to provide a reincarnation of Lucy into another turkish angora kitty (she was a turkish angora). Everyone knows how little the chances are, that a cat reincarnates into a living cat of the similar breed, and moreover, that you will find this new kitty in a big city, whereever he is. But Sumerian gods did a smarter thing: they know where i live, so they made many copies with the same mentality and put them into breeders' houses, where they raise these cats for commercial purposes. I asked Sumerian gods: "How much time will it take for my dad to stop grieving and start wanting a new cat of the same breed, if it's even possible??" They said: "The period of eraising of the memories [in that case] is six months" (sounds odd, but that was exactly what they said). Having heard that, i woke up, found the breeder in SPb online and began to wait. I wanted to buy a kitty myself, but it was too expensive, so i just was waiting until dad's "memories erase", like they had said. (They and i have a very horrible linguistic barrier, almost insurmountable, plus their mentality is far from human mentality, but i understand some of their sumerian murmuring, especially if they use a voice imitator and show me pictures).
Only about 4 months had passed, when dad started talking about a new similar kitty. I gave him the phone number, we contacted the breeder, and it appeared to be that there was 1 completely white female kitty with blue eyes, and not deaf, which is very important too (and rare, because white blue-eyed turkish angoras are genetically predisposed to be deaf).
Dad was ill then, he had cancer too (in remission), but he was literally jumping with joy, so, he took his cane, the special bag for pets (i bought it beforehead and he improved it by making an arch), and headed out to the city to buy the kitty.
When he saw the kitty, she was about 4.5 months old,- it means that she was born right after Sumerian gods put the copy of her soul into the species of that exact litter. The kitty recognized him at once, he called her "Lucy", and she came over without a shade of fear. The breeder-woman was amazed. When he brought her home, it turned out, that she was an "upgraded" copy of our dead kitty. It was exactly what i had ordered. She knew the same things, and had a complete knowledge of what dead Lucy knew, but she was a lot more kind and smart (Sumerian gods decided that it would be better to make a little upgrade, as all they usually do is initially meant to be perfect,- there have been cases when their perfect deeds had to be made less perfect, in order to adopt them to Earth conditions, otherwise nothing worked).
On the first day, we washed new Lucy, and she loved the water and the shower! Then we vacuum-cleaned her with the scary noisy vacuum cleaner, and she enjoyed it very much as well!:cat: Then i found out that she had been constructed to understand Sumerian language. I knew very little Sumerian, but when i took her for a first walk, she wasn't afraid of dogs at all,- she was afraid of humans. I said: "Lucy, lu-ulu!" ("Lucy, [these are] humans!"). Having heard that, she calmed down, and this "maneuver" was working every time. After a few times, she got used to all the humans. And time after time, i practiced speaking short sumerian phrases with her. She also learned Russian very quickly.
Now new Lucy is dead too, but i know, that the copy of Lucy is still available in the universum, and i can get it at any time, if i wish, but i have no conditions right now to keep her and take care of her. When i can, i will find a new Lucy, plus a kitty-boy and name him "Saa-kaa" (sumerian: "Baby-fox-kitty"),- that is the name Sumerian gods advised me in case i have a new MALE cat. But meanwhile, i have a toy cat which i bought during the tour to town Tikhvin with cello girl Sasha and her dad,- (there was a competition for string instrument players among school kids,- i was a konzertmeister in cello class then). On my way to the school (in Tikhvin) where the event was held, i saw a tiny market, and there was a showcase with hand-made toys. I made the vendor put out all the toys from the bag, so, i chose a white fluffy kitten with NORMAL eyes:p, and continued my way to the school. I said that Saa-kaa is our talisman, and he really helped us to get the 4th prize (not a great achievement, i know, but it was a miracle, because there were too much obstacles, and it was insanity - to let a 16-y.o. schoolgirl play Davidoff's chello concert).:eek: They even gave me a diploma, hehehe. Later, we performed together in SPb "Capella" concert hall (we were playing a piece from Schostakovitch's ballet "The limpid stream").:ma:
Saa-kaa. (As a rule, he sits on my piano, and listens to my awful playing, lol).
IMG_20190410_092256.jpg
 
It's really, really hard to decide when it is time.

Looking back, I've never done it too soon, but in some instances, I've waited too long. I've had instances of really remarkable health turnarounds, and the memory of those and hope for something similar happening has led me to wait too long in some instances.
 
n some ways, it can be harder to be a doctor of animals than a doctor of humans.


SHOTS - HEALTH NEWS
For Veterinarians, Caring For Sick Pets And Grieving Owners Takes A Toll

"The most poignant example is when a young dog has a fracture — so a totally fixable, non-life-threatening problem," she says. But an owner neither wants to pay for a proper fix nor have a three-legged dog, and opts for euthanasia instead.

"That's a really tough thing to go through," she says. It's also particularly hard, she says, when owners, caught up in their grief, project their anger onto the vet. "So in this example," she says, they might say, " 'We have to kill our dog because you're all about the money,' which is of course not the case."


