killing with kindness: veterinary euthanasia and the social construction of personhood

Sociological Forum, Vol. 10, No. 2, 1995

Killing with Kindness: Veterinary Euthanasia and the Social Construction of Personhood 1

Clinton R. Sanders 2

Euthanizing companion animals is a common feature of veterinary practice. Based on data collected during participant observation in a large general veterinary clinic in the Northeast, this discussion focuses on how veterinarians evaluate euthanasia cases, orchestrate euthanasia encounters, and experience the occupational activity of routinely dispensing death. The description of the ambivalence that surrounds euthanasia in veterinary practice is used to ground a general analysis of "personhood" as a constructed social designation and the conflicts focused around the implemented deaths of those beings defined as existing in the contested realm between person~subject and nonperson~object.

KEY WORDS: euthanasia; veterinary practice; social construction of personhood.

INTRODUCTION

Death is a central and omnipresent feature of medical settings. Typi- cally, death is viewed as an enemy to be feared, fought against, and, if all goes well, defeated (Coombs and Powers, 1977; Sudnow, 1967; Zussman, 1992). However, in some situations prolonging life may simply prolong a patient's agony (Benrubi, 1992). This problematic consequence gives rise to heated debates regarding the appropriateness of euthanasia and situations in which medical practitioners are justified in actively providing, or passively allowing, a pain-ridden, comatose, and/or terminally ill patient to experience a "peaceful" or "easy" death (see Angell, 1988; Cassel and Meier, 1990; Singer and Siegler, 1990).

1An earlier version of this discussion was presented at the Annual Conference on Symbolic Interaction and Ethnographic Research, University of Waterloo, Waterloo, Ontario, Canada, May 1993.

2Department of Sociology, University of Connecticut, Greater Hartford Campus, 85 Lawler Road, West Hartford, Connecticut 06117.

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0884-8971/95/0600-0195507.50/0 © 1995 Plenum Publishing Corporation

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In human medical settings the debate over euthanasia generally focuses around whether the sanctity of life should or should not be valued over the quality of life. Giving primacy to the former value leads to a rejection of "mercy killing," while the quality of life position acts as a foundation for medical personnel allowing or actively assisting death in certain circumstances. 3

Though it is a matter of considerable concern in animal rights circles (Jasper and Nelkin, 1992; Sapontzis, 1987), the killing of nonhuman animals typically is regarded as far less controversial in the larger society than is the killing of humans. This relative lack of discomfort surrounding the death of animals in western culture derives largely from their traditional definition as objects (Tuan, 1984). From this perspective nonhuman animals are excluded from the social designation of "person." Animals are alingual (i.e., mindless) and therefore seen as unable to conceive of pain, death, the future, or to construct and reflect upon their "selves" (Noske, 1989; Rollin, 1990). As such, animals typically are viewed as property to be owned or used by humans rather than sentient coactors involved in some degree of mutually constructed interaction and therefore worthy of respect and care other than that usually afforded to valued property.

Nonhuman animals are culturally defined as a generic group and, as such, relegated to the social category of "nonpersons." Companion animals, however, exist in the liminal space between object and individual being, between the culturally constructed statuses of nonperson and unique person. In turn, the purposive killing of companion animals is a matter of ambivalence, though this ambivalence typically has a considerably different character than that which accompanies the euthanasia of terminally ill, permanently unconscious, or severely damaged humans. While the latter also reside in the liminal realm between death and life, their identity as once- humans or potential-humans imbues their orchestrated deaths with considerably heavier moral weight than is seen in the controversy surrounding the euthanasia of "never-human" social actors (see Cantanzaro, 1992; Ka- hler, 1992). The philosophical, scientific, and commonsensical arguments commonly offered to justify the human ownership, use, and eventual dis- posal of nonhuman animals--that is, to deny their personhood--sometimes become problematic when they are applied to severely damaged neonates (Anspach, 1993; Jennings, 1990) or more mature beings (Bogdan and Tay- lor, 1989; Goode, 1994) who are ostensibly human but, lacking inde-

3Recent studies of medical personnel and religious leaders as well as polls of the general public have demonstrated that there is considerable support for euthanasia as a morally justifiable alternative in dealing with terminally ill patients (see Anderson and Caddell, 1993, for an overview of this research).

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pendence, language, the apparent ability to self-reflect, and other key attributes, may be relegated to the status of nonperson.

The emotional intensity of the relationships that often develop between people and their nonhuman companion animals commonly prompts human caretakers to be ambivalent about, or reject entirely, the definition of their animals as mindless, objectified, nonpersons (see Sanders, 1993; Shapiro, 1990). Instead, they see the animals with whom they share their everyday lives as unique, emotional, reciprocating, and thoughtful "friends" or "family members" (Bulcroft et al., 1986; Cain, 1985). Widespread un- certainty concerning, or outright rejection of, the animal-as-object perspective generates considerable societal ambivalence about the appropriateness of mistreating nonhuman animals, killing and eating them (Adams, 1990), using them as scientific instruments (Arluke, 1990; Bowd and Shapiro, 1993), or callously disposing of them when they are "used up." Given the close ties that commonly develop between people and their animal companions, these philosophical and social policy issues become intensely personal when caretakers confront decisions regarding the provision of medical care and if, when, and how to manage their animals' deaths.

