Veterinary Medical Ethics Déontologie vétérinaire Ethical question of the month — June 2014 Discussions concerning animal welfare take many forms. Positions on both sides of the debate range from philosophically complex to fundamentally blunt. One common argument against investing time and resources to improve the welfare of domestic animals is advanced in this manner, “Why are we trying to improve the lives of farm animals when children are starving and dying in developing countries?” Such pronouncements commonly result in head nods from others in the room. How should one respond to this common and basic criticism of efforts to improve the lives of domestic animals?
Question de déontologie du mois — Juin 2014 Les discussions concernant le bien-être animal se déroulent sous de nombreuses formes diverses. Les positions des deux camps du débat peuvent être philosophiquement complexes ou fondamentalement simples. Un argument courant contre l’investissement de temps et de ressources afin d’améliorer le bien-être des animaux domestiques est présenté de cette manière : «Pourquoi tentons-nous d’améliorer la vie des animaux de ferme lorsque des enfants meurent de faim dans les pays en développement?» Des déclarations de ce genre suscitent généralement des hochements de tête des autres personnes dans la pièce. Comment doit-on répondre à cette critique fréquente et élémentaire des efforts en vue d’améliorer la vie des animaux domestiques? Comments/Commentaires :
Name/Nom : Address/Adresse :
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 55 / JUNE 2014
521
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 — March 2014 Veterinarians working with racehorses face unique challenges. No other type of practice expects veterinarians to “correct” such minute deficiencies in performance. Since the actual performance potential of many horses cannot be known, treatments may be targeted at “perceived” deficiencies in performance. Nevertheless, seconds or fractions of a second determine profit and loss and thus the animal’s value for the trainer and owner. One or two seconds may ultimately determine whether a horse continues racing or is sold for slaughter. Is a veterinarian who works to maintain or improve racehorse performance in keeping with the veterinarian’s oath to “promote animal health and welfare?”
Question de déontologie du mois — Mars 2014 Les vétérinaires travaillant auprès des chevaux de course doivent relever des défis uniques. Aucun autre type de pratique ne s’attend à ce que les vétérinaires «corrigent» des anomalies infimes au niveau de la performance. Vu que le potentiel de performance réel de nombreux chevaux ne peut pas être connu, les traitements peuvent cibler des anomalies «perçues» au niveau de la performance. Ce sont d’ailleurs des secondes ou des fractions de seconde qui déterminent les profits et les pertes et, en conséquence, la valeur de l’animal pour l’entraîneur et le propriétaire. Une ou deux secondes peuvent déterminer si un cheval continuera de courir ou s’il sera vendu à l’abattoir. Le vétérinaire qui travaille pour maintenir ou améliorer la performance d’un cheval de course est-il fidèle au serment vétérinaire de «protéger la santé et le bien-être des animaux»?
An ethicist’s commentary on animal health and welfare The question of what constitutes “health and welfare” in treating animals is at the crux of endeavors where animals are expected to compete, not only in racing Thoroughbreds, but also in show horses of various disciplines, and even in small animals (e.g., canine agility). It is an interesting question to parse. If we accept that horses will be used in sporting activities for the enjoyment of people (a hotly contested topic in some circles, to be sure), then it seems inarguable that those animals should be healthy when they perform. As such, treatments to restore health and welfare where disease previously existed — antibiotics to treat respiratory infections, surgeries to correct repairable fractures, etc. — are certainly not only ethical, but part of the veterinarian’s responsibility to horse, him or herself, and society. Ethical concerns arise when animals are given treatments to affect performance when no obvious health issue arises, or, alternatively, are given treatments in an effort to hide or “mask” underlying pathology. Here, too, there is usually a clear ethical line. For example, it would be obviously unethical to inject a local anesthetic into a horse’s osteoarthritic joint prior to performance, and there are regulations against such practice. Such an action would put at risk the life of both horse and rider. Similarly, one could not ethically support giving a horse a nonsteroidal anti-inflammatory drug to mask a viral respiratory disease-induced fever; such an action would put not only the health of the treated horse at risk, but also the health of other horses. As a result, in both racing and show horse industries, administration of such medications is tightly regulated. For similar reasons, denerving procedures, in which the palmar digital nerves are cut, causing partial loss of sensation to the hoof, are not permitted in racing horses in California, and in many other jurisdictions of the United States. However, the ethical line may be somewhat blurrier when the horse is otherwise healthy (ideally, as determined by a veterinarian), but still “fails to perform.” Animals have no knowl522
