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Thursday, December 1, 2011

Veterinary Euthanasia: Cultural Influences in Bangkok, Thailand

Posted December 1, 2011
Guest Author, Katherine Bibi
DVM Candidate 2015 (Cornell University)

During spring 2011, I traveled to four cities on three continents seeking to understand how various governments regulate their small animal veterinary clinics, if at all. Among my destinations was Bangkok, Thailand, where I spent an amazing two weeks working at Thonglor Pet Hospital. After arriving from Hanoi, Vietnam, where veterinary medicine was still in the early stages of development, I was unsure of what to expect in Bangkok. 

After only a few days of observing, I noticed something that astounded me: I had not seen one euthanasia procedure since my arrival. 

Thonglor Pet Hospital, Bangkok, Thailand
Photo by Author
Coming from an area in the U.S. where I was often used to seeing one or two euthanasia procedures each day, I questioned why this procedure was such a rarity.  Dr. Jakaphan Wannawong, one of the dermatologists at the Bangkok clinic, told me that he had euthanized only three pets over his entire career.

The veterinarians explained that euthanasia is rare, and there were some doctors who refused to perform it under any circumstances. The rationale was completely intertwined with their religious values and culture. The majority of the Thai people are Buddhist, and because of the value that the Buddhist religion places on life, euthanasia is avoided in the majority of cases.

The stark contrast between my experiences in the United States and Bangkok made me wonder if euthanasia is too frequently used in our culture as a “way out” rather than a last resort.  The Thai veterinarians were unwaveringly persistent in every case. For example, I saw them perform endless CPR on one dog and remove multiple tumors on a client’s hamster.

This begs the question: Does the elimination of euthanasia as a medical option compel the Thai veterinarians to provide better care and make them more determined to succeed? On the other hand, when does the value of life exceed the amount of suffering required to live such a severely compromised life?  Some patients received endless and uncertain palliative care while unable to stand and covered in pressure sores. At what point does it become important to compromise one’s beliefs and traditions for doing what may not be “acceptable”, but right?  This is a conflict that many of the Thai vets had to face.

Regardless of one’s position on euthanasia, it was obvious that Thonglor had the facilities to accommodate such extensive palliative care.  Though Thailand lacks the board certification program that exists in the U.S., the doctors’ specialty knowledge was impressive, and it was clear that each individual was motivated to learn more about his or her specific veterinary interest. This enthusiasm allowed for over 12 different specialty clinics within the Thonglor hospital, including a physical therapy clinic fitted with a hydrobath.  Though doctors informed me that Thonglor was more progressive than the average Thai clinic, I was astonished by how advanced the clinic was and how dedicated the veterinarians were to learning new procedures. 

Katherine Bibi is a first-year DVM student (Class of 2015)
at Cornell's College of Veterinary Medicine.
Photo provided by Author.

Though I had originally set out on my journey to determine how governments monitor and standardize the procedures of veterinary clinics, I soon realized that I was focusing on the wrong leading authority.  It became apparent that it was the culture of each region, rather than the protocols set forth by the government, that was at the heart of each clinic’s practices. Veterinary clinics aren’t run in totality by management, by the government, or by the desires of the clients; rather, they are guided by the customs of their people. 

If we as veterinary students choose to make an impact on the veterinary world, we must first understand the cultural values that lie within its foundation.