Committee contemplation

When should we advise euthanasia for a terminally ill animal rather than palliative care? Should we reduce or waive the fee to save the life of an ill patient? Would it be a good idea to insist that patients who need surgical correction for significant hereditary problems also be desexed to prevent genetic transmission? Might we refer people for grief counselling when they appear to be having trouble coping? In this day and age, should we be killing healthy, non-dangerous animals simply because the animal’s owner requests it?

Ethical questions like these crop up in ordinary veterinary clinics and hospitals. Vets and nurses handle these questions in, as it were, an informal manner – sometimes by consulting their consciences and occasionally also by discussing them with friends and colleagues. As we know, however, vets/nurses often lack time to discuss these issues. Very often, they will not have received much formal education in bioethics or animal ethics.

In 2013, the Lort Smith Animal Hospital in North Melbourne became the first vet clinic in Australia, and possibly the first in the world, to address ethical questions in a more formal manner by establishing a hospital ethics committee. This committee is more like a human hospital ethics committee than the usual kind of animal ethics committee. The animal ethics committees – or AECs – that are more familiar to many of us are those that oversee the use of animals in scientific research and teaching.

Under the auspices of the National Health and Medical Research Council, AECs are formed and run by institutions according to a Code of Practice. The Code seeks to minimize the numbers of animals used and the harm that befalls them. The Lort Smith ethics committee is a different beast. Not only was it formed voluntarily by the hospital, it is also not concerned primarily with the use of animals, but rather with their care and treatment as patients, or as homeless individuals.

Nevertheless, the Lort Smith believes it to be an important and valuable addition to the hospital and its ethos. The committee’s purpose coincides with the mission statement of the Animal Welfare League of Australia, of which Lort Smith Animal Hospital is a member. Specifically, the mission is “to uphold and promote high welfare standards for companion animals.”

Some of the relevant ethical issues in this area pertain to the clinic’s role of supporting people of limited means and in desperate circumstances. Other issues relate to its welfare function of receiving and rehoming relinquished and abandoned animals. One question, for example, is how vet hospitals can ethically source blood for emergency transfusions in a way that does not exploit or disrespect animals – such as when discarded racing greyhounds are bled and then, either immediately or some time later, killed. To take another example, the hospital has decided that it is more ethical to rehome FIV-positive cats than to have otherwise healthy cats killed simply for posing a theoretical risk to the health of other felines.

Interestingly, the committee’s membership includes a professional bioethicist from the Royal Children’s Hospital and University of Melbourne, who can provide an informed perspective from the realms of human medical ethics. In addition to members from the hospital’s Board and nursing and veterinary staff, the committee also includes a person who does not work in animal health or in ethics. Such a person is similar to the lay member of scientific research AEC’s, who qualifies for membership simply in virtue of an interest in animals and their wellbeing.

Although it is not laid down as a legal requirement, the presence of an ethics committee offers a vet hospital some advantages. Obviously, it allows the clinic to explore, with increased care and deliberation, some of the ethical questions that arise in vet practice. It also permits various sorts of moral concerns which may trouble and worry members of staff to be heard and addressed rather than ignored. This recognizes that ethical issues impact not only on the animals’ wellbeing but also, in a different way, on the wellbeing of the people who work directly with them.

Another reason that could justify animal ethics committees is the fact that the animals, like children or older patients in hospitals, are in a highly vulnerable position. This vulnerability applies both to the animal patients and, to an even greater degree, to the “non-owned” animals who are relinquished or abandoned. It seems fair to say that the process of forming policy vis-à-vis the treatment of these vulnerable individuals is likely to be improved by moving the ethical discussion into a dispassionate, informative, and constructive space.

Finally, it may be proper to ask whether there are any problems or risks associated with ethics committees. Most people would support the idea of ethics committees for scientific research and teaching. However, some individuals and academics have alleged that those committees have generally failed to meet the Code’s stated goal of finding alternatives to animals used in science. One possible reason for this alleged failure lies in the form of the institutional membership of AECs.

Whatever the truth there, the relevant point is that ethics committees can sometimes be accused of effectively rubber-stamping proposals and policies that support the interests of the institution in which they are formed, and in opposition to the interests of the animals and humans it was created to protect. Hence the importance of including on the committee, in the right proportions, members who are free of a range of conflicts of interest.

Of course, that ethics committees may have problems is hardly a reason for not having them in the first place. With the innovative instigation of such a group, the Lort Smith Animal Hospital has offered a model for enhanced professional engagement with some of the big (and small) ethical issues in veterinary practice.

Comments? Email editor@vetmag.com.au