Low and No-Contact Euthanasia: Associated Ethical Challenges Experienced by Veterinary Team Members during the Early Months of the COVID-19 Pandemic
2. Materials and Methods
3.1. No-Contact Euthanasia as a Unique Ethical Challenge
“Disallowing witnessing euthanasia”veterinarian, Singapore
“Putting animals to sleep without owners allowed to be present”veterinary nurse, UK
“Having to make owners stay outside while we take their pet inside”veterinary nurse, Australia
3.2. Balancing Veterinary Team Safety with the Emotional Needs of Clients
“Being forced to choose between allowing clients into the facility for a euthanasia or maintain “no client access” policies instituted to reduce potential exposure and allow for social distancing. By allowing clients to be present during a euthanasia there is a risk of exposure to both our staff members and the clients in question. It uses scarce and valuable PPE and adds further stress to the team in an already emotionally taxing situation. However, denying clients the opportunity to be present during the euthanasia compounds the grief and loss of an already deeply traumatic situation and denies them a sense of closure and control.”Veterinary nurse, USA
“Not being allowed to have owners present or even visit their pet again prior to euthanasia. I found it to be excessive and unnecessary. While I am worried about COVID just as much as the next person and I want to take precautions, I don’t see why we can’t offer the client to be present outside the building on a bench with masks and long extension set etc. I was reprimanded by management for doing just that.”Veterinarian, Canada
“…having to decline house calls for elderly clients for both our, and their, protection.”Veterinarian, Australia
“It is difficult to receive a patient, specifically one that is critical or in pain, and tell the owner they have to wait in their car and/or are not allowed to come in with their pet. Similarly, when owners want their hospitalized pet to have a blanket or shirt with them, it is hard to tell them no.”Veterinary nurse, USA
“Not being able to provide clients contact with their seriously ill hospitalized pet…it is not what I would consider acceptable for my own pets.”Veterinary nurse, Australia
“Balancing the needs of clients to see/visit their critically ill pet with the needs of our staff/hospital to maintain a socially distant and ideally client free hospital.”Veterinarian, Australia
3.3. Low and No-Contact Protocols May Cause or Exacerbate Fear, Anxiety and Distress in Veterinary Patients
“Many dogs are stressed away from their owner. Also, in the case of very sick animals/emergencies/euthanasias owners are distressed about not being able to be with their animal. Do you cave and let them be there knowing that if you get covid19[sic] the entire clinic team and possibly other clients could get infected, or stick to the policy knowing you are causing emotional distress to the owner and animal?”Veterinarian, Australia
“Anxious animals being away from their owners creating a more negative environment for the animal to be in.”Veterinary nurse, Australia
“…distress of pets and owners when separated from [each] other to allow social distancing during exam.”Veterinarian, Australia
“People want to be with their animals, and some need to be…sometimes the dog or cat needs them. We finds[sic] ways to accommodate that.”Veterinarian, Canada
“I thought it was very over the top that in Australia some clinics were either not allowing clients to be present for euthanasia of their pet or required the client to be gowned up in a hazmat suit to be present (and scaring the poor dog with the outfit).”Veterinarian, Australia
3.4. Physical Distancing Is More Challenging during Euthanasia Consultations
“Not being able to allow clients to be present the whole euthanasia procedure i.e., taking the animal off them in the car park, placing IVC [intravenous catheter], then bringing clients around the back to outside where they must remain for the procedure, never allowing them in the clinic.”Veterinary nurse, Australia
“Being in close proximity to grieving owners (with increased secretions) is stressful on the staff.”Animal health technician, USA
“Owners crying without masks during euthanasia.”Veterinarian, USA
“…only allowing 1 person to be present when saying goodbye to their pet. It causes moral conflict because it feels wrong asking other family members to leave in a hard time when they are also grieving and would like closure.”Veterinary nurse, Australia
“Family’s [sic] not allowed to be present during euthanasia. Only one family member outside the building. Seeing the sadness/distress of the one family member shouldering the burden alone.”Veterinary nurse, Australia
“Clients are quicker to elect euthanasia as apposed [sic] to diagnostics as it’s more difficult to bring them into the practice.”Veterinarian, Canada
3.5. Biosecurity Measures Complicated Communication around Euthanasia and End-of-Life Decision Making
“Trying to convince an owner that it’s the right time to euthanise their pet when the owner is unable to see their pet’s clinical status and what is happening in the hospital.”Veterinarian, Canada
“Euthanasia being refused by clients as they cannot be present with their animal.”Veterinarian, UK
“Clients not wanting to put their pets to sleep as they are unable to attend euthanasia.”Veterinary nurse, UK
“It has been difficult to have to refrain from any human touch or closeness during such a personal procedure which requires empathy.”Veterinary nurse, Australia
“…not hugging the client or spending time with them which we normally do.”Veterinarian, Australia
“Euthanasia appointments should be structured so that time in close proximity to the client is minimized. For example, contactless or quick transfer of the patient, distanced escort of an owner to a room, insertion of a catheter in a separate room, keeping personnel distant from the owner until the time of injection, having the owner stand distant or, if they will hold the animal, have personnel wear PPE to protect themselves (mask and eye protection); Documentation of verbal consent rather than requiring signatures; Using contactless electronic payment wherever possible”
Biosecurity Measures Complicated Communication around Euthanasia and End-of-Life Decision Making
5. Strengths and Limitations
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
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|Demographic Parameter||Category||Number (Overall Responses, n = 540)||Number (Subset of Responses, n = 123)||Percentage (% Overall Responses)||Percentage (% Subset of Responses)|
|Animal health technician||11||2||2.0||1.6|
|Other animal health professional||9||2||1.7||1.6|
|Caseload||Companion animal practice clinical||367||92||68.0||74.8|
|Mixed animal practice clinical||38||10||7.0||8.1|
|Zoo and/or wildlife practice clinical||27||5||5.0||4.1|
|Equine practice clinical||13||3||2.4||2.4|
|Exotic/unusual pet practice clinical||12||3||2.2||2.4|
|Scientific research/laboratory animals||8||0||1.5||0|
|Industry (e.g., pharmaceutical companies, food companies)||4||1||0.7||0.8|
|No longer working as a veterinarian||1||0||0.2||0|
|United States of America||125||24||23.1||19.5|
|Year of birth for total number of respondents (n = 528)||1926–2000||1979||1980||11.9|
|Year of birth for subset of respondents (n = 120)||1956–1998||1980||1982||11.3|
|Year of graduation for total number of respondents (n = 540)||1958–2020||2004||2007||11.9|
|Year of graduation for subset of respondents (n = 123)||1956–1998||2005||2007||11.1|
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Quain, A.; Mullan, S.; Ward, M.P. Low and No-Contact Euthanasia: Associated Ethical Challenges Experienced by Veterinary Team Members during the Early Months of the COVID-19 Pandemic. Animals 2022, 12, 560. https://doi.org/10.3390/ani12050560
Quain A, Mullan S, Ward MP. Low and No-Contact Euthanasia: Associated Ethical Challenges Experienced by Veterinary Team Members during the Early Months of the COVID-19 Pandemic. Animals. 2022; 12(5):560. https://doi.org/10.3390/ani12050560Chicago/Turabian Style
Quain, Anne, Siobhan Mullan, and Michael P. Ward. 2022. "Low and No-Contact Euthanasia: Associated Ethical Challenges Experienced by Veterinary Team Members during the Early Months of the COVID-19 Pandemic" Animals 12, no. 5: 560. https://doi.org/10.3390/ani12050560