Veterinary Ethics: Life & Death Decisions in the Real World

Trying to do the "right" thing when animals are suffering can be very difficult.

Posted May 10, 2017

The need for reflective practice in veterinary medicine.

Veterinarians are often faced with extremely difficult choices ranging from whether or not to do surgery to assessing the quality of life of an individual animal to deciding when it's time to "put them to sleep." A new book called Veterinary Ethics: Navigating Tough Cases edited by veterinarians Dr. Siobhan Mullan and Dr. Anne Fawcett is a landmark book that should be required reading for all students of veterinary medicine and practicing veterinarians. The book's description reads as follows:

With permission of the publisher
Source: With permission of the publisher

What should a vet do when a client can't pay for their animal's treatment? Or when asked their opinion on the killing of wildlife for disease control? Or when observing an animal welfare problem whilst off duty? Ethical problems are an everyday part of life for veterinarians, but it can be difficult to combine personal values with professional conduct. Veterinary Ethics presents a range of ethical scenarios that veterinarians and other allied animal health professionals may face in practice. The scenarios discussed are not only exceptional cases with potentially significant consequences, but often less dramatic everyday situations. The responses to these ethical problems are from practising veterinarians and acknowledged world experts in animal welfare and ethics. The advice given is thorough and detailed, covering different eventualities, the ethical knots and dilemmas, the personal feelings of those involved, as well as objective recommendations on ethical decision making and, where relevant, guidance from veterinary governing bodies and the law. The advice is framed in the form of veterinary life in the real world, not necessarily an ideal world. As well as practical guidance, the book takes a step back and explores the different philosophical arguments and standpoints and the resultant solutions and problems of each approach, examining the background and relationship between different philosophical schools of thought, ethics and veterinary care. The book strives to present decision making in response to ethical problems as transparently as possible, employing a range of ethical frameworks. The book also challenges the reader about their own decision making in given situations, what factors to consider and how they would achieve certain outcomes.

Clearly, practicing veterinary medicine can be both enjoyable and very rewarding, and also extremely challenging. Veterinarians are not only interacting with their nonhuman animal (animal) clients, but also with their humans. And, this mixture of beings can present serious questions that demand informed answers and decisions.

Courtesy Dr. Anne Fawcett
Source: Courtesy Dr. Anne Fawcett

Doing what is "right" isn't always doing what is easy.

I'm very interested in the rapidly growing field of veterinary ethics and was thrilled when Drs. Mullan and Fawcett agreed to do an interview with me. Their answers to the questions I posed are as follows:

Why did you both write Veterinary Ethics: Navigating Tough Cases?

Siobhan edited a column in the British Veterinary Journal's In Practice magazine which continues to be a very successful, thought-provoking column. Anne was one of many contributors, also teaching veterinary ethics at the University of Sydney and also the University of Queensland. Siobhan teaches animal welfare science, ethics and law at the University of Bristol Veterinary School. We're both passionate about ethics and animal welfare so we teamed up. We had 40 contributors write responses to ethically challenging scenarios, covering a huge range of species and settings. This team of authors made extraordinary contributions and provide a really diverse voice. We're not trying to give the right answers, rather show logical ethical analysis applied to realistic scenarios. We hope this will stimulate some ethical thinking, increase people's ethical sensitivity and allow them to provide ethical frameworks in the real world.

Can you please share some personal stories from your own practices?

Anne: As a companion animal veterinarian, a scenario that I am often presented with is the animal whose suffering is severe, but the owner wants to continue with treatment that is medically futile. This can be challenging. By providing an ethical justification for my recommendations, my communication with owners is enhanced. They know where I am coming from. But I am also setting the scene for them to give their ethical justification. By being explicit about ethical reasoning we can often come to a better decision for the animal, rather than second-guess what the other party is thinking.

There's a great line from your own book, Rewilding Our Hearts, which resonates here: "...ethics, not money, typically inspires people to take action, and no single ethical reason moves everyone." (p.78). Therefore, understanding ethics—and how to have conversations about ethics—is really important, whether we're talking about individual animal welfare or conservation. Just like we refine diagnostic tests to improve their sensitivity and specificity, so veterinary professions can refine their performance by reflecting on their practice. We hope this book will help stimulate more reflective practice.
 
