Veterinarians and the best interests of animals
By Charles Foster
English law has traditionally, for most purposes, regarded animals as mere chattels. There is now animal welfare legislation which seeks to prevent or limit animal suffering, but provided that legislation is complied with, and that no other relevant laws (eg those related to public health) are broken, you are free to do what you want with your animal.
Veterinary surgeons are in an interesting position. The UK regulatory body for veterinarians, the Royal College of Veterinary Surgeons (‘RCVS’) publishes a Code of Professional Conduct. This provides, inter alia:
‘1.1 Veterinary surgeons must make animal health and welfare their first consideration when attending to animals.’
‘2.2 Veterinary surgeons must provide independent and impartial advice and inform a client of any conflict of interest.’
‘First consideration’ in 1.1 is a rather weasly formulation. Does it mean that it is the overriding consideration, trumping all others, however weighty those others might be? Or the one that veterinarians ought to consider first, before moving on to other criteria which might well prevail?
The RCVS also publishes Supporting Guidance. The relevant guidance is that relating to ‘Veterinary Care’:
‘2.2 Veterinary surgeons and veterinary nurses are personally accountable for their professional practice and must always be prepared to justify their decisions and actions. When providing care, veterinary surgeons and veterinary nurses should:
(c)…. make decisions on treatment regimes based first and foremost on animal health and welfare considerations, but also the needs and circumstances of the client;
(d) recognise the need, in some cases, to balance what treatment might be necessary, appropriate or possible against the circumstances, wishes and financial considerations of the client*…..
(f) consider the welfare implications of any surgical or other procedure and advise or act appropriately;
*There may be additional considerations for owners of animals kept for commercial or production purposes. Whatever the circumstances, the overriding priority is to ensure that animal health and welfare is not compromised.’
2.2(c), (d) and (e), taken together, seem to support the weaker construction of the primary obligation in the Code of Professional Conduct. The ‘needs and circumstances of the client’ can sometimes, it seems, outweigh animal welfare considerations (2.2 (c)): The treatment necessary to discharge the veterinarian’s ethical obligation might sometimes depend on ‘the circumstances, wishes and financial considerations of the client’ (2.2 (d)): and the welfare implications of a possible course of action or inaction only have to be ‘consider[ed’ (2.2(f)) – they are not necessarily decisive.
But then, just as you were getting frustrated with the absence of real guidance or ethical support in this ‘Supporting Guidance’, there is that interesting asterisked note, which seems to assert, pretty decisively, the stronger construction of the Code: ‘Whatever the circumstances, the overriding priority is to ensure that animal health and welfare is not compromised.’ (Emphasis added). What can ‘overriding’ mean if it does not mean ‘all-trumping’?
I’ll assume that this conclusion is correct, and that the Code imposes on veterinarians an ethical duty to act at all times in a way that does not compromise the health or welfare of their animal patients. I will refer to this as a duty to act in the best interests of the animal. This cannot mean that they are under a positive duty to do everything they can to maximize health and welfare: limited resources, just as in human medicine, will inevitably mean that some clinically possible treatments which might increase health or welfare will not be financially possible. But subject to that caveat, the duty to act in the animal’s best interests seems absolute.
But what does it mean to act in an animal’s best interests? Suppose it is clear that a particular drug, which increases meat production in beef cattle, compromises the welfare of those beef cattle. At first blush it might seem that a veterinarian could not ethically prescribe or administer it. But what if the economics of the industry were such that, absent that drug, the cattle could not be economically kept, and therefore would not be kept at all? Could it then be said that the drug should be given because it is better for the particular (patient) cows (and future generations of cows) to exist, even with the detriment of the drug, than not to exist at all? We are immediately in deep philosophical waters.
Few of those waters have been charted. The same is true for many other questions pertaining to animal best interests. That is often because we kill animals so readily and unreflectively – thereby disposing of the problems that their continued existence would otherwise entail. The euthanasist’s needle kills philosophical difficulties as well as patients.
