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, ‘Immediate dispatch?’, was submitted and 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 ‘The mating game’, which was published in the April issue of In Practice, appears on page 263.
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.
You are called out from your rural practice to a fox that has been run down and is in extremis. Since you are uncertain of the exact circumstances, you take a fully equipped car including collapsible cage, dog catching pole, dart gun and pistol. A student accompanies you. You find the fox on a quiet isolated lane. The three people who called you get out of a large saloon car and are very upset to have hit the fox, and you can tell by their dress and behaviour they probably do not live in the countryside.
You see the fox has bilateral hindleg paresis, a compound fracture of one leg, a wound on the back, is tachynpnoeic with saliva drooling from its mouth. It is alert and trying to pull its body along with its forelegs. The most reasonable course of action appears to be immediate euthanasia.
While you are explaining this, a farmer drives up and offers to shoot the fox with his shotgun. The three beg you to instead inject the fox with a painkiller and anaesthetic, and to make sure the case is hopeless before dispatching it in its sleep. They proffer £300 as a down payment and add that if anyone is going to use a gun it should be a professional vet not a farmer.
Issues to consider
The background and dress of the people present should be irrelevant to your decision. When meeting city dwellers in the countryside the temptation is to assume that those who live in the country are always correct. They often are but not always.
First of all, if you don't hold the licence to the shotgun you can't use it. So you cannot accede to their suggestion that you use it instead of the farmer. You could use your pistol but you must be sure that you can make an accurate head shot. You must take into account that using a free bullet directed into such a small target, which is against the road surface, raises the real possibility of a ricochet. These do not normally fly straight and can wound, or even on occasion kill, a person. There is less risk of ricochet with many shot gun cartridges.
You do need to get a good look at the fox without pressuring it to move. This might entail getting the student to stand on the other side of the fox to box it in, but careful judgment will still be needed to gauge how close to get.
A fox is a feral creature with a potentially wide range (200 to 4000 hectares) and cannot be welfare assessed in the same way as a dog (Anon 2015) – and this is particularly true of adults. If you were to treat the fox, you would need to have confidence in a plan with a good chance of success and which would satisfy both short- and long-term welfare requirements. Plus, although you do not need a licence, it is not generally advisable to keep wild foxes in captivity, except under special circumstances, particularly if you do not have prior experience (Wildlife Online 2014, Flashman Foxes 2015).
In situations like this, giving any hint that the receipt of money has influenced your decision would be very unwise, but you should listen carefully to the request being made and respond to them in a polite, calm and firm manner.
Possible way forward
You should trust your own judgment, since you are the professional. You have training and expertise that the others in this situation do not. Without being dictatorial, this is a circumstance where you do have to take the lead and act with authority. If, after a brief closer look, you are convinced on clinical grounds that the case is hopeless then there is no need for further inspection. The fox needs quick euthanasia.
If you are to use the pistol this is best done with the fox off the road so that the bullet will bury itself in the soil. Otherwise the best course of action would probably be to ask the farmer to shoot the fox (having checked that it will be a head shot using a gun with the right calibre of cartridge).
With the student's help you would be well advised to use a blanket to screen the view of the shot from the three callers. If they insist on seeing the result, let them, advising that it is not a pleasant sight. You should be aware that they are within their rights to use a mobile phone to video your actions.⇓
You should make notes of what has occurred and you could request that the student to do the same. This is a good exercise for a student and gives you another piece of useful documentation should you require it. It would probably be best to take the carcase away yourself and dispose of it.
The money is problematic. The three visitors called you out but, although you have performed the correct veterinary service, you have not done what they wanted – your reasoning being based on welfare grounds. You have the right to charge them since, in terms of contract, they made a request for veterinary services to which you agreed. However, there is a tradition in many rural practices to charge nominal or no fees for welfare matters like these, assuming they are one-off events, as it usually engenders goodwill.
Readers with views to contribute on ‘Immediate dispatch?’ should e-mail them to firstname.lastname@example.org as soon as possible so that they can be considered for publication in the next issue. The deadline for receipt of comments is Friday, May 29. Please limit contributions to 200 words.
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