We all want to see the progression of animal welfare and to increase the standard of our veterinary practice. Often, our daily choices can affect this in ways we may not intuitively consider. As we progress as a culture, we gather more information on what the people want in a broader sense and how we can better serve our clients and patients.
Taking this cultural progression into account, the AVMA created a new policy on aftercare that affects us all. We can now be held accountable for the aftercare providers we choose. The AVMA has adapted their guidelines to the evolution of the human-animal bond and it starts out by small actions that can have a ripple effect bigger than we can imagine.
In 2008, Dr. Bernard Rollin, a professor of biomedical sciences and philosophy of animal welfare, set out to eliminate the sow stalls that were being used as breeding factories for pigs. The first time he had ever encountered one, he was shocked. He was taken aback by the utter lack of moral treatment of animals, and right then and there he made a promise to himself that he would do whatever was in his power to eliminate that style of farming.
Instead of going through legislative power, his strategy was to show big businesses that their customers despised that style of practice. He marched into Smithfield, the largest pork producer at the time, and challenged them to poll their customers. “What will we find?” They asked. “You will find 75% rejection of this style of farming,” he replied.1
They called him back six months later to inform him, “Actually, it was 78%.” Seventy eight percent of the public does not like this.
So why keep giving it to them?
The genius in the way Dr. Rollin strategized was that he simply asked people for their opinions and Smithfield stopped using that style of sow stalls. Actions like this have a large effect on the industry as a whole. We are progressing culturally, and the relevance of public opinion is something we will come back to when we look at the third point in the policy.
Our perception of the human-animal bond worldwide has strongly evolved in the last decade, and the AVMA took the lead in bringing a policy to frame our practice of aftercare.
Here are the three main points from the AVMA Companion Animal Aftercare Policy, some examples of how they work and how they can affect you:
1. “Veterinarians must understand that they may be responsible and may be held accountable for the aftercare provider they recommend.”*
The International Association of Pet Cemeteries and Crematories (IAOPCC) told Stephen Dubner of the Freakonomics podcast that 10 years ago, only a handful of facilities specialized in pet aftercare. There is now a vast increase in the number of pet aftercare facilities to complement the ever-increasing number of pet owners. However, there is limited legislation in this industry and it varies substantially.
With so much emotion surrounding death and aftercare, along with the increase in number and size of aftercare providers, it makes us wonder what the margins of error are. Have you, yourself, ever visited a pet cremation facility?
Freakonomics hosts investigated this issue.2 They wanted to know, are we indeed getting the appropriate ashes back when we take our beloved pets to the crematorium?
To investigate this, they created a fake cat. They took fur from a rabbit, stuffed it with hamburger meat and named it Stevie. As there were no bones in Stevie, the amount of ashes returned to them should be minimal compared to normal cremains. Crematoriums should likely flag this, as the second step in cremation is to crush the bones, a process called “cremulation.”
They sent a version of Stevie to three crematoriums to see what they would get back. For each one, they received bone ash in the cremains. How is this possible? None of the crematoriums gave an explanation of how there could be bone fragments in the ashes. The Freakonomics team sent all of their data to the attorney general’s office and will update the viewers in the event this is pursued.
In line with an increasing number of pet parents and their concern, it is clear there are issues in the aftercare industry. The AVMA Policy is there to guide us and help prevent such traumatizing events.
One reason there will be more accountability on the part of the veterinarian is because the IAOPCC decided to conduct a mock trial in the event of cremation fraud to see what the peoples’ perspectives are and how they would be judged in a court setting. In the trial, jurors ruled in favor of the prosecution in all counts, with a total of $3.5 million dollars in punitive damages. The jurors charged the veterinary clinic damages for not going out to check on the crematorium.
The public is clear that they don’t take cremation fraud lightly. So it is important we hold crematoriums to a high standard. The AVMA goes on to say, “Aftercare providers you work with or refer clients to should be seen to always handle pets with dignity and respect.”
