14 Veterinary Times

Table 1. Distinction of Ethics I and Ethics II (after Rollin, 2006)

THIS article aims to give an introduction to veterinary and animal ethics and will try to explain its relevance today.

As animal advocates, it is of paramount importance that any professional working with animals is familiar with exigent aspects of this challenging melting pot of differing thoughts and prin-ciples, widely relating to matters of morality and philosophy.

In a series of articles, I will look into issues of veterinary and animal ethics of interest to the veterinary professional, and give examples of ethical dilem-mas that may be encountered on a daily basis.

Challenging cases in veteri-nary medical ethics and how best to resolve them will also be pre-sented and discussed. Because veterinary (medical) ethics is concerned with all aspects of ani-mal issues, excursions into topics of animal rights, animal welfare and their respective philosophi-cal backgrounds relating to these closely related subjects are nec-essary, and will be touched upon for a better understanding of the relevant issues.

Flavour of the monthLately, issues in veterinary eth-ics have become more widely

publicised, and more journals are willing to devote column space to debating these issues, many of which continue to be controversial and are yet to be fully answered. In this and forthcoming articles, a discus-sion of the differing ideas and viewpoints surrounding animals – and, consequently, the treat-ments they receive – is not only intended to explore and improve animal understand-ing and, consequently, animal welfare, but also aim to increase the understanding of philosophi-cal matters that impact on the moral and ethical values on display in our society.

Having become almost fash-

ionable, ethical topics have sprung up everywhere in jour-nalism. Ethics, our moral points of view, are constantly changing. Not only have ethical issues and products become big business, but it is also en vogue to be socially conscious.

What is called by Fairtrade Foundation director Harriet Lamb “a social phenomenon and here to stay”1, is merely one account of societies’ constant change of thought and action – boycotts of companies because of consum-ers’ concerns about sweatshop labour or animal welfare are ris-ing all the time (Hall, 2006).

In l ine with a power-to-the-people mindset are other

examples of fairly recent social changes, such as the continued rise of public suspicion of science and technology, and the demand for green-fingered politics, cou-pled with the acceptance of environmentalism and mass questioning of animal use in sci-ence and industry.

As a society, other social con-cerns are reflected by societal changes of attitudes. What has been accepted or not been questioned in the past – pos-sibly because it had not been in the public domain – may not be acceptable today, and is now under scrutiny.

As we have recently marked the bicentenary of the abolition of the slave trade, we should be reminded that the driving force behind Wilberforce and other anti-slave trade campaign-ers was not only their religious beliefs (they often saw their personal battle against slavery as a divinely ordained crusade), but also their conviction that slavery was immoral and a blight upon humanity. Even DirectGov, the website of the UK Government, explicitly mentions morality by remarking that: “The 1807 Act marked an important point in this country’s development towards the nation it is today – a critical step into the modern world and into a new, and more just, moral universe,” (DirectGov, 2007).

The general application of ethics in veterinary medicine is to define a code of conduct for our professional activities. The issue of animal rights, for example, has questioned not our professional conduct as vets, but also our personal value system as it relates to animals. As the

veterinary profession covers a full spectrum of animal uses, from pets to the livestock industry, it is unavoidable that, at points, an animal rights philosophy may come into direct conflict with our charge as veterinarians – that of care providers and animal welfare proponents.

Another main issue is the mandate for moral concern for living things and how to deter-mine the moral obligation we have to living things through some assessment of the moral status of the animal concerned.

The need to balance patient care and welfare, client needs and means, public protection and welfare, and self interest, try-ing to avoid what Rollin (1986) calls “moral stress”2, is a complex process and requires con-stant discussion, not only within, but also outside, the veterinary profession.

Unresolved issuesIn short, ethical debates are necessary because there are still too many unresolved issues that impact directly, and all too often negatively, on animals we swore an oath to protect.

These issues will not go away, unless each and every individual working professionally with and for animals has gone through some active detailed analysis of the problems at hand. Unre-solved issues, such as those surrounding convenience eutha-nasia, will undoubtedly impact on practitioners’ daily performance and quality of life.

Another issue at hand is what

Rollin (1978, 1981) calls the “fundamental question of vet-erinary ethics” – to whom does the veterinarian owe primary obligation: the animal or the owner? Are animals moral objects in themselves or are they of moral concern only as someone’s animals?

