There are great days for veterinarians when puppies and kittens come in for their first exams and when pets bounce in, recovered from life-threatening injuries and illnesses.

But sandwiched in between the happy times are heartrending moments. Sometimes an owner decides to put a pet to sleep because they can't — or won't — pay for treatment. Or there's the other extreme: An owner opts to keep prolonging treatment when the animal is suffering and won't get better.

A new study looks at this "moral distress" among veterinarians. While balancing the medical needs of their patients with the requests of the owners, veterinarians say they often feel ethically conflicted by what they are asked to do. For the study, which was published in the Journal of Veterinary Internal Medicine, 889 veterinarians were surveyed about these conflicts and the toll it takes on their mental health.

"We are in the really unenviable, and really difficult, position of caring for patients maybe for their entire lives, developing our own relationships with those animals — and then being asked to kill them," lead author Dr. Lisa Moses told NPR. Moses is a veterinarian at MSPCA-Angell (the Massachusetts Society for the Prevention of Cruelty to Animals-Angell Animal Medical Center) and a bioethicist at Harvard Medical School.

'They feel it'

vet and pet owner with dog More than half of veterinarians surveyed said they sometimes have conflicts with owners over treatment for their pets. (Photo: Ivonne Wierink/Shutterstock)

More than 70 percent of veterinarians in the survey felt that the obstacles that prevented them from providing care caused them moderate to severe distress. Nearly 80 percent said they've been asked to provide care they consider futile. More than 70 percent said they've had no training in conflict resolution or self‐care.

Moses points out that even if euthanasia is the right choice, it's never easy for the vet who's doing it.

"I want to make a plea to the pet-owning public to understand that, no matter what you think, odds are the person who's trying to help you take care of your animal has pretty strong feelings about how important that is," she says. "And they feel it."

Nearly one-third of veterinarians surveyed for the study said they often had a conflict of opinion with pet owners about treatment for their pets. More than half said they sometimes had conflicts. When asked, "How often have you been asked to do something in the course of your clinical practice that feels like the wrong thing to do?" 45 percent said "sometimes" and 5.6 percent said "often."

The ethical conflict may account for the high suicide rate in the profession, researchers say. The rate of suicide for veterinarians is more than twice that of people in the medical profession and four times the rate in the general population.

The authors of the study say veterinary schools should offer more training in self-care and how to navigate these ethical conflicts.

When asked how they coped with their stress when they felt they couldn't do the right thing for their patients, only 11 percent said they got professional help. Three-quarters of participants talked about it with a friend, partner or colleague, and 20 percent said they they "did nothing."

Compassionate practice

Some veterinarians have found a way to deal with the stress they face daily. There have certainly been times when owners wanted to prolong treatment on a dog with little hope, says Dr. Will Draper of The Village Vets in metro Atlanta.

"If it's a client that wants to continue treatment on an animal that's not going to get any better and they can't let go, we won't do it," Draper says. "I have to be able to sleep at night, and I always try to do the right thing."

Similarly, if an animal is brought in with easily treatable injuries like a broken leg that an owner can't or won't treat, Draper's practice won't agree to euthanize them. They'll ask the owner to sign the pet over to them and they'll work to find an animal a home once it has been treated.

"If it's an animal that has a chance, we work with so many rescue groups; it's a no brainer," he says.

Of course, not all veterinarians and practices have that luxury. There are bills to pay and the practice owner may not be able to justify free veterinary treatment.

"It has to be a compassionate practice. Everybody here understands the animal comes first and the well-being of the animal comes first," Draper says. "I think a lot of veterinarians don't have that support from their administration and that can be stressful, especially if you're euthanizing a pet that you deep-down know could be placed in a good home with a good family and have a good quality of life."

Mary Jo DiLonardo writes about everything from health to parenting — and anything that helps explain why her dog does what he does.

Many veterinarians have ethical qualms about what some pet owners ask them to do
Study finds veterinarians struggle with "moral distress" as they balance the needs of pets with the requests of their owners.