Veterinary Medical Ethics  Déontologie vétérinaire Ethical question of the month — September 2013 Unnecessary suffering in domestic livestock is inexcusable in the eyes of the Canadian public and justice system. Consequently, transporting livestock on overcrowded trucks, shipping non-ambulatory animals to slaughter, or transporting animals with large umbilical hernias result in fines and/or prosecution. A new viral enteritis (porcine epidemic diarrhea, PED) has recently spread rapidly in the United States swine population and has killed an estimated 1 million pigs over a two-month period. The virus has not entered Canada, but the threat is real and the consequences would be dramatic. Canadian regulatory veterinarians claim jurisdictional limitations prevent them from taking appropriate steps to prevent the introduction of this disease into Canada or to respond to initial cases should they occur. Are jurisdictional limitations an acceptable excuse for this failure by regulatory veterinarians to recommend appropriate measures to prevent such grave animal suffering?

Question de déontologie du mois — Septembre 2013 La souffrance inutile du bétail est impardonnable aux yeux du public canadien et du système judiciaire. Par conséquent, le transport du bétail dans des camions surpeuplés, l’expédition d’animaux non ambulatoires à l’abattoir ou le transport d’animaux avec de grosses hernies ombilicales se traduisent par des amendes et/ou des poursuites. Une nouvelle entérite virale (diarrhée épidémique porcine, DEP) s’est récemment propagée rapidement dans la population porcine des États-Unis et a tué environ 1 million de porcs pendant une période de deux mois. Le virus n’a pas encore pénétré au Canada, mais la menace est réelle et les conséquences seraient dramatiques. Les vétérinaires canadiens chargés de la réglementation allèguent que les limitations de la juridiction les empêchent de prendre des mesures appropriées pour prévenir l’introduction de cette maladie au Canada ou de répondre aux premiers cas lorsqu’ils se présenteront. Les limitations de la juridiction représentent-elles une excuse acceptable pour justifier l’absence de la recommandation de mesures appropriées de la part des vétérinaires chargés de la réglementation en vue de prévenir une telle souffrance grave 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, 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: [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 Dr Tim Blackwell, Science vétérinaire, ministère de l’Agriculture, de l’Alimentation et des Affaires rurales de l’Ontario, 6484, chemin Wellington 7, unité 10, Elora, (Ontario) N0B 1S0; téléphone : (519) 846-3413; télé­ copieur : (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 54 / SEPTEMBER 2013

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Ethical question of the month — June 2013 Farm dogs are often left intact which can result in unplanned litters of puppies that are advertised at the lane end for $20 to $50. Equally common are kittens born in barns and advertised as free. These puppies and kittens are taken by well-meaning people who often cannot afford a purebred dog, a pet store puppy or kitten, or even a shelter animal. These pets are well cared for and dewormed with a pet store anthelmintic, but seldom if ever see their local veterinarian unless a rabies vaccination is required by law. These dogs and cats play important roles in families with limited financial resources. If a serious medical condition arises in early or mid-life that necessitates expensive veterinary care or euthanasia, a crisis can result. The owners appear at the veterinarian’s office, sometimes for the first time in the life of the pet, desperate for assistance but without the means to pay. Veterinarians in rural areas receive a disproportionately large number of these cases and the nature of small towns ensures that the local community will soon be aware of whatever decision the veterinarian made in the case. Although treating the pet at a greatly reduced cost can have a positive effect on public relations, it can also produce a stream of “new” clients who did not realize that “free” veterinary care was available. Is there a way to assist these “non-clients” without opening the door to every dog and cat in the community in need of veterinary care and owned by individuals who are either unable or unwilling to pay? Should there be a means test for owning a pet?

