Veterinarians must make ethical decisions involving euthanasia on a daily basis and these decisions can be the root of moral stress in the profession. A common situation involving an ethical dilemma includes expensive surgeries that are not always feasible for a client. As a result, this may lead to euthanasia, despite treatment options being available for the animal. The aim of this report is to investigate the current issues surrounding the ethics of euthanasia in companion animals, as well as looking for solutions and assistance that are available to minimise or prevent the risk of these companion animals being euthanised. The main issues identified in this report are financial difficulties to afford veterinary treatment, behavioural problems, convenience euthanasia and religious beliefs. The aspects of this report include financial support available to clients in the form of insurance policies and charitable organisations, as well as seeking veterinary and behavioural advice from veterinarians and behaviourists respectively. The relevant laws surrounding animal welfare in relation to euthanasia and the RCVS Code of Professional Conduct were referred to and applied along with published sources to justify whether euthanising a treatable animal is legitimate.
(189 words)
Introduction
According to the Cambridge dictionary, ethics is a set of beliefs about what is morally right and wrong (Cambridge University Press, 2015). Furthermore, the legislation of the Animal Welfare Act 2006 states that animals have to be protected from pain, injury, suffering and disease (Animal Welfare Act, 2006). Euthanasia may be defined as painless killing to relieve suffering, but it is not an act of veterinary surgery. This means that veterinary surgeons are not obliged to euthanise a healthy animal. However, they have the privilege to carry out this procedure under appropriate circumstances. This is decided by assessing many factors, such as extent and nature of the disease or injuries, alternative treatment options, prognosis, potential quality of life after treatment and the owner’s capability to pay for the treatment (Royal College of Veterinary Surgeons, 2017). However, there are still many uncertainties surrounding veterinarians and their decisions regarding small animal euthanasia. Although there are ongoing research and resources available to help guide the client and the veterinarian in their decision, there are still situations that do not apply to the guidelines provided by the Royal College of Veterinary Surgeons (RCVS), such as convenience euthanasia, behavioural problems, and religious beliefs. Hence, such circumstances lead to difficult ethical dilemmas for the veterinarian and the client (Kipperman, Morris and Rollin, 2018).
Finance
In a survey carried out during Kipperman, Morris and Rollin’s research, veterinarians were asked about euthanasia in the context of the client having economic limitations. There were two main areas: clients that couldn’t afford the treatment their animal required and clients that were not willing to pay for treatment. 66% of respondents believed that the client’s unwillingness to pay for the treatment that their animal needed, and instead opted for euthanasia, was an ethical dilemma. Around three-quarters of the respondents reported that they come across these situations at least a few times a week (Kipperman, Morris and Rollin, 2018).
With the rise of veterinary bills, most notably due to a growth in sophisticated treatments offered to animals in veterinary clinics, the cost of insuring a household pet has undoubtedly risen. According to a study by the Association of British Insurers (ABI), released in 2018, £785 million was distributed by pet insurers to cover veterinary bills for over 4.8 million insured pets, which has likely risen due to an increase in claim size. The average premium price to insure companion animals has increased by 50%, which is due to a 75% rise in pet insurance claims in the last decade (Association of British Insurers, 2019). With insurance policy prices on the rise, the PDSA’s Pet Wellbeing report estimates that in 2018, 62% of cats and 43% of dogs in the UK were uninsured (PDSA, 2018). Due to the current economic climate, owners are struggling to provide insurance and cover the cost of expensive veterinary bills which may ultimately lead to their animal’s euthanasia.