The interesting part about the mock trial is that it shows veterinary facilities will likely be held accountable for any indiscretion on their part. To this point, the AVMA took the lead again in pointing it out in their policy that it is a very real possibility that the facilities can face damages—something to keep in mind the next time you name your crematorium. It is also notable to mention that in many cases, crematory providers are sometimes chosen on the price of their service. Many veterinarians and vet teams likely have not visited a crematorium, though we send deceased pets to them every week.
2. “Encourage prior planning so that owners are aware of their options and can easily communicate their preferences. Pre-planning can be offered by the veterinarian or delegated to the aftercare facility.”*
The power of pre-planning for euthanasia is exceptional in that it gives the owners a chance to both prepare and begin to cope with the loss of their companion. It often empowers owners as they face the circumstance of loss. Opening a dialogue about this also gives them the time to think about what they want in terms of the appointment itself, when it should occur and aftercare options.
The Companion Animal Euthanasia Training Academy suggests a few points to consider for the appointment:3
- Where to gather (home, hospital, favorite place)
- When it should take place (before a crisis, when loved ones will be able to attend)
- Who should be there (family and friends, children, other pets)
- What special touches to include (music, photos, ceremonies)
- How the aftercare will be managed (personal preference of crematorium, cemetery or memorialization)
Many people do not know what to expect with regard to the euthanasia appointment. A pre-euthanasia appointment is useful in helping map out the experience and inform clients of what to expect on the day of their appointment. These appointments provide time to discuss pre-planning for aftercare options.
3. Companion animal veterinarians should […] provide adequate containment of the remains.”*
This can be interpreted in a variety of ways, but it’s safe to say we are phasing out the use of plastic bags to store remains in. As anyone who works in a medical field knows, we have all witnessed our fair share of less-than-pleasant sights. The status-quo cannot be the definition of “adequate.” Pet parents are trusting us to protect their companions so we must keep dignity intact. The use of an appropriate body bag is not only dignified but symbolic. Think of all the extra effort we put in for our patients, but when it comes to how the body is handled after death, the same standards do not apply.
According to a survey conducted with pet owners in July, 2019, 86% of pet owners consider proper containment important.4 There are more options available now to satisfy this market problem and pet parents all over are feeling the difference.
The AVMA writes “[…] veterinarians should handle animal remains in a sensitive manner, such that it is not unnecessarily disturbing to the owner or any other person with a valid reason to see the remains.” They go on to say, “Deceased pets, whenever possible, should be maintained in a condition suitable for return to the owner or to the aftercare providers such that families may witness their pets’ aftercare.”
Further, “the sensitive handling of pet remains is an important aspect of veterinary practice.” This adds to our code of ethics as well as professionalism as a whole.
Like our friend Dr. Rollin, a veterinarian was curious about asking clients what their preferences were on aftercare of their pets. In a recent study by Dr. Kathy Cooney, she showed that the majority of people found it unacceptable that animals were placed in garbage bags.5 Much like Dr. Rollin, it begs the question:
The majority of the public does not like this…so why are we giving it to them?
The perception of the human-animal bond is evolving, and decisions to adhere to these higher-order guidelines help us to create a world that treats all life with respect and protects its dignity. It is something we all intuitively know, yet we must work hard to achieve. We already know what the right thing to do is and the AVMA is helping us get there. To paraphrase a concept by the philosopher Plato: we do not teach, simply, we remind. +
You can find the main policy detailed here: https://www.avma.org/sites/default/files/resources/AWF-AftercareBrochure.pdf
*Companion Animal Aftercare Policy by the AVMA is subject to the CC BY-NC-ND license.
References:
- PRMR, P. R. (2014), https://www.youtube.com/watch?v=HzOH_Mm7hEM
- Dubner, (2013), https://freakonomics.com/podcast/the-troubled-cremation-of-stevie-the-cat-a-new-freakonomics-radio-podcast/
- CAETA,(2019), https://caetainternational.com/making-pre-euthanasia-arrangements/
- Euthabag, (2021), https://static1.squarespace.com/static/56473d98e4b0b493dee0ea49/t/5efbaf3e670b5d4f87aa2c1f/1593552703770/Sondage+pet+owner+EN+US+2020+WEB.pdf
- Cooney, K. B. (2021), https://www.sciencedirect.com/science/article/pii/S193897362030101X
