Author: nancyvalko

Is it Time for a Two-Track Nursing Education System?

nancyvalko education, nursing

In what may be news to most people, a March 6, 2016 Wall Street article “Colleges Lock Horns Over Nursing Programs-Four-year institutions try to prevent community colleges from offering advanced programs” states:

The Institute of Medicine, now part of the nonprofit National Academy of Sciences, in 2010 recommended that 80% of nurses hold bachelor’s degrees by 2020, up from about 50% at the time.

Spurred by the report, as well as incentives in the Affordable Care Act to use more highly credentialed nurses, hospitals are scrambling to bring on new staff with bachelor of science degrees in nursing, or push nurses with associate degrees to upgrade to a BSN. That means additional coursework emphasizing community health, critical thinking and evaluating research, in addition to liberal-arts or general-education classes….

That means nurses like Kristina Spaete, who landed a job as a surgical nurse at Scripps Mercy Hospital in San Diego after completing her associate degree in nursing at a community college last May, could soon find herself back in school.

“I feel selfish if I were to go back and pay a ton of money for school,” said the 35-year-old mother of three, who is hoping she can get a BSN at a community college.
For now, getting into any program is tough. U.S. schools turned away 68,938 qualified applicants from bachelor’s and graduate nursing programs in 2014, according to the American Association of Colleges of Nursing, citing a dearth of faculty, clinical sites and classroom space.

Leaders at community colleges, which now train nurses to the associate-degree level, argue they can help fill a hole in the nursing labor market at a low price. Administrators at four-year colleges counter that community colleges aren’t equipped to teach upper-level nursing courses and say there aren’t enough qualified faculty to go around.

“We have to be responsible in terms of how many students realistically can complete these programs, and how many can get jobs,” said Christine Mallon, assistant vice chancellor of academic programs and faculty development at the California State University System.

Here is the letter to the editor I sent to the Wall Street Journal about the crisis in nursing education.

In 1969, I graduated from one of the first associate degree nursing programs due to limited funds and an intense desire to start my nursing career. Some of my high school classmates chose a 4 year BSN degree but the vast majority of nurses then were three year hospital diploma nurses. Now there are almost no diploma programs which were then considered the “gold standard” for nursing education.

At the time, I felt I received a great nursing education but I also felt I needed more clinical experience so I went to the only hospital in my area to offer a nursing internship. I spent the next year in different divisions: 3 months each on medical and surgical divisions including ICUs, 3 months in operating rooms and 3 months as an elective in the cardiac ICU.

By the end of that year, not only did I gain an enormous amount of knowledge and confidence but I also was able to make the decision that I wanted to be an ICU nurse able to work in any type of ICU. I did achieve my dream and more.

A few years after working, I decided I wanted to learn more and I signed up for a BSN completion course at my own expense since scholarships were few and far between. However, I was disappointed that the program seemed geared to producing administrative nurses rather than clinical nurses. I wanted to be a great bedside nurse so instead, I took courses in music and considered pursuing an economics degree to give me more options.

But now, only a BSN will protect many fine nurses from termination or even finding employment at the beginning of their careers. In addition, the shortage of good, reasonably priced BSN completion programs will probably deter many people from even considering a nursing career.

I propose a 2 track nursing education system.

Those who want to be a great bedside nurse could obtain an associate degree and complete a year of internship as a kind of apprenticeship. This plan would not only give new nurses the support to take on the challenges of a bedside nursing career but also help them discover what kind of nursing fit their capabilities best. Such nurses could advance by becoming certified in their chosen specialties. A BSN completion course would always be available if wanted but not required as it is in many health care institutions today.

Some students would choose a BSN program from the beginning but might also want access to the support of an internship when they begin their nursing careers.
I believe this would produce the dedicated nurses we need both at the bedside and in administrative roles.

And after almost 47 years in nursing after following this plan, I would still choose this career again.