Another stumbling block is the lack of a clear consensus about how society values animals in general. Arkow (1998) com-ments that the status of animals is inconsistent and remarks that: “Some are doted upon and spared no expense by their owners. Some are abandoned by owners and by society and

will be euthanised in animal shelters. Some are highly prized economic investments. And some will wind up on someone’s dinner plate. As a

result, veterinarians frequently find their values conflicting with others who also care about animal well-being.”

Other questions that divide opinions include:l Can one lie to a client to save an animal? l Do animals have an intrinsic value? l Are all animals equal? l Are animals sentient? l Is it better to have a painful life or no life at all? l Should one support or be involved in activities such as grey-hound or horse racing, which may cause animal suffering? l Like all other animal advocates, shouldn’t veterinary professionals play a role in raising the moral status of animals?

Why ethical debates are necessary

Ethical issues seem to come

up more and more these days – how do they affect the

veterinary community and its working

practices, and can one lie to save an animal?

“Are animals moral objects in themselves or are they of moral

concern only as someone’s animals?”

FRANK BUSCHPhD, MRCVS

kjhuob

examines the ethical conflicts inherent to the profession in the first of a series of articles

Ethics I Ethics II

Definition

Moral rules that one believes ought to bind society or oneself; a set of principles that governs people’s views of right and wrong, good or bad, fair and unfair and just and unjust.

The logical, rational study and examination of Ethics I. Ethics II is a branch of philosophy.

Further distinction and explanation

Social ethic, personal ethic and professional ethic.

Attempting to justify the principles of Ethics I; seeking out inconsistencies in the principles of Ethics I.

POINT-OF-VIEW ETHICS

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l What roles are practice team members to play in raising the moral status of animals, and what input are they allowed to have in the process?3

l Are we able to identify the most pressing current social concern about animals and ani-mal treatment?l Aren’t we confused by the individual values we assign to life, suffering and science? l What are the current social attitudes towards animals, in the context of modernisation and technology? l What is the moral status of ani-mals other than humans? What roles do animals play in human society?4

l What role should, and can, veterinarians play with regard to humane educat ion and humane understanding of the animal world?l Does every practitioner truly understand the intricacies of the human-animal bond?

Although important questions such as these will be addressed within this series, it is disheart-ening that these issues are not sufficiently debated at university level. Is the veterinary nurse, the veterinary student or the practi-tioner to acquire such knowledge on a “learning by doing” basis?5

Arkow (1986) points out that it is becoming increasingly imperative that veterinarians not only apply ethics – especially as they impact on animal welfare – to their practices, but that they also assume leadership roles and take the moral high ground proactively, rather than respond defensively to pressing social concerns. The veterinary profession continues to be increasingly drawn into ethical debates as society explores, and redefines, many of its values regarding animals.

Arkow also says a failure to debate these issues as animal advocates will damage the vet-erinarian’s credibility in society. The emerging social consensus ethic is concerned with ensuring that the animals we “use” live decent and happy lives – hence, as vets, we are well placed to take the lead on animal welfare and animal rights issues as well.

Theoretical framework Ethics is the study of moral issues (Broom, 2006), the prac-tical application into daily living o f those be l i e f s tha t we strongly value as individuals and as a culture.

Whereas Tannenbaum (1995) differentiates between normative veterinary ethics (“what should I do?”), descriptive veterinary eth-ics (“what do other practitioners think ought to be done?”), admin-istrative veterinary ethics (“what does the government body think is appropriate?”) and official veterinary ethics (“what does the organised profession think is appropriate?”), Rollin (2006) makes a distinction between social, personal and professional ethics (which encompasses what

he calls Ethics I) and Ethics II. Eth-ics I is defined by Rollin as a set of principles that governs people’s views of right and wrong, good and bad, fair and unfair, and just and unjust. Ethics II, on the other hand, is defined as examining the logic of Ethics I, which includes important ques-t i o n s a s t o whether all socie-ties ought to have the same Ethics I and, hence, branches very much into the realm of philosophy (Table I).

Rollin (2006) comments that “whereas we in society learn Ethics I from parents, teachers, churches, movies, books, peers, magazines, newspapers and mass media, we rarely learn to engage in Ethics II”. Rollin is of the opinion that, as a general rule, veterinarians are ill-pre-pared to confront ethical debates and adds that “the practitioner may be excused if he or she finds moral dilemmas uncomfortably troubling. Trained first in science, veterinarians may be frustrated by philosophical questions which are not amenable to empiri-cal resolution” (Rollin, 1991). He adds that as business own-ers, veterinarians may believe there is little economic pay-off in basing decisions solely on issues of morality.