As key participants in decisions about the medical management and eventual death of companion animals, veterinarians must confront these issues on a dally basis. For the veterinarian these matters are more than simply the focus of rational occupational practice. The mistreatment, mal- treatment, and especially, the deaths of animals often are, for the veterinarian, matters of considerable moral and emotional weight.

The following discussion focuses on the "death encounter" in which the companion animal's "easy death" is negotiated, accomplished, and experienced. After a brief discussion of the research and a comparison of the clinical activities of physicians with those of veterinarians, I describe the euthanasia episode from initial clinical encounter through disposition of the animal's body. This is followed by a discussion of the factors precipi- tating clients' decisions, veterinarians' evaluations of the justifying accounts provided, and exchanges during which the veterinarian's guidance concerning euthanasia is solicited by the client. Finally, I discuss the ways in which veterinarians experience the role they play in the routine dispensing of death. The concluding section uses the relationships of people with companion animals and those of veterinarians with their patients to focus on an issue of considerable sociological interest. The emotional ambivalence of the key actors in the euthanasia encounter calls attention to the fact that the "personhood" of sentient others is a matter of social definition. Those "candidates" who are effectively excluded from the category of person may be routinely disposed of with minimal emotional cost. In contrast, the deaths of social others who are defined as minded, autonomous, and

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self-aware individuals with whom one may have authentic and emotionally rewarding mutual relationships typically precipitate intense grief. The elemental issue of the construction of social identity, I maintain, is most strikingly revealed through examining interactions with those who are defined as being on the border between person and nonperson.

THE RESEARCH

This discussion is based on data drawn from 14 months of fieldwork carried out in a large private veterinary clinic in the Northeast. As is conventional, I conducted lengthy, semistructured, tape-recorded interviews with the 9 veterinarians (6 men and 3 women) who worked in the clinic during the time I was there. These interviews lasted from one to three and one-half hours. All the doctors were asked to talk about their experiences with euthanasia at some length. My fieldnotes record 33 euthanasia inci- dents that I observed as a researcher or, as I became more involved as a direct participant in the clinic, in which I assisted. 4

Emotions--good and bad, painful and joyful--are natural features of fieldwork and essential elements of the data. Much is to be gained, both personally and analytically, from fieldworkers confronting the emotions that the flow of interactions in the field generates in them and empathically partaking in the feelings of those with whom the work brings them in con- tact (Ellis, 1991; Kleinman and Copp, 1993). I recognize my tendency in the following to employ a "realist" presentational style (Van Mannen, 1988) that analytically objectifies the issues discussed. However, my immediate emotional encounters with dying animals and grieving clients, as well as the personal experience of deciding on and attending the euthanasia of one of my own dogs during the course of my fieldwork in the clinic, were sadly instructive and orient much of what follows.

CLINICAL WORK WITH HUMANS AND ANIMALS

A number of significant differences exist between medical settings in which humans are ministered to and those in which nonhuman animals are the focus of care. In human-to-human medical exchanges the physician is

4According to my sampling of the clinic's computer records, during the time I was involved in the research an average of 4.6 euthanasias were performed each working day. This translates to each doctor in the clinic performing slightly over 11 euthanasias a month. A study of California veterinarians conducted by Hart et al. (1990) found that the doctors surveyed conducted an average of 8 euthanasias a month with a range of 3-20 per month.


clearly in charge (Friedson, 1987). He or she typically directs the conver- sation with the patient and his or her companions (Fisher and Todd, 1983); takes pains to ritually demonstrate competence through demeanor, cos- tume, and other expressive devices; and is commonly the dominant party in determining treatment decisions. Further, physicians are subject to ex- tensive legal and ethical regulation (Fox, 1990). Considerations of cost are of minimal import in human clinical settings and overtreatment is preferred due to the moral, ethical, and legal risks inherent in undertreatment of patient disorders (Jennings, 1990).

In contrast, clinical exchanges in veterinary settings are far more ne- gotiative than those played out in human medical interactions. This difference derives from various factors. In general, veterinarians enjoy considerably less occupational status than do practitioners who make life- or-death decisions regarding humans (Bryant and Snizek, 1976). Veterinary medicine is also client oriented as opposed to patient oriented. Obviously, the veterinary patient lacks the linguistic and intellectual abilities to play a direct role in determining treatment, while the veterinary client is ostensibly the "owner" of the animal/property being treated. Also, as opposed to human medicine, the cost of potential treatments is a prime considera- tion in veterinary decisions with the euthanizing of the patient as a viable final option should the client determine that the expense of treatment out- weighs the medical and emotional consequences one may reasonably ex- pect.