I would like to hear what you think or what ideas you have, especially if you are a nurse yourself!

Arguing Life, Death and Assisted Suicide

nancyvalko assisted suicide, Canada, disability, euthanasia, law, medical ethics, mental health, palliative care

In the article “Sides discuss NY proposal for aid in dying”, the exchange between Diane Coleman, a founder of Not Dead Yet, the foremost disability organization fighting physician-assisted suicide, and  Dr Timothy Quill, who fought for the constitutionality of physician-assisted suicide in the landmark 1997 US Supreme Court Vacco v Quill decision, is very enlightening.

Diane Coleman of Not Dead Yet spoke simply and eloquently:

“I don’t think I speak for all (opponents), but the disability community’s core message is that if assisted suicide is legal, some people’s lives will be lost due to mistakes, coercion and abuse, and that’s an outcome that can never be undone.

There is inherent discrimination in assisted-suicide laws. Most suicidal people receive suicide prevention. Assisted suicide laws would carve out an exception to that, and that exception would apply to people who are elderly, ill, disabled, and those are devalued groups in society. … Assisted-suicide laws would say, ‘these certain people, we not only agree with their suicide but give them the means to carry it out.’ We’re saying it comes down to social justice. Equal rights means equal suicide prevention.”

And

“It’s really not about physical pain. If you look at Oregon reports, about reasons people want to commit suicide, the reasons are things like feeling like the person has lost their autonomy, they’ve lost their dignity, they can’t do the things they used to do. They feel like a burden on their families. Those are psychosocial reasons that relate to the disability that people have when they have an advanced stage or chronic condition.”

On the other hand, Dr. Quill portrayed assisted suicide as little more than a benign discussion:

“Whether or not this practice is legalized, seriously ill patients are asking us to talk about it, they’re asking us to consider it” said Quill, founding director of the palliative care program at URMC and a board-certified palliative care consultant. (Emphasis added)

But to the question “Why do people with a terminal illness want to end their lives?”, Dr. Quill telling states:

“Some of it has to do with severe symptoms. I would say that’s not the majority. The majority is people who are tired of dying. It’s going on way too long for them. The kind of debility and weakness that accompany it, particularly for people that are used to being in charge of their lives, is very, very, very hard. Some of those people want to talk about what options they have to accelerate the process.” (Emphasis added)

This is very different from the way physician-assisted suicide has been sold to the public as a necessary last resort for terminally ill people in “unbearable pain”. However, as a 2014 article  “Dignity, Death, and Dilemmas: A Study of Washington Hospices and Physician-Assisted Death” admits, pain is not even a requirement for receiving physician-assisted suicide  in Oregon and Washington state:

The authorizing legal statutes in both states make no reference to the experience of severe pain or intolerable suffering as an indication for a patient to make a request for physician-assisted death but rely entirely on the entitlement due a patient in respect of their personal dignity. A patient rights framework provides the primary moral structure… (Emphasis added)

Thus, physician-assisted suicide is really about power and control over death, not the  suffering of the individual. And it is this power and control that has led European countries like the Netherlands to expand physician-assisted suicide even to non-terminally ill people who cannot or have not made the death decision themselves such as babies with deformities and people with dementia, mental illness or other impairments.

Closer to the US, the Canadian Supreme Court  has legalized physician-assisted suicide but still  without formalized rules, even on conscience rights.  In the province of Quebec, legal injection euthanasia kits  can be distributed to any doctor who wants them.

The Assisted Suicide Agenda in the US

It is alarming that the influential American Academy of Hospice and Palliative Medicine that had this same Dr. Timothy Quill in the article as a recent past president and honoree of their Visionary award. But it should not be surprising that the AAHPM has changed its former position of opposition to physician-assisted suicide to a position of “studied neutrality” towards what it now calls “physician-assisted death”.  Neutrality is progress to physician-assisted suicide activists like Dr. Quill and organizations like Compassion and Choices that need to neutralize medical opposition as much as possible while quietly setting up relentless campaigns to legalize assisted suicide in every state. If enough states give in, a new Supreme Court decision may even overturn the Vacco v Quill decision and legalize physician-assisted suicide throughout the US.

