Veterinary Ethics In The Animal Intensive Care Unit

Many pet guardians have faced  the difficulty of deciding when a sick or injured companion animal should be euthanized to prevent unnecessary and unavoidable suffering. Because animals cannot communicate verbally, the decision is generally made in consultation with a veterinarian on the basis of perceived suffering and quality of life. In veterinary intensive care units (ICUs), such decisions often entail determining whether “heroic” or increasingly available extreme treatments are in the best interest of animals.

This paper, published in Veterinary Anesthesia and Analgesia and based on veterinary practices in the UK, defines different types and levels of suffering that may inform treatment decisions in veterinary ICUs. Specifically, the author hopes the information is useful for veterinary anesthetists whom he believes are in ideal positions to act as advocates for animals based on their training.

The author first explores what constitutes suffering, noting that while veterinarians agree that animal suffering entails more than physical pain, the idea is not well-defined in the veterinary field or the UK legal system. To better define the concept, the author suggests that veterinarians look to three well-known models of animal welfare: the Farm Animal Welfare Council’s Five Freedoms, a list of five principles for considering averse welfare states that animals would want to avoid; the Animal Welfare Act 2006, which stipulates five “needs” that owners and care givers must provide for their animals; and Dr. David Mellor’s “Five Domains” model, which combines elements of the other two models by situating needs in the domains of nutrition, environment, and health, and “extrapolating them with a much larger range of ‘affective states’ (consciously and subjectively experienced feelings) that might be generated by the corresponding restriction on the animal’s ‘Freedoms’.”

Next, the author attempts to determine when suffering is acceptable.  He states that suffering is necessary if it is for the “purpose of benefiting the animal” but that an animal should not be subjected to protracted suffering if treatment is becoming futile and death is likely. However, he notes that there are no set protocols for making decisions about euthanasia in the ICU. He suggests that veterinarians look to Extended Welfare Assessment Grids (EWAGs), systems used by biomedical researchers that estimate and visualize the overall amount of suffering an animal will experience during and after a scientific procedure based on scores of physical, psychological, environmental, and procedural suffering.

The author concludes by recommending that veterinary anesthetists work together to develop objective animal welfare criteria and scoring systems based on the models above, particularly EWAGs and the Five Domains. He notes that such systems may help prevent “transgressions against animals” in the ICU, no matter how good the “intent” of their guardians and healthcare providers.