Searching for Ethical Guidance

Veterinary ethics teaching and application in practice have changed considerably recently. When it was first taught, veterinary ethics dealt mostly with aspects of professionalism, with little focus on the ethical questions such as euthanasia decision-making. Ethics is now included in most veterinary curricula, not least because it is an expected Day-1 competency for veterinary graduates in many countries. New graduates are required to understand their ethical and legal responsibilities in relation to their patients and clients. The North American Veterinary Medical Education Consortium (NAVMEC) identified ethics as a core component of leadership, as well as an emerging area of concern for veterinarians, stating that “(veterinarians) are committed to the health and welfare of animals and the protection of human health through ethical practice, professional self-regulation, legal compliance and high personal standards of behavior and practice.” NAVMEC has called for colleges of veterinary medicine to create and update course materials on ethics and leadership for use in and sharing among, veterinary schools. So, the scope for improvement in the education of our profession’s students is immense; but who is guiding and educating those of us that have left the classroom and have to deal with frequent ethical dilemmas?²

“Humanity’s true moral test, its fundamental test…consists of its attitude towards those who are at its mercy: animals.”¹
— Milan Kundera

An interesting study released this year investigated the frequency and nature of ethical dilemmas encountered by small animal veterinarians, as well as their beliefs regarding euthanasia and balancing client and animal interests. Study results showed that of the 484 respondents more than half experienced an ethical dilemma regarding the interests of clients and those of their patients on at least a weekly basis.3 Client financial concern-based situations were commonly reported causes of ethical conflicts. Half of all respondents also reported that ethical dilemmas are the leading cause, or are one of many equal causes, of work-related stress. Results suggested that most small animal practitioners believe that greater awareness of moral stress and providing training in ethical theories and tools for coping with ethical dilemmas can ameliorate moral stress.³ So if the problem has now been defined, how do we find broad solutions for our profession?

One solution has been implemented by clinicians and researchers at North Carolina State University and Duke University. These teams have developed a first-of-its-kind veterinary medical ethics committee to aid care providers in navigating ethical situations. The committee consists of 7 people: 3 doctors, 3 veterinary nurses, and 1 social worker. When cases arise, 2 to 4 committee members meet with the veterinary patient’s care team to serve as a resource. The entire process operates independently from the academic and business aspects of the university’s veterinary hospital to avoid conflicts of interest. Is it a model that we can implement and somehow use to guide us in making the best decisions for those that have no voice?