In today’s market, there is a wide variety of pet insurance policies available that may be able to provide financial support to a client and ultimately, their pet. Therefore, pet insurance is a significant decision that requires research to find the most suitable policy to cover veterinary bills. In general, the 4 types of insurance policies that are offered for pets, listed from most-comprehensive and expensive to the lower budget options are, respectively; lifetime, maximum benefit, limited-time, and accident-only policies. Lifetime coverage are the premium pet insurance policies offered, as they cover any new medical illness or injury to a pet. Some of these policies may, however, only cover a set number of claims per year, and must be renewed yearly. Maximum benefit policies are the mid-budget option, which provides a set amount of money for each illness/injury. This covers the pet until the maximum amount is spent, and if the maximum is reached, will require the owner to pay the remaining balance. Limited-time policies and accident-only policies provide a certain amount to treat a specific illness or accidental injury. These policies will typically cover only 12 months of treatment for a specific injury/illness and then afterwards the pet will not be covered, however, these plans may be suitable for covering minor injuries (Association of British Insurers, 2019). It is valuable for owners to understand the different options available to them, and to reach out to veterinary professionals if they are unsure or require guidance on what plan will provide sufficient coverage for their pet.
If the client cannot afford treatment or surgery that their pet requires, veterinary practices may offer discounts for certain clients such as students and pensioners or discuss and redirect clients to charities (Royal College of Veterinary Surgeons, 2017). In the UK charities such as the Blue Cross, PDSA and RSPCA support pet owners who are unable to afford veterinary care by providing low cost or free treatment at their charity-run practices. To be eligible to register with a veterinary practice run by a charity the client must live in a certain catchment area and receive housing benefit or council tax benefit (PDSA, 2018).
These charities are vital in improving animal health and welfare across the UK, in 2018 alone the PDSA supported 1.7 million owners and provided 2.5 million treatments (PDSA, 2018). These staggering numbers indicate just how many people in the UK struggle to afford care at private practices. The PDSA provides much-needed education to the public about all aspects of animal welfare, behavioural issues and pet first aid through community talks and events. These events are hugely important in improving an owners understanding of their pets’ requirements and could potentially prevent euthanasia, especially in the case of behavioural issues. Another way that the charity may prevent euthanasia is through the ‘chronic voucher’ scheme where if an owner is struggling to pay for regular medication or treatments for an on-going chronic condition, the PDSA will contribute £25 per month towards the expenses in the pet’s lifetime (PDSA, 2018).
Unfortunately, if an owner does not qualify for support from these charities and they can no longer afford to pay for a chronic condition or life-saving treatment at a private practice, euthanasia may be considered on economic grounds. Section 9.18 of the RCVS Professional Code of Conduct states that “If the client is not eligible for the charitable assistance and no other form of financial assistance can be found, euthanasia may have to be considered on economic grounds.”(Royal College of Veterinary Surgeons, 2017). This leads to question the ethics of putting an animal down that could have been treated.
When an animal requires treatment, the veterinary surgeon should discuss options and provide the best available information for each animal. This is in order to educate owners on the realistic estimated fees for the treatment, a range of reasonable treatment options and prognosis. They should check with their client whether they have any questions or concerns regarding the diagnosis, treatment and costs. To help a client to better manage or reduce their financial burden for the veterinary treatment, they should be provided with the medicine prices or significant changes to practice’s charges at the earliest opportunity (Royal College of Veterinary Surgeons, 2017). This allows owners to understand better about what they are paying, as well as making decisive decisions such as remaining with the same practice or choosing to visit another practice where similar or same treatment is provided, but more affordable. Hence, owners should be made aware of enquiring this information with the practice before deciding to go ahead with any services provided by the practice. All of this should enable the client to make an educated decision on the treatment their animal will receive and whether they can afford the available treatment (Royal College of Veterinary Surgeons, 2017). It is also appropriate for veterinary surgeons to direct clients to online retailers that comply with the Veterinary Medicines Directorate’s Accredited Internet Retailer Scheme (AIRS) to alleviate medicinal costs (Royal College of Veterinary Surgeons, 2017). For example, drugs that are used to treat liver dysfunctions are 64% cheaper if bought from an online retailer. Thus, this could result in a significant amount of savings especially when the course of treatment is lengthy (Woodmansey, 2018).
2020-3-26-1585238584