Helping pet patients with euthanasia as they reach the natural end of their life remains one of my greatest honors. Those of you out there doing the same know what I’m talking about. This act of beneficence is only paralleled by the ability to cure disease and alleviate pain. Ending suffering through euthanasia is an act of compassion, and supporting animals in this way is a gift that licensed veterinary and shelter professionals may bestow. We want to release an animal from suffering at the right time, for the right reason. When something feels right, saying no feels cruel, and we are not in the business of cruelty.

For ten years, I owned and provided home euthanasias 24/7 through my mobile euthanasia service in northern Colorado, and these days I still provide euthanasia at Dr. Cooney’s Euthanasia Comfort Center. In starting these services, the mission was to provide welcomed relief for all struggling animals (dogs, cats, exotics, and companion livestock). To meet the growing demand, I eventually employed nine doctors and five support staff to handle the volume of pets and families that needed end-of-life services in the home. We did everything we could to always say yes and rarely said no. Part of this was due to my core principles of leading with compassion but also my innate need to be positive. Turning away a crying family felt like poison to my soul, extremely hard and unnatural. What I came to learn is that sometimes saying no is necessary, no matter how hard it is.

Why We Say Yes to a Euthanasia Request
~ Desire to please – Make people happy, match their expectations.
~ Prevent guilt – Don’t want to fail the client, our patient, our oath.
~ Sense of duty – Do what we promise.
~ Reciprocation / Karma – If I do this, someone will do something good for me. The universe will reward me.
~ Grow business – Hard to turn away revenue, want to work, don’t want to encourage competition.
~ End suffering – Patients need us. I have to say yes to take away the patient’s pain.
~ Make change – Saying yes means things will change, hopefully improve the world in some way.
~ Feel good – Pleasing others makes us feel good. Ending suffering makes us feel good.  

Why We Say No
~ Lack of time – Simply not enough time in the day.
~ Unskilled – The patient and situation go beyond my expertise, I may do more harm than good.
~ Conflict – Inner personal struggle against euthanasia. Doubt that it’s needed.
~ Unclear on needs – There is a breakdown in communication.
~ No support – External support is missing such as help moving a large, deceased patient, working with an aggressive animal, or emotional support for a client with pathologic grief.
~ Safety risk – A situation where personnel and owners are in danger.  
~ Lack of supplies – The skill is there but the supplies aren’t available.
~ Prevent exhaustion – Just needing a break. I’m pushing myself too hard. 

The Euthanasia Volume You Can Handle
Veterinary professionals serving patients in the hospital or home, especially those just starting up a business may be more inclined to say yes to everyone. It’s time for good, meaningful reflection on what kind of company you envision. If you plan to offer euthanasia 24/7, saying no will be very difficult. You have to develop a business plan that is fully staffed so almost every patient gets care. I say “almost” because even 24/7 services have to recognize when saying no is necessary (see the list above). If you want to remain a small company, you will need to get comfortable saying no because the calls for euthanasia services will come. The goal should be to set hours and services, and stick to it. When we make exceptions, we have to be prepared for growth outside of our bubble.            

Realistic Euthanasia Expectations 
~ How many pets can you help per day, week, month?
~ What have you defined as acceptable to say no to?

• Convenience
• Behavior issues
• Volume beyond your comfort level
• Clients that have no funding
• Species that fall outside your scope of expertise
• Lack of equipment to ensure a peaceful death

There will be instances when a client requests the euthanasia of their pet before the veterinarian or team feels it’s time. Veterinarians reserve the right to say no and offer alternatives to euthanasia that are in the patient’s best interest. This is one of the reasons why the Companion Animal Euthanasia Training Academy advocates for scheduling end-of-life consultations for new pet patients rather than euthanasia itself. This opens the door for other options, such as palliative care, until the patient is ready for something as permanent as euthanasia. A scheduling approach like this implies that euthanasia is not a guarantee but does remain an option if everyone is in agreement.

Spreading Your Availability Message
It’s important that your current and prospective clients understand when you are and aren’t available. During conversations and especially on your marketing materials, lay out the company’s availability for euthanasia. Adhering to the available appointment hours, service range (if mobile), and the species you know how to safely euthanize reduces having to deny patients later on. In other words, spread the word on what you can do offensively rather than say no defensively.

If you must say no, find the best way to say yes. When your heart tells you to help this patient but you cannot, that’s when you lean on others in the community to help. Other veterinary services in the area can also perform euthanasia, and if home euthanasia is desired, learn who is out there providing amazing support. The best way to say yes is to connect the pet owner with someone who can help. Follow the HELP acronym… 

H – harness each other’s strengths (share cases, find out what others are best at)
E – earn loyalty (your local colleagues will appreciate the trust you show in them)
L – list resources (have a list of respected services at the ready for families to refer to)
P – plan ahead (take the time now to build your relationships and resources)

Ultimately, we are trying to find the win-win-win, a path that meets everyone’s needs: the suffering pet patient receives relief through euthanasia, the family feels gratitude for finding help for their pet, and the veterinary team knows they acted professionally with compassion to assist an animal in need. Even though you wanted to help the dying animal yourself – because, let’s face it, you are amazing and skilled at what you do – this euthanasia was not yours to carry out. We help when we can, where we can. The rest of the details may not be ours to control.