Friday, July 18, 2008

Differences in mentality

I read a lot of med blogs. I think they're hilarious, and relish the chance to see a side of a life I almost chose for myself. However, the difference in mentality inherent in a vet and a person in the human medical profession are instantly obvious to anybody "in the know."

However, similar changes in mentality are even more pronounced in some lay people I see. Most people, if their loved one wound up at the doctor's office or emergency room, are only thinking about saving that loved one. No expense is to be spared, no procedure too exotic. But, when their loved pet winds up in the vet's office, a whole new set of rules suddenly apply.

There are several variations on this theme. Some come out in the preventative medicine that they get for their pet. "Just what the county requires" is a common quote we hear when people bring their pet in for vaccines and we offer them the FOUR recommended yearly/tri-yearly vaccines their pet probably really needs. However, only Rabies is a law and is the only the one the county will nail them on if it's found out they don't have one. Other variations are less tangible.

If a 15 year old small breed dog comes in an acute renal failure on top of already being in chronic renal failure and the owners can't afford/don't want to pay for hospitalization and fluid dialysis...

Or a hit-by-car (HBC) dog that has several broken bones and needs an orthopedic surgeon...

Or somebody who drives up in a Hummer with large rocks on their fingers who wants to euthanize their pet because it's urinating on the carpet...

All these pose moral, ethical and legal delimas that are not found in human medicine. Since our clients are required to pay for services themselves without insurance it is hard sometimes. Hard to refuse to treat a sick pet because the owner can't pay and we have to afford eat, ourselves. Hard to see a sick pet get euthanized because the owner "doesn't want to put them through" a treatment that would save their life. Hard to watch a pet that has been sick for a while while their owner tried everything possible to save their life...

So what is the better way? We don't usually have cancer victims that are kept alive only by ventilator, or nursing home patients whose relatives "can't stand to loose" them as they get shipped to the ER over and over and over. Vet med has that which can be the greatest of gifts- a final, dignified and painless end. However, it can also be an "out" that, instead of a last kind resort is the way of the lazy or careless. So what is right? Is any of it? Or perhaps, all?

Maybe like many things, there is "no one, true way" but many ways, all equally valid or invalid?

Maybe I need to quit posting after a bad morning.

2 comments:

Somenurse said...

on the other hand we can't put people to sleep the really need it. When the 90 year old rolls in in full cardiac arrest we have to flog them back to life, break every rib in their body and pump them full of drugs when they really should just die. Or the cancer patient that lives with pain everyday the would cripple most people that just can't seem to die on their own, but one good supertheraputic dose of morphine or the like would kill their respiratory drive and let them slip away. That would be illegal, why can't we eutinize them when they want it. I have seen hospice patients plead with the nurse or doctor to just kill them now, they don't want to go on. Treating people like animals would be great some days.

Anonymous said...

Working in human critical care I see a lot of people who we are keeping alive against their will. Lots of patients come in who had a signed DNR but their family over-rode it. Plenty of patient want to die but aren't allowed to...sometimes, letting people choose the manner and timing of their death would be a blessing.

I never thought about the other side of it, though. It just seems so callous that any pet owner would put their animal down just because it was inconvenient for them. Un-be-lievable.