Additionally, while the ethics of practice are given considerable attention in veterinary training and literature (e.g., Herzog et al., 1989; Self et al., 1991; Tannenbaum, 1993), legal regulation is far more minimal than is that which formally constrains physicians. For the most part, this difference is due to the conventional definition of companion animals as the property of their caretakers, as objects that are possessed rather than beings with interests, perspectives, and rights. Consequently, regulations under which veterinarians labor reflect the legal status of animals as items of personal property. 5 The owner has the right to do with his or her property as he or she will within the bounds defined by legal responsibility to avoid overt mistreatment and exercise sufficient control such that the animal does not damage the property or physical welfare of others. In this light, veterinary practitioners are constrained by local, state, and federal laws specifying such things as minimal professional qualifications, condition of treatment facilities, and matters of malpractice and negligence. Of course, should the

sit is, however, interesting to note that nonhuman animals have been defined, in certain circumstances, as legal beings with formally identifiable rights and responsibilities (see Animal Welfare Institute, 1990; Lessley, 1991).

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veterinarian be found legally liable for treatment errors resulting in the death or injury of a nonhuman patient, public condemnation and legal consequences are significantly less drastic than those suffered by a physician in similar circumstances. Because of the animal's conventional designation as property, the veterinarian's occupational errors formally are regarded, in essence, as comparable to those of a plumber or auto mechanic (Soave and Crawford, 1981).

Further, to a degree not commonly evident in most human medical encounters, veterinarians are involved in a triadic relationship. Since the animal patient is alingual, the human client is commonly called upon to provide everyday "interactional" information to supplement the "technical" and "perceptual" information (Anspach, 1993) elicited through the doctor's use of his or her training and equipment. Veterinarians and their clients cooperate to cast the animal as a "virtual patient." This exchange differs from those typically encountered in human practice by being less clouded with medical ritual and mystery, more likely to entail overt negotiation of diagnosis and treatment, characterized by use of "plain" rather than technical language, and more apt to involve the human participants in direct discussion of the patient's death (Gregory and Keto, 1991; Samuelson, 1988). Physicians also are socialized and expected to demonstrate "detached concern." This entails the suppression of emotion and the display of a predominantly analytic approach when interacting with patients, their friends, and relatives (Smith and Kleinman, 1989). In contrast, it is more acceptable for veterinarians to display emotion overtly during clinical interactions. Veterinarians, as presented below, are far more open in express- ing anger, demonstrating sorrow, showing concern, and exhibiting joy than is conventionally the case of physicians operating in human medical settings (see Sanders, 1994a, 1994b).

In turn, the "death work" in which physicians are involved is quite different from that of veterinarians. Veterinary practitioners and clients recognize that "dispensing death" is a part of veterinary work 6 while physicians and other human medical personnel, confined by numerous legal and ethical restraints, are ambivalent about euthanasia as a practice alternative, discuss it reluctantly (if at all) among themselves or with those who pur- chase their services, and/or engage in active euthanasia secretively. Conse-

6Somewhere between 2 and 4% of veterinarians' clinical encounters involve euthanasia (American Veterinary Medical Association, 1988; Harris, 1983; McCulloch and Bustad, 1983). This represents a massive, voluntary termination of companion animal lives. Given the most reliable national data, somewhere between 1.8 and 3.6 million dogs and cats are euthanized yearly in the course of routine veterinary practice. This figure does not include between 4 and 25 million unwanted dogs and cats estimated to be euthanized each year in some 3600 animal "shelters" in the United States (Akrow, 1993; Kahler, 1992).


quently, while veterinarians are usually present during and directly involved in their patients' deaths, physicians are rarely in attendance when their patients die (Fogle and Abrahamson, 1990:147; Sudnow, 1967:43).

THE EUTHANASIA ENCOUNTER

Euthanasia encounters represent the most time-consuming (Harris, 1983:375) and emotionally wearing clinical exchanges in which veterinarians routinely are involved. Made aware of the upcoming euthanasia by a no- tation on the clinical record provided by the receptionist, the doctor typically offered some form of neutral opening statement upon entering the examination room. He or she would, for example, make an observation about the animal's physical condition, ask the client questions about the patient's age, or offer some other interactional move to "break the ice." Usually after some brief discussion of the animal's negative prognosis or the signs and symptoms that prompted the client to approach this final decision, the veterinarian would ask clients whether or not they wished to stay for the euthanasia.

Most of the clients I observed during my fieldwork chose to stay (cf. Garcia, 1991:126). From the veterinarian's perspective, the presence of the client was potentially problematic. The euthanasia was not always an "aes- thetic death" (Shelp, 1989:192)--the veterinarian could "miss the vein," the patient could struggle or cry out when the hypodermic needle was inserted or might urinate or defecate while dying. As a consequence, the presence of the client increased the veterinarian's stress. This was particularly the case for those just beginning their practice careers. As one experienced vet observed:

When they first start working, a lot of the young kids don't like to euthanize an animal with the client there. They're afraid they won't get the vein and will do a subcute with the pentobarbital and the animal will show pain. It's a lot of stress anyway. They don't anticipate having to deal with the client's emotion. You don't learn anything in school about that.