But in the meantime, trying to sell “neutrality” to doctors and convincing the media to change the term “physician-assisted suicide” to  “physician-assisted death” cannot mask the inevitable and lethal damage done not only to individuals but also to our medical and legal institutions that can no longer ensure ethical protection for our lives.

College professor Rachel Adams:”My son with Down syndrome is not a mascot for abortion restrictions”

nancyvalko abortion, adoption, disability

In this Washington Post article, Rachel Adams, herself a mother of a child with Down Syndrome, maintains that

“But we won’t end discrimination by limiting access to abortion, which will have the unwanted consequence of driving some women to risk their health by seeking illegal alternatives and other women to bear children they are not prepared to raise. Better to put resources into services and supports that improve the lives of people with Down syndrome and their families.” (Emphasis added)

This presents a false choice between aborting a child because of a probable diagnosis (without knowing the eventual prognosis) and a possibly difficult life for the mother, even though studies have shown great satisfaction in families with a child with Down Syndrome.

Also, it is very telling that nowhere in this article does Ms. Adams even mention adoption. There are groups helping prospective adoptive parents for children with Down Syndrome and other special needs. Here are just a few (this does not imply my personal endorsement of any group) : National Down Syndrome Adoption Network, Special Angels Adoption, Adopt America Network, Love without Boundaries-Adopt Special Needs, Special Needs Adoption Coalition.

Ms. Adams obviously loves her son but prenatal medical discrimination has led to medical discrimination after birth for people with disabilities. All the “resources into services and supports that improve the lives of people with Down syndrome and their families” she mentions will not necessarily protect her son’s life as he ages and especially if her son outlives her.

My son and daughter-in-law hope to adopt or foster a child when my daughter-in-law recovers from her recent kidney transplant. They have said they would be happy to have a child with special needs, especially a child with Down Syndrome like my son’s late sister Karen.

My testimony for Simon’s Law

nancyvalko disability, futility, law, medical ethics, Simon's Law

On February 16,  a hearing was held by the Health committee of the Missouri Legislature on Simon’s Law.

Here is my submitted testimony to Dr. Frederick and all the committee members:

I am a past member of the Down Syndrome Association in St. Louis, an RN and legal nurse consultant and most importantly, the mother of a daughter who had special needs.
I cannot be at the hearing tomorrow but please accept my testimony in favor of Simon’s Law:

In September 1982, I gave birth to a beautiful baby girl we named Karen. Karen was born with both Down Syndrome and a severe heart defect called a complete endocardial cushion defect. A pediatric cardiologist was called in and even before I left the recovery room, he gave me the bad news about our Karen’s heart defect and even said that it was inoperable. He said to take Karen home where she would die in 2 weeks to 2 months.

This doctor turned out to be wrong. Further testing revealed that Karen’s heart defect could be fixed with one open heart operation and she had a 90% chance of survival.

My husband (a doctor) and I (an ICU nurse) were determined that our daughter receive the best medical care possible for her heart condition and without bias because she had Down Syndrome. We knew about the recent Baby Doe case where the parents of baby boy with Down Syndrome and an easily correctable tracheoesophageal fistula refused surgery so that their baby would die. The case went to court and a judge ruled that the parents could make that lethal choice. As medical professionals, we were appalled by this case but at least we could make sure that our daughter would have her chance at life. Or so I thought.

The bias against children like Karen soon became apparent when the cardiologist said he would support us “100%” if we chose to let our Karen die without surgery. I had to insist that Karen be treated for her heart defect the same way any other child would be treated for the same heart defect. To do otherwise was medical discrimination and illegal.

