Canine Chemotherapy: The Ethics Behind Hard Decisions
Companion animals, especially dogs and cats, have come to be seen as part of the family in large segments of the American population. This elevated status affects how we treat them towards the end of their lives. As companion mortality from vehicle collisions and infectious diseases dwindles, age-related diseases, like cancer, see a rise. As cancer rates increase in the companion population, many guardians turn to chemotherapy, which is a standard cancer treatment in humans.
However, chemo comes with a cost. Chemotherapy involves injection of the patient with one or more drugs designed to inhibit cell division, block cellular signals, and inhibit hormone production. As these are all essential biological functions, the side effects can be grueling. Weight loss, hair loss, nausea, immunodeficiency, and general pain are all common with chemotherapy. In addition, chemotherapy in companions is rarely curative; the intent is only to extend the life of the animal, usually by fewer than 2 years.
In humans, doctors can explain the purpose of chemotherapy as well as its side-effects. Humans can also weigh the potential costs of this treatment against the potential bonuses of living more years. With dogs, none of these things are possible. As far as we know, dogs can’t comprehend the future to the extent humans can. All the dog understands when it comes to chemotherapy is the actual treatment itself, which is usually horribly unpleasant. Given this information, is it ethical to perform this treatment on companion animals, or should guardians and veterinarians opt for palliative care and euthanasia?
Animal rights theorists could, of course, make arguments for either option. The animal has the right to whatever treatments available, but unfortunately, animals aren’t able to make these kinds of decisions for themselves nor understand why choices were made on their behalf. Take a relatively uncontroversial statement: an infant with cancer should be given any effective treatment available. The infant can’t make the choice themselves, nor understand how chemotherapy works, but if they make a full recovery the parents can explain it to them. A dog will never be able to understand the purpose of their suffering during chemotherapy, and this makes it unclear whether it can be ethical to subject a dog to this treatment.
Utilitarians simply balance the potential pleasure and pain caused by either decision. This ethical framework includes not only the interests of the animal and guardian, but also the veterinarian and society at large. The animal, veterinarian, and guardian will all undergo suffering in either choice. However, the potential amount of suffering varies with each situation. If chemotherapy has a good chance at letting the animal live many more healthy years, it could be the right option. If the animal is already near the end of its life, palliative care and euthanasia may be more ethical.
Each guardian will also have different preferences. Some may be able to deal with their companions’ passing immediately, while others need more time. An important point is that utilitarianism treats everyone’s interests equally. While the animal rights theory of ethics puts the animal’s interests at the forefront, utilitarianism treats them equal to the guardian, veterinarian, and everyone else involved.
Finally, we come to relational theorists, who believe that preserving the guardian-companion relationship above all else. Again, this could support either option. The bond is obviously severed with the animal’s death, so there may be an interest in keeping the animal alive as long as possible. However, caring for a terminally ill, suffering companion will undoubtedly strain the relationship, and so it may be better to preserve quality of life and euthanize sooner rather than drag out the dying process. Again, making this decision will come down to the individual animal and guardian.
It’s impossible to eliminate suffering from the process of aging and dying as best as we can for our companions. As more healthcare options become available to companion animals, the ethical complications grow with them. We as guardians face the unique dilemma of having to act in the interest of a being who cannot and will not communicate their preferences clearly nor understand the actions we take on their behalf. Guardians and veterinarians need to be absolutely transparent with each other regarding treatments’ side effects and likelihood of success. In addition, further research into animal chemotherapy and palliative care is needed to further reduce suffering in this inescapable part of animal guardianship.