Drawing the line in clinical treatment of companion animals: recommendations from an ethics working party

Abstract

Modern veterinary medicine offers numerous options for treatment and clinicians must decide on the best one to use. Interventions causing short-term harm but ultimately benefitting the animal are often justified as being in the animal’s best interest. Highly invasive clinical veterinary procedures with high morbidity and low success rates may not be in the animal’s best interest. A working party was set up by the European College of Veterinary Anaesthesia and Analgesia to discuss the ethics of clinical veterinary practice and improve the approach to ethically challenging clinical cases. Relevant literature was reviewed. The ‘best interest principle’ was translated into norms immanent to the clinic by means of the ‘open question argument’. Clinical interventions with potential to cause harm need ethical justification, and suggest a comparable structure of ethical reflection to that used in the context of in vivo research should be applied to the clinical setting. To structure the ethical debate, pertinent questions for ethical decision-making were identified. These were incorporated into a prototype ethical tool developed to facilitate clinical ethical decision-making. The ethical question ‘Where should the line on treatment be drawn’ should be replaced by ‘How should the line be drawn?’

Philosophy of a “Good Death” in Small Animals and Consequences for Euthanasia in Animal Law and Veterinary Practice

“…At the same time, progress in veterinary medicine holds the potential for overtreating patients [55], an issue that has become an important concern in veterinary practice [56]. Owners who consider their companion animals as family members might want to make use of every possible treatment to keep their pet alive as long as possible-and presumably against the animal's own interest in cases of an unfavorable prognosis.…”

A Retrospective Analysis of Owner-reported Reasons for Canine Illness and Injury Visits in Veterinary General Practice: A List of the Top 50% of Complaints

“…2,3 Such decisions are affected by a number of variables, including client finances, owner perceptions and attitudes toward the animal, and the nature and severity of the illness. 4,5 Nevertheless, the course of action recommended by the clinician must be scientifically verifiable, ethically sound, and fairly priced in order for the veterinarian to continue practicing high quality medicine and maintain economic productivity. 4,5,6,7 Given the wide spectrum of diagnostic and treatment options available to veterinarians, it is important that veterinarians are adequately trained to recognize situations where their ability to be flexible and innovative in their approach to treatment may be required.…”

“…4,5 Nevertheless, the course of action recommended by the clinician must be scientifically verifiable, ethically sound, and fairly priced in order for the veterinarian to continue practicing high quality medicine and maintain economic productivity. 4,5,6,7 Given the wide spectrum of diagnostic and treatment options available to veterinarians, it is important that veterinarians are adequately trained to recognize situations where their ability to be flexible and innovative in their approach to treatment may be required. While every encounter with a patient and client is different, the veterinarian's ability to recognize that there may be multiple treatment approaches to a common problem is paramount to upholding modern standards of care.…”

“…1,3 From this information, the training of future veterinarians to be receptive to alternative approaches to treatment and care can be better directed toward areas where it will be most effective. By understanding the types of illnesses and or injuries that will most frequently prompt a pet owner to seek veterinary care, veterinary curriculums can be better tailored to prepare future veterinarians for situations they will encounter in daily general practice 1,4 In this study, the frequency with which specific types of presenting canine complaints, as reported by the owner, are encountered in general veterinary practice is described and analyzed. To accomplish 4 this, a retrospective analysis of owner identified complaints for common canine conditions that presented at general veterinary practices, over the course of a one-year period was conducted.…”

Let's talk about veterinary ethics: developing tools, finding spaces and recognising institutional responsibilities

“…Indeed, what is interesting and novel about Grimm and others’4 work is that it not only presents the steps taken to develop a new ethics tool to aid decision making in practice, but it also proposes several important aspects of ethical tool development and use that should be taken forward from this research. The authors argue that: collaborative working is needed to develop ethical approaches; ethical tools should be grounded in theory and that drawing upon comparable ethical work in other fields can be useful; and institutional conditions are important and these can affect ethical discourses.…”