edge of the nature of performance and competition. A horse that finishes last in a race is not concerned by his “failure” to win; a horse that doesn’t switch its leads behind is clearly not hampered by the “problem.” Horses that fail to perform up to expectations, although otherwise healthy, are a clear target for those who claim to be able to affect performance by some intervention, be it a veterinary treatment, a supplement, or some form of “alternative” therapy. Without some sort of evidence that a problem really exists, and that the treatment might be effective, promoting such a therapy would likely waste time and the owner’s money, and subject the horse to risk (of treatment) without expected benefit. Those circumstances may seem unethical, but they form the focus of a good deal of product and service promotion, and, unfortunately, occur in every segment of the equine industry. Nevertheless, unless a horse performs to expectations, the owner/trainer will have concerns that the considerable investment made in maintaining the horse is being wasted. For some owners, that investment is the primary consideration, and if the animal isn’t “earning its keep,” the investment may not continue to be made. Under such circumstances, the welfare of the horse really isn’t an issue at all, and if a veterinarian engages in activities solely to improve performance in the absence of any physical problem, the veterinarian would be in danger or violating his or her oath. But even this line may not be clear. For example, in racing horses, furosemide has been shown to both increase performance and decrease the incidence of exercise-induced pulmonary hemorrhage (EIPH). One can rather easily argue either side of the question of whether furosemide should be used pre-race. As another example, administering a non-steroidal anti-inflammatory drug may improve the health and welfare of the horse if given post-race, in an effort to relieve post-exercise soreness, but may be entirely unethical pre-race if given in an effort to mask limb soreness. CVJ / VOL 55 / JUNE 2014
V E T E R I N A RY M E D I CA L E T H I C S
Ultimately, decisions about working to “improve” equine performance may be taken out of the hands of the veterinary profession, as well as horse owners and trainers. Society has clearly expressed its distaste for the use of performance-enhancing medications in all human sporting endeavors. Further, society is expressing increasing interest in animal welfare, and it is apparently frowning on what it perceives (rightly or wrongly) as an indiscriminate use of performance enhancing treatments. Because of societal concerns, many performance horse endeavors are coming under increasing scrutiny, and society is stepping in to regulate such endeavors with little interest other than the horse: witness United States legislation pertaining to “soring” or Tennessee Walking Horses, or horse slaughter. If veterinarians, owners, trainers, who may be interested only in performance, do not give serious attention to the ethical questions that you raise, they may find that the decisions about what is necessary to “promote animal health and welfare” have been taken from their hands. Finally, it should be noted that the initial choice given, “racing or sold for slaughter” is an impression of which the racing industry is aware, although it is not necessarily the truth. “Race or die” is no longer strictly the norm. In fact, the horse racing industry has taken steps to develop second career programs and retirement programs in an effort to reduce wastage, and for that they should be applauded. But that doesn’t change the fact that if the only thing that matters is that the horse wins, no matter what, there are many openings in the ethical fence which can be climbed through. David Ramey, DVM [email protected] Bernard Rollin, PhD [email protected]
CVJ / VOL 55 / JUNE 2014
523
Question de déontologie du mois — Juin 2014 Les discussions concernant le bien-être animal se déroulent sous de nombreuses formes diverses. Les positions des deux camps du débat peuvent être philosophiquement complexes ou fondamentalement simples. Un argument courant contre l’investissement de temps et de ressources afin d’améliorer le bien-être des animaux domestiques est présenté de cette manière : «Pourquoi tentons-nous d’améliorer la vie des animaux de ferme lorsque des enfants meurent de faim dans les pays en développement?» Des déclarations de ce genre suscitent généralement des hochements de tête des autres personnes dans la pièce. Comment doit-on répondre à cette critique fréquente et élémentaire des efforts en vue d’améliorer la vie des animaux domestiques? Comments/Commentaires :
Name/Nom : Address/Adresse :
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 55 / JUNE 2014
521
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 — March 2014 Veterinarians working with racehorses face unique challenges. No other type of practice expects veterinarians to “correct” such minute deficiencies in performance. Since the actual performance potential of many horses cannot be known, treatments may be targeted at “perceived” deficiencies in performance. Nevertheless, seconds or fractions of a second determine profit and loss and thus the animal’s value for the trainer and owner. One or two seconds may ultimately determine whether a horse continues racing or is sold for slaughter. Is a veterinarian who works to maintain or improve racehorse performance in keeping with the veterinarian’s oath to “promote animal health and welfare?”
Question de déontologie du mois — Mars 2014 Les vétérinaires travaillant auprès des chevaux de course doivent relever des défis uniques. Aucun autre type de pratique ne s’attend à ce que les vétérinaires «corrigent» des anomalies infimes au niveau de la performance. Vu que le potentiel de performance réel de nombreux chevaux ne peut pas être connu, les traitements peuvent cibler des anomalies «perçues» au niveau de la performance. Ce sont d’ailleurs des secondes ou des fractions de seconde qui déterminent les profits et les pertes et, en conséquence, la valeur de l’animal pour l’entraîneur et le propriétaire. Une ou deux secondes peuvent déterminer si un cheval continuera de courir ou s’il sera vendu à l’abattoir. Le vétérinaire qui travaille pour maintenir ou améliorer la performance d’un cheval de course est-il fidèle au serment vétérinaire de «protéger la santé et le bien-être des animaux»?