Siobhan: I spend a good deal of my time working with industry bodies to develop policies around farming practices. This requires an understanding of the perspectives of the different stakeholders and the ethical tensions that underlie the issue. One of the most common disputes surrounds the ethical weight given to behavioural opportunities for animals. This is where animal welfare science can really have an impact as we gain greater understanding of how the animals themselves value such opportunities.

What are your major messages?

Our major messages are that ethical issues are common in veterinary settings, clinical or otherwise, and that moral distress impacts team members. We believe that sound ethical decision making skills may reduce moral distress, and not only that but move veterinarians to address issues that give rise to recurrent stress, e.g., working to change policy and legislation to improve animal welfare where this is applicable. Doing what is "right" isn't always doing what is easy. An employer, colleague or client may disagree with you, but it might help to know that experts from around the world may have navigated the case in the same way.

Who is your intended audience?

The book is aimed at veterinary professionals—veterinarians in clinics, government veterinarians, technicians, nurses, veterinary students and people interested in biomedical and applied ethics.

Do you think most people who share their lives with animals are aware of some of the issues with which you're concerned?

There is a lack of consensus about the moral status of animals in society which can make working with animals ethically challenging. Its hard to believe that anyone relating to animals is not aware of ethical issues, but some people have more ethical sensitivity than others (fortunately this can be developed). There is definitely a consciousness from veterinary professional associations that veterinarians need to improve their ethical reasoning skills. For example, the British Veterinary Association's animal welfare strategy, "Vets Speaking Up for Animal Welfare", highlights the need—raised by veterinarians—to improve skills in dealing with ethical issues.

What are some of your current projects and plans for the future?

Anne: I plan to continue to work in veterinary practice and in academia. I think they complement one another and I am always learning. I'm also keen to undertake further studies in animal behaviour as there is huge crossover with animal welfare, for example in assessing (and hopefully treating/helping) the painful or distressed animal.

Siobhan: I am still very focused on utilising welfare assessment tools to try to improve animal welfare. Where possible I try to focus my energies on areas likely to have the most impact, either through the scale of the improvement or the number of animals likely to be affected. I am particularly interested in how we can improve animals' lives through offering opportunities for pleasurable experiences. I love the diverse nature of my job which can see me involved in a study on enrichment for zoo giraffe, down on a farm training inspectors in animal welfare or teaching ethical decision-making to students on any given day. I am passionate about veterinary ethics but unfortunately this is a hugely underfunded area. There is much more to learn about how and why ethical decisions are made in practice, and the effect of these decisions on animals and their owners.

Thank you very much for taking the time to answer my questions. It's clear that veterinary ethics must be taken seriously, and that this book, as I mentioned above, should be required reading for anyone who makes decisions, often very tough ones, for nonhuman animals who thoroughly depend on their knowledge of what is going on and their goodwill. And, as the editors stress, "Doing what is 'right' isn't always doing what is easy."

We all want the best for the animals with whom we share our lives in one way or another (for more discussion on this topic please see "Dogs Want and Need Much More Than They Usually Get from Us"), and Veterinary Ethics: Navigating Tough Cases will be an invaluable guide for making quality of life and life and death decisions in the real world. 

Note: Another excellent book in this general area is Hospice and Palliative Care for Companion Animals: Principles and Practice, edited by veterinarians Amir Shanan and Tamara Shearer and bioethicist and Psychology Today writer Dr. Jessica Pierce. Psychology Today writer Adam Clark also considers many relevant topics.

Marc Bekoff’s latest books are Jasper’s Story: Saving Moon Bears (with Jill Robinson)Ignoring Nature No More: The Case for Compassionate ConservationWhy Dogs Hump and Bees Get Depressed: The Fascinating Science of Animal Intelligence, Emotions, Friendship, and ConservationRewilding Our Hearts: Building Pathways of Compassion and Coexistence; The Jane Effect: Celebrating Jane Goodall (edited with Dale Peterson); and The Animals’ Agenda: Freedom, Compassion, and Coexistence in the Human Age (with Jessica Pierce). Canine Confidential: An Insider’s Guide to the Best Lives For Dogs and Us will be published in early 2018. Marc's homepage is marcbekoff.com.