When the client wished to be present, the veterinarian would shape the client's expectations of what was to follow by explaining the euthanasia procedure. He or she usually explained that the animal was to be injected with an overdose of pentobarbital, that the animal would feel no pain other than the prick of the needle, and the patient would be dead when its eyes closed though there might be some continued movement or apparent ("ago- nal") breathing. Here is a description drawn from my fieldnotes:

[The client] opens the door--'~ve're ready." Deborah has drawn up the pale lavender pentobarbital solution and comes in after calling [the tech] to come hold the vein.

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She has him go get the electric dippers on the counter. She explains, "Have you ever done this before? I am going to shave his arm and then I will be giving him an injection of an anesthetic. The only pain he will feel will be the prick of the needle--it will be like drawing blood. Then he will just go to sleep. He may seem to breath or make some movements, but they are just electrical messages to the muscles."

Either before or immediately following the description of the procedure, the vet would ask clients if they wanted a few minutes alone with their animal. Most said they did and used this time to bid farewell. Of all the interactions between people and their animals I observed during my time in the clinic, these sorrowful moments were the most emotionally difficult. My fieldnotes record an instance of my eavesdropping on such an exchange and the feelings generated by my overhearing the leave-taking between an older couple and their dog.

I am not real happy with this, but I am committed to tapping into this experience. [The tech] brings the dog--a small gray terrier--into examination room 4 and gently hands it to the man and his wife. I go into the adjoining room to listen and watch what I can through the half closed door. I am very uncomfortable with doing this. I feel like I am spying on an intimate and painful moment in these people's lives. The man says, "He doesn't look like he is in any pain." The wife agrees. They both pet the dog, hug him, call him by name. They are both crying. The man keeps repeating, "Be a good puppy. We love you."

After injecting the patient with pentobarbital and checking his or her vital signs, the veterinarian would, once again, routinely ask if clients wanted a few more minutes with the animal's remains. Again, most owners who attended the euthanasia wanted some time with the body. Having previously asked clients what they wanted to do with their animals' remains, vets frequently used this time to prepare for the disposition of the body.

JUDGING LEGITIMACY AND NEGOTIATING DEATH

As a form of medical interaction, the exchange that takes place in the veterinary clinic is interestingly unique in that it frequently involves overt negotiation between the doctor and the client around the diagnosis and treatment of the animal-patient. In the end, however, the animal's owner, as the purchaser of the veterinarian's services, has the final say as to the fate of the object/being which/who is his or her property. It is in the case of the euthanasia decision that the control exercised by the client cre- ates the most troublesome ethical dilemma for the doctor. As the person possessing the most expertise and ultimately the one who causes death, the veterinarian has various alternatives when interacting with clients who have decided, or are in the process of deciding, to euthanize their animals. The doctor can attempt to dissuade the client, consent to the client's request,


or send the client e lsewhere. T h e course the ve te r inar ian chooses largely d e p e n d s on his o r her evaluat ion of the client 's ra t ionale for euthanas ia . In general , these j udgmen t s range f rom reasons the ve te r ina r ian sees as legi t imate and the re fo re supports , to those seen as i l legi t imate and, to a cons iderab le degree , reflective of a mora l fai lure on the pa r t of the owner (Sanders , 1994b).

F r o m the ve te r inar ian ' s perspect ive , the mos t legi t imate reasons for eu thaniz ing a pe t revolve a round the animal ' s quality of life. In the clinic pa t ien ts who were old and infirm or suffer ing pa in because of severe illness or injury were seen as the mos t app rop r i a t e candida tes for euthanas ia . 7 O n e vet emphas i zed quali ty of life issues when he descr ibed his discussions with clients con templa t ing eu thanas ia (notice the distinction he m a k e s between legi t imate and i l legi t imate reasons) .

I always tell people that dogs really live for two things--their bodies and their love for their owner. So if the animal isn't eating and having that pleasure or they don't recognize their owner--if one or both of those things takes place--then it is time to consider euthanasia. You would be surprised how people come to the decision. Some people will bring in a dog that looks like it has gone through a lawn mower--really a mess--and they will say, "You have to do something, I'll pay anything." Other people will bring in a dog that has been hit by a car or something and it just has a little limp and they'll say, "It's in pain, put it out of its misery."

In cont ras t to ra t ionales emphas iz ing illness, infirmity, o r pa in expe- r i enced by the animal , the o the r ma jo r ca tegory of reasons typically o f fe red for eu thanas ia focuses on the owner's quality of life. As such, ve te r inar ians typically view these just i f icat ions as be ing significantly less legi t imate. Be- haviora l p rob lems , especial ly aggressiveness, are one of the ma jo r issues fo r which cl ients seek ve te r ina ry assis tance (Antelyes , 1990; Landsbe rg , 1991). A l though the vast major i ty of behaviora l p r o b l e m s owners experience with their animals could be r emed ied fairly easily th rough min imal t ra ining (Can tanza ro , 1992:8), the ve te r inar ians t ended to view this prof- f e red reason for eu thanas ia to be mode ra t e ly legi t imate given the l imited t ime, energy, and knowledge of mos t clients. O n e interviewee p re sen t ed he r accep tance of the owner ' s ra t ionale as involving her eva lua t ion of the p r o b l e m a t i c an imal ' s quali ty of life.