Then, the surgeon recommended for Karen’s pre-op heart catheterization was overheard questioning the wisdom of even treating “all these little mongoloids”! Another doctor sympathetically told us that “people like you shouldn’t be saddled with a child like this.” We were stunned by this negative view of children with Down Syndrome.

Later on when Karen developed a pneumonia that was being successfully treated in the hospital, I found out that my trusted pediatrician had even made Karen a “Do Not Resuscitate” behind my back because I “was too emotionally involved with that retarded baby”. The DNR was rescinded and we took Karen home but I found it hard to trust any doctor after that.

Unfortunately, Karen developed another bout of pneumonia and died of complications just before her scheduled open-heart surgery. But even at the very end, when Karen was apparently dying, a young resident physician “offered” to pull all her tubes so that she would die as soon as possible. I reported this young man to the chief of pediatric cardiology who was furious with the resident. (This chief of cardiology later started a clinic for children with Down Syndrome to meet their special health needs.)

Although we lost Karen when she was just 5 ½ months old, I still treasure my time with her and because of her, I became an advocate and volunteer for people with disabilities.
I wish I could say that my story is unique but I have seen many similar situations over the last three decades involving people of all ages with disabilities.

Therefore, I beg you to approve Simon’s Law. It will potentially save lives as well as send a strong message that medical discrimination against the disabled based on subjective judgements of “medical futility” and/or predicted “poor quality of life” is wrong.

Sincerely,

Nancy Valko, RN ALNC

Justice Antonin Scalia, RIP

nancyvalko family, law

The sudden death of US Supreme Court Justice Antonin Scalia was announced Saturday, February 13, 2016.

His death was not just the devastating loss of a brilliant, wise and witty man but also the loss of the Supreme Court Justice I most admired and read over the years. Justice Scalia and his writings inspired me to pursue the study of the Constitution and law.

I never met Justice Scalia personally but I was privileged to be asked to serve on a panel to discuss end of life issues at a 2009 conference organized by his son, Fr. Paul Scalia.

Fr. Paul was apparently used to people like me gushing about his father but Fr. Paul himself is very proud of his father. Fr. Paul is great example of his father’s deep devotion to his wife and 9 children.

The loss of Justice Scalia has tremendous national implications since so many important cases have been decided by a 5 to 4 majority of justices and now there are several crucial cases being considered, including cases involving abortion and religious rights. It is widely recognized that with the loss of Justice Scalia, there are four justices who lean liberal and four justices who lean more conservative.

With only 8 justices now, such close cases may result in very different decisions than if Justice Scalia were there.

However, our country has been very fortunate to have someone like Justice Scalia both for his personal and his professional example of excellence.

May he rest in peace.

 

 

 

 

 

 

“David Daleiden Refuses Plea Deal for Probation: ‘What We Want is an Apology’”

nancyvalko abortion, fetal tissue, Planned Parenthood

I was glad to read the LifeNews.com article by Steven Ertelt about this response to the Houston grand jury indictment of David Daleiden and Sandra Merritt, especially one day after reading an outrageous USA Today op-ed titled “The great deception behind the anti-Planned Parenthood videos: Column” by Dawn Laguens, Executive Vice President and Chief Experience Officer for Planned Parenthood Federation of America.

Ms. Laguens’s op-ed claims that

“Daleiden, working in concert with other well-known anti-abortion extremists including Troy Newman of Operation Rescue, who has documented ties to violence, spent nearly three years creating a fake company, creating fake identities (including fake government IDs), obtaining a credit card using a fake name and information, trespassing onto private property and illegally recording conversations without consent with the express goal of finding a way to attack Planned Parenthood and the health care services we provide.”

Unfortunately, almost all mainstream media have supported the Planned Parenthood explanation of the surprising Houston grand jury’s indictment of Mr. Daleiden and Ms. Merrit rather than investigating whether a Houston Planned Parenthood clinic had sold the organs of aborted babies, the original purpose of the grand jury.

