Motivational interviewing in veterinary euthanasia consultations: a client-centred approach to navigating ethically challenging conversations

Euthanasia consultations are among the most emotionally and ethically demanding conversations in veterinary practice. Despite growing recognition of the importance of client-centred communication, research consistently shows that veterinarians underperform in this area. Motivational interviewing (MI) offers a practical framework for addressing this gap, giving veterinarians a structured way to help clients resolve ambivalence and reach decisions consistent with their own values. MI has a growing evidence base in veterinary medicine, but its application to euthanasia decision-making raises ethical challenges that do not arise in standard behaviour change consultations because the decision is irreversible, the veterinarian holds simultaneous obligations to the animal and the client, and the same skills that support autonomous decision-making can, without self-awareness, become a tool for steering the client toward the veterinarian's preferred outcome.Drawing on the MI literature, veterinary communication research, and veterinary ethics, this paper provides a practical guide to applying MI ethically across seven common companion animal euthanasia scenarios. For each scenario, worked clinical examples illustrate how MI-consistent communication differs from standard advisory approaches, where its limits lie, and when the veterinarian needs to step outside the MI framework entirely. The article also addresses how MI principles apply to the euthanasia procedural consultation once the decision has been made. Three ethical risks warrant particular attention when applying MI in this context: the risk of manipulation through selective or deliberate use of MI skills to steer rather than support, the risk of harm through low-fidelity application, and the risk of conversations moving beyond the veterinarian's scope of practice. To address the manipulation concern specifically, we propose a two-step framework where a quality-of-life assessment based on the Five Domains Model of animal welfare is performed to establish a welfare-based clinical position, before the full range of clinically acceptable options is worked through with the client to find what is feasible in their circumstances, an approach consistent with contextualised care. Both steps are underpinned by ethical reflexivity to actively monitor whose interests are being served throughout the conversation. While MI shows considerable promise as a communication framework for veterinary euthanasia consultations, empirical evidence evaluating its specific application in this context remains limited. Research examining its impact on client experience, decision quality, animal welfare, and veterinarian wellbeing would help establish what ethical, high-fidelity MI practice looks like in euthanasia conversations and whether it produces better outcomes for animals, clients, and veterinary teams.Abbreviations: MI: Motivational interviewing; MITI: Motivational interviewing treatment integrity; OARS: Open-ended questions, affirmations, reflections, summaries; PACE: Partnership, acceptance, compassion, empowerment.