Veterinary Medical Ethics

Ethical question of the month — October 2013

You are an experienced veterinary surgeon who has worked for decades with a number of show breeders who are among your best clients. These breeders strongly believe that the standard elective surgical procedures that are routine in many breeds protect their dogs from infections, hematomas, and allow the dogs to do their intended work more effectively. The Canadian Veterinary Medical Association’s new position statement opposing “purely cosmetic” surgery has forced you to stop performing these procedures. Your clients now go to the United States to have this work done. One of these clients presents you with a 12-week-old puppy with badly infected ears following an ear cropping in the United States. She is distraught regarding the pain the dog is suffering and concerned because this is an outstanding individual from her best line of dogs. The ears are infected, sutures are tearing out, and the quality of the surgery is far below your standards. You are confident you can treat the infection, but some re-trimming is necessary to allow this dog to have any chance of a future on the show circuit. The breeder will euthanize the dog if it cannot be re-trimmed as she does not want the dog in its current state to represent her kennel even as someone’s pet. What should you do?

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: tim.blackwell@ontario.ca

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 — July 2013

One of your client’s horses develops a mild ataxia while at a very good boarding stable that you have worked at for the past 25 years. Your client recently read about a strain of equine herpes virus (EHV) that can cause neurologic deficits and is concerned this may be the cause of his horse’s ataxia (EHV myeloencephalopathy). His concern quickly spreads to other boarders at the stable who worry that the infection may spread to their horses. The owner of the boarding stable believes the problem is more likely the result of an injury as the horse has had two traumatic events in the past year. If you suspect EHV myeloencephalopathy, quarantine of the farm including biosecurity practices that would limit in-coming and out-going horses would be indicated although the efficacy of such practices to prevent spread are not well-documented. This would cause serious problems for the owner as well as the other boarders, including loss of income for the owner and inability to enter upcoming competitions for the boarders. If the ataxia is due to an injury, no such restrictions would be necessary.

The horse dies suddenly within 24 hours of becoming ataxic. The owner is distraught and wants to bury the horse and does not want to spend money on diagnostics. How should you proceed?

An ethicist’s commentary on horse with possible equine herpes virus

This is an interesting situation, in that both the horse owner and the stable owner are clients of yours. If the horse does have equine herpes virus (EHV), both of these clients are adversely affected, as are all the horse owners whose animals are quartered at this stable. Thus all parties in this situation lose if the horse indeed has EHV, including the horse owner whose horse has died, the stable owner whose income derived from boarding horses is threatened, and all of the people boarding horses at the stable whose horses are unable to compete. It would appear that the owner of the sick horse has a moral obligation to undertake the diagnostics, since his horse is the suspected source of the disease.

However, he is reluctant to assume the cost of diagnostics, as he has already incurred a significant loss, and, unless he has other horses, has nothing left to lose. On the other hand, as a member of the horse community, he might do well to contribute some money to the diagnostic effort as a matter of good will and solidarity with the other horse owners. In any case, it falls to the other injured parties to ascertain whether the disease is EHV as soon as possible, since they stand to lose the most by waiting.

Were I the veterinarian, I would suggest that the cost of relevant diagnostics be split between the stable owner and the owners of the other horses being boarded, as well as the owner of the dead horse, if I can convince him to participate. In any case, splitting the cost of diagnostics gives all the relevant parties the information they need without anyone sustaining too large a hit. The horse owners would know whether they can compete, and the stable owner would know whether to shut down boarding. Not performing diagnostic tests would hurt everyone maximally, since the prudent course of action entailed by the failure to diagnose would be to act as if the horse were EHV-infected and freeze competition and boarding. Sharing the cost limits the penalty imposed on each party, and demonstrates good faith and a spirit of cooperation among all involved.