Tan Ho - Japan

This past summer, I had the opportunity to travel to Japan for my externship project, thanks to the generous support of the Global Program. With the guidance of Dr. Lynette Hart and Dr. Takuo Ishida, I developed a research project to explore the approaches of veterinarians to euthanasia in Japan where euthanasia is a culturally sensitive topic. I had a chance to meet Dr. Takefumi Kikusui who introduced me to several animal hospitals in Tokyo. I had an eye-opening tour at their facilities and interviewed the veterinarians about their approaches to euthanasia. In addition, I created a survey, and I sent it out to the veterinarians who couldn’t participate in the interviews.

According to the survey and interview responses, I’ve learned that Japanese veterinarians prioritize two main things during emergency situations, which are stabilizing the patient and calm, clear communication with pet owners. This protocol helped provide necessary medical intervention for the pets and emotional support to the owners during a stressful event. Japanese veterinarians pointed out that client communication was one of the greatest challenges in these emergency situations. Pet owners often panic and struggled to decide treatment options due to the complex prognoses. Thus, Japanese veterinarians recognized the important role of communication in building a veterinarian-client-patient relationship, which is crucial during emergencies. This bond helps the veterinarian effectively calm the owner and discuss the best course of actions for the pet. Many animal hospitals I visited in Japan had dedicated comfort rooms. The comfort room is in a quiet space where the veterinarian would privately discuss euthanasia with the clients. These rooms offered a safe space for the client to share their values and perspective to the veterinarian. Japanese veterinarians showed their respects to each client’s beliefs and perspectives, and it helped reinforce their veterinarian-client-patient relationships.

Although euthanasia cases in Japan have been gradually increasing in recent years, it is relatively uncommon. Many Japanese pet owners still prefer natural passing over euthanasia for their pets. However, Japanese veterinarians generally support euthanasia as an ethical option to relieve the pet’s suffering when necessary. Thus, over time in practice, Japanese veterinarians have learned to balance between providing palliative care and considering euthanasia. Their goal is not only to provide medical care for the animals, but also to align treatment decisions with the owner’s values.

During my time at the Akasaka Animal Hospital, I had an opportunity to shadow Dr. Akiko Shibanai for the case of Musashi. Musashi is a 20-year-old cat, who was diagnosed with lymphoma. However, his prognosis was poor due to his geriatric age. I was invited to join the discussion with Dr. Shibanai and Musashi’s family. After Dr. Shibanai explained the diagnosis thoroughly, the family decided at-home palliative care for Musashi with provided detailed guidance. A supportive veterinarian-client-patient relationship had built trust between the veterinarian and the family, which helped reduce stress for both parties during this sensitive conversation.

This life-changing experience has helped me grow both personally and professionally. Japanese veterinarians have shown me the importance of the veterinarian-client-patient relationship which is strengthened by the deep respect for the owner’s values. Respect is a central value in Japanese culture, and I had the opportunity to experience and learn their culture during my time in Japan. Everywhere I visited, I was treated with kindness and respect, which made me feel genuinely welcome. These valuable insights will help me effectively serve a multicultural community where euthanasia can be a culturally sensitive topic.