Journalism and Ethics

As a former reporter myself, I am constantly amazed by the lack of investigative reporting on abortion-related as well as other “politically incorrect” issues.

The Cambridge Dictionary defines investigative journalism as “a type of journalism that tries to discover information of public interest that someone is trying to hide.”

The mission statement for the Center for Medical Progress that was founded by David Daleidan shows how important this is:

The Center for Medical Progress is a group of citizen journalists dedicated to monitoring and reporting on medical ethics and advances. We are concerned about contemporary bioethical issues that impact human dignity, and we oppose any interventions, procedures, and experiments that exploit the unequal legal status of any class of human beings. We envision a world in which medical practice and biotechnology ally with and serve the goods of human nature and do not destroy, disfigure, or work against them.

Investigative journalism itself has had a long and mostly proud history and for many years there has even been a Pulitzer Prize for Investigative Reporting.

While Planned Parenthood criticizes David Daleiden’s and his Center for Medical Progress’ “deception” in making the undercover videos about selling fetal tissue from aborted babies, the Society of Professional Journalist’s Code of Ethics states that journalists should:

Avoid undercover or other surreptitious methods of gathering information unless traditional, open methods will not yield information vital to the public. (Emphasis added)

The Center for Medical Progress’ undercover investigation undoubtedly meets this criteria.

Planned Parenthood has long gone to great lengths to keep negative information about its activities from the public while taking over $500 million dollars a year in taxpayer money. Planned Parenthood is now endorsing Hillary Clinton for president and its’ “advocacy and political organizations have plans to spend at least $20 million in the upcoming election cycle”.

It seems the real problem with the undercover investigation of Planned Parenthood is not really the alleged “crimes” of the investigators but rather a fear of damaging information undermining Planned Parenthood’s carefully crafted public façade as a benevolent, “top-ranked non-profit” organization that helps women and families.

But even the threat of a lawsuit such as Planned Parenthood’s against the Center for Medical Progress has caused many individuals and organizations to settle cases rather than potentially be imprisoned and/or bankrupted by legal fees. It takes a lot of courage to stand up to such intimidation tactics by an entrenched, politically connected and well-funded organization like Planned Parenthood.

Good for David Daleidan and the Center for Medical Progress!

 

A Belated But Wonderful Christmas Present

nancyvalko family, organ donation

Last December, I wrote a blog “All I want for Christmas is…a kidney” about Bernie, my daughter-in-law, and her need for a kidney transplant. Last Friday, she received one!

Bernie is doing well and should be home sometime this week. It will be a new life for her and my son Steve without the hours of dialysis, strict dietary restrictions and other limitations. Their faith, hope, patience and acceptance of their situation have been truly inspiring!

Unfortunately, Bernie’s wonderful father Gene Buerke did not live to see this day. He died from a massive stroke 2 weeks ago but we are sure he is celebrating in heaven. Please pray for the repose of his soul as well as Bernie’s speedy recovery.

Thank you all for your prayers and support!

 

God Bless the Dedicated Marchers for Life

nancyvalko abortion

This year I was scheduled to go to Washington DC to speak at the Cardinal O’Connor Conference for Life at Georgetown University the day after the annual March for Life commemorating the tragic anniversary of the Roe v. Wade decision and the 58 million lives lost by abortion.

Unfortunately, my flight was cancelled because of the impending snowstorm. However, I did watch the proceedings live on the EWTN network and I salute all of you who marched, especially the hundreds of St. Louis ‘Right-to-Life’ teens who were unfortunately later  trapped in the east coast snow storm! See their story at http://fox2now.com/2016/01/22/hundreds-of-st-louis-right-to-life-teens-trapped-in-east-coast-snow-storm/

 

 

“Good” News about Dying in America?

nancyvalko assisted suicide, conscience rights, euthanasia, medical ethics

This month Medscape, a subscription news service for medical professionals, published the article “Good News about Dying in America” by Dr. George Lundberg. Dr. Lundberg is the former editor of the Journal of the American Medical Association (JAMA)  and editor-at-large of Medscape itself as well as a member of the Institute of Medicine of the National Academies.