I can accept putting an animal down for behavioral problems as long as I think you have given it a good shot at trying to rectify the situation. I can sympathize with clients who don't have the facilities to handle a dangerous animal. If the animal is not going to really be an acceptable pet for someone else--the quality of life for an animal like that is not going to be high. I don't have much trouble with euthanasia when I think it is a quality of life question. If the animal's quality of life is not going to be good--this is a hard thing to hear myself say--I think they are better off not being around than being stuck in a cage for the rest of their life.

7Studies indicate that the vast majority of euthanasia decisions--from 70 to 80%--are precipitated by the animal's age and infirmity (McCulloch and Bustad, 1983).

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C o n s i d e r a b l y fu r the r down on the leg i t imacy scale we re c l ien t e u t h a - nas ia dec i s ions p r e d o m i n a n t l y b a s e d on e c o n o m i c cons ide ra t ions . W h i l e v e t e r i n a r i a n s t y p i c a l l y d i s a p p r o v e d o f c rass m o n e t a r y r a t i o n a l e s , t h e y t e n d e d t o be s o m e w h a t r e s igned to dec i s ions m a d e on e c o n o m i c g rounds , e m p h a s i z i n g the ba l anc ing o f the c l ien t ' s in te res t s and those o f the an imal . W i t h s o m e show of d is tas te , one o f my in te rv iewees de sc r ibed a case in which a w o m a n chose to eu than ize h e r cat ba sed on f inancia l c ons ide r a -

t ions.

I had one the other day. It was a sick cat and I suggested that we keep it in the hospital for a day because it was so sick, an old cat. I thought we could do a CBC, send a profile off and have that all back the next day, and the cat would do better if it were in the hospital with injectable antibiotics and fluids under the skin. She said, "How much is it? We are more attached to the dog than we are to the cat." So I gave her an estimate of 70 or 80 dollars for overnight . . . "That's too much, put it to sleep."

F r o m t h e d o c t o r ' s p e r s p e c t i v e , t h e l e a s t j u s t i f i a b l e r e a s o n f o r eu than i z ing an a n i m a l - - e s p e c i a l l y a hea l thy o n e - - w a s for the s imple con- v e n i e n c e o f the owner . C l ien t s who e m p l o y e d this type o f r a t i ona l e typica l ly

we re j u d g e d to be mora l ly suspect . They were pe rce ived as de f in ing the a n i m a l as a p i ece o f p r o p e r t y r a t h e r than as a sen t i en t be ing wi th fee l ings

and in teres ts .

The ones I really can't stand are the clients who come in here and they want to euth the animal for all kinds of ridiculous reasons--they are moving to a smaller apartment, or they just got a new couch and the cat doesn't match the color, or the dog has grown up and isn't as cute anymore. It's like it's this piece of trash that they just want to throw away.

A s the level of p e r c e i v e d l eg i t imacy o f the c l i en t ' s r e a s o n for re - q u e s t i n g e u t h a n a s i a dec l ined , t he v e t e r i n a r i a n ' s e th ica l d i l e m m a c o n c e r n - i n g w h e t h e r o r n o t to a c c e d e to t h e o w n e r ' s w i s h e s b e c a m e m o r e

p r o n o u n c e d . In s o m e c i r cums t ances v e t e r i n a r i a n s t r i ed to p e r s u a d e p e o p l e to c h a n g e t h e i r m i n d s o r s imply r e fu sed to p a r t i c i p a t e . 8 O n e i n t e r v i e w e e

d e s c r i b e d an e n c o u n t e r in which he successful ly s t e e r e d c l ien ts away f r o m

e u t h a n a s i a .

Just today I had these people come in with this cat. It was this argumentative mother and daughter and they said that the cat had had a stroke. The cat has vestibular disease, head tilt, falling to the side, there's no ear disease. It has idiopathic vestibular disease. With no treatment it will get over it in a couple of days. They said, "It's had a stroke. Put it to sleep." I said, "Well, let me show you. It's moving its tail. It's alert and knows where it is. Watch me move its paws. It is totally proprioceptive. It's doing fine and I would really like to not put it to sleep. Give it a couple of days and it will get better." They really didn't want to hear it, but I

SCultural differences appear to shape veterinarians' decisions whether or not to euthanize healthy animals. See Fogle and Abrahamson, 1990, and Kogure and Yamazaki, 1990.


was able to talk them into it. I said, "It's your cat, but I would really like to wait a few days and see if there is any improvement." She says, "Well, if you can tell me she is probably going to get better, then I'll do it." I said, "She's uncomfortable, she's not in pain." People sometimes try to corner me into saying that the animal is suffering.

