American pet owners and veterinary practices face a quiet crisis. Specifically, how can our profession provide affordable and humane in-home care when the time comes to put a pet down? Let’s dive into why it’s a quiet crisis, how we got here and what to do about it.
First, meet your co-author, Dr. Dani McVety-Leinen, a celebrated University of Florida College of Veterinary Medicine graduate and the founder and CEO of Lap of Love Veterinary Hospice. Dr. McVety-Leinen and her team of veterinarians and veterinary technicians confront the crisis daily, providing in-home end-of-life care nationwide. She also works closely with hospice practitioners inside and outside of Lap of Love. Together, they designed a solution for the profession and animal health industry, working with me and my Animal Policy Group, which handles regulatory, legal and educational issues involving pet health care.
Limited Options
Americans want humane alternatives to end-of-life pet procedures. In-home euthanasia visits are the delivery model of choice for many pet owners, but current laws require that a licensed veterinarian travel to the home. Otherwise, the pet must be taken to a clinic, defeating the purpose of a peaceful experience. Transporting a pet is often impossible or difficult, causing prolonged suffering or danger to the owner when the animal is in pain or aggressive.
Hundreds of thousands of pet owners confirm that in-home services make all the difference for the family, other animals living there and, ultimately, the pet being put down. Euthanasia services are critical in a family’s decision to welcome another dog or cat later following the loss.
How Did We Get Here?
Life is full of unintended consequences. Veterinary practice acts are lengthy and date back decades in most states. Designed to protect the public, these legislative enactments often are bound by social, educational or medical customs at the time of adoption. They remain the law of the land and are rarely updated despite the accelerating pace of technology, research and advancements in health care.
Proper euthanasia undoubtedly requires medications. State practice acts contemplate or assume that such pet medications are administered in clinics, which is no surprise since veterinary colleges designed their curricula around veterinarian-centric, in-clinic practices. States did not experience shortages of licensed veterinarians when legislating practice acts.
Most states allowed only licensed veterinarians to administer euthanasia medications. However, in a few states, technicians may do so with direct or immediate veterinarian supervision. Those states are Connecticut, Georgia, Kentucky, Missouri, Nebraska, Nevada, New Hampshire, New Jersey, Oklahoma, South Carolina and Texas. In addition, four states (Alabama, Illinois, Montana and Pennsylvania) allow indirect supervision. Three states (Delaware, New York and Ohio) do not specify the level of supervision.
Meanwhile, shelters and animal-control agencies in some states face space and financial constraints, forcing the facilities to euthanize scores of animals. Requiring the presence of a licensed veterinarian in such situations isn’t feasible. In three states with large populations (California, Florida and Tennessee), exemptions in practice acts are carved out for credentialed veterinary technicians in shelters or animal control agencies who receive eight to 16 hours of training to be certified as euthanasia technicians.
The good news is that no collateral harm to companion animals was reported in states that updated their practice acts to permit credentialed veterinary technicians to perform euthanasia. The bad news is that no state has considered expanding the privileges beyond the walls of clinics, shelters or animal control agencies.
What We Propose
It’s time for a grassroots initiative with state veterinary medical boards and legislatures to address the issue practically and safely for the benefit of pets, their owners, veterinarians and credentialed veterinary technicians.
Here is model legislation that all 50 states should implement:
A state may allow credentialed veterinary technicians to perform in-home hospice services and administer euthanasia if:
- They are certified as euthanasia technicians through a minimum 16-hour course and 20 hours of veterinarian-supervised euthanasia experience.
- The technician is employed by a veterinary practice in the state.
- A licensed veterinarian at the practice uses real-time video communication to oversee euthanasia procedures performed by the technician.
Such a solution would:
- Lead to more humane and readily available euthanasia for pets in need.
- Satisfy pet owners during a difficult time.
- Potentially lower the costs for pet owners.
- Reduce the pressure on clinics whose veterinarians otherwise would have to travel to a pet owner’s home.
The new regulatory approach would create work opportunities for credentialed veterinary technicians and greatly increase the number of clients who could access humane end-of-life procedures. Our solution requires a veterinarian to oversee in real time the euthanasia procedure and ensure that the technician understands how to handle any problems. The veterinary clinic would receive a fee for services, so the reforms would not jeopardize practice income.
A Sensible Alternative
Worsening shortages make it difficult, if not impossible, for veterinarians to leave their clinics and travel to client homes. Rapid availability of in-home end-of-life care is crucial for pets in failing health. At Lap of Love, for example, 80% of appointments are scheduled with less than 48 hours’ notice.
Pet owners unable to obtain help for a dying pet at a critical time lose trust in the veterinary community. As a result, the risk increases that some might take matters into their own hands to relieve their pets’ suffering.
A safe and practical solution for professionally guided in-home euthanasia is feasible. Current laws and regulations, unfortunately, prevent its use. However one looks at the problem, what we propose makes sense, as there are no losers.
It’s time for all stakeholders to join hands and make the reforms happen.
WHERE TECHNICIANS DO MORE
Here are excerpts of codes and laws in some states.
- Alabama: “A veterinary technician may perform [euthanasia] under the indirect supervision of a veterinarian.”
- Florida: “Euthanasia shall be performed by … a certified veterinary technician who is an employee or agent of a public or private agency [or] animal shelter.”
- Illinois: “A certified veterinary technician shall perform the following tasks only under the indirect, direct or immediate supervision of a veterinarian. … Humane euthanasia
of animals.” - New Jersey: “All persons administering animal euthanasia shall be a New Jersey licensed veterinarian or be certified by a licensed veterinarian in the acceptable euthanasia technique or techniques used at the facility.”
- Texas: “Euthanasia may be performed by a non-veterinarian only under the immediate supervision of a veterinarian.”