But the title “Good News about Dying in America” is ironic because this article is really a homage to the pro-death movement. In the article, Dr. Lundberg approvingly chronicles a recent history of the “right to die” movement in the US including the rise of legalized physician-assisted suicide and his part in it.

Although he writes that he is not looking forward to his own death, he maintains that

To accomplish medical and cultural change, one needs to work at the levels of moral beliefs and ethical standards with professional and individual leadership.Subsequent changes in state and federal laws and regulations may be needed. Economic drivers can move it along. But first, you have to get their attention.” (Emphasis added)

Dr. Lundberg congratulates himself for getting this attention started by publishing the anonymous 1988 JAMA article “It’s Over Debbie”  which Lundberg claims is a “factual tale of a caring physician using intravenous morphine to end the horrid pain-wracked life of a young woman with terminal ovarian cancer.”

However, when you read this short article, you read about a doctor in training who, under the cloak of anonymity, writes about being on call at a hospital and awakened in the middle of the night to see a patient he had never met before. He describes “a 20-year-old girl named Debbie was dying of ovarian cancer. She was having unrelenting vomiting apparently as the result of an alcohol drip administered for sedation.” He writes that her condition was“a cruel mockery of her youth and unfulfilled potential” but that Debbie’s only words to him were “Let’s get this over with”. An older, dark-haired woman staying with Debbie was assumed by the young doctor to be her mother.

Then, in the anonymous doctor’s own words, he writes :

The patient was tired and needed rest. I could not give her health, but I could give her rest. I asked the nurse to draw 20 mg of morphine sulfate into a syringe. Enough, I thought, to do the job. I took the syringe into the room and told the two women I was going to give Debbie something that would let her rest and to say good-bye. (Emphasis added)

After giving Debbie the the lethal overdose, the doctor writes:

I waited for the inevitable next effect of depressing the respiratory drive. With clocklike certainty, within four minutes the breathing rate slowed even more, then became irregular, then ceased. The dark-haired woman stood erect and seemed relieved.

Quite a different story from what Dr. Lundberg  proudly portrays as a caring act. Is the deliberate killing of a newly met patient without request, explanation or actual consent by a doctor in training really part of Dr. Lundberg’s  vision of “(t)he cultural change we need now is to allow death to occur when its time has come and to do so with dignity and without undue pain and suffering for the patient to the greatest extent possible?”

Dr. Lundberg writes further on other “breakthrough” moments in medicalized killing after the “It’s Over Debbie” article:

Next was Dr Timothy Quill and his disclosure in the New England Journal of Medicine in 1991 that he prescribed barbiturates at the request of a leukemia patient to allow her to end her life. Then, beginning in 1990, Dr Jack Kevorkian and his suicide machine assisted in the deaths of more than 100 patients; the right message writ large but by a deeply flawed messenger. (emphasis added)

As a medical professional myself, it is horrifying that such influential medical people not only have embraced the concept that it is acceptable and even compassionate to medically kill people, but now promote it.

And there is a jarring apparent lack of empathy and understanding of the challenges serious illness poses to patients and their families at the end of Dr. Lundberg’s article:

hospitals interested in their patient safety statistics might do well to note that much of what is chalked up as deaths related to medical error is actually occurring with the frail elderly, often in critical care units (CCUs). Many of these patients probably should not be in the CCU anyway. Maybe not even in hospitals. …. Help your safety statistics; let the dying die at home. (Emphasis added)

While Dr. Lundberg’s article is appalling to those of us who refuse to kill our patients or help them kill themselves, it is important for all of us to understand that many of our alleged “experts” are leading us into a cultural as well as medical and legal war over human extermination.