W h e n veter inarians reluctantly went along with a client 's request to euthanize, they frequent ly neutral ized the guilt associated with the decision. They made reference to the "fact" that they were paid by the client to pe r fo rm a service and/or they would call on the s tandard rat ionale (which was also used to suppor t c ropping the ears and docking the tails o f cer tain

breeds o f dogs) "if we don ' t do it they will just go to s o m e o n e else o r do it themselves."

I t is rare that the exchange between the veter inarian and the client a round a pet ' s eu thanas ia involves the latter request ing the p rocedure and

the fo rmer complying with the client 's wishes. More c o m m o n l y the client approaches the emot ion- laden decision hesitantly and with intense feelings

o f ambivalence and comes to the vet for his or her medically in formed advice. In this role o f counselor (Har t et al. 1990; Soares, 1991) the veter inar ian assesses the animal 's situation, judges the client 's or ientat ion, de- te rmines whe the r fur ther medical intervention is feasible, and, commonly , "s teers" the client toward or away f rom euthanas ia (Harris, 1983:272). O n e vet descr ibed the exchange as a complex mix of making medical judgments , evaluat ing the client, making a decision, and ultimately, taking responsibility

for the decision.

When [clients] ask me [about euthanasia] in a medical context I try to assess what the prognosis is for this animal having a comfortable life--how long he is going to live, how comfortable we can make him for the time he is going to be alive. I try to get as much medical information as I can in order to make those judgments. People ask, "Well, what would you do?" I'll tell them if I think the animal is comfortable and has some comfortable time left. [In that ease] I'll try to encourage people to give them a little more time if they can financially swing it. I had a client the other day ask for advice, "Is it time?" And I said, "If he is still functioning like a dog and if we can make him a little more comfortable on a medication that is not going to make him really sick, let's try this and see if it works. If it doesn't we will deal with it in three or four weeks." Most clients are willing to do that. If I know they want to put the animal to sleep--you can read them sometimes if you open up to them and feel where they are at--you can tell when they want you to say, "I think it is time." Sometimes they need you to say that but they can't directly ask you. You can tell by the look in their eyes and their emotional state that they want someone to say, "I think it is time." That's what you say to those people. It's funny, I'm helping the animals, but in some ways you are counselling the owners as much as you are helping the animal. I think they are very grateful and relieved. I don ' t mind taking that responsibility.

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T H E V E T E R I N A R I A N ' S E X P E R I E N C E O F E U T H A N A S I A

Regular ly beset with animals ' pain, illness, and fear, and their owners ' anxiety and grief, the veterinarians, o f necessity, had to find ways o f coping with the ongoing emotional i ty o f their occupat iona l experience. O n e ma jo r protect ive mechan i sm they employed was emotional ly to separa te themselves f rom euthanasias and o the r emot ional ly painful si tuations they encountered . As is c o m m o n in medical settings (see C o o m b s and Powers, 1977:60; Smith and Kleinman, 1989), the vets of ten employed h u m o r as a protec t ive device. They would, for example, somet imes half-jokingly refer to themselves as "Dr . D e a t h " or "Dr. D o o m " when prepar ing to go into an examinat ion r o o m to pe r fo rm a euthanas ia or after having been respon- sible for a series o f deaths in the course o f a single work day. H u m o r was also used when "s t ranger" animals (such as dogs b rough t in by the local animal control officer) or physically and/or behavioral ly unappea l ing animals were euthanized. For example, here is a passage drawn f rom my field- no te s . N o t i c e tha t t he ve t ' s nega t ive de f in i t i on o f the c l ient p lays a significant role in the relative lack of concern shown dur ing the incident.

I go with Dwayne into the exam room where there is a ferret in cage. It is breathing in labored manner and is unable to stand up. The animal appears to be very sick. It is wheezing badly and has lost most of its fur. Dwayne takes it into x-ray to get a picture and then brings it out to surgery table and gives oxygen. I hold the animal and mask while he goes off for something. The ferret obviously likes the oxygen, sticking its head farther and farther into the mask. Its breathing is eased. Lisa comes in with the developed xray. Even I can see that the chest is not good--very hazy. Dwayne and Deborah comment on how bad the xray looks. Dwayne says, "This is a hard situation. The problem is [the owner] doesn't have much money. She was going to take it to [another clinic] and they wouldn't give credit--just cash, check or credit card. She brought it here because we would give her a break at least until Saturday. All she keeps saying is, 'How much will it cost?' If the ferret dies we can kiss the money goodbye." After a brief time in the exam room he comes back. "Well, this ferret is going to get 'hit on the head.'" (I find this to be an interesting euphemism.) Dwayne fills a syringe with the blue euthanasia solution and slicks the needle into the ferret's body. "If I get this into the liver it will go right away." He explains that the liver has ducts that send blood directly to the heart. The animal dies immediately and Dwayne puts another needle into its chest and draws out fluid. He shows the fluid to Ed who is getting ready for surgery. Ed comments on the lack of blood in the fluid indicating that the ferret had a tumor. Ed laughs and says, "That ferret was full of fluid. Say that fast three times." We all try it and laugh.