An ethicist’s commentary on animal health and welfare The question of what constitutes “health and welfare” in treating animals is at the crux of endeavors where animals are expected to compete, not only in racing Thoroughbreds, but also in show horses of various disciplines, and even in small animals (e.g., canine agility). It is an interesting question to parse. If we accept that horses will be used in sporting activities for the enjoyment of people (a hotly contested topic in some circles, to be sure), then it seems inarguable that those animals should be healthy when they perform. As such, treatments to restore health and welfare where disease previously existed — antibiotics to treat respiratory infections, surgeries to correct repairable fractures, etc. — are certainly not only ethical, but part of the veterinarian’s responsibility to horse, him or herself, and society. Ethical concerns arise when animals are given treatments to affect performance when no obvious health issue arises, or, alternatively, are given treatments in an effort to hide or “mask” underlying pathology. Here, too, there is usually a clear ethical line. For example, it would be obviously unethical to inject a local anesthetic into a horse’s osteoarthritic joint prior to performance, and there are regulations against such practice. Such an action would put at risk the life of both horse and rider. Similarly, one could not ethically support giving a horse a nonsteroidal anti-inflammatory drug to mask a viral respiratory disease-induced fever; such an action would put not only the health of the treated horse at risk, but also the health of other horses. As a result, in both racing and show horse industries, administration of such medications is tightly regulated. For similar reasons, denerving procedures, in which the palmar digital nerves are cut, causing partial loss of sensation to the hoof, are not permitted in racing horses in California, and in many other jurisdictions of the United States. However, the ethical line may be somewhat blurrier when the horse is otherwise healthy (ideally, as determined by a veterinarian), but still “fails to perform.” Animals have no knowl522
edge of the nature of performance and competition. A horse that finishes last in a race is not concerned by his “failure” to win; a horse that doesn’t switch its leads behind is clearly not hampered by the “problem.” Horses that fail to perform up to expectations, although otherwise healthy, are a clear target for those who claim to be able to affect performance by some intervention, be it a veterinary treatment, a supplement, or some form of “alternative” therapy. Without some sort of evidence that a problem really exists, and that the treatment might be effective, promoting such a therapy would likely waste time and the owner’s money, and subject the horse to risk (of treatment) without expected benefit. Those circumstances may seem unethical, but they form the focus of a good deal of product and service promotion, and, unfortunately, occur in every segment of the equine industry. Nevertheless, unless a horse performs to expectations, the owner/trainer will have concerns that the considerable investment made in maintaining the horse is being wasted. For some owners, that investment is the primary consideration, and if the animal isn’t “earning its keep,” the investment may not continue to be made. Under such circumstances, the welfare of the horse really isn’t an issue at all, and if a veterinarian engages in activities solely to improve performance in the absence of any physical problem, the veterinarian would be in danger or violating his or her oath. But even this line may not be clear. For example, in racing horses, furosemide has been shown to both increase performance and decrease the incidence of exercise-induced pulmonary hemorrhage (EIPH). One can rather easily argue either side of the question of whether furosemide should be used pre-race. As another example, administering a non-steroidal anti-inflammatory drug may improve the health and welfare of the horse if given post-race, in an effort to relieve post-exercise soreness, but may be entirely unethical pre-race if given in an effort to mask limb soreness. CVJ / VOL 55 / JUNE 2014
V E T E R I N A RY M E D I CA L E T H I C S
Ultimately, decisions about working to “improve” equine performance may be taken out of the hands of the veterinary profession, as well as horse owners and trainers. Society has clearly expressed its distaste for the use of performance-enhancing medications in all human sporting endeavors. Further, society is expressing increasing interest in animal welfare, and it is apparently frowning on what it perceives (rightly or wrongly) as an indiscriminate use of performance enhancing treatments. Because of societal concerns, many performance horse endeavors are coming under increasing scrutiny, and society is stepping in to regulate such endeavors with little interest other than the horse: witness United States legislation pertaining to “soring” or Tennessee Walking Horses, or horse slaughter. If veterinarians, owners, trainers, who may be interested only in performance, do not give serious attention to the ethical questions that you raise, they may find that the decisions about what is necessary to “promote animal health and welfare” have been taken from their hands. Finally, it should be noted that the initial choice given, “racing or sold for slaughter” is an impression of which the racing industry is aware, although it is not necessarily the truth. “Race or die” is no longer strictly the norm. In fact, the horse racing industry has taken steps to develop second career programs and retirement programs in an effort to reduce wastage, and for that they should be applauded. But that doesn’t change the fact that if the only thing that matters is that the horse wins, no matter what, there are many openings in the ethical fence which can be climbed through. David Ramey, DVM [email protected] Bernard Rollin, PhD [email protected]
CVJ / VOL 55 / JUNE 2014
523