Question de déontologie du mois — Juin 2013 Les chiens de ferme sont souvent laissés intacts, ce qui peut produire des portées de chiots non désirées qui sont annoncées au bout du chemin à un prix de 20 $ à 50 $. Les chatons nés dans les granges et offerts gratuitement sont tout aussi fréquents. Ces chiots et chatons sont adoptés par des personnes bien intentionnées qui n’ont souvent pas les moyens de s’acheter un chien de race, un chiot ou un chaton d’une animalerie ou même un animal de refuge. Ces animaux sont bien traités et vermifugés avec un anthelminthique de l’animalerie, mais ils visitent rarement, voire jamais, leur vétérinaire local à moins qu’une vaccination contre la rage soit exigée par la loi. Ces chiens et chats occupent une place importante dans les familles ayant des ressources financières limitées. Si, au début ou au milieu de la vie, il se déclare une affection médicale grave qui nécessite des soins vétérinaires dispendieux ou l’euthanasie, une crise peut éclater. Les propriétaires se présentent au bureau du vétérinaire, parfois pour la première fois de la vie de l’animal, désespérés d’obtenir de l’aide mais sans les moyens de payer. Les vétérinaires dans les régions rurales reçoivent un nombre disproportionnellement important de ces cas et la nature des petites villes fait en sorte que la collectivité est bientôt au courant de la décision prise par le vétérinaire. Même si le traitement d’un animal à un coût considérablement réduit peut avoir un effort positif sur les relations publiques, cela peut aussi créer un groupe de «nouveaux» clients qui ne savaient pas qu’il y avait des soins vétérinaires «gratuits». Y a-t-il une façon d’aider ces «non-clients» sans ouvrir la porte à tous les chiens et chats de la collectivité qui ont besoin de soins vétérinaires et appartiennent à des personnes qui ne peuvent pas ou ne veulent pas payer? Devrait-il y avoir un examen des ressources pour la possession d’un animal de compagnie?

An ethicist’s commentary on the case of animals resulting from unplanned matings and adopted by rural people This is an extremely vexatious case, as it involves a fair amount of financial commitment, with no obvious source of compensation. There are at least two levels of funding required. In the first place, there is a pressing need to spay and neuter these animals before their first reproductive cycle. While I do not advocate wholesale spay-neuter, both because it may remove excellent genetics from the companion animal gene pool (responsible people tend to get the best animals and also to dutifully spay and neuter them), and because it replaces human irresponsibility with a surgical procedure on the animals. In this case it appears to be the only way to forestall a proliferative flow of unwanted animals. (In Sweden, I was pointedly told that people need nothing more than a leash in order to manage reproduction of pets.) Theoretically, if each animal is rendered reproductively incapable, we will not see these animals increase in a geometrical progression. 818

I do not expect, nor would it be fair to ask, that veterinarians servicing the farm people in question do the work for nothing. But there is a significant cost to not doing anything, in terms of costs of animal control, rabies and other diseases from the wild population spreading to farm pets, accidents precipitated by drivers swerving to avoid animals, and road cleanup of those animals hit by cars, as well as dog bites. So at least some of the cost of spay/neuter could be recouped from the government. The rest could be absorbed into public health budgets with a bit of creative accounting. The second level of expenses is more difficult to manage, as one is talking about lifetime healthcare for these animals. Doubtless some veterinarians would accept payment in terms of barter — labor or farm products. Dr. Brian Forsgren has created a model for veterinary care serving an indigent ghetto community. He cuts diagnostic tests to an absolute minimum, and uses CVJ / VOL 54 / SEPTEMBER 2013

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his 5 senses as a basis for diagnosis. Many older practitioners can palpate a fracture, and repair it using a cast rather than going to pinning and plating entailing expensive surgery. Regrettably, that kind of veterinary medicine is rapidly disappearing, as the veterinary schools teach only Cadillac, defensive medicine. Dr. Forsgren and other veterinarians of his persuasion have told me that it grows increasingly difficult to hire veterinary school graduates who can perform a credible physical examination! These sorts of skills are essential if veterinary medicine is to serve the indigent or those clients constituting the lowest tier of the socioeconomic ladder. After all, as Dr. Forsgren has often remarked, there is absolutely no reason to believe that poor people’s animals mean less to them than rich people’s animals! It appears to me that Dr. Forsgren’s model could easily be adapted to fit the rural situation. Alternatively, the local veterinary community can establish a series of fundraisers to cover the cost of indigent care. This sort of thing has, in fact, been done with some success by various altruistic practitioners. There is no reason that the veterinary

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community cannot establish creative funding sources by working in tandem with local, regional, or even national humane organizations. After all, care for these animals represents acknowledging the best of the human animal bond. I recently wrote a talk for the American Veterinary Medical Association national annual meeting, after having been asked to defend horse slaughter as a putative solution to the problem of the “unwanted horse.” I refused, and argued that horses are not by nature “unwanted;” rather human beings do not accept the responsibility of acquiring an animal as a lifetime contract. I stand behind that claim, even if it means adding a “means test” to horse ownership. Ultimately, the same logic applies to small animals. But in the case we are discussing, the situation is reversed, and in a real sense, the animals acquire the people, and the people care for the animals out of kindness. In such a situation, a means test is not appropriate. Bernard E. Rollin, PhD

CVJ / VOL 54 / SEPTEMBER 2013

Veterinary medical ethics.

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