As seen here , the ve ter inar ian ' s definit ion o f the client was a signifi- can t fac tor shaping the emot ion he o r she exper ienced w h e n eu thaniz ing an animal. Far less was felt when the owner was demanding , excessively c o n c e r n e d with the expense o f t rea tment , o r displayed o the r characteris t ics o f a "bad" client (Sanders, 1994b). O n e doc to r emphas ized his re la t ionship with the client and told o f a recent case when I asked h im to talk about


the difference between euthansias that were, or were not, emotionally problematic.

I think it is usually where I know the client more and I know what is going into the decision. I put a cat down last week. It was an older woman that I have been dealing with for umpteen years and she has taken in older animals. She is a private duty nurse and she gets really attached to her patients and when they get ready to die she takes their animals for them . . . . (Soon after her husband) died all of her dogs died one at a time. Through every one of these she was really upset. Then I just put one cat to sleep about two weeks ago because it had a huge abdominal mass--a kidney tumor. And then I put another one to sleep last week because it had a huge tumor in the mouth. This was just like more than this poor woman could handle. I was really upset about that.

Veterinarians differentiated, then, among types of clients, qualities of interactions, characteristics of occupationally based relationships, and attributes of patients when anticipating and confronting t h e emotional consequences of eu thanas ia in teract ions . In drawing dist inctions among animals, they either related to the patient primarily as a medica l case or as an ind iv idual (cf, Arluke, 1988, 1990; Wieder, 1980).

Whatever the means they used to distance themselves from the emotional experience of routinely dealing in death, the veterinarians all saw at least some degree of emotional separation as being essential to their ongoing psychological well-being. One doctor observed during an inter- view,

I find that emotionally I just have to insulate myself from a lot of (client pain over euthanasia). If I were wrapped up in every case I would just be a mess. I'm not cold, but I am detached. I try to give the people what they need, be calm about it, and tell them not to feel guilty.

Since the veterinarian's emotional experience is closely entwined with that of the bereaved owner, he or she has a vested interest in fostering the healing process mentioned by the doctor in the above fieldnote excerpt. In the clinic clients anticipating euthanizing their animals were provided with informative pamphlets, offered helpful books and videotapes, and, as seen, advised by the doctors. Following euthanasia, clinic personnel did what they could to ease the client's pain. Bereaved owners were provided time and privacy to bid their animals farewell and doctors and staff members routinely t reated them with solicitation and sympathy. For regular clients the clinic also took an important symbolic step to provide closure to the owner's loss experience and speed the healing process. The doctor who had euthanized an animal would send a donation in the pet 's name to a local veterinary school. The school, in turn, would write to the owners informing them of the donation and offering condolences for their loss. Upon receiving the letter from the veterinary school, owners commonly sent grateful and heart-

208 Sanders

touching letters to the doctor who had euthanized their animal. For example:

Dear Dr. Thank you very much for your kind, thoughtful gift in memory of our beloved Bear. We received a very touching letter from [University] which moved us to tears. They say, "Time heals all wounds," but we still find it difficult to mention Bear. We realize how much you must miss our beloved dog too. We appreciate your thoughtfulness greatly with hopes research will someday help many animals with problems. Thank you again for caring for our Bear. He left us with so many beautiful memories.

This letter and the many like them clearly demonstrated the intensity of the relationships many clients had with their animal companions and the appreciation elicited by the veterinarian's display of understanding concern. For the vet, in turn, the memorial donation and subsequent appre- ciative interactions with clients helped to bring closure to, and ease the personal sadness attendant upon, causing the death of a regular patient.

CONCLUSION: DEATH AND PERSONHOOD

The dominant theme in the contrast briefly outlined above is that the central differences between human and animal medical death work interactions revolve around differences in conventional understandings of the distinctions among persons, nonpersons, and those beings residing in the definitional space between these two constructed categories. In all societies there are certain actors defined as being "worthy of death." People ritually relegated to such social categories as murderer, blasphemer, traitor, and the like typically are executed. These types of members are deemed un- worthy of continued life because they have violated significant rules and, in so doing, have broken the social contract.

Another group of actors whose lives are taken with little regard to their individual interests and whose collective deaths are not regarded as constituting "misfortune" (Cigman, 1980) are those defined as "nonpersons." Historically, slaves have been placed in this category (Spiegel, 1988). In contemporary society nonhuman animals considered to be useful for food or scientific experimentation (Adams, 1990; Rollin, 1990), dangerous, or nuisances are put to death with relative impunity. Between these two categorical extremes of violative persons and nonpersons are beings socially regarded as liminal (Turner, 1974). Such individuals on the borders of life-- embryos, the aged, the terminally ill, damaged newborns, and the permanently unconscious, for example--are deemed expendable because they exist on the boundaries of recognized status positions (Jennings, 1990; Suckiel, 1978; Sweeting and Gilhooly, 1991/92; ~lhuer, 1985). In many cases,


these actors once may have been socially defined persons but have moved by circumstance or been moved by means of some ritual mechanism to the edge of personhood and therefore justifiably may be put to death or allowed to die (Burkhart, 1989; Shalinsky and Glascock, 1988).

