End-of-life issues: How to answer the "What would you do?" question

When clients are grappling with a pet’s failing health, they often ask, “What would you do if this were your pet, Doc?” These clients are genuinely seeking the opinion of someone they trust, says Cindy Adams, MSW, PhD, associate professor of clinical and diagnostic sciences and director of the clinical communication program at the University of Calgary School of Veterinary Medicine in Calgary, Alberta.

Before you respond to this question, it’s important to ask for more information so you understand the client’s situation. Your goal is to share the decision-making process by providing information clients need and using the right questions to reveal clients’ underlying views and beliefs.

“Often I like to counter with something like, ‘You’re really confused and concerned about how to go forward,’” Adams says. “And that can be just enough to let people speak a little bit more. You don’t want to get prescriptive without really understanding where the question is coming from.”

For example, when a client asks, “What would you do if you were me?” you may respond, “I’m hearing that you’re lacking direction and you’re unclear about what to do.” Clients may respond in a few ways. They might say, “You’re darned right, that’s why I’m asking.” Then you can answer, “OK, well, let’s figure out what’s best for your pet.” This opens the door to continue the dialogue.

Or they may answer with, “I’ve never been through this before. My older kids are at college. I know this is urgent and my pet’s in bad shape, but I have all of these connections and people I’m responsible for. I’m so confused.” This is an important piece of information, and it prompts you to mine for more data. “The family situation is a crucial piece of information to discern before we tell them what to do,” Adams says.

Finally, remember the key to a successful end-of-life conversation is beginning at the client’s starting place. And this is something you’ll diagnose with each client you face. Ask these questions:

> What other situations is the client dealing with?

> What types of information does he or she need?

> What does the client know already?

> What does the client need to know, and how does he or sh need to learn it?

“Practice teams become less frustrated when they get good at this type of communication,” Adams says. “These conversations enable them to help make decisions in the best interests of the animal and the client.”