When Money Decides Who Lives: The Hidden Weight of Economic Euthanasia
It’s not a failure of compassion. It’s a failure we’re left to carry.
A two-year-old Lab comes into the emergency clinic. Laterally recumbent, distended abdomen. You tap it and find septic peritonitis. The history comes out: she ate a blanket two weeks ago. Probable obstruction, now perforated.
You explain the options. Surgery, ICU, guarded prognosis even with aggressive treatment. The owners can’t afford it. You hear the wife lean over the dog and whisper: “If we had a million dollars, we would do this for you.”
And you find yourself saying: “Even if you had all the money in the world, this might not end well. You could put her through multiple surgeries, days in the hospital, a lot of pain and suffering, and still not have her come through this.”
That case stays with you. They all do.
The Numbers Behind the Weight
According to a 2017 JAVMA survey, 57% of veterinarians reported that client financial limitations affected their ability to provide desired care on a daily basis, and approximately half reported moderate-to-substantial burnout, with many citing those economic limitations as an important contributing factor.¹
The Galaxy Vets burnout survey found that economic euthanasia specifically was a contributor to burnout for many veterinary professionals.² And in the NAVC Voice of the Vet study, team members listed clients being unwilling or unable to provide needed care as one of their top three stressors.³
This isn’t occasional. It happens every day in most practices.
Moral Distress: Knowing but Not Being Able
There’s a term for what happens when you know the right thing to do but can’t do it for reasons beyond your control: moral distress.
It’s different from burnout, though they feed each other. Moral distress is that specific tension of seeing a path forward and watching it close. The cat with the treatable obstruction. The dog with the manageable diabetes. The senior pet who could have a few more good years with the right intervention.
When euthanasia becomes the only option because of economics, the weight lands on everyone: the family, the staff, and you.
What Resilience Actually Means
Resilience isn’t toughing it out. It’s not putting your head down and pushing through until you can collapse at home. Resilience is the ability to rebound after a stressful situation, not just survive it.
Sometimes that means taking a few minutes after a hard case. Sitting in your office. Taking some deep breaths before walking into that puppy appointment.
As Dr. Kate Boatwright puts it: “I still have cases that really get under my skin. When I have clients where I’m not able to find a solution, or they’re not willing to work with me and I feel the pet is suffering, those pieces really bug me.”
If someone who literally teaches this material still feels it, you’re allowed to feel it too.
Skills That Actually Help
These aren’t platitudes. They’re learnable skills:
Boundary setting. Not just with clients, but with yourself. How much mental space are you giving the clinic when you’re not there? Can you build a buffer between work and home, even 15 minutes, to transition between worlds?
Mindfulness. The ability to notice your thoughts and emotions in a difficult moment without being swept away by them. Not suppressing, just observing.
Stress management plans. What do you actually do when a case hits hard? Having a plan beats winging it every time.
Team debriefs. Even five minutes at the end of a tough day. The doctors often have context the team doesn’t, like why a client couldn’t move forward. Sharing that information helps everyone process.
When Euthanasia Is the Right Call
This is the part nobody wants to say out loud: sometimes euthanasia is the best option. Not a failure. Not a compromise. The best option.
A pet in septic shock with a guarded prognosis even with intervention. A chronic condition the owner genuinely cannot manage long-term. A quality of life that’s already gone.
Offering euthanasia as a compassionate choice in these situations isn’t giving up. It’s being honest about what medicine can and can’t do, and what suffering looks like when we push past it.
The goal of spectrum of care is to reduce economic euthanasia when other options exist. But when euthanasia is the most humane path, saying so clearly, without judgment, is part of the job too.
You’re Not Alone in This
If financial limitations are affecting your daily practice, your mental health, or your relationship with the work you trained years to do, you’re in the majority. Literally.
That doesn’t make it easier. But it might make it easier to talk about. With your team. With your colleagues. With someone who gets it.
The cases stay with you because you care. That’s not a flaw. It’s why you’re good at this.
This post is based on a VetOnIt CE webinar by Dr. Kate Boatwright. For RACE-approved continuing education on spectrum of care, communication, and clinician well-being, explore our On-Demand Library.
References
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Kipperman BS, Kass PH, Rishniw M. Factors that influence small animal veterinarians’ opinions and actions regarding cost of care and effects of economic limitations on patient care and outcome and professional career satisfaction and burnout. J Am Vet Med Assoc. 2017;250(7):785-794.
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Galaxy Vets. Annual Veterinary Burnout Survey (3rd Edition). 2023. Findings on economic euthanasia as a contributor to professional burnout.
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NAVC. Voice of the Veterinarian Survey. 2020.