In contemporary society, companion animals exist in the liminal position between the socially constructed categories of person/being and that of nonperson/object (Eddy et al., 1993; Rasmussen et al., 1993; Sanders, 1993). As is the case with ostensibly human actors in such a liminal position, the trajectory of a companion animal from life to the imposed death of euthanasia depends upon a certain social calculus. In addition to the being's defined social worth--especially as sentient being or possessed object-- his/her/its perceived health, available treatment alternatives, and the impact of survival on those on whom he/she/it depends are elements of this cal- culation. While the euthanasia of severely damaged neonates, the comatose, those in extreme pain, and terminally ill humans generates considerable social controversy in the larger society, the purposive killing of nonhuman animals is a matter of less concern given available cultural definitions by which they may be officially excluded from personhood. Conventionally, nonhuman animals, lacking language, are presumed to lack the ability to construct concepts. Having no concepts, they do not possess a sense of self and, therefore, are unaware of the potential misfortune of self-loss (Cig- man, 1980:60; Frey, 1980). As sentient beings they can suffer, but they can- not conceive of or fear death.

However, people who have enjoyed long-term relationships with companion animals typically engage in what Palmer (1991) refers to as "emo- tionalized anthropomorphism." As seen above, pet owners commonly regard their animal companions as virtual persons. Rather than relegating them to generic species categories, these caretakers relate to their nonhuman companions as individuals with whom they enjoy authentic social relationships bounded by shared histories and encompassing direct knowledge of the animals' unique personal attributes (Sanders, 1993). 9 In short, they see their pets as subjects, as friends or members of their families whose pain and illnesses are matters of regret and whose natural or imposed

9Shapiro (1989:187) captures this perspective in writing about his relationship with his dog Sabaka.

[H]istory informs the experience of a particular animal whether or not it can tell that history. Events in the life of an animal shape and even constitute him or her. • . . [Shared] events inform Sabaka's behavior, his personality, and partly consti tute his individuality. Sabaka is an individual in that he is not consti tuted through and I do not live toward him as a species-specific behavioral repertoire or developmental sequence• More positively, he is an individual in that he is both subject to and subject of " t rue historical p a r t i c u l a r s " . . . . I can not replace him, nor ethically, can I "sacrifice" him for he is a unique individual being•

210 Sanders

deaths are defined as significant misfortunes and precipitants of intense remorse.

However, some owners relate to their animals as objects to be possessed. While these "objects" may have some measure of value as pieces of property, their disabilities, possible deaths, and their euthanasias are experienced as events with little emotional weight. As objects the animals can be disposed of and similar species/models can easily be acquired.

For their part, the veterinarians make analogous distinctions among their patients. Some are generic animals/patients/cases. These are "put down" routinely and with little show of regret. Typically, these executions are accomplished rather off-handedly and sometimes are accompanied by macabre humorous banter. Regular patients with whom the veterinarians have identifiable relationships and for whom they can provide the narrative historical accounts that constitute individuality, however, are "put to sleep" gently and their passing exacts emotional costs that must be paid as part of the dues of clinical practice.

We see in the exchange about euthanasia between veterinarians and their clients, then, a rich and striking example of the creation of personhood as a social accomplishment and the emotional consequences generated by the loss of significant relationships with beings defined into this valued position. While for some pet owners the loss of the animal is a matter of minimal import, more commonly the owner sees the pet as a unique individual and experiences the "unlinking" of their shared histories as an emotionally painful ordeal.

Humans often "neutralize" (Sykes and Matza, 1957) the potential emotional trauma of doing violence to or ending the life of other sentient beings with surprising ease. The predominant means by which this is accomplished is through "symbolically annihilating" (Tuchman, 1978) others by relegating them to the category of nonperson.

Personhood is, then, an elemental social designation that may be acquired or forfeited, given or taken away. It is a matter of social identity that determines how a being is treated, the rights and freedoms he/she/it possesses, and even whether and under what conditions the being is allowed to live. Therefore, it is in the close examination of the process by which this key social status is acquired, achieved, afforded, or removed and the interactional consequences of its possession that we may gain central in- sights into the exchanges that constitute social life.

It is at the border between the identities of person and nonperson that these issues and processes are most strikingly revealed. Ambivalence, the making of problem claims (Spector and Kitsuse, 1987), and emotion- alized social controversy revolve around conflicts as to the moral status of those on the boundaries of personhood. Liminal others such as fetuses, the


terminally ill, those who are permanently unconscious, and as discussed here, nonhuman companion animals, are those whose personhood is in dis- pute. It is here in the contested realm between person and nonperson we may gain significant insight into social relationships and the emotional experiences generated as these relationships are interactionally played out or ultimately terminated.

ACKNOWLEDGMENTS

I am grateful for the assistance provided by Eleanor Lyon and two anonymous reviewers.

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