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There's a bit of correspondence in the independent this week about end-of-life issues, vets and euthanasia. Having been immersed in human end-of-life issues for the last few years now this is a very real issue for me. What our own family issues have taught me is that you cannot judge an elderly person's quality of life by your own frame of reference at all. Just because you'd hate what's happening to them if it happened to you today that's irrelevant. What you have to do is broaden your view, accept that the life of the person you're caring for has changed and look for anything at all that seems to give them happiness, satisfaction or just comfort. In some respects the issues you face are similar to the issues you face with animals as increasingly with old-age-dementia you run into communication problems and you have to look for other evidence of unhappiness or satisfaction beyond listening to words that may no longer make much logical sense.

A number of vets have responded to the correspondence in the guardian with their own views, amongst them Robin Hargreaves, who was quoted as saying "..it is one of the aspects of my job that I genuinely enjoy." Whether he said that I don't know although I suspect it is not quite what he meant in the common sense of the word "enjoy". But certainly it is one aspect of the job that brings the most satisfaction as it is one area of veterinary life where your capacity to relieve both the suffering of the animal and the emotional distress of the client are at their maximum.

I'm not completely comfortable with the link the article makes between the numbers of euthanasia cases being undertaken by vets and mental health in the profession, a relatively high proportion of whom 'reach for their own blue juice'. There is a problem with depression in the profession but I suspect that the reason for that is to do with the burden placed upon vets by virtue of the Code of Conduct imposed by the Royal College of Veterinary Surgeons which only has powers to regulate individual vets and not veterinary businesses. The majority of vets working in the profession have no managerial responsibility in the businesses they work for and no equity stake in in the businesses they are in. And yet because of the Code of Conduct in the most difficult situations the buck always stops with them and many work under the constant cloud of fear of a complaint being made against them.

Euthanasia isn't the most stressful situation you encounter by and large in practice; mostly it is because of situations where you are faced with a variety of causes of treatment failure due to circumstances you cannot control. Things going wrong where you are expected to rectify the consequences of poor breeding, or poor management, or perhaps unrealistic owner expectations or resources; and when despite your best efforts, which may be heroic at times, things go wrong it is you the individual vet that carries the can and is in the firing line if the situation is not resolvable. Mostly that's not the euthanasia cases...you get lots of thank you cards for them if you treat both the owner and the animal with sympathy and compassion.

My own experience of dealing with the stress of end-of-life issues is that in addition to broadening my view of what might improve quality of life for the person I've been caring for I've also had to rely on things that I would not have made a priority at veterinary college in order to relieve my own stress...specifically yoga and dancing. Had I not had the support of my family and those things to fall back on, who knows, maybe I'd have been a candidate for the blue juice. However, at the time of my veterinary career when my job in clinical practice was at its most stressful I would have had little or no chance of doing the things that have helped me manage my stress over the last few years because of the obligations with respect to out-of-hours 24/7 emergency cover imposed by the Code. The introduction of out-of-hours service providers in recent years must have eased that burden a little for those in companion animal practice but I suspect that many people still underestimate just how important that is.

The national purse is coming under increasing pressure at a time when we are already clearly struggling to fund end-of-life care for elderly people and when we don't adequately fund their carers at all. At such a time I think we need to be careful that we do not permit any government agency or public body to place any further obligations upon vets that are not absolutely justified and that we should also seek to remove those obligations that are already unreasonable.

Every hard working vet on the register deserves quality of life during his or her life; not just when life ends.