Death and dying. Are doctors and vets doing enough? Or too much?

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I have been trying to formulate ideas about over-treatment of animals for a while now. I’ve just read an opinion-article written by “Periscope” in one of the vet papers. The writer (Periscope) managed to clear some things up for me which I’ll try to summary:

Human Medicine – Friendly Doctors are now a service provider

He began by talking about human medicine. In particular the idea that medical professionals now saw themselves as service providers. And driving that service is what is known as “evidence-based medicine (EBM)”. This is the current approach to medicine which involves getting as much data on a person’s case as possible, and then relating it to accepted research data. It is because of EBM that when your doctor is explaining your symptoms and possible treatments, he now gives you percentages rather than opinions. EBM is also part of the reason why so many tests and investigations are being carried out.

Seamus O’Mahoney, a medic writing on this subject uses the term “information paradox” to detail the situation in which there is so much data and information being accumulated for each patient, that the patient’s care is suffering. Doctors who are struggling from “information overload” are being distracted from what should be their prime role which is to relieve suffering. He suggests doctors  are failing to consider when “enough is enough”. Doctors are now customer-friendly and many only tell people what they want to hear.

An insatiable appetite for medicine: for scans, for drugs, for tests, for screening.

Atul Gawande, writes that in America, dying patients are routinely subjected to futile and painful medical treatments while their doctors fail to discuss with them the reality that they are dying. Because they see themselves as providers of a service, they are more likely to offer another test or surgery rather than having the hard conversation about the surety of death.

Animals are a different case

“Periscope”, in his article says this is particularly important with animals nearing the end of their lives. Morally, there can be no excuse not to have the hard discussion with the animal’s owners. He wonders whether there could be any information on just how many procedures animals have to go through in the immediate weeks and days before they die? I have met many many dogs and cats during my Quietus Vet – Caring Pet Euthanasia home visits who have had just that experience:

Bobby was a 15 year old collie cross. He hadn’t been to the vet for anything much in the last 4 years. His owners had been aware that he was “ageing” – losing weight, sleeping more and wanting to exercise less. His owners began to consider his quality of life, and wanting guidance they turned to the vet. Nine hundred pounds, 4 vet visits and a bunch of tests later, they were told Bobby may have cancer, or may have organ failure.

I understand that many people need to hear the “cancer” word, or the “terminal illness” term before they can accept having their pet put to sleep. But as I see it, like Periscope, these owners are not really looking for x-rays and blood tests. They are looking for a discussion on what would be best for Bobby. Unfortunately, as service providers, many vets now take the easy route and just offer more tests or procedures rather than help and support.

It is all about timing and reassurance

Periscope reminds me that owners want reassurance that their timing is correct. Yes a diagnosis can help with people’s thinking, but much more important to me in my welfare euthanasia work is what Bobby is actually experiencing. It doesn’t matter if he has cancer, or a terminal illness. What matters is that he is suffering, and that there is nothing to be done:

“I don’t believe that two days or a week’s hence has any meaning to an animal… there can be no benefit to [the animal] in postponing the inevitable if there is suffering involved” (Periscope). Every extra day of life is for the owner’s sake, not the animal’s.

Consider Rocky, the 6 year old Doberman with osteosarcoma (a particularly painful bone cancer). I received a call six months ago from his owner. She was struggling. She knew she would have to have Rocky put to sleep, but just didn’t know when. Rocky’s vet prescribed pain-relief. Increasingly vets also offer Tramadol (see my future blog post) which disassociated Rocky from the pain (rather than decreasing it). Rocky was still limping and slept a lot. But his owner told me he had a sparkle in his eye and still eat pretty well. Q. Do you think he was suffering?

Suffering – How very important it is to recognize

Periscope finishes his article with:

Suffering is suffering no matter how it is “dressed up”, and if there is no good reason for it from the animal’s perspective then it should not be condoned, far less encouraged.


Paul Stevens – Quietus Vet – Caring Pet Euthanasia Derbyshire, Nottinghamshire, South Yorkshire.

  • Veterinary Practice October 2017 “Periscope” Confronting Death: When is enough enough?
  • “Being Mortal” Atul Gwande 2014
  • “Medicine has become a service industry, and it’s making doctors unable to confront death.”  Seamus O’Mahoney :-

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