If you’re going to dispose (by killing animals) of the need for serious thought about animal best interests, you should at least do the basic philosophical work of justifying animal killing. It hasn’t happened outside the Academy. Of course there are vegan and vegetarian veterinarians, but it seems to have been decided by the veterinary profession – really without much moral deliberation – that there is nothing so ethically problematic about killing animals that it demands any great justification. A recent survey by the British Veterinary Association revealed that 98% of small animal vets had been asked to euthanase healthy animals. The BVA President was mainly concerned about the distress which this caused to vets, rather than with any ethical difficulty. He used the language of ‘best interests’ in justifying the practice:
“Nobody enters the veterinary profession wanting to euthanise healthy pets, but this is the stressful situation that many vets are facing because of undesirable behaviours in pet animals. Vets will do all they can in these situations to avoid euthanasia, including offering evidence-based behavioural advice, referring to accredited pet behaviourists or assisting with rehoming through reputable rehoming organisations, but sometimes these options are not appropriate, particularly where the behavioural issues make it extremely difficult to rehome the animal. Vets are not required to euthanise healthy animals at an owner’s request, but sometimes, having carefully considered all options and given the circumstances the pet finds themselves in, it may be in an animal’s best interests to do so.’
Well, maybe, but there are a lot of unexamined assumptions there.
The ‘best interests’ test is of course used by medical lawyers (at least in England and Wales) to decide on the lawfulness of actions and inactions that relate to a person who lacks capacity. Life-sustaining treatment can, for instance, be refused to or withheld from an incapacitous patient if the treatment is not the patient’s best interests. The determination of ‘best interests’ requires a holistic audit. In relation to adult patients the procedure is governed by statute (see s. 4 of the Mental Capacity Act 2005), and there is a sophisticated Code of Practice giving guidance as to how to conduct an assessment of best interests. Many of the relevant criteria are not (or at least not demonstrably) relevant to the assessment of animal best interests, but the veterinary profession might usefully note the systematic way in which human best interests determinations are approached.
There are cases in which judges have ruled that an incapacitous child who could be saved by medical treatment objected to by the parents (typically on religious grounds), should not have the medical treatment. Accordingly the child dies, in circumstances where, had the parents had a different view, the child would have lived. This is justified, and can only lawfully be justified, on the grounds that it is not in the child’s own best interests to survive bearing in mind that she would have to live in an oppressive climate of (say religious) disapproval in the parents’ home.
That’s a situation akin to a typical situation of healthy-pet euthanasia. Some (perhaps most) owners might be able to cope with the animal as it is: but the owner with whom, absent the possibility of adoption, the animal would have to continue to live, cannot cope. But the point to note is that judicial endorsement of withholding or withdrawing the life-sustaining treatment in these circumstances is vanishingly rare. Endorsement of active killing, in jurisdictions that permitted it, would be unthinkable in those circumstances.
Of course I do not contend that the treatment and non-treatment of animals and the treatment and non-treatment of humans are ethically, and should be legally, identical. Only the most extreme animal rights activists argue that humans and animals enjoy identical moral status. But the two situations are sufficiently comparable to make us pause to wonder, more intensely than we normally do, why the situations should not be approached identically.
Even if one concludes that animals have no moral status whatever – that cattle should be treated as chattels – that is not the end of the matter. Defacing or destroying a chattel can do terrible things to the defacer or the destroyer – things that I would choose (but that’s an argument for another day) to articulate in the language of dignity. Perhaps that is behind the BVA President’s concern about the effect on veterinary morale of requests to kill healthy animals. I doubt that all those veterinarians distressed by those requests were distressed because of their metaphysical conclusions about the high moral status of animals.
Even if the animals don’t mind being abused, abuse is dangerous to the abuser. A professional code of ethics should take that into account. Acting in the apparent best interests of animals (however anthropomorphic or unscientific our basis for concluding where those best interests lie) is good not only for professional ethics, but also professional well-being.