How to have end-of-life conversations

Speakers at the AVMA Humane Endings Symposium touch on ethics and empathy

When is death the best or even an acceptable option for an animal?

It’s a complex question, one that neither science nor ethics can fully answer. Given all that is at stake, conversations about euthanasia and depopulation can be extremely difficult and contentious.

With that in mind, the opening morning of the AVMA Humane Endings Symposium, held Jan. 26-29 in Chicago, featured presentations on the challenges of talking about ending animal life.

Jen Brandt, PhD, AVMA director of member wellbeing, diversity, equity, and inclusion initiatives, speaks at the AVMA Humane Endings Symposium.

“Part of what makes these conversations so difficult is that there’s a need to engage the embedded ethics questions hidden within the topic, and sometimes it can be difficult to discuss these conversations collegially,” said Candace Croney, PhD, director of the Center for Animal Welfare Science at Purdue University College of Veterinary Medicine.

As the opening speaker of the symposium, Dr. Croney suggested following Campbell’s ethics assessment process as a model ethical framework for difficult decisions that balance the interests and values of all stakeholders. The six-step process is as follows:

  • Ethical framing: What are the ethical issues? Who or what is impacted?
  • Ethics jam: What values or principles are creating conflict and how?
  • Ethical fact-finding: What do we need to know?
  • Constructing alternatives: What could be done?
  • Moral justification: Which options are the most ethically defensible? What should be done?
  • Moral testing: Can the proposed verdict be implemented? If made public, could decision-makers defend it?

“This last part is the most important test—the ‘golden rule’ test,” Dr. Croney said. “If you were not involved in the decision making, would you willingly accept the decision?”

Before the conversation, Dr. Croney said, it’s necessary to determine whether the decision-making process will be inclusive and how minority opinions will be handled. She advised accepting that perfect alignment may not be feasible.

“Remember, empathy, compassion, and respect are critical for colleagues as well as animals,” Dr. Croney said. “Stay open to new information and perspectives. And if consensus can’t be found at the moment, leave the door open for further deliberation in the future.”

Jen Brandt, PhD, AVMA director of member well-being initiatives, highlighted key communication skills in her presentation, including the importance of asking open-ended questions and the approach of tactical empathy.

Dr. Brandt defined tactical empathy as a combination of reflective listening and empathy. Rather than trying to relate to the speakers by sharing a story of your own or offering solutions to a problem, Dr. Brandt advised listening to the speakers and imagining how they must feel. Avoid “why” questions, which can feel confrontational.

In addition, pepper conversations with encouraging comments such as “go on” and “I hear you,” and reassure the speaker you’re listening by summarizing their main points.

“Even when you aren’t speaking, you are still communicating,” Dr. Brandt told attendees, reminding them to pay attention to their body language and facial expressions. “Keep your judgement in check,” she added, “and assume the speaker’s positive intent.”