Modern ethical issues and best practices in companion animal euthanasia

Kathleen Cooney, DVM, MS, CHPV, CCFP, founder of the Companion Animal Euthanasia Training Academy, discusses emerging ethical issues in companion animal euthanasia and practical strategies clinics can use to improve the quality of end-of-life care. In this Q&A, Cooney addresses communication techniques, team roles, hospice and palliative care integration, workforce well-being, cost and access concerns, common misconceptions and mistakes, and the evolving aftercare landscape.

Editor’s note: Answers have been lightly edited for clarity and length while adhering to the original spirit of the discussion as much as possible.

What are the most important emerging ethical issues in companion animal euthanasia today?

Cooney: Euthanasia will always be part of veterinary medicine, and it brings potential moral conflict and moral distress when owners’ wishes differ from those of the veterinary team. Overall, veterinary teams are doing well at considering ethical issues and caring for owners during end-of-life events, and research suggests pet owners are generally satisfied with care during these times. Emerging issues to monitor include rising costs of specialized euthanasia services, [including mobile and specialty experiences], greater use of hospice and palliative care earlier in the disease course, more intentional team utilization and role definition for technicians and assistants, and environmental considerations related to drugs and disposal practices.

How should veterinary teams structure conversations about end-of-life care with clients?

Cooney: Start by listening. The initial goal is to get the client talking so you can understand their prior experiences, psychosocial factors [finances, time constraints], and what matters most to them and their pet. Use prompts such as “tell me more” to draw out details and build a picture of the pet’s condition and the client’s priorities. If team members are concerned that the client’s perspective differs from the team’s, give a clear but gentle “warning shot,” such as, “I’m worried what you are seeing might be different than what I’m seeing. Let’s review what we’re observing.” Slowing down, building rapport, and creating trust are essential. With that foundation, honest recommendations and explanations are more likely to be heard and accepted.

How do you handle owners who ask to “do everything” for their pet?

Cooney: Again, begin by listening to understand why the client wants to pursue all possible interventions. There are often underlying reasons such as guilt from prior experiences, fear of regret, or a desire to do everything possible. After understanding the motivation, discuss what is important for the pet’s welfare and quality of life. Will repeated interventions improve or worsen the pet’s experience? Be open to alternatives that may preserve quality time, such as robust pain management, palliative procedures, or referral for treatments you cannot provide. If an intervention would clearly do more harm than good, the clinician has an ethical responsibility to voice concerns and explain why.

What can practices do to protect staff emotional well-being around end-of-life work?

Cooney: Build an intentional end-of-life culture that includes standards and written protocols for euthanasia, hospice, bereavement support, and aftercare. Creating manuals and norms that everyone helps develop reduces intrateam conflict and clarifies expectations for new staff. Regular discussion forums, like euthanasia rounds held monthly or at least quarterly, provide space for debriefing and continuous improvement. Leadership should monitor workload, mood, and cumulative death exposure to make adjustments where needed. Promote emotional intelligence across the team—self-awareness, empathy, social skills, and self-regulation—and lead with kindness, tolerance, and grace.

How should clinics think about cost and access for euthanasia services?

Cooney: Clinics need to pay attention to costs while preserving quality, which encompasses drugs, supplies, and trained personnel. Home euthanasia is important and should be kept as affordable as feasible. Consider the total cost picture, including aftercare, and be creative about matching [the client’s] ability to pay. Payment plans, angel funds, and tiered service offerings can help. Clinics should review their supply, personnel, and operational costs to identify where efficiencies are possible without compromising care.

Are there common mistakes clinicians make during euthanasia appointments?

Cooney: Most mistakes are unintentional and result from not recognizing how much the appointment involves beyond the injection itself. A frequent issue is approaching euthanasia too clinically or matter-of-factly…rushing rather than building rapport at the outset. Slowing down, establishing trust early, ensuring correct drug administration and dosing, allowing adequate time for questions, and providing meaningful support reduce the chance that technical problems will result in client distress or regret. Another misconception is believing there is only 1 proper technique. For example, pentobarbital can be administered by multiple routes as long as it reaches the vascular system.

What practical communication tools do you recommend for teams?

Cooney: Train staff to “seek first to understand” and use short, open prompts such as “tell me more.” Provide role-specific scripts for receptionists, technicians, and veterinarians for handing the client to an aftercare partner, explaining options, and discussing hospice vs euthanasia. Use the team to operationalize roles, such as who speaks with the client pre-procedure, who coordinates aftercare, and who follows up. Implement laminated desk cards or printable 1-page handouts with aftercare options and sample language to standardize communication.

What is “end-of-life culture,” and how is it implemented?

Cooney: End-of-life culture encompasses written standards and practices for euthanasia, hospice and palliative care, bereavement support, and aftercare. Implementation includes creating manuals, involving the entire team in developing norms, scheduling regular euthanasia rounds, and training staff in emotional intelligence and resilience. The goal is to reduce variability, make expectations explicit, and provide safe places for staff to voice concerns and suggest improvements.

What role should hospice and palliative care play in veterinary medicine?

Cooney: Hospice and palliative care should be integrated earlier, not just in the final hours. These approaches can preserve quality of life and sometimes extend meaningful time for the pet and family. Organizations such as the International Association for Animal Hospice and Palliative Care provide education and accreditation; the field is growing and moving toward formal recognition, including an emerging college of veterinary hospice and palliative care. Practices should offer information about hospice options and consider accreditation or referral pathways as the field expands.

How can clinics better use aftercare partners?

Cooney: Many clinics operate under an outdated paradigm that they must act as funeral directors and manage every aspect of aftercare. Partnering with reputable aftercare companies lets vendors handle pickup, cremation or aquamation, and memorialization, which meets client needs and reduces clinic workload. Clinics should vet vendors on service types, ID tracking and guarantees, pricing transparency, transport logistics, environmental practices, permits, and client education materials. When partnered appropriately, aftercare vendors can provide more choices to clients and save clinic staff time.

Any final practical advice for clinicians who perform euthanasia?

Cooney: Practice the right skills and stay within your competence. If a requested procedure is outside your experience, refer or seek training. Keep euthanasia affordable while using quality supplies and trained personnel. Always discuss all options with clients. Some may prefer hospice or palliative measures and want more time. Lead with honesty to reduce regret, leverage the full team, provide preplanning resources, and invest in modern best practices. Above all, slow down, build trust, and maintain compassion for both clients and staff.