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Comments on the dilemma in the April issue: Euthanasing treatable patients
  1. Steven McCulloch

Abstract

In the dilemma discussed in the April issue of In Practice, a recently employed veterinary surgeon is informed by their employer that the practice has a policy of only euthanasing patients who are terminally ill and suffering; it will not kill healthy or treatable patients. While the veterinary surgeon believes the policy is sincerely held, they wonder if it is fair. Does the practice's policy infringe on the veterinary surgeon's moral choice, and should he challenge it? (IP, April 2017, vol 39, pp 190-191). Simon Coghlan suggested that the veterinary surgeon was entitled to discuss their moral concerns with the employer. This discussion may foster mutual understanding, and even improve the policy and details of its implementation. He also suggested that the employer should have informed the veterinary surgeon before they began work at the practice, to show greater respect for the veterinary surgeon's moral autonomy.

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Simon Coghlan's article is an interesting one and raises important issues. Poll respondents were divided with a majority leaning toward the practice euthanasia policy being unjustifiable. In the poll, 17 per cent support practice policy, 25 per cent support if staff are made aware at time of employment, and 58 per cent believe vets should have full discretion.

The moral conflict in Dr Coghlan's scenario is between the employer's rights to make rules, based on his/her moral conscience, on euthanasia, and employed veterinarians' rights to full autonomy in euthanasia decision making. The employer's conditions for morally justifiable euthanasia (MJE) are the patient is terminally ill and the patient is suffering. Dr Coghlan also writes that staff are told to decline requests to kill healthy or treatable patients. Let us consider for now that all cases of MJE are not healthy or treatable patients, and that all healthy or treatable patients are not MJE (the issue is in fact more complex, as can be seen in the aggression example below). Furthermore, consider as a thought experiment that the conditions outlined in MJE (and therefore decline requests to kill healthy or treatable patients) are objectively morally right in all possible clinical scenarios. If this were the case, it would seem unnecessary to claim that the vet should have discretion (ie, autonomy) in decision making. This is simply because, in our thought experiment, MJE is morally right in all cases. Hence, vet autonomy is at best superfluous, and at worst susceptible to making human errors of judgement.

Given the above, the 58 per cent of respondents polled who believe vets should have discretion presumably hold that MJE is not morally right in all cases. It might be claimed, for instance, that painless death is not actually a moral harm to non-human veterinary patients. Additionally, it might be argued that although the patient does not satisfy MJE and/or is healthy or treatable, morally relevant circumstances mean that the patient ought to be euthanased, all things considered. For example, the patient might have an aggression problem that is not treatable (an example of a non-terminal condition which is also not treatable). Again, and perhaps more commonly, the patient might have a condition that is treatable, but where the owner does not have the financial means to pay for the treatment. Hence, respondents supporting full vet autonomy might argue that the conditions for MJE outlined by the employer are not sufficient to cover all cases where euthanasia is in reality the right course of action.

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