Deciding to euthanize a beloved family pet is hard work for most clients. It’s hard for them to know what’s best as their pet ages, succumbs to a disease, or struggles with poor mental health. Veterinary teams working with pet patients as they near the end of life have experience in this area and are likely to have beliefs and biases around what is best, even without knowing the full context of the pet/family situation in front of them. The trick is recognizing early judgment and avoiding it whenever possible.

It may be concerning to learn that many euthanized pets have not seen a veterinarian in 18 months or more. One reason may be that pet parents feel judged by the veterinary team for making delayed hospice and euthanasia decisions, or embarrassed about the poor physical health of their pet. Many may avoid the vet’s office because they don’t want any pressure to euthanize. I suspect there are more reasons for delaying veterinary care at the end of life so let’s consider it a bit. 

Dr. Mary Gardner, a well-known veterinary hospice and geriatric care doctor, writes, “In my veterinary hospice business, I was helping families say goodbye to their pets, yet a large percentage had not been to their veterinarian in years. Diving deeper into this notion, I evaluated data (with help from VetSuccess) from more than 817,000 pets who were euthanized in clinics and uncovered that 55% of cats and 40% of dogs did not see their veterinarian in the 18 months before they were euthanized.”   https://www.dvm360.com/view/is-your-practice-seeing-enough-senior-pets-

Many years ago, I was working at a rural, mixed animal practice in a small town of 5,000 people, and there was a special case that always pulls on my heartstrings. I found out a young family’s ten-year-old son had been diagnosed with leukemia. Shortly after the son’s diagnosis, the family brought their 10-year-old Siamese cat into our hospital because he was not feeling well, and we diagnosed the same condition. So sad. After due consideration, heartbreak, and tears, the family chose to humanely euthanize. I remember my colleague quickly protesting this decision until she learned about the son’s condition and the complexities around saying goodbye to the cat. Her quick snap judgment on what was right or wrong has stuck with me.

I recently met with a group of practice managers at a veterinary conference. The topic of conversation was “good grief” and how to best support clients and team members during pet hospice, anticipatory grief, and loss. We talked about Dr. Gardner’s statistics and how many pets euthanized in a clinic had not been to a veterinarian in 18 months, meaning much of the patient’s backstory was unknown. What followed was a good discussion on “perceived or experienced” judgment. 

When the practice managers were asked, “Does your team pass judgment on clients choosing hospice or euthanasia?”, the reaction was as expected. Of course not! My team is judgment-free. Then I asked them to monitor and watch for judgment and bias by the team, placed on pet parents making end-of-life decisions for the next three weeks. Within a week, I was receiving emails from the managers who were discovering their team’s level of judgment was far higher than they had anticipated (or wanted to be true). 

While researching and reading content for this blog, I have learned an immense amount. One is that the veterinary community lacks quality articles on passing judgment or biases onto clients. The other revelation is that we hold onto judgment and biases simply because we are human and wired that way. Through self-awareness and reflection, and by shifting in attributions and intent, we can become less judgmental at work. 

Elizabeth Dorrance Hall, Ph.D, writes in her Psychology Today article, “Why We Judge Others,” to consider perspective-taking or mindful processing instead of snap (knee-jerk) judgments. She describes two differing types of attribution biases we make about others’ behavior: 

1. Situational attributions – believing a behavior is due to something or a situation. For example, a coworker might have been short with a team member, because s/he is tired or overworked. 
2. Personality attributions – are more about a person’s character believing the behavior is due to the person’s personality. For example, assuming that the same coworker who was short with a team member is impatient or unkind.

Attributions are thoughts we have about others, designed to help us make sense of the world we live in. Often these thoughts influence us to pass judgment because we are wired for biases and to feel or show propensity or prejudice for or against someone or something. These are pathways in our brain that allow us to think fast on our feet. The assumption is that the first instinct is the correct one and that further information isn’t needed. 

Essentially, avoiding judgment is a gift we can give to others, especially when considering families making difficult decisions related to the care of their pet during hospice or euthanasia. Dr. Hall goes on to report, “Research has found that people tend to overestimate personality and underestimate the situation when making attributions, especially with people they do not know well.”

For our clients, giving them the benefit of the doubt may help us as veterinary professionals to step away from attribution biases and judgment. In self-awareness and testing assumptions, we may be able to create a judge-free environment improving pet care for those pets with a terminal illness, the aged, and the dying. Your homework is to watch your own team closely and look for judgment and biased behaviors. What a great opportunity to address it, while encouraging more tolerance and patience with clients facing a very hard decision.

Resources

Is Practice Seeing Enough Senior Pets? Mary Gardner, DVM, Lap of Love Veterinary Hospice, DVM360, November 2023 

https://www.dvm360.com/view/is-your-practice-seeing-enough-senior-pets-

Why We Judge Others, Elizabeth Dorrance Hall, Ph.D, Psychology Today, May, 2011