Abstract
When I discuss veterinary medicine with students in my Animals and Society class, many report that they would consider becoming veterinarians if only the job did not involve “putting animals to sleep.” Most people who have cared for companion animals have taken them on that wrenching final trip to the veterinarian’s office, and those who have done this with numerous animals can usually recall better and worse visits of this sort. In addition, most can recall the difficulty, often the agony, of determining that an animal has reached the time when their life should end. Some emergencies and accidents make the right decision clear, but other situations present moral, emotional, and financial quandaries.
Blue Juice, by Patricia Morris, examines euthanasia from the veterinarians’ side of the experience. Veterinarians routinely perform a task that most people speak of only in euphemisms. They must know how to do it well, not just in the technical terms of getting all aspects of the injection right, but also in terms of professional ethics surrounding animal welfare and interactions with human clients that can involve financial negotiations and intense emotions. In Blue Juice, part of the Animals, Culture, and Society series from Temple University Press, Morris skillfully analyzes these and other aspects of veterinary euthanasia. In doing so, she sheds light on issues salient for the fields of work and occupations, the sociology of emotions, and, perhaps most significantly, death and dying. Moreover, the book enhances the research on dramaturgy and constitutes an important addition to the growing literature on human/animal relations.
The title of Morris’ book comes from the color of the dye that drug manufacturers add to a leading barbiturate solution used in euthanasia to distinguish its lethal concentration. (Some brands use pink dye.) Veterinarians and workers in animal shelters commonly use the term “blue juice,” and Morris points out that her decision to use insiders’ slang as the book’s title conveys some of the complexity of euthanasia. Veterinarians would never refer to “blue juice” with their human clients. But the term’s ubiquity behind the scenes indicates how gallows humor helps veterinarians, as well as physicians and others whose work involves contact with death, cope with end-of-life situations.
Blue Juice draws on ethnographic research in two large veterinary teaching hospitals in the northeastern United States and an emergency veterinary clinic on the West Coast. Morris spent over six hundred hours in these settings, shadowing members of the clinical staff and observing cases around the clock. She observed routine cases but also saw many in the growing number of veterinary specialties, such as oncology, cardiology, and neurology. In addition, she interviewed fifty-four veterinarians, some numerous times. The veterinarians had a wide range of experience in the profession. Many were seasoned practitioners, but timing allowed her to follow an entire cohort of interns through their first year of practice. Consequently, she observed how veterinarians’ euthanasia-related stressors and coping strategies change and others persist across a career. She focused on small animal veterinarians (i.e., those who treat pets, mostly dogs and cats). Morris’ willingness to clean examination tables, deliver charts, assist in noncritical procedures, and generally help where needed enabled her to develop the rapport that leads to insider information. Consequently, Blue Juice brims with insights about the complexity, conflict, and satisfaction associated with not only protecting life but also dispensing death.
One of the strengths of the book comes through Morris’ analysis of how veterinarians navigate the dual role of healer of animals and provider of services to clients. Earlier generations of veterinarians understood their role as one of offering a menu of options to the client, who then made a decision about how to proceed. The veterinarian honored the client’s wishes. Newer generations have departed from this traditional role and increasingly become advocates for animals. Consequently, the veterinarians Morris interviewed faced three moral and ethical tensions. The first source of tension stems from differing attitudes regarding the importance of animals. For example, veterinarians and clients sometimes disagreed on the legitimacy of a particular rationale for euthanasia. Owners sometimes asked veterinarians to euthanize healthy but “inconvenient” animals. Nearly all of the veterinarians Morris interviewed had refused at least one request of this sort. Most considered it unethical to euthanize a healthy animal simply because the owner objected to the amount of shedding or a family member had developed allergies. Although many worked to exhaust options to euthanasia, others chose not to risk losing a client and abided by owners’ requests.
Morris traced a second source of tension to differing beliefs about human responsibility to animals. Nearly every veterinarian could recall clients who insisted on extensive treatment of conditions or injuries from which their animal would never recover, as well as cases in which an animal would have had a good prognosis following reasonable treatment that the owner simply could not afford. Most participants objected to euthanizing animals because their owners were unwilling to provide necessary care. At the same time, they recognized that, in some situations, owners truly could not cope with the “treatment burden” of caring for an animal at home. The case of a 150-pound dog who could no longer walk makes for an easier decision than the case of the cat whose owner cannot bear to have to give him daily medication.
The third source of veterinary/client tension involved differences in defining the best interests of animals. Clients often have flawed assessments of whether their animal is suffering, and although some take the veterinarian’s assessment seriously, others make decisions against that advice. The situation becomes complicated because the animal is both the veterinarian’s patient and the owner’s property. Veterinarians must find ways to care for the animal while respecting the owner’s autonomy.
Another of the book’s strengths is its analysis of emotions. In analyzing the emotion work that veterinarians engage in with clients, Morris draws on Goffman’s insights about “tightness” and “looseness” in emotional situations. She reveals the circumstances under which veterinarians encourage a tight approach from clients to manage their guilt and conflicted emotions over a euthanasia decision so that the animal does not suffer. After euthanasia, however, veterinarians grant clients greater looseness to express grief. Consequently, they experience what Morris calls a “strange intimacy” with their clients, first creating conditions for rational decisions and then providing extensive emotional support. In their own emotional lives, veterinarians must manage euthanasia-related emotional strain, and Morris examines their use of problem-focused and emotion-focused techniques to do so. Her analysis of the various dimensions of emotion that veterinarians confront can inform debates about the practice of euthanasia in human medicine.
In sum, Blue Juice is a thoroughly researched, clearly written, well-organized book. It offers a rich ethnographic analysis of euthanasia in veterinary medicine while reflecting on implications that extend far beyond that domain.