For the past 3 years, I’ve been recording my patients’ euthanasia appointments. It started out of as necessity to give myself protection should a client every voice concerns about my skills, technique and compassion. I’m a euthanasia expert who has devoted my career to teaching other veterinary professionals how to make euthanasia the best it can be. What would it look like if someone claimed I was doing things wrong? Would I be able to prove what I did and what I said to create the calmest, smoothest end-of-life event for my patient and their family? Recording my appointments felt like the best way, especially since I’m alone in my work; no other staff to discuss things with.
And so I’ve continued to do so, with my clients’ knowledge. My online scheduling system informs clients that “All appointments are audio recorded for quality assurance purposes, and to hold myself to the highest of standards. If you have concerns or questions about audio recording, please let me know.”* Colorado where I practice is a ‘one person aware of the recording’ state, so while I don’t need to inform clients, I still do. Some states require that both parties be aware of the recording, making it even more important to inform.
About a year ago, I reached out to some veterinary colleagues with Juris Doctor (JD) degrees to ask their impression of veterinarians recording appointments. The general consensus was that while they’d like it to be unnecessary, the truth is having a recording offers both the veterinary team and client multiple layers of protection. Litigation is at an all time high in the United States, and this includes animal-related businesses. It’s like having a neutral third party in the room, and the recordings remain as part of the patient’s medical record.
The recording, as I see it, provides insights into:
- What the veterinarian said, what they informed the client about, how they treated the patient, and the level of compassion given.
- What the client said, what they asked for, and any concerns raised during the appointment.
- How the pet patient responded to handling and medication administration.
- Any possible theft to controlled substances and other veterinary supplies.
- Ownership of the patient (proving ownership is harder than one might think).
This last one about theft is a bit unique to modern euthanasia protocols, including home euthanasia settings. Veterinarians and veterinary teams now commonly bring controlled substances into exam rooms or into the home for use during euthanasia. This is done to improve patient welfare, ensuring everything they need is right there. In the home setting in particular, a veterinarian may leave their doctor bag and supplies in the room with the client/patient when offering privacy both before and after death. When the veterinarian returns to the room, it is assumed their drugs and supplies are untouched. A recorder left running in the bag can capture sounds of theft such as zippers opening, drug lock boxes opening, etc. While it is advisable to not leave supplies unattended, the reality is it happens sometimes.
Audio recordings can be done with cell phones or tablets, using Apps or other programs that record sounds. Before I begin my appointments, I put my phone on silent, turn on the recording App (Voice Record), and make a quick soundbite with the patient’s first and last name. The phone is placed in a pocket in my doctor bag with the microphone end sticking up. The bag remains next to me during every stage of the appointment so talking and sounds can be recorded. Afterwards, I upload the file to my computer where it becomes part of my medical records. I can refer back to it if I forgot specific details such as whom I should notify regarding the death, or aftercare requests important to the client. Most importantly though, it can be used if the client raises concerns about how the appointment was conducted. This gives me peace of mind knowing an accurate, neutral recording exists if I ever need it. After 1 year, I delete it for client protection so it never gets inadvertently released. And it will give my clients peace of mind knowing I’m holding myself to the highest standards to deliver the best euthanasia experience.
I share this information for all veterinarians to consider. It’s a straightforward process that can be easily taught to associate veterinarians and technicians. The Companion Animal Euthanasia Training Academy (CAETA) hears sad stories from pet owners and veterinarians alike who have experienced an unpleasant euthanasia appointment. Recordings give voice to what actually took place and can be used to improve understanding.
*This statement was recently updated due to recommendations from J. Pierce, June 2023.