|Home | About | Journals | Submit | Contact Us | Français|
Until recently, you routinely discharged pets after uncomplicated spay and castration procedures, without medications. Based on recent reports concerning post-operative pain management, you decided to routinely dispense analgesics to clients when they pick up their pets after surgical procedures. A long-time client is retired and facing some financial restrictions. She arrives to pick up her two new young cats one day after one had been spayed and the other had been castrated. She scrutinizes the bill and asks what the pills are for. When told they are to manage post-operative pain, she says she cannot afford the extra charge, never did this before, doesn’t think she can get the drugs into the cats, and does not believe that either cat is experiencing any discomfort. Several clients in the waiting room are listening intently as this discussion unfolds. For most of your career you have never prescribed post-operative analgesics for routine spays or castrations. Is it acceptable now to discharge these two bright and alert young cats without analgesics? How should you respond?
Responses to the case presented are welcome. Please limit your reply to approximately 50 words and forward along with your name and address to: Ethical Choices, c/o Dr. Tim Blackwell, Veterinary Science, Ontario Ministry of Agriculture, Food and Rural Affairs, 6484 Wellington Road 7, Unit 10, Elora, Ontario N0B 1S0; telephone: (519) 846-3413; fax: (519) 846-8178; e-mail: firstname.lastname@example.org
Suggested ethical questions of the month are also welcome! All ethical questions or scenarios in the ethics column are based on actual events, which are changed, including names, locations, species, etc., to protect the confidentiality of the parties involved.
Les réponses au cas présenté sont les bienvenues. Veuillez limiter votre réponse à environ 50 mots et nous la faire parvenir par la poste avec vos nom et adresse à l’adresse suivante : Choix déontologiques, a/s du Dr Tim Blackwell, Science vétérinaire, ministère de l’Agriculture, de l’Alimentation et des Affaires rurales de l’Ontario, 6484, chemin Wellington 7, unité 10, Elora, (Ontario) N0B 1S0; téléphone : (519) 846-3413; télé-copieur : (519) 846-8178; courriel : email@example.com Les propositions de questions déontologiques sont toujours bien-venues! Toutes les questions et situations présentées dans cette chronique s’inspirent d’événements réels dont nous modifions certains éléments, comme les noms, les endroits ou les espèces, pour protéger l’anonymat des personnes en cause.
Assessing animal welfare in an individual animal can be difficult. Judging the welfare of animals in a herd or flock is more problematic. Most food animal veterinarians service some farms where the sick pens are always full and the treatment success rate in those pens is uncharacteristically low. This pattern is consistent on these farms and, over time, both the producer and the veterinarian accept this as normal. Practitioners understand that not all producers possess equivalent husbandry skills and some will always be far below average. Nevertheless, farmers with substandard husbandry skills are often committed to their farms and work long hours. Their farms struggle as much to survive financially as the animals struggle to survive the substandard husbandry practices. Veterinarians find it frustrating to work with these units for a number of reasons, including the overall welfare of the livestock. Do they have a choice?
This situation is a classic example of what my friend and colleague Temple Grandin calls “bad becoming normal.” In other words, a practice, however problematic, comes to be seen as the only way to do things. Workers come to accept what should be seen as unacceptable, as inevitable. While some farmers will always be better managers and better husbandry people than others, there is no reason why routinely bad practice cannot be elevated to the level of acceptability. Obviously, such elevation can only be accomplished by education.
The 18th century philosopher, David Hume, vividly explained the extent to which human life is governed by established “custom and habit.” According to Hume, human survival depends upon myriad daily practices becoming automatic, not requiring thought, reflection, or deliberation. For example, when we drive a familiar route or when we perform at some athletic event, we rarely think consciously of the steps involved. As a longtime weightlifter, I do not think of the steps involved in doing a bench press. On the few occasions where I have thought of the sequence of steps required, the lift turned into an unmitigated failure. Imagine needing to think through one’s response to a falling safe. What saves us is instinct and habit. In this situation described, on the other hand, habit is the enemy of success and even of survival. It is necessary to replace the habituated bad practice by new habits. And the natural person to teach proper animal management and good husbandry, including preventive medicine, is the veterinarian.
Veterinarians, if properly educated, ought to be well aware of principles of proper animal management and good husbandry. Furthermore, they possess Aesculapean authority, as we have discussed before. This is the special authority, possessed by medical professionals in human and animal medicine, associated with the ability to heal. What is necessary is for veterinarians to vigorously reject bad becoming normal, and not succumb to fatalistic acceptance thereof. Thus, in the kind of situation described, the veterinarian should utilize Aesculapean authority to get the client’s attention, and appeal to client self-interest to keep that attention, and motivate the client to unlearn poor practice habits and relearn good practice habits. The point should be made clearly that poor conditions eventuate in disease, which leads to a decline in productivity, which in turn leads to a loss of profit, and in the long-term, to the loss of one’s business. In some cases, for example if the farmer is old or ailing, it may be necessary to hire new blood, for example a recent graduate in animal science, to create a turnaround in management. In other cases, it may simply take the veterinarian showing the farmer a well-run operation to inspire change.
Once again, this kind of situation attests to the oft-repeated mantra that veterinarians need to be “people persons” and singularly adept at communication and persuasion. Fortunately, virtually all rational people are motivated primarily by self-interest, and self-interest dictates the improvement of management in this case. Knowing how to access this natural inclination in the direction of self-interest requires that the veterinarian be a good psychologist and know what sort of leverage to apply to different individuals. Once again, we see that a high grade point average is surely not as important to potential success in veterinary practice as are personality and skills in persuasion.
We know from human medicine that surgeons who are unique in being able to perform a life-saving procedure need not be possessed of excellent communication skills or warm personalities. Veterinarians, on the other hand, to be successful in such situations as the case described, absolutely require both, particularly in farm animal practice. As I have long argued, veterinary colleges must make a major effort to recruit applicants with both a strong agricultural background and an understanding of rural culture to lubricate communication. While it is possible for an urban person to garner great credibility with agricultural people, it is far easier for people growing up in a culture to do so.
Of paramount importance is that veterinarians never lapse into accepting poor animal husbandry and management as right or inevitable. Such a stance not only erodes job satisfaction, but creates moral stress and a sense of impotence. One of the great rewards inherent in successful veterinary practice is the notion that one has been responsible for elevating the welfare of animals under one’s aegis. An additional reward comes from helping one’s clients succeed financially or at least stay in business. The sort of situation described, while all too common, creates a unique opportunity to actualize one’s potential as a healer and as an educator.
Use of this article is limited to a single copy for personal study. Anyone interested in obtaining reprints should contact the CVMA office ( gro.vmca-amvc@nothguorbh) for additional copies or permission to use this material elsewhere.