TrainingAs students, veterinarians have traditionally received little or no formal training in resolving veteri-nary ethical dilemmas, although teaching ethics and welfare at some veterinary schools, such as Glasgow and Liverpool, seems to be on the horizon (“Teach-ing ethics and welfare”, The Veterinary Record , May 26, 2007). Compared to the stand-ards in some veterinary schools in the USA, the UK efforts seem wholly insufficient.

For example, students at the Cummings School of Veterinary Medicine at Tufts University are expected to study ethics in their first year – with a manda-tory course in human-animal relations. Formal instruction in professional ethics begins with their third year with the compul-sory course, “Jurisprudence and Ethics”. The school states that the combination of law and eth-ics has encouraged students to consider ethical questions inher-ent in legal ones, and vice versa. In their fourth year, all students must present an ethics case as part of their clinical work in small animal medicine.

The students select a case that they themselves have handled or observed, and present a case work-up similar to the required report of a medical case. An oral presentation is also undertaken.

Students are taught to realise early on that ethics is not apart from medicine but is, in fact, intertwined with daily practice6.

As medical practitioners, vet-

erinarians face unique dilemmas with few comparative analogies in human medicine.

This is particularly true with regard to the widespread

n e c e s s i t y f o r animal euthan-asia. It may be a r g u e d t h a t implementation of ethical principles is easier in human medic ine than i n v e t e r i n a r y medicine, because

human medicine assumes that all human life is equally valuable.

However, in comparison, the physician, confronted by distress-ing ethical dilemmas in human medicine, is frequently guided by externally imposed guidelines (laws), which dictate what is culturally acceptable.

To date, the legal obligations of veterinarians are rarely as

codified as are those of human hea l th ca re pro fess iona l s (Rosenberg, 1990).

As already mentioned, eutha-nasia raises disturbing ques-tions regarding the value of life, the freedom of choice, and the nature of trust among patient, practitioner and client. When all these moral values are integrated, an extremely comp lex mode l emerges (Quackenbush, 1988).

Veterinary medicine is unique in that it has twin heritages of medicine and agriculture (Loew, 1992). The former has an ethical basis representing the patient; the latter has an economic pur-pose and represents the client. This dualism inevitably leads to misunderstandings by those out-side the profession and conflicts of interest for those within. As an example, Arkow (1986) asks us to consider a common sce-

nario from small animal practice.A client asks the veterinarian

to euthanise a physically healthy dog for the sake of the owner’s convenience. Perhaps the cli-ent lacks the patience to solve the dog’s behavioural problem; perhaps the client is moving and cannot find new housing that will accept the animal.

For the veterinarian to satisfy

the client’s needs demeans the patient’s interests – to protect the patient risks losing the client. The veterinarian is in conflict. To euthanise the animal, for argument’s sake, is justifiable, but to do so accepts four uncomfort-able premises:l that the dog has no inherent right to live;

continued overleaf

“Compared to the standards in some veterinary schools

in the USA, the UK efforts seem

wholly insufficient.”

FRANK BUSCH currently works in mixed practice. Frank has a predominantly small animal background and his main interests are physiotherapy, acupuncture and animal welfare. He primarily writes on veterinary ethics and animal assisted therapy.

POINT-OF-VIEW ETHICS

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16 Veterinary Times

l that the client is an owner with an incontrovertible right to dictate what to do with his or her property;l that the most expedient way to resolve an inconvenience is to eliminate it, rather than to solve the problem and prevent it from recurring; andl that the veterinarian is obliged to follow the exact instructions of the client.

Obviously, there are solu-tions other than euthanasia. Obedience training or educa-tional interventions can teach the client to correct the animal’s behaviour.

Assistance can be secured to help the cl ient and the patient with the move.

Adoption services can be arranged and, finally – as we all know too well – many ani-mals that were destined to be destroyed due to owner igno-rance, short sightedness, or just a cannot-be-bothered attitude, often find a new home with a compassionate member of staff.

