"How long is life worth living for the horse?" A focus group study on how Austrian equine stakeholders assess quality of life for chronically ill or old horses.

BACKGROUND: Quality of life (QoL) provides a comprehensive concept underpinning veterinary decision-making that encompasses factors beyond physical health. It becomes particularly pertinent when seeking responsible choices for chronically ill or old horses that emphasise their well-being and a good QoL over the extension of life. How different stakeholders use the concept of QoL is highly relevant when considering the complexity of these decisions in real-life situations. METHODS: Seven focus group discussions (N = 39) were conducted to gain insights into how stakeholders assess and use equine QoL in veterinary care decisions for chronically ill and/or old horses. The discussions included horse owners (n = 17), equine veterinarians (n = 7), veterinary officers (n = 6), farriers (n = 4), and horse caregivers (n = 5). The combination of deductive and inductive qualitative content analysis of the group discussions focused on identifying both similarities and differences in the views of these groups regarding QoL for old and/or chronically ill horses. RESULTS: Findings show agreement about two issues: the importance of the individuality of the horse for assessing QoL and the relevance of QoL in making decisions about veterinary interventions. We identified differences between the groups with respect to three issues: the time required to assess QoL, stakeholders' contributions to QoL assessments, and challenges resulting from those contributions. While owners and caregivers of horses emphasised their knowledge of a horse and the relevance of the time they spend with their horse, the veterinarians in the study focused on the differences between their own QoL assessments and those of horse owners. In response to challenges regarding QoL assessments and decision-making, stakeholders described different strategies such as drawing comparisons to human experiences. CONCLUSIONS: Differences between stakeholders regarding equine QoL assessments contribute to challenges when making decisions about the care of chronically ill or old horses. The results of this study suggest that individual and collaborative reflection about a horse's QoL should be encouraged, for example by developing practicable QoL assessment tools that support relevant stakeholders in this process.

Mission impossible accomplished? A European cross-national comparative study on the integration of the harm-benefit analysis into law and policy documents.

The harm-benefit analysis (HBA) is a cornerstone of the European Directive 2010/63/EU (the Directive). The Directive regulates the care and handling of animals used for scientific purposes in the European Union (EU). Since its implementation, there has been ongoing debate around the practical applicability of the HBA for research project review processes. The objectives of this study are to analyze the operationalization of HBA in EU member states and investigate the consistency of HBA's implementation in terms of national legislation and available policy documents. To meet these objectives, we evaluated the transposition of the HBA requirement into national legislation. We also conducted a comprehensive comparative cross-national analysis of all guidance documents pertinent to HBA. The results of our study show that there are (1) deficits in the transposition of the HBA requirement into national laws, (2) significant discrepancies in available policy documents relating to HBA, and (3) insufficiently consistent implementations of HBA in European countries.

What Is Wrong with Eating Pets? Wittgensteinian Animal Ethics and Its Need for Empirical Data.

Wittgensteinian approaches to animal ethics highlight the significance of practical concepts like 'pet', 'patient', or 'companion' in shaping our understanding of how we should treat non-human animals. For Wittgensteinian animal ethicists, moral principles alone cannot ground moral judgments about our treatment of animals. Instead, moral reflection must begin with acknowledging the practical relations that tie us to animals. Morality emerges within practical contexts. Context-dependent conceptualisations form our moral outlook. In this paper, we argue that Wittgensteinians should, for methodological reasons, pay more attention to empirical data from the social sciences such as sociology, psychology or anthropology. Such data can ground Wittgensteinians' moral inquiry and thereby render their topical views more dialectically robust.

Advancing the 3Rs: innovation, implementation, ethics and society.

