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Can Vet J. 2012 November; 53(11): 1153–1155.
PMCID: PMC3474570

Veterinary Medical Ethics

Ethical question of the month — November 2012

Investments in modern livestock facilities are costly and require decades to recover once the buildings are in production. An ever increasing number of large, influential retail businesses selling products of animal origin are setting standards for the housing and management of cattle, pigs, and poultry in response to their customers’ demands. These companies are requiring changes from their suppliers within 5 to 10 years regarding how livestock are raised. These deadlines are well before many current facilities will be paid for or will be in need of major renovations. Even livestock producers who are planning to expand or renovate within the time period set by these companies are concerned that their new facilities may not be compliant with these same companies’ subsequent series of demands. The companies have made these announcements regarding welfare standards without consulting or offering compensation to the producers on whom the entire cost of meeting these demands rests. It appears to livestock producers that this is a public relations effort which is completely at their expense. Should producers be expected to bear the full cost of such well-intentioned announcements?

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: ac.oiratno@llewkcalb.mit

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.

Ethical question of the month — August 2012

A 14-year-old Labrador retriever is owned by a young professional couple. They obtained this dog as a puppy and have been regular clients since the first puppy appointment. This dog is self-described as their “only child.” The dog has osteoarthritis (managed successfully with daily oral NSAID administration), and is hypothyroid (managed well with daily oral levothyroxine). This past weekend, the dog collapsed and was taken to a very well-respected emergency and referral hospital. A diagnosis of hemangiosarcoma was made, with tumors identified on the right atrium, the spleen, and the lungs. The treatment plan proposed by the referral surgeon is to stabilize the dog and perform a thoracotomy to resect the tumor on the atrium. Following recovery from the thoracotomy, a splenectomy would be performed, followed by chemotherapy. The owners are advised that survival time with this treatment plan is, at best, 6 months. The owners are understandably distraught when they advise you of the recent events. They wish to pursue any and all options to extend the life of their pet. Cost is not a concern. What advice should you give?

Comments

Happily, you don’t have to give advice. This decision has nothing to do with you. The only players are oncologists, who believe in clinical care heedless of (all aspects of) cost and the owners, who are in denial of death and reality. The dog really has no part of this decision. If you feel compelled, get involved. Otherwise just defer, nod, and bob. The (human) personalities in this case will do what they want to do anyway. As for the dog? Well, it will die, and it will die of cancer, and that amount of time will not be changed much by the humans intervening. When the dog is dead, the egos involved will pat themselves on their backs for their Godly interventions and their self ascribed compassion. The key word for the humans involved is “self “ whereas the dog would have trouble understanding the concept.

Gerald (Gary) Goeree, DVM, MSc, Kitchener, Ontario

I read:

  • The dog was taken to a very well-respected emergency and referral hospital.
  • The owners wish to pursue any and all options to extend the life of their pet.
  • Cost is not a concern.

Considering these facts, I cannot see that I should discourage the owners of the dog from following the advice of that reputable and knowledgeable hospital.

I would agree with the plan of surgery, chemotherapy, etc.

Six months is definitely six months for these owners. Arguing for euthanasia in this context is a bad idea.

Dr. Bernard Chapuis, Prince Albert, Saskatchewan

An ethicist’s commentary on prolonging the life of cancer patient

Virtually every companion animal veterinary practitioner deals with clients who identify their animals as their children. Generally, as the case description details, such clients are scrupulous about medical attention to their animals. In this case, however, as genuinely concerned as these people may be about their animals, they are dwelling under a significant misapprehension, namely, that whatever will extend the life of their animal is a good that is worth pursuing. In the situation described, the animal will experience a thoracotomy, which is of course an extremely painful and invasive procedure, a splenectomy, and eventually chemotherapy, which is likely to be extremely unpleasant for the animal. The general veterinarian faces a very difficult task of educating these clients regarding some things they do not wish to hear.

In a recent article published in Veterinary Clinics of North America: Small Animal Practice, entitled “Euthanasia, Moral Stress, and Chronic Illness in Veterinary Medicine,” I explored numerous issues related to chronic illness, in particular, cancer. Whereas a major ethical concern for veterinarians, historically, was persuading clients out of asking for convenience euthanasia, that is now compounded by the opposite problem, clients unwilling to euthanize to ameliorate pain, no matter how much the animal is suffering. I have argued on many occasions in this column that the primary obligation of a veterinarian is to serve the good of the animal, not the wishes of the client if they conflict. Since, ultimately, the decision rests with the client, the veterinarian’s job must be to provide a method of changing the client’s way of thinking.

As I wrote in that article,

“Human thought is irreducibly tied to language, which allows us ingression into modes of thought closed to animals. Humans can think in very abstract terms, in negative terms; in conditional terms; in future terms; in universal terms; in fictional terms; in counter-factual terms. These are all made possible by being able to structure thought linguistically, which in turn allows linguistic syntax to transcend thought rooted in immediate experience. Animals cannot.

There is thus, a striking dissimilarity between humans and animals facing life-threatening illnesses. Human cognition is such that it can value long-term future goals and endure short-run negative experiences for the sake of achieving them. We endure chemotherapy, radiation, dialysis, physical therapy and transplants to achieve longer life and a better quality of life than we would have without it, or, in some cases, merely to prolong the length of life to see our children graduate, or to complete an opus. In the case of animals, however, there is no evidence, either empirical or conceptual, that they have the capability to weigh future benefits or possibilities against current misery. To entertain the belief that “My current pain and distress, resulting from the nausea of chemotherapy, or some highly invasive surgery will be offset by the possibility of indefinite amount of future time,” is taken to be axiomatic of human thinking. But reflection reveals that such thinking requires some complex cognitive machinery. For example, one needs both temporal and abstract concepts, such as “possible future times” and the ability to compare them; a concept of death; the ability to articulate possible suffering.

To treat our companion animals morally and with respect, we need to keep in mind their mentational limits. Paramount in importance is the extreme unlikelihood that they can understand the concepts of “life” and “death” in themselves, rather than the pains and pleasure associated with life or death. To the animal mind, in a real sense there is only quality of life, i.e. whether its experiential content is pleasant or unpleasant in all of the modes it is capable of. We have no reason to believe that an animal can grasp the notion of extended life, let alone choose to trade current suffering for it.” (1) (From pages 655–656).

These differences in mentational ability must be clearly communicated to the clients. It must be made plain to them that, however much they may value the extra six months of having the animal around, for the animal the period will be consumed by unmitigated suffering. You must explain that inflicting such suffering is not the way to demonstrate love — letting go in a timely way is.

Footnotes

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.

Reference

1. Rollin BE. Euthanasia, moral stress, and chronic illness in veterinary medicine. Vet Clin Small Anim. 2011;41:651–659. [PubMed]

Articles from The Canadian Veterinary Journal are provided here courtesy of Canadian Veterinary Medical Association