But back to the above-men-

tioned euthanasia conflict – is there a right or wrong way to deal with this admittedly sim-plistic scenario? It is troubling that the profession is undivided on the issue7 and that there are no guidelines for the vet-erinary practitioner whatsoever. Especially for new graduates, this scenario must be over-whelming (bearing in mind that in a busy practice, support on these issues may not always available) and, ultimately, will lead to moral stress8. There is a pressing need for guidelines and, ideally, a legal framework concerning these and other troublesome ethical dilemmas faced by veterinarians on a daily basis. The BMA, for example, has a medical ethics department, which advises BMA committees on medicoethical issues and offers guidance9.

The BVA, at least, has the Ethics and Welfare Group for its members to access (for non-members and members of the public, a search on the BVA website returns no results). The BVA states that the committee considers the ethical issues relat-ing to society’s use of animals. It prioritises the issues that the pro-fession should address and rec-ommends policy developments where necessary. It stresses that it is not concerned with pro-

Footnotes

1. The Fairtrade Foundation says British sales rose by 46 per cent last year to £290m (www.telegraph.co.uk/money/main.jhtml?xml=/money/2006/02/12/ccfash12.xml, last accessed on 13/08/2007).

2. Rollin (1986) distinguishes between professional/occupational stress and “moral stress“. He comments that: “The stress and pain of killing healthy animals (or being asked to kill them even if one refuses to do so) is, in my experience, the most demoralising part of companion animal practice… I have called it moral stress because it arises out of a fundamental conflict between one’s reasons for going into animal work and what one is in fact doing or being asked to do.” 3. This is a particularly important point, not only for busy veterinary hospitals where support staff often are left in limbo as to which veteri-

fessional ethics and states that this responsibility would fall upon the RCVS10.

However, a search conducted on the RCVS website returns no useful information or links to resources in veterinary or pro-fessional ethics, and a search for “ethics” on the BSAVA website returns no results. It is hoped that these omissions will be urgently addressed.l A full reference list will be published with the final article in this series. However, com-prehensive details of references from this article are available by contacting the editor.

nary surgeon is responsible for which patient, the result being that, all too often, care plans have not been issued to veterinary nurses, which in turns impacts negatively or even catastrophically on the care (and/or welfare) of the animal. Also, what role should the veterinary nurse play in voicing concerns on behalf of the animal? Should nurses or colleagues accept instructions from a colleague, for example, as to withhold water from a patient for a great length of time?Is it ethical and/or essential to conduct, for example, the water deprivation test?

4. In Poetic Animals and Animal Souls Malamud refers to contemporary western society as “the box,” suggest-ing it is a neatly packaged, pleasingly wrapped set of assumptions about humans and animals in particular. In the content of society’s box, humans are central to everything. Everything outside the box (animals, wilder-ness, cultures with other stories) is considered empty of value.

5. The author recognises that at least two universities in England, courses in ethics (often taught in combina-tion with animal welfare) either have been or are about to be introduced – see discussion within the theoretical framework chapter.6. www.tufts.edu/vet/signature/ e t h i c s . h t m l ( l a s t a c c e s s e d 10.10.2007).7. At the moment, it is at the dis-cretion of the veterinarian con-fronted with the issue. He or she will make a decision based on personal experience and personal moral val-ues. At the moment society still respects our (personal) judgement as professionals. If a veterinarian performs convenience euthana-sia, he or she will go unpunished because the veterinarian acts outside any legal framework. In comparison, punishment for killing a protected spe-cies often results in imprisonment. 8. See footnote two.9. The BMA produces reports, codes of practice and discussion documents

on topical and often controver-sial issues. These include genetic technology, euthanasia, and organ donation. The Medical Ethics Com-mittee debates issues of principle in medical ethics, medical law, ethical matters concerning the relationship between the medical profession, the public and the state. The committee comprises 18 members – doctors, philosophers, lawyers, theologians and lay people. It debates issues of principle in medical ethics, medical law, ethical matters concerning the relationship between the medical profession, the public and the state. The Medical Ethics Department answers ethical enquiries from doc-tors and produces guidelines and books. Enquiries from members of the public or press are handled by the public affairs department. www.bma.org.uk/ap.nsf/Content/LIBEthics?OpenDocument&Highlight=2,ethics (last accessed 10.10.2007).10. www.bva.co.uk/members/com-mittees/ethics.asp (last accessed 10.10.2007). n

nWHY ETHICAL DEBATES ARE NECESSARY – from page 15 What is more important?

The client’s wishes, or the welfare of the patient?

Got a story? Call the Veterinary Times newsdesk on 01733 383547/383559

POINT-OF-VIEW ETHICS

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