Animal versus human hospice care

Animal hospice care has its origins in human hospice philosophy and practice. Human hospice care focuses on the palliation of a chronically ill or seriously ill patient’s pain and symptoms and attending to their emotional and spiritual needs as they near the end of life and as they die. Human hospice care also assists patients’ families to help them cope with the patient’s circumstances and to provide care and support in the home care setting. Similarly, animal hospice care seeks to maximize comfort and minimize suffering for the patient, and address the needs of the caregiver in preparation for the death of the pet.

Several important aspects of animal hospice care, however, are distinct from its human counterpart. Legally, and in terms of our social norms, the acceptance of pet euthanasia is in sharp contrast to what is acceptable in human hospice care. A guiding principle of human hospice care is to “neither hasten nor postpone death.” Rather, as the death of a person becomes imminent, human hospice care seeks to relieve pain and anxiety.4 Life-prolonging interventions such as cardiopulmonary resuscitation are declined if they no longer contribute to the patient’s QOL. The same approach applies when the death of an animal is imminent. However, when caring for seriously ill animals, euthanasia is a legal and widely accepted option for relieving suffering. Animal hospice accepts that it is the pet owner’s ethical and legal right and responsibility to decide whether the terminally ill animal will die by euthanasia or by hospice-supported natural death. Animal hospice does not accept a pet owner’s decision to allow a pet to die without euthanasia unless effective measures are in place to alleviate discomfort under the care of a licensed veterinarian. Such practices are considered unethical and inhumane.

Unfortunately, there may be situations where a veterinarian must consider terminating the veterinarian-client-patient relationship because he or she is unable to provide a patient with the necessary standard of care required to fulfill the veterinary oath. As with any other such case, the practitioner should be guided by his or her ethical obligations to both patient and client and the legal considerations of his or her State Practice Acts.

Lastly, there are considerable differences between the resources, financial and otherwise, available for providing animal EOL care compared to human EOL care. In human hospice care, the patient’s main care providers are the family caregiver and a hospice nurse who makes periodic visits. Although the cost of providing care for a hospice patient at home is generally lower than the cost of hospitalization, significant expense is still involved.5 These costs are covered in the United States by Medicare and other health insurance providers. Qualifying for hospice benefits is dictated by law, limiting the coverage to patients who are medically certified to have a prognosis of less than 6 mo to live. This is in contrast to animal hospice, where a vast majority of the costs are covered by pet owners as an out-of-pocket expense. As a result, the financial resources available to some caregivers to cover the costs of animal hospice services are significantly more limited.

Take-away points

  • Like human hospice, animal hospice focuses on palliation of a patient’s clinical signs while addressing the emotional, social, and spiritual needs of the caregiver.
  • Animal hospice does not accept a pet owner’s decision to allow a pet to die without euthanasia unless measures are in place to alleviate discomfort and distress.