Euthanizing patients has always been hard on practice staff. But social-distancing requirements during the COVID-19 pandemic made it even harder, according to a new study by researchers from the University of Sydney (US) in Australia.

The researchers developed an online, mixed-methods survey to measure moral stress, a type of stress that arises from ethically challenging situations (ECS) that is now used commonly to describe the type of stress experienced by veterinary professionals in daily practice. The researchers sought to determine the frequency, stressfulness, and types of ECSs experienced by veterinarians, veterinary technicians, and other veterinary staff since the advent of the global COVID-19 pandemic in March 2020.

The researchers analyzed responses from 540 veterinary team members in 22 countries collected between May and July of 2020.

The researchers released a previous study based on the same data last fall that focused on pandemic-specific ECS, including concerns about biosecurity and safe working conditions. 

The new study focuses on one particular pandemic-specific stressor: no- and low-contact euthanasias.

Corresponding author Anne Quain, MVetStud, DECAWBM, told NEWStat that her team found it striking that one fifth of respondents spontaneously volunteered that low- or no-contact euthanasia was the most common ethically challenging situation they faced, and the most stressful.

So striking that they believed it deserved its own study.

“We defined no-contact euthanasia as strategies used to eliminate physical contact of the veterinary team with clients, who were usually required to remain outside of veterinary premises at all times, even when their animal was inside,” said Quain, a lecturer in veterinary science at US and a PhD candidate in veterinary ethics. “These clients may have had phone or video contact with the veterinary team to provide a history, make decisions and provide consent, but no contact with the animal, during euthanasia.”

The researchers defined low-contact euthanasia as strategies such as limiting the number of people present in the consult room, physical distancing, and the wearing of PPE by veterinary team members and clients.  Intermittent global shortages of PPE, especially early in the pandemic, meant that low-contact euthanasias were not an option for some teams.

Quain said many respondents were very conflicted between the need to protect their team from an infectious disease—this was pre-vaccine—and wanting to respect and honor the human-animal bond at the end of an animal’s life: “In an era where our profession has become increasingly aware of the potential fear, anxiety and distress that veterinary visits can cause to animals, no-contact euthanasia in particular was experienced as transgressing [team members’] deeply held moral beliefs or values.”

Unsurprisingly, this led to considerable frustration—and in some cases conflict—in the workplace.

“This was an extremely difficult situation for both pet owners and veterinary team members,” Quain said. She pointed out that at the same time, in human health care settings, family members were often not permitted contact with their hospitalized loved ones at end of life. To be separated from their beloved pets under similar circumstances was an additional blow.

How teams can respond to the challenges presented by low- and no-contact euthanasias

Quain said that, ideally, in the face of a highly infectious disease, veterinary practices should have protocols to facilitate low-contact euthanasia. “This would help ensure the safety of the veterinary team and client while also honoring the human animal bond and, importantly, preserving animal welfare.”

She said the profession can help.

“Now is the time for professional associations and other bodies to develop protocols to effectively eliminate the need for no-contact euthanasia, and develop a protocol for low-contact euthanasia—including outdoor euthanasia, where appropriate—that enables animals and their bonded human to experience minimal distress.”

Protocols which will, in turn, reduce the stress on staff.

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