The 3Rs principle of replacing, reducing and refining the use of animals in science has been gaining widespread support in the international research community and appears in transnational legislation such as the European Directive 2010/63/EU, a number of national legislative frameworks like in Switzerland and the UK, and other rules and guidance in place in countries around the world. At the same time, progress in technical and biomedical research, along with the changing status of animals in many societies, challenges the view of the 3Rs principle as a sufficient and effective approach to the moral challenges set by animal use in research. Given this growing awareness of our moral responsibilities to animals, the aim of this paper is to address the question: Can the 3Rs, as a policy instrument for science and research, still guide the morally acceptable use of animals for scientific purposes, and if so, how? The fact that the increased availability of alternatives to animal models has not correlated inversely with a decrease in the number of animals used in research has led to public and political calls for more radical action. However, a focus on the simple measure of total animal numbers distracts from the need for a more nuanced understanding of how the 3Rs principle can have a genuine influence as a guiding instrument in research and testing. Hence, we focus on three core dimensions of the 3Rs in contemporary research: (1) What scientific innovations are needed to advance the goals of the 3Rs? (2) What can be done to facilitate the implementation of existing and new 3R methods? (3) Do the 3Rs still offer an adequate ethical framework given the increasing social awareness of animal needs and human moral responsibilities? By answering these questions, we will identify core perspectives in the debate over the advancement of the 3Rs.

Between Leisure and Pressure-Veterinarians' Attitudes towards the Care of Competition Horses in Germany, Austria and Switzerland.

Equine veterinarians face a range of challenges when attending competition horses. Athletic goals may significantly impact veterinary decision making, and the veterinarian's work can be complicated by reputational considerations and rival opinions during an assessment of whether a horse is "fit to compete". Using an online questionnaire, we found that the majority of German, Austrian and Swiss equine veterinarians (N = 172) surveyed agreed that the owners of competition horses are more likely than owners of leisure horses to approach them with clear treatment ideas, and that the former have higher expectations of the medical services provided. The data also show that the veterinarian's reputation plays a more important role in the competition sphere. Using a case vignette, we established that, on the grounds of equine welfare, the majority of respondents indicated that they would decide against starting a dressage horse with low-grade lameness in a competition. Those respondents who indicated that they would approve a start of the dressage horse indicated that a horse with a low-grade lameness was fit enough "to compete". We conclude that clearer definitions of phrases, such as "fit to compete", may be helpful in guiding veterinarians as they discharge their professional responsibilities during competitions and reduce the reputational stress they experience in this working context.

Putting the Questions First-Flipped Classroom Methods in Animal Ethics Online Teaching and Its Evaluation.

Despite the challenges the pandemic presented for university teaching, it opened up opportunities to set up and explore digital teaching formats like never before. This paper presents a case study of teaching introductory animal ethics in a digital format with flipped-classroom methods. The Interactive Literature Lecturing Format (ILLF) was designed along the following criteria: 1. Conformity with students' varying educational needs; 2. Consistent high level of interaction; 3. Maximum transparency in an application-oriented exam; 4. No further contribution to the workload of the teaching staff; 5. Flexibility regarding online or on-site conversions. Rather than provide the students with input in lecture sessions, the ILLF presents students with selected literature and a list of structured questions. This literature questionnaire serves as the main didactic element that guides the knowledge transfer, the structure of the sessions and the exam. This paper reviews the outcome of the redesigning process and the steps we took to implement it. To discuss the overall quality of the format from a student's perspective, the data from the systematically conducted students' evaluation (n = 65) are interpreted using quantitative and qualitative methods. Bringing these results together with the perspective of the teaching staff, the following question is discussed: did the ILLF meet these criteria? This case study explores the potential and limits of flipped-classroom methods for applied ethics teaching in a university setting.

Compete or Cooperate with 'Dr. Google'? Small Animal Veterinarians' Attitudes towards Clients' Use of Internet Resources-A Comparative Study across Austria, Denmark and the UK.

Veterinary medicine is increasingly affected by animal owners having the opportunity to become better informed on pet health issues by using various internet resources. Using an online questionnaire including a section on clients' use of internet resources to obtain medical information, this study aimed to investigate veterinarians' estimates of the percentage of clients using internet resources, how often clients question veterinarians' professional medical advice based on online information, and veterinarians' attitudes towards clients' use of internet resources, across Austrian, Danish, and UK veterinarians (n = 641). The results show that 48.8% of respondents estimated that 40-79% of their clients use internet resources to find medical information. Further, 70-80% of respondents stated that they are occasionally challenged by clients questioning their advice based on online information. Although veterinarians recognized the potential advantages related to clients' use of internet resources, such as an increased acceptance of advanced diagnostics and treatments, they also highlighted clients' increased expectations or false impressions of small animal practices as potentially negative aspects in this context. As internet use increases, it seems likely that these issues will become increasingly important in the future.

