Researching the relationship between performing euthanasia and veterinarian wellbeing

Why and Why Now?

Please note that this article discusses the topics of suicide and euthanasia. Please read with caution and if you or anyone you know needs help, contact Lifeline on 13 11 14 or Beyond Blue on 1300 224 636.

Whilst the prevalence of mental health issues in Australian veterinarians has been investigated, comparatively less research has sought to understand why the veterinary profession reports higher rates of mental health issues than the general population(1). Research has investigated performing euthanasia as a potential predictor of mental illness in veterinarians, but findings suggest that this relationship is more complicated and nuanced than previously thought(2).

In an attempt to uncover further information, a collaborative research team from the University of Queensland, Macquarie University, and Flinders University are currently conducting a study on euthanasia and veterinarian wellbeing and the implications of euthanasia, both positive and negative (for more information on the study or to participate, visit the website).

Several studies have compared the mental health of Veterinarians to the general population and other professions, finding that veterinarians report higher on mental illnesses and experience greater rates of suicide (1, 3). Multiple factors may contribute to this unfortunate finding, for example, access to lethal means and high workloads that cause stress (4). Animal euthanasia is a work stressor that is occupationally unique to veterinarians. Consequentially, it has been highlighted as a potentially distinguishing work task that may create distress and contribute to the incidence of mental health issues in the veterinary profession (5).

Animals may be euthanised to alleviate their suffering, but there are also reported instances of convenience euthanasia raised as an issue by researchers in the area (6). Convenience euthanasia may cause internal conflict in veterinarians if they disagree with the choice to euthanise. Another way in which the euthanasia process is suggested to take a toll on veterinarians is the emotional labour involved in repeatedly witnessing and responding with care to distressed owners (7). A third suggestion raised by researchers with some empirical evidence is that routinely performing euthanasia can shift an individual’s attitude to death, becoming more fearless about dying, and perhaps more capable of completing suicide5. These factors have led researchers to believe there is a connection between performing euthanasia and wellbeing, that would help explain the rates of mental health issues in veterinarians.

In contrast, there are mixed findings when it comes to the role of euthanasia in veterinarians’ mental health. A research team at Macquarie University has previously found that the frequency of euthanasia in a typical week was weakly associated with greater reporting of depression symptoms2. Despite this, much of the variation in mood was left unexplained, indicating that the frequency that euthanasia was typically performed was not the most pivotal factor to symptoms of depression. Moreover, inconsistent with suggestions that frequency of performing euthanasia might increase capability for suicide, veterinarians experiencing current depression symptoms, were less likely to report suicide-related cognitions and behaviours if they were performing euthanasia more regularly. Considering these mixed results, more research is needed to ascertain the complex relationship between euthanasia and wellbeing.

The current collaboration of researchers suspects that norms and attitudes the individual veterinarian holds towards euthanasia will impact the relationship between performing euthanasia and wellbeing outcomes. As previously mentioned, the context surrounding animal euthanasia can vary widely from one case to another. It may be impacted by the socio-psychological context in which it occurs and therefore the experiences and outcomes of one veterinarian may not be the same as another veterinarian. In this way it makes sense to look deeper into the veterinarian’s personal stance on performing euthanasia and what they believe their peers in the profession think about it, to identify if there are higher- and lower-risk situations for practitioners.

The current study aims to test these hypotheses to understand why veterinarians may be a more vulnerable occupational group when it comes to mental health issues. Not only is this research important to support Australian veterinarians’ wellbeing, but it also comes at a significant time in our nation’s history.

Voluntary assisted dying legislation came into action in Victoria mid-2019, and by the end of the year Western Australia had also passed a bill legalising assisted dying. With further legislation potentially passing in other states of Australia, the nation is anticipating the outcomes of voluntary assisted dying – both the positive and the negative.

While there are obvious and important differences between practitioners’ experiences of animal euthanasia and voluntary assisted dying for humans, there are also similarities in that concerns have been raised about a possible risk for practitioner mental illness and suicidality. Investigating how veterinarians are impacted by performing euthanasia and what protective and risk factors exist that mitigate or increase distress may provide important findings that can inform the practice of voluntary assisted dying. Veterinarians after all, are our only known ‘experts’ in performing euthanasia and our most relatable source of information to anticipate the impact it can have on practitioners and when it is or is not distressing.

Already over 100 veterinarians across Australia have taken part in this study. If you would like to find out more and participate in this confidential survey, please visit this website.

Madison Kho, Monique Crane and Winnifred Louis

References
1. Fritzchi, L., Morrison, D., Shirangi, A., & Day, L. (2009). Psychological well-being of Australian veterinarians. Australia Veterinary Journal, 87, 76-81. doi: 10.1111/j.1751-0813.2009.00391.x
2. Tran, L., Crane, M. F., & Phillips, J. K. (2014) The distinct role of performing euthanasia on depression and suicide in veterinarians. Journal of Occupational Health Psychology, 19(2), 123-132. doi: 10.1037/a0035837
3. Milner, A. J., Niven, H., Page, K., & LaMontagne, A. D. (2015). Suicide in veterinarians and veterinary nurses in Australia: 2001-2012. Australian Veterinary Journal, 93(9), 308-310. doi: 10.1111/avj.12358
4. Platt, B., Hawton, K., Simkin, S., & Mellanby, R. J. (2012). Suicidal behaviour and psychosocial problems in veterinary surgeons: A systematic review. Social Psychiatry and Psychiatric Epidemiology, 47(2), 223-240. doi: 10.1007/s00127-010-0328-6
5. Witte, T. K., Correia, C. J., & Angarano, D. (2012). Experience with euthanasia is associated with fearlessness about death in veterinary students. Suicide and Life-Threatening Behavior, 43(2), 125-138. doi: 10.1111/sltb.12000
6. Rathwell-Deault, D., Godard, B., Frank, D., & Doizé, B. (2017). Expected consequences of convenience euthanasia perceived by veterinarians in Quebec. The Canadian Veterinary Journal, 58(7), 723-728. doi:
7. Dow, M. Q., Chur-Hansen, A., Hamood, W., & Edwards, S. (2019). Impact of dealing with bereaved clients on the psychological wellbeing of veterinarians. Australian Veterinary Journal, 97(1), 382-389. doi: 10.1111/avj.12842

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