Veterinary Medical Ethics

Ethical question of the month — August 2019

Ms. Smith has been a longtime client of your practice and a great lover of dogs. After Ms. Smith’s death, her 7-year-old cocker spaniel is brought into the practice for boarding while her family deals with the funeral arrangements. The dog is well-known and well-loved by the staff at your clinic and is given special privileges while boarding. Two weeks following the death of Ms. Smith, her son comes in requesting that you euthanize her dog. You tell the son that the dog is healthy and happy and would make a wonderful pet and would easily be adopted by a loving family. The son explains that in her will, Ms. Smith requested that the dog be cremated, and that her and the dog’s ashes were to be scattered together in her garden. Neither you nor your staff were aware of this arrangement and are reluctant to comply. How should you respond?

Client requests for euthanasia and cremation — A comment

Until the legal status of pets undergoes substantive change whereby their current juridical status as chattel is abandoned in favor of their status as creatures with independent rights and privileges (which require specific definition in law), the wishes of the owner of the dog — now ostensibly inherited by the son — are paramount. Given the scenario, the options are few: either the clinic can refuse the request for “euthanasia” (a wholly inappropriate word in this case) and recommend that the client seek such veterinary attention elsewhere, or the suggestion could be put forward that the dog be cared for by an adoptive family until the end of its natural life under the condition that at such time the original owner’s wishes would be complied with.

John B. Delack, PhD, DVM, Saskatoon Saskatchewan

An ethicist’s commentary on client requests for euthanasia and cremation

In the 1980s I articulated the concept of moral stress as a horrendous burden imposed upon veterinarians. This is a situation in which veterinary practitioners are asked to euthanize animals for owner convenience, such as the animal is too old to run any more. Requests like that fly directly in the face of most veterinarians’ sense of purpose. Most veterinarians see themselves as committed to healing, not to gratuitous killing. Routinely acquiescing to client requests for convenience euthanasia creates major stress for most veterinarians. There are situations in which a veterinarian has worked tirelessly to save the life of the animal; now the client wants it euthanized.

There is increasingly strong evidence, both anecdotal and statistical, that suicide among veterinary practitioners has greatly increased. This evidence comes from both Great Britain and the United States. In the 1980s, I predicted that constant moral stress on a person would lead to major psychological damage. This has been confirmed during the past decade both in Great Britain and in the United States. The suicide rate among young veterinarians is far higher than in other occupations. You are committed to healing, and end up being bombarded with requests for euthanasia, arguably the worst thing you can do to a healthy animal. The tools for an easy suicide are readily available to you. Small wonder that killing yourself presents itself as a viable and pain-free option.

Not getting involved in convenience euthanasia is not only a moral imperative for veterinarians; it is an imperative ultimately grounded in self-interest. Ms. Smith’s failure to discuss euthanizing the dog after her death, but instead writing into her will and placing the burden on you is nothing short of despicable. The dog is not a piece of rubbish to be disposed of as she sees fit. The conditions of the case make it clear that the dog could bring joy to another household as well as continue to enjoy life. Closing down this avenue is ultimately selfish, and the veterinarian has absolutely no moral obligation to respect it.

Were I the veterinarian, I would agree to euthanize the dog at the point in its life, possibly 7 to 10 years from now, where it is medically indicated. In this way, I will be respecting the owner’s last wishes, but also failing to incur the moral stress attendant upon performing convenience euthanasia. Simply put, moral stress is a deep-rooted conflict between what one finds oneself doing, and what one believes one should be doing.

People become veterinarians in order to help animals — to alleviate animal sickness, pain, and disease. If one is placed in a situation where one cannot actualize these goals, moral stress is created in such a person. Even worse, in far too many cases veterinarians are asked to kill the animal, to alleviate what has become a burden to a client.

Physicians are never asked to dispatch sick patients; even the incurably ill. Such a request is seen as monstrous, except perhaps when laws have been passed allowing people to choose to die. But veterinarians encounter this request on a regular basis. And for the most horrendous reasons: the dog is old and cannot run with me; we have redecorated and the dog no longer goes with the color scheme; we want a puppy; I do not have time to care for him. And this may be an animal which, at an earlier stage of life, the client demanded that the veterinarian save the animal at all costs.

To get an idea of the impact of such a euthanasia request, imagine a pediatrician being asked to euthanize a child because the couple has decided they no longer wish to raise a child. In a world with disposable infants, such a request is not as outrageous as it once was. Recall the movement to allow fully formed babies to be killed! This is moral stress at its most extreme. Demanding that a veterinarian kill a dog which is no longer wanted is on a par with baby killing. No veterinarian is required morally to incur such an obligation.

Ethical question of the month — November 2019

As a large animal practitioner in western Canada, you have diagnosed and treated the occasional case of tick paralysis in beef cows on pasture. You are called to a bison farm where several bison are down, and a couple others are staggering. You observe several ticks on the recumbent bison and based on the history and your clinical examination, you suspect these animals are suffering from tick paralysis. You have successfully treated affected cattle with an over-the-counter topical permethrin insecticide that is labelled for the treatment of tick infections in bovines. The only products that treat tick infections in cattle are licensed as pesticide control products (PCP) and do not have drug identification numbers. Although these are over-the-counter products, it is illegal for you or anyone else to use these products in an extra-label manner. As a veterinarian, if you prescribe these products in an extra-label manner, you risk a malpractice claim by your licensing body. You are tempted to recommend that the producer treat these animals herself with a PCP product since penalties for off-label use by producers are extremely rare. Your choices appear to be to recommend extra-label (illegal) use of a PCP product to the producer, to perform the illegal activity yourself, to euthanize the bison, or to allow them to succumb or recover on their own. How should you respond in this situation?

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.