That indeed is particularly heartbreaking. I have no idea how much it would cost to have a cast put onto a dog.
 
I can tell you that it cost me upwards of $10,000 for Bratt when he broke his leg. Granted, it required surgery, the first which didn’t “take” (my gut tells me they didn’t do it right the first time...they didn’t put a cast on afterward because they felt he “wouldn’t tolerate it”). So guess what...he ended up bending the rod and popping out some screws. And after they went in and did the second surgery, he ended up with a cast. I was so mad, not only because of the money but because it dragged out his recovery even longer. :(

If it weren’t for the fact that we had just refinanced for some other expenses plus taking out care credit, I can’t say for sure what I would have done. It’s not like the veterinarians allow payment plans. And when you have an emergency you are expected to pay up front. So I’m really torn with seeing both side. Obviously, if someone has the money and they just don’t feel like spending it on their pet, that’s not acceptable. But sometimes people really can’t afford it. And I know it comes down to, if you can’t afford an animal, you shouldn’t get one. But that’s so hard, sometimes. And your circumstances might be good when you first adopt but we all know how things can change quickly for the worse. It can be a tough call.
 
I can tell you that it cost me upwards of $10,000 for Bratt when he broke his leg. Granted, it required surgery, the first which didn’t “take” (my gut tells me they didn’t do it right the first time...they didn’t put a cast on afterward because they felt he “wouldn’t tolerate it”). So guess what...he ended up bending the rod and popping out some screws. And after they went in and did the second surgery, he ended up with a cast. I was so mad, not only because of the money but because it dragged out his recovery even longer. :(

If it weren’t for the fact that we had just refinanced for some other expenses plus taking out care credit, I can’t say for sure what I would have done. It’s not like the veterinarians allow payment plans. And when you have an emergency you are expected to pay up front. So I’m really torn with seeing both side. Obviously, if someone has the money and they just don’t feel like spending it on their pet, that’s not acceptable. But sometimes people really can’t afford it. And I know it comes down to, if you can’t afford an animal, you shouldn’t get one. But that’s so hard, sometimes. And your circumstances might be good when you first adopt but we all know how things can change quickly for the worse. It can be a tough call.

Plus, I mean, It's one thing for a person to say they can afford the cost of pet supplies, checkups and maybe have a bit of an emergency fund for the just in case, but it's not realistic that every single well-intentioned, responsible pet owner is always going to have $10,000 or more in reserve at all times. As you said, a lot can change for an owner throughout the span of a pet's life to alter their financial situation.

With human healthcare, most people are insured and most facilities have payment plan options. Not to mention, if you were talking about a human child vs. a pet, you as the parent would not legally be able to neglect your child's medical needs because of budgetary restraints. The laws support what is necessary for the human child's survival. The same laws do not govern treatable medical conditions in pets.

Just a side note though - There are times I am thankful to know that humane euthanasia (when it's medically appropriate) is a legally accessible option for pet owners.
 
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$10,000 is an awful lot of money for most people. Over here there is a problem with pet insurers wriggling out of paying out as people don't read the small print of their policies. I didn't even read my policy properly until my dog was ill.

After you told me that KLS52 about your cat and when my dog was ill and ran up a huge vet bill I now make sure I have that amount in savings. I want to make sure I always have it just in case something like that happens again.:(
 
I don’t know what made me take out insurance on Ben when I adopted him, but I did. I couldn’t afford it for all four, though. I’m so thankful that it covered 90% of most of the charges for those three months. It was over $6000. And I was being conservative for the most part, not wanting to put him through exploratory surgery since they were having such a hard time diagnosing him, even with three biopsies.

I’m already stressing over what will happen since I will be retiring soon and will have a lot less income as Bratt, Joon and Stella age. :( I may look into insuring them now...it might be better to pay the premium monthly instead of worrying about a bill that ends up being thousands of dollars.
 
$10,000 is an awful lot of money for most people.

After you told me that KLS52 about your cat and when my dog was ill and ran up a huge vet bill I now make sure I have that amount in savings. I want to make sure I always have it just in case something like that happens again.:(

You are such a good mum and a responsable person. Your pets are very lucky to have you. Indeed $10 000 is a huge lump sum that many people do not have.

I don’t know what made me take out insurance on Ben when I adopted him, but I did.

I’m already stressing over what will happen since I will be retiring soon and will have a lot less income as Bratt, Joon and Stella age. :( I may look into insuring them now...it might be better to pay the premium monthly instead of worrying about a bill that ends up being thousands of dollars.

That was a good thing that Ben was fully covered and it permitted you to give him the best medical care.

It's harder to make ends meet when you retire unless you have been either an executive or firm owner. Most people do struggle to survive on a state pension. It is a good idea to obtain medical insurance for the 3 mites, just in case. Moreover, it will not be a source of stress for you.;)

Your pets are very lucky to have both of you as their mums.:yes: