Veterinary Medical Ethics  Déontologie vétérinaire Ethical question of the month — February 2017 Several niche marketing programs forbid the use of antimicrobials in livestock production. This creates problems for producers and for the animals they care for. These niche marketing programs require that if an animal is treated with an antibiotic, it must be identified and removed from the niche marketing program. This creates an incentive for producers to “wait and see” if an animal can resolve an infection on its own. Regardless of the outcome, there is unnecessary suffering associated with the delay in treatment. This violates both the husbandry ethic as well as public expectations. If the stockperson eventually treats the animal, it seldom responds as well as it would have if the treatment has been given in a timely manner. Individual animals treated with an antimicrobial can be difficult to market. Irregular marketing of treated animals is time-consuming and often less profitable. As a result, “no antibiotic” marketing schemes have the potential to create negative effects on animal welfare. Can veterinarians be associated with no antibiotic niche programs and still adhere to their oath to prevent unnecessary animal suffering?

Question de déontologie du mois — Février 2017 Plusieurs programmes de marketing de créneau interdisent l’utilisation des antimicrobiens dans la production du bétail. Cela crée des problèmes pour les producteurs et les animaux dont ils s’occupent. Ces programmes de marketing de créneau exigent que, si un animal est traité à l’aide d’un antibiotique, il doit être identifié et retiré du programme de marketing de créneau. Cette situation incite les producteurs à attendre pour voir si un animal peut vaincre l’infection par lui-même. Sans égard au résultat, il se produit des souffrances inutiles lorsque l’on retarde le début du traitement, ce qui est contraire à l’éthique d’élevage ainsi qu’aux attentes du public. Si le préposé au bétail traite finalement l’animal, il répond rarement aussi bien que si le traitement avait été administré plus rapidement. Les animaux individuels traités à l’aide d’un antimicrobien peuvent être difficiles à commercialiser. La commercialisation irrégulière des animaux traités est longue et souvent moins rentable. Par conséquent, les programmes de commercialisation «sans antibiotiques» ont le potentiel d’avoir des effets négatifs sur le bien-être animal. Les vétérinaires peuvent-ils être associés à des programmes de créneau sans antibiotiques et toujours respecter leur serment de prévenir les souffrances inutiles des animaux? 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: [email protected] 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.

Les réponses au cas présenté sont les bienvenues. Veuillez limiter votre réponse à environ 50 mots et nous la faire parvenir par la poste avec vos nom et adresse à l’adresse suivante : Choix déontologiques, a/s du D r Tim Blackwell, 6486, E. Garafraxa, Townline, Belwood (Ontario) N0B 1J0; téléphone : (519) 846-3413; télécopieur : (519) 846-8178; courriel : [email protected] Les propositions de questions déontologiques sont toujours bienvenues! Toutes les questions et situations présentées dans cette chronique s’inspirent d’événements réels dont nous modifions certains éléments, comme les noms, les endroits ou les espèces, pour protéger l’anonymat des personnes en cause.

Use of this article is limited to a single copy for personal study. Anyone interested in obtaining reprints should contact the CVMA office ([email protected]) for additional copies or permission to use this material elsewhere. L’usage du présent article se limite à un seul exemplaire pour étude personnelle. Les personnes intéressées à se procurer des ­réimpressions devraient communiquer avec le bureau de l’ACMV ([email protected]) pour obtenir des exemplaires additionnels ou la permission d’utiliser cet article ailleurs. CVJ / VOL 58 / FEBRUARY 2017

117

D É O N TO LO G I E V É T É R I N A I R E

Ethical question of the month — November 2016 A veterinarian who recently joined your 4-person small animal practice is engaged in a discussion with a longtime client over euthanizing her 16-year-old cat. The cat has been losing weight (although the owner reports a normal appetite) over the last several months due to kidney failure. The cat responded moderately well to the interventions applied but is not expected to recover. Your new colleague believes it is time to euthanize the cat. The owner wishes to give the cat more time. The veterinarian emphasizes his responsibility to avoid unnecessary suffering and mentions his professional obligation to call in the humane society in cases in which owners allow their pets to suffer unnecessarily. The owner is shocked that the veterinarian would accuse her of treating her long-time companion inhumanely. She is certain that after 16 years with this animal that she is a better judge of its comfort and well-being than a veterinarian who has spent 15 minutes examining the cat and associated lab reports. You feel that you should intervene. How should you respond? Submitted by Linda Chow, Ottawa, Ontario.

Question de déontologie du mois — Novembre 2016 Un vétérinaire qui s’est récemment joint à votre pratique pour petits animaux de quatre personnes discute avec un client de longue date à propos de l’euthanasie de son chat âgé de 16 ans. Le chat a perdu du poids (mais la propriétaire signale que le chat a un appétit normal) au cours des derniers mois en raison d’une insuffisance rénale. Le chat a réagi modérément bien aux interventions effectuées, mais on ne s’attend pas à un rétablissement. Votre nouveau collègue croit qu’il est temps d’euthanasier le chat. La propriétaire désire donner plus de temps au chat. Le vétérinaire insiste sur la responsabilité de la propriétaire à éviter des souffrances inutiles et mentionne son obligation professionnelle de contacter la société de protection des animaux dans les cas où les propriétaires laissent les animaux souffrir inutilement. La propriétaire est scandalisée que le vétérinaire l’accuse de traiter avec cruauté son compagnon de longue date. Elle est convaincue que, après 16 ans auprès de cet animal, elle est meilleure juge de son confort et de son bien-être qu’un vétérinaire qui a passé 15 minutes à examiner le chat et à consulter des rapports de laboratoire. Vous estimez que vous devriez intervenir. Comment devriez-vous réagir? Soumise par Linda Chow, Ottawa (Ontario)

Veterinarian displays great insensitivity to client — A comment Essential information left out of the scenario is the cat owner’s relationship with the veterinary practice prior to her being assigned to the recently added veterinarian, in particular how long the now 16-year-old cat has been a patient in the practice. Ostensibly she has been satisfied for a considerable time with the treatment she and her cat have been accorded. Why she and her cat have been assigned to the new veterinarian is likewise questionable. That said, the cat owner’s reaction to the new veterinarian’s callous and unempathetic attitude and behavior is understandable and justified. Her feelings and assessment of her cat’s status are most likely correct (especially given no evidence to the contrary).

No matter whether the practice’s recent addition is a newly minted practitioner or a seasoned veteran, such behavior should not be countenanced on any level; it is an affront to the pet owner and casts the practice’s ethics in a bad light. Such issues should be brought to the individual’s attention for remediation. If he/she is unwilling to modify his/her approach in dealing with the cat owner, the latter should be referred to a more sympathetic and conscientious member of the practice. John B. Delack, PhD, DVM, Saskatoon Saskatchewan

An ethicist’s commentary on a veterinarian displays great insensitivity to client However knowledgeable and technically skilled this new veterinarian is, he or she is significantly lacking both in common sense and common decency. The client is altogether correct in objecting to how the veterinarian has approached her. He/she has absolutely no place second-guessing the client who has lived in close contact with the cat for 16 years. One well-established way of detecting pain in an animal is to pay attention to deviations in behavior, food intake, demeanor, and even personality exhibited by the animal. The veterinarian who has examined the cat for 15 minutes has no background knowledge to compare 118

with what he sees in this brief period. The sensitive client on the other hand, however medically uneducated he or she may be, very likely possesses an acute awareness of variation in how the cat behaves. Far more egregious, indeed downright offensive, is his invoking the threat of reporting the owner to the Humane Society. That threat, expressed in the context described in this case, bespeaks a remarkable degree of insensitivity that merges into stupidity. If I were the client, I would say goodbye to the veterinarian and never return. CVJ / VOL 58 / FEBRUARY 2017

CVJ / VOL 58 / FEBRUARY 2017

treated by him, which treatment was quite invasive and at one point required a fore-limb amputation. She was always delighted to see him and they developed a bond beyond the medical and scientific. He was a tough man from a cowboy background. On the day when her disease had progressed to the point that euthanasia was necessary, and he injected her with the solution, I saw a tear roll down his cheek. He was very embarrassed, and apologized profusely, and yet because of that incident he will forever have a place in my heart. I have serious doubts that any amount of training can rectify the degree of insensitivity displayed by the veterinarian in this case. But it is worth a try. Perhaps we cannot create sensitivity to the simple fact that what one says and how one says it can create great hurt in clients. But we can at least hope that he can learn to check his insensitivity. Without such sensitivity, the veterinarian will never be able to successfully deploy the Aesculapean authority essential to good medicine.

Bernard E. Rollin, PhD

119

V E T E R I N A RY M E D I CA L E T H I C S

As I have said before in this column, when clients praise a veterinarian to others as being “an excellent veterinarian” virtually none of them have studied the rates of cure achieved by this practitioner, his or her medical knowledge, the number of publications he or she has on diverse topics, or any other modality medically justifying such a claim. What they are really addressing is the degree of what is known in Yiddish and German as menschlichkeit, human decency, the veterinarian displays. Unfortunately possession of this trait does not enjoy a high correlation with technical proficiency. People are referring to the concern the practitioner shows, the empathy he or she displays, the degree of identification with you and the animal that shines through in the course of the visit. This is a major part of what is meant when people talk about medicine, human or veterinary, as much art as science. The old cliché is operative here — “people do not care about how much you know, until they know how much you care.” I am reminded of a veterinarian at Colorado State University in the 1970s who was a pioneer in developing procedures for treating osteosarcoma in dogs. My beloved Great Dane was

Ethical question of the month - February 2017.

Ethical question of the month - February 2017. - PDF Download Free
445KB Sizes 0 Downloads 18 Views