THIS series gives readers the opportunity to consider and contribute to discussion of some of the ethical dilemmas that can arise in veterinary practice. Each month, a case scenario is presented, followed by discussion of some of the issues involved.
In addition, a possible way forward is suggested; however, there is rarely a cut-and-dried answer in such cases, and readers may wish to suggest an alternative approach. This month's dilemma, ‘Delivering profit?’, was submitted and is discussed by Richard Brown. Readers with comments to contribute are invited to send them as soon as possible, so that they can be considered for publication in the next issue. Discussion of the dilemma ‘Accounting for a lame cow’, which was published in the October issue of In Practice, appears on page 551.
The series is being coordinated by Siobhan Mullan, of the University of Bristol. It is hoped it will provide a framework that will help practices find solutions when facing similar dilemmas.
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Richard Brown qualified from the University of Cambridge in 1981. He gained an MSc in tropical veterinary medicine from the Royal (Dick) School of Veterinary Studies in 1986. He has served as a veterinarian with various overseas governments and has practised for over 20 years in the UK. He is currently an associate director at the School of Veterinary Medicine at City University in Hong Kong.
A client who values your judgment on sheep matters asks you to accompany him to a ‘friend's’ farm to look at a two-year-old pedigree continental tup he has been offered for private sale. He considers it possesses exemplary conformation, comes from a good line and is an excellent buy. He tells you that he has been told that it weighed 6.9 kg when it was born, it has grown like a mushroom in its first year and that he is grateful for the opportunity of this sale. You recollect that on the last lambing of your client's flock of 70 pedigree continental breeding females, 14 caesarian sections were performed on them, and another 20 ewes had vet-assisted lambings.
Issues to consider
It is nice for a client to say that he really values your judgment, but this should light up a small warning sign: pride comes before a fall. You should prepare to criticise your own objectivity in this matter. You need to check that the ‘friend’ is not one of your own clients, since this matter is shaping up to be similar to a vetting. You may not be able to assist him if the ‘friend’ is also a client. In that case, you may advise your client that, on his behalf, you will seek another vet practice to do this piece of work.
Another potential conflict is that a tup like this might generate more income for the practice by an increased number of caesarian sections performed and vet-assisted lambing. Yet good planning for animal welfare indicates that vet-assisted lambing and caesarean sections should be kept to a minimum.
Even if the economics makes sense, you still should make him aware that, generally speaking when considering sheep, the optimum is to get the majority of ewes to lamb themselves. Therefore, even if you go through the following economic exercise, it is not relevant to the ethics. Together you can estimate the additional caesarian section costs, the vet-assisted lambing costs and also the likely subsequent increased infertility costs, and even the possibility, with many more caesarian sections, of a ewe dying. These additional costs, if one looks at economics alone, must be less than the additional value the lambs might get compared to a ‘normal’ crop.
He may counter your welfare concerns by suggesting that because of their value he is able to spend more on the lambs in supplementary feeding, buildings, preventive medicine, etc, and this indicates a high welfare standard. In addition, he may say that he assumes that, as a qualified vet, you perform caesarian sections and lambings with sufficient analgesia and care as to be welfare acceptable. Besides, he always considered natural birth to include some degree of pain and yet administration of analgesia for all births is not a standard. He may add that, unlike many commercial flocks, his tup lambs will not have to undergo castration. The reply to this is that the optimum solution consists of good health and good productivity with low interference; but you may have to desist if a heated argument is about to develop. It is important to fully understand your client in these circumstances.
Possible way forward
It is tempting to think that one vet and one farmer cannot cause a revolution in thinking and thus it is pointless to try to aim for a significant reduction in birth-assisted lambings in well-muscled breeds of sheep. But there are a few flocks that do have minimum intervention, so it is possible. All revolutions start with just one or two people. And you would not be alone: some breed societies are addressing this issue by recording estimated breeding values for lambing ease. It is worth spending time with the farmer to see if he might be receptive to aiming for a lambing that will overall have less interference from man.
By suggesting to him that his plan is not acceptable, you have created a problem for the farmer. If you produce a problem you also need to try to find a solution. Therefore, it would be worth asking him to give you time to find possible solutions, with the aim being to find an easy lambing tup which produces commercially viable offspring. This could involve help from vets in the practice, contacting in confidence the local agricultural college and using your own contacts in the industry. This could be a challenge but could be very rewarding.
In discussions with the farmer, you need to see if you can double check his estimate of income. He may have been influenced by some of the astronomical prices fetched by some tups. A serious overestimate on his part could mean he has to change his plan, providing an opportunity to aim for a better one.
If you do go to the farm, you will have to be very attentive about biosecurity and insist that your client does the same. You do not want, for example, to accidentally bring orf or sheep scab on to the farm. You should make it clear, unless you have years of experience of the breed, that you are focusing on matters relating animal health and welfare, and that you are not going to pass any specific opinions on the conformation or genetic merits of the animal unless in your opinion it relates directly to welfare or health.⇓
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