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InFocus

Can we justify advancements?

THE opening of the Glasgow veterinary school’s £15 million small animal hospital received widespread coverage in the national press and on the BBC news website.

The facilities certainly look impressive and the video clip of Sula, the collie cross, walking on the hydrotherapy tank treadmill is a joy to behold. A real feel-good story that surely no one can find anything to be critical about. Well, perhaps.

Quite naturally, veterinary medicine is going to progress in parallel with human medicine but there are accompanying ethical concerns and questions that need to be asked and indeed answered. First, is there justification for providing such facilities for the use of animals when so many humans are facing “rationing” for the care they need and receive in this country, and far worse still in the developing world? And secondly, do the benefits to the animals themselves outweigh the “suffering” that is inevitably involved in some of the treatments that are now available?

No easy answers

I should begin by suggesting that there are no easy answers to these most difficult of questions and perhaps no definitive answer at all.

After all, much of what is right and ethical is a relative concept: in the 18th century it was probably ethical to saw off the leg of a person suffering a compound fracture using only alcohol as an “anaesthetic”, whereas now this would clearly not be the case. Likewise, the spaying of cats and bitches 40 years ago without the administration of post-op analgesia.

However, when state-of-the-art veterinary medicine mirrors or in some cases even surpasses that of human medicine, I have to admit to feeling just a little bit uncomfortable. Hence my somewhat disloyal reservations about the new Glasgow small animal hospital.

There will be many people who cannot see a problem. In a free-market economy, demand and the ability to pay for services are the only deciding influences on what is or is not available. That is all well and good, but in a wider political and sociological context, the ability of the “haves” to pay for what the “have-nots” cannot afford is a serious problem and indeed predicament for the general cohesion of society as a whole.

Pets v. children

That probably extends to the sort of care that some people can afford for their pets when the children of those on the “other side of town” are being reared in relative or even absolute poverty.

To be clear, I “love” my dogs and cats dearly but I don’t think I could ever morally justify one of them having an MRI scan. Or justify them exercising in a hydrotherapy pool when lead exercise in the park or on the pavement is readily (and freely) available. And whilst the latter might not be the very best of treatment for them, it is undoubtedly, in my opinion, quite good enough.

Availing one’s animal of hydrotherapy pool treatment could be seen as a case where wealth has become more of a measure of status than a means to secure well-being.

I would also feel somewhat self-conscious about using such treatment for my pets when most human patients inevitably endure woefully inadequate physiotherapy and rehabilitation after injury and surgery, largely through lack of funding.

To give greater clarity to my views and to emphasise the ethical dilemma, I should add that I am as impressed as the next person with what some of our colleagues are now able to do by way of their treatment of animals and the results they can achieve. And it is clear that the new facilities at Glasgow will undoubtedly help push the barriers even further down the path of previously unimagined possibilities.

But when I look at all this in the cold light of dayIcan’t seem to get past this huge mental barrier that few people appear to want to voice for fear of being branded reactionary or stuck in the past: that is the ethical “elephant in the room”. Because for me, the bottom line in safeguarding animal welfare is the ability to practise compassionate and humane euthanasia, pure and simple.

Please don’t think that I am advocating this “treatment” of euthanasia in a cavalier fashion, nor am I suggesting that it should be used without very careful thought and consideration. But crucially, I believe that no less thought and consideration should be given before recommending a potentially traumatic (and almost inevitably expensive) treatment for an animal, just because that treatment is possible and available.

I know that the treatment of humans can sometimes involve much suffering. If the standard of care is good then much of that suffering can be ameliorated, though not always be removed completely.

No pain – no gain…

If there is the prospect of recovery, then the person involved can usually put his or her suffering in some sort of context; crudely put, “no pain – no gain”. The suffering can be rationalised as a necessary part of the road to feeling well again.

I don’t believe animals are capable of that type of thought process. They cannot “see” beyond any period of fear or suffering to a time when all is well again. So any fear or suffering that we consciously expose them to is very real, immediate and, one could argue, unnecessary.

The trick is for us humans to weigh up on the animal’s behalf the long-term benefits to the animal of a particular treatment against the degree of short or medium term suffering that the treatment involves.

Variations

That will vary between individual animals depending on a wide range of parameters such as its temperament, age, physical condition, the quality of pain relief, etc.

In addition, the ability of the owner to pay is very relevant from a practical and business viewpoint but, importantly, has no bearing on the balance of benefits or otherwise to the animal. It might, though, have a significant bearing on the clinician’s advice as to what he or she considers to be the animal’s best interests. That influence could be both conscious and sub-conscious.

To summarise, I know that the veterinary care available to animals will continue to progress in parallel with the care of humans.

Some people will give a blanket welcome to that fact but I have a more cautious approach based on what is ethical both in terms of the inequalities of treatment available to humans, and the balance of benefits to the animal itself.

Such ethical considerations are likely to become more and more complex as technology allows us to do more and more things. We must not lose sight of the fact that we are dealing with living, sentient animals that rely solely on us to make the “right” decision on their behalf.

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