by Walt Weirich
Jack B. Boomer brings in his dog for a consultation. You watch him drive up in his "beamer" and roughly extract the dog from the back seat. After he has the dog out on the parking lot he stops to brush the dog hair off the seat. The dog tangles the leash around Jacks leg and you notice Jack is wearing well shined loafers and expensive slacks, but, no socks.
When Jack is in your examination room he tells you that he wants "Clarence" put down. He explains that the dog has caused him grief one too many times and he wants Clarence put to sleep. You question him why and he says that his former girl friend liked the dog but that his current girl friend does not. Just when he and his girl friend get in a certain "mood" the dog interrupts and spoils everything. He will not listen to any of your suggestions and insists that you euthanize Clarence. Clarence is a neutered four year old Jack Russell Terrier in excellent health.
What do you do?
What are the consequences for Jack if you euthanatize Clarence?
What are the consequences for you if you euthanatize Clarence?
What are the consequences for Clarence if you do not euthanatize Clarence? (Remember Jack is determined)
Objective: Introduce a very serious and very common problem in small animal veterinary practice. The student must make a decision on how he/she will deal with this kind of situation because it is so common.
Student may refuse to euthanatize Clarence. Or they may euthanatize him because there are no other alternatives.
The primary purpose of this exercise is to encourage students to sort out in their own mind how to deal with this kind of situation in a manner that is consistent with their over all personal philosophy.
Student should be asked to express themselves and then the teacher should help them to sort out valid premises that can lead to a valid conclusion.
If no alternative exists that Jack will accept, than I believe that Clarence must be euthanized. If not, what will Jack do? He might try to kill him and botch the job. He may dump him on the freeway or out in the country. Clarence certainly does not deserve to die this young, but he is Jack's property and Jack insists that he be destroyed. Clarence will be better off dead than suffering an unknown fate if you refuse to euthanize him.
Mrs. Jane B. Practical brings in her beloved "Poochie," an 18-month-old Yorkshire Terrier that has been acting strangely of late. Poochie has been very depressed after eating to the point of appearing to be in a light coma. There have been some "spells" that might hust have been seizure. Poochie is small and has never been a very vigorous dog. Mrs. Practical asks that you work up Poochie to find out what is wrong.
The work-up shows Poochie has what is almost certainly a porto-systemic shunt. You recommend that she take Poochie to the University for surgery and a special diet that will relieve Poochie's symptoms, allowing for a nearly normal life. Poochie will require special care but, with a little diligence on Mrs. Practical's part, Poochie will be all right.
Mrs. Practical's face goes dark when you tell her this. She does not want to put Poochie through all of that and asks you to put Poochie to sleep.
Objective: Euthanasia is a viable treatment alternative in veterinary medicine.
Not every owner is willing to accept the responsibility to take care of a sick pet. In this case, the care will very likely be minimal. Most but not every dog survives the surgery; some have postoperative complications. So there are valid reasons why an owner might not want to pursue care for this kind of patient.
Cost is another consideration. Some owners are either unable or unwilling to spend their money in this manner.
Some compassion must be offered to the owner because she is going through a difficult time in giving up a dog she obviously loves. You must not make that decision harder for her as she undoubtedly feels guilty.
Students need to be encouraged to state their thoughts. They also need help in sorting through the set of premises and conclusion for the veterinarian and the separate set of premises and conclusion for Mrs. Practical.
Ima V. DeVoted brings in her aging mixed breed Beagle female "Mitzie." Mitzie has several moderate to large size mammary tumors in her right chain and smaller ones on the left. Aspiration of one of the masses reveals adenocarcinom with a high score for malignancy. You recommend radical mastectomy as a two-stage procedure. Mrs. DeVoted quickly accepts and the surgery is done on the right side.
Everything seems to go well but before the second stage of the surgery can be done, regrowth on the right side has already started. The growth is very aggressive and in a short time, the new tumor is ulcerated and draining profusely. Thoracic radiographs reveal metastatic masses within the lung that were not there at the initial examination six weeks prior. Mitzie is in a lot of pain with the rapidly growing tumors. Nothing more can be done to correct the problem and make Mitzie more comfortable. You recommend that Mitzie be euthanized. Mrs. DeVoted refuses and stomps out of your office. She subsequently quits her job and stays home with Mitzie full time.
What is causing Mrs. DeVoted to take such drastic steps for Mitzie when Mitzie is clearly suffering?
What do you tell Mrs. DeVoted to encourage her to change her mind? What is the moral basis for your argument that you might be able to present to convince Mrs. DeVoated that what she has done is wrong?
Johnny Dollar of the Dollar Cattle Farms calls you to see a cow on his farm. The last two weeks before calving, the cow has fallen on the way to the barn and fractured her left femur and probably her pelvis. Johnny is very concerned that she deliver the calf she is carrying because the calf could be the basis of a new line of genetically improved dairy cattle. He wants you to do what you can to keep her alive until she calves naturally. After that he does not care what happens to the cow.
He would like to get some money out of her but the calf is of paramount importance to him.
How will you deal with this situation?
Will you acquiesce to his request to keep her alive for two weeks until she calves?
Are there alternatives that might be morally correct for the cow?
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Last Update 06/06/03