Some Canadian Veterinarians Offer to Teach Doctors about Euthanasia

nancyvalko assisted suicide, euthanasia, medical ethics

In February 2015, the Canadian Supreme Court unanimously voted to legalize physician-assisted suicide.  In September 2015, it was revealed that Canada’s Quebec province was preparing euthanasia kits with lethal injections for distribution to doctors for assisted suicide.

In December, Canada’s National Post published an article titled “‘We can definitely help’: What vets can teach doctors about assisted dying“ that reports:

Before every euthanasia, Dr. Amy Wilson prays things will go smoothly — that her patient will sedate well, that she’ll hit the vein with the catheter on the first try, that there will be no sudden, involuntary spasms or grunts for breath that can be agonizing for owners.
Wilson, like all veterinarians, is trained to put suffering animals to death as humanely as possible. She does it more often than she wishes she had to, but she does it well. Now, as Canada continues to debate the way forward on assisted dying, she and other vets say there is much they can teach doctors about a different kind of animal — humans

One argument long promulgated by assisted suicide/euthanasia proponents is that we should put people out of their misery just as we do for our pets.

However, pets become at risk for many reasons:

According to the American Humane Association, the most common reasons why people relinquish or give away their dogs is because their place of residence does not allow pets (29%), not enough time, divorce/death and behavior issues (10% each). The most common reasons for cats are that they were not allowed in the residence (21%) and allergies (11%).

Many are then taken to animal shelters. About twice as many animals enter shelters as strays compared to the number that are relinquished by their owners but nevertheless about 1/3 each year, approximately 2.7 million animals, are euthanized.

According to the website Petful, pets in animal shelters in the United States are euthanized every year for three major reasons: illness, aggression and overpopulation.

Regarding illness, the website states:

Because most shelters operate on tight budgets, the cost of treating every animal’s illness is impossibly high.Many shelters have veterinarians to prescribe medications and perform exams for sick animals, but the decision to euthanize must still be made sometimes after considering several factors:
•The severity of the illness
•The chance of recovery
•How infectious the disease is
•The cost of treatment
•The length of treatment
•The adoptability of the pet

Do we really want to adopt a veterinary standard that makes it acceptable to euthanize people as well as pets when illnesses are too expensive or  personalities are too difficult or simply when there are too many of them around?

Effects of Euthanasia on Veterinarians

Although the National Post article is generally supportive of veterinarians teaching doctors to perform euthanasia, it does document the emotional distress that can affect even veterinarians who perform euthanasia:

Studies suggest people whose jobs require them to kill animals are at risk of a phenomenon known as PITS – perpetration-induced traumatic stress. Euthanasia was one of the reasons Rothenburger (a veterinarian) chose to leave practice; she now specializes in pathology. When she used to perform euthanasia, “I put this filter on: This was ending suffering. That was the role I had to play. But it often wasn’t easy, and it’s hard to keep your professional persona on when you’re trying not to shake while you’re injecting the medication, or not cry with the owners until you’ve done your job.”

Studies have documented a higher suicide risk among vets than the general population. A 2010 survey by the Canadian Veterinary Medical Association found 19 per cent of those who responded had seriously thought about suicide, half reported experiencing burnout and 27 per cent were taking anti-depressants. Rothenburger belongs to a closed Facebook page called Not One More Vet. “It’s a safe place for vets to talk about things they need to get off their chest,” she says, “like compassion fatigue, and maybe that tough euthanasia.” (Emphasis added)

Many years ago, my adult children and I had to have our beloved cat Callie euthanized because of an inoperable cancer. We decided to stay with Callie throughout the procedure because we wanted to surround her with love until the end. However, the procedure had some unexpected difficulties and we all found the process stressful and incredibly sad.

When we left, I told my children that if anyone ever tried to euthanize me for any reason, they had better stop them.

People are not animals and they must not be treated like animals.