Veterinary Medical Ethics

Ethical question of the month — August 2018

Emergency on-farm slaughter is meant to provide a practical solution to situations in which an animal cannot be humanely transported to a slaughter facility but is fit for human consumption. Emergency slaughter involves killing and bleeding the animal on-farm before transporting the carcass to a meat plant for processing. This practice allows the farmer to recover some of the animal’s value and removes the incentive to “hang on” to a compromised animal hoping it improves so it can be transported alive to a slaughter facility. Emergency slaughter provisions, therefore, can reduce the risk of unnecessary suffering in livestock. For example, if a feedlot steer seriously injures a limb on a weekday morning, under ideal conditions, the steer can be isolated and slaughtered on-farm within hours of the incident. However the possibility of recovering some value from an injured animal means that the same injury on a Friday evening may cause the animal to be held over the weekend without treatment until an abattoir is available to handle the carcass. In such cases the emergency slaughter option could be seen as contributing to animal suffering. How should one balance the benefits of emergency slaughter with the increase in suffering it may create in other situations?

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, 6486 E. Garafraxa, Townline, Belwood, Ontario N0B 1J0; telephone: (519) 846-3413; fax: (519) 846-8178; e-mail: tim.e.blackwell@gmail.com

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 — May 2018

A 6-month-old crossbred dog is presented to you early one morning with unusual central nervous system signs. The husband and wife are new clients and appear “edgy.” They are there with their two young children. It is difficult for you to obtain a clear history regarding the onset or progression of the clinical signs. Due to the reluctance of the couple to provide an adequate history, you assure them that anything they tell you will be kept confidential within the veterinary-client-patient relationship. They then admit that the dog consumed some of their recreational opioids. The dog responds well to treatment with naloxone. The couple and their children are relieved and grateful. You are not comfortable lecturing these people about the dangers of recreational narcotics; however, with two young children and the dog as evidence that these drugs are not always stored in a secure manner, it does not seem right to register this as a successful treatment outcome and get on with your day. You have a professional obligation to report animal abuse. What are your professional obligations in this situation?

Veterinarian detects failure on the part of a client to properly store opiates — A comment

The case presents as accidental ingestion of opioids. Unless you have definitive evidence that the clients intentionally administered non-prescribed controlled substances to the puppy, no legitimate case can be made for animal abuse or for you to report the incident as such.

By the same token, irrespective of your ‘discomfort’ with the situation, especially given the clients’ nervousness regarding the situation in the presence of their children, you have an excellent (right and proper) opening for a brief educational discussion (not lecture) of the dangers of recreational narcotics, including the safekeeping of such. You are remiss in not availing yourself of the opportunity.

Dr. John B. Delack, Saskatoon, Saskatchewan

An ethicist’s commentary on a veterinarian detecting failure on the part of a client to properly store opiates

“Aesculapian authority” is the authority inhering in a person by virtue of being societally recognized as a medical professional. The term, devised by sociologist Talcott Parsons, was originally intended to apply to human physicians. Aesculapian authority is the uniquely powerful authority vested in those that society perceives as healers, historically traceable to the time when medicine was inseparable from magic and religion.

As I explained in a 2002 AVMA Journal commentary (1), it is Aesculapian authority that licenses a medical practitioner to handle a patient with great intimacy. Physicians may probe all parts of the body of patients of either gender, with barely a “by your leave” — “they tell a patient they must enter an otherwise forbidden area rather than ask for permission. Aesculapian authority confers the sick role, allowing patients to escape from responsibilities of work, school, or family. Such authority also compels patients to ingest unpalatable medications; change their eating or sleeping habits; submit to moral lectures on child rearing; surrender blood, urine, or fecal material; be immobilized; undergo surgery preceded by imposed loss of consciousness; or even change their temperament. What would be dismissed as torture in the absence of Aesculapian authority is meekly accepted by even the most powerful in its presence.” As one physician once told me, “As a physician, I can get almost anyone to do whatever I tell him or her” (1).

Though rarely discussed in veterinary circles, virtually all veterinarians are familiar with how this authority manifests itself. Veterinarians, like physicians, are approached by virtual strangers asking for information about an affliction they have been diagnosed with. I remember talking to a Wyoming rancher who lived hundreds of miles away from the nearest physician. I asked him what he does with medical problems. He said, “Hell, if I get a fracture or a severe cut, for example from barbed wire, I call my vet! After all, flesh is flesh and bone is bone. And if the vet is good enough to treat my animals, he or she is good enough to treat me!”

Bearing this thought in mind, we can approach the situation at issue here. If the veterinarian is morally certain that the dog acquired the opiates either directly from the owners, or by heedlessness on the part of the owners in failing to keep the drugs away from animals or children, there is a very strong presumption for the veterinarian to intercede. After all, the situation could well have resulted in tragic consequences for the children or the animal. As a medical professional cognizant of the awful results that could ensue from failure to store opiates in a secure location that cannot be breached by children or animals, it is unquestionably your duty to educate the clients in highly dramatic terms of the potential dire consequences. This duty is quite simply a consequence of your special knowledge and deserves to be fulfilled in the strongest possible terms based in your Aesculapian authority. I would further argue that failure to make this point would be an abrogation of the responsibility flowing from a veterinarian’s authority and that he or she would probably be morally and legally justified in reporting the cavalier disposition of the drug.

Borrowing a page from one of my veterinarian friends, he approaches suspected animal abuse as follows: he calls the client into his office while holding a folder. He tells the client that the folder is an account of the situation which could be submitted to authorities. He asks the clients to bring the dog in periodically so he can check for signs of abuse. If there are no signs, he retains the file. If there are signs, he passes it on to authorities.

One could deploy a similar strategy in the case of the clients heedless of secreting drugs in a place inaccessible to animals or children. I would also request that they sign a “contract” agreeing to sequester the drugs. Such a strategy can underscore the seriousness of the situation. If I were suspicious that this sort of thing is a regular occurrence in the household in question, I would ask the owners to bring in the animal for a quick inspection on a regular basis in order to assure that they have grasped the point. Although the chances of your detecting something are virtually nil, your Aesculapian authority coupled with the threat might do the job. I would not charge them a fee so as not to appear self-serving. By acting in this way, you would stress the gravity of the situation, and help avoid potential tragedy.