Principles for ethical treatment decision‐making in veterinary oncology

Abstract

Many owners of companion animals with cancer are overwhelmed by having to choose the "right course of action." With the aim of reducing the burden on owners who are forced to act as surrogates for their animals, this work discusses principles that apply to ethical treatment decision-making for animal patients with cancer. Four principles frequently used for ethical decision-making in human medicine will be considered for their potential applicability in veterinary medicine. As a result of these considerations, preliminary guidelines are presented, along which a decision-making discussion can be held. The deliberate integration of the nonmaleficence and beneficence principles into the purely empirical facts of what is medically possible helps to maintain a moral perspective in specialized veterinary medicine. At the same time, such guidelines may contribute to individual decision-making in a way that animal patients neither have to endure unnecessarily severe side effects, nor that they are euthanized prematurely.animal cancer, applied ethics, quality of life, treatment decision-making, veterinary oncology | INTRODUCTIONSurveys indicate that companion animals are seen by 88% to 98% of their owners as members of the family.1 Having such deep relationships with animals is an increasingly accepted social phenomenon.The increase in such relationships is partly due to changes in our social fabric caused by increasing urbanization and self-selected or involuntary social isolation. For many owners, these animals thus play an important social role, and the idea of a "companion" animal reflects the social component of the human-animal relationship. According to conventional wisdom, the choice of treatment should be in the animal's "best interest," but this concept lacks a clear definition. 6,7 Rollin notes that the animal's owner may not necessarily represent the animal's best interest: "(…) many owners will, for their own sakes, do anything possible to keep the animal alive at all costs, ignoring or downplaying the animal's suffering, despite their professed (and heartfelt) love for these animals." 7 Hence, it has become part of the professional responsibility of the veterinarian to support the owner in both medical and ethical decision-making issues regarding choosing the optimal treatment strategy for their companion animal.3,6-9

Peripheral blood cell ratios as prognostic factors in canine diffuse large B‐cell lymphoma treated withCHOPprotocol

“…This data can impact veterinary‐client communication, client understanding of prognosis and consequent decision to treat, financial investment and ethical choices. 15,16 …”

Killing Kira, Letting Tom Go?—An Empirical Study on Intuitions Regarding End-of-Life Decisions in Companion Animals and Humans

“…Nevertheless, a clear majority of all three groups was willing to put the younger dog through the treatment C procedure as the healing chances were estimated as sufficiently high, and about a fifth of all participants even opted for this in the scenario with the elderly dog. After all, one of the ethical justifications for performing euthanasia in severely ill animals is the basic assumption that, for them, the current suffering outweighs future potential happiness after a time-consuming treatment [ 13 ]. An order effect cannot be excluded as a reason for the unexpected results in this regard [ 14 ].…”

Assessing Moral Judgements in Veterinary Students: An Exploratory Mixed-Methods Study from Germany

“…Veterinary and human medical ethics, despite sharing various common challenges and arguments, vary in a number of crucial aspects [ 31 ], such as the complex triangular relationship between the veterinarian, the client/patient owner and the patient itself [ 26 ], financial constraints or the general accessibility of animal preferences and welfare. Acknowledging the attempts to establish principles in veterinary ethics [ 32 , 33 , 34 ], the presented study starts with the assumption of several, normatively not (yet) unified approaches and personal orientations in veterinary ethics.…”