Quality of Life within Horse Welfare Assessment Tools: Informing Decisions for Chronically Ill and Geriatric Horses.

Equine Quality of Life (QoL) is an important concern in decision making in veterinary medicine and is especially relevant for chronically ill or geriatric horses towards the end of their lives. To our knowledge, there is no currently available QoL assessment tool for chronically ill or geriatric horses that assesses equine QoL defined as the horse's evaluation of their life. However, tools exist to assess equine welfare in different contexts. Hence, the aims of this study were to analyse how equine welfare, QoL, well-being and happiness assessment tools label, define and operationalise the concepts and to discuss the tools' suitability to assess equine QoL in the context of end-of-life decisions for chronically ill or geriatric horses. Fourteen articles were found through a systematic literature search, describing ten equine welfare assessment tools and one approach to integrating equine QoL in veterinary practice that suggests QoL assessment parameters. We discuss that some welfare assessment tools have the potential to support the development of a QoL assessment tool informing decisions towards the end of horses' lives if they are adjusted to focus on the horses' experiences, to provide an integration into an overall QoL grade and are tailored to chronically ill or geriatric horses.

Digital opportunities to connect and complain - the use of Facebook in small animal practice.

BACKGROUND: Social media is increasingly used in small animal practice, enabling veterinarians to connect with clients and promote their business online. It can also be used by clients to quickly distribute complaints via online communities. MATERIAL/METHODS: Using a questionnaire study we investigated Austrian, Danish and UK veterinarians' attitudes towards Facebook, the contents of clients' online complaints and how they were handled by veterinarians (N = 648). RESULTS: In Denmark and the UK, around 90% of practices had a Facebook page, in contrast to 40% of Austrian practices. Most Danish and UK veterinarians agreed that the use of Facebook was relevant and expected by clients. Agreement was lower among Austrian veterinarians, probably reflecting the lower uptake of social media there. In particular, younger veterinarians and those who actively used Facebook for the practice, could see benefits. In all three countries, we found that clients most frequently complained about treatment costs. Most veterinarians preferred to actively deal with clients' complaints, either replying online or discussing them directly. CONCLUSIONS: We recommend future research focusing on veterinarians' personal use of social media and on clients' use of and attitudes towards social media in the veterinary context.

Comparing veterinarians' attitudes to and the potential influence of pet health insurance in Austria, Denmark and the UK.

BACKGROUND: Health insurance offers many benefits to clients and veterinarians, such as the ability to perform necessary and possibly cost-intensive medical interventions without financial constraints, or to potentially prevent euthanasia based on financial challenges. However, concerns about negative consequences, such as the overuse of diagnostic tests or overtreatment, have also been raised. METHODS: Using an online questionnaire distributed via e-mail, which included a section on health insurance, we investigated the relative number of insured dogs and cats treated by Austrian, Danish and UK veterinarians (N = 636) and the attitudes of those veterinarians toward health insurance. Further, using a case vignette, we examined whether coverage by health insurance may influence treatment suggestions. RESULTS: Even though veterinarians in all three countries believe that health insurance reduces stress since clients' financial resources will be less important, we found that Austrian veterinarians are more likely to agree that health insurance is unnecessary compared to Danish and UK veterinarians. Further, many raised the concern that insurance policies influence clinical decisions; and less than half supported the idea of making insurance mandatory. A majority of veterinarians in Austria and the UK thought that insurance can lead to the overuse of diagnostic tests, and in the UK a majority also thought that it can lead to overtreatment. Using case vignettes, we found that veterinarians were significantly more likely to suggest a CT scan to a client with an insured animal, in contrast to a client with stated financial limitations. Further, UK veterinarians were more likely to suggest a CT scan to a client with an insured animal, in contrast to a client without insurance. CONCLUSION: In conclusion, we found that veterinarians, in general, were in favour of health insurance, and that greater coverage may increase more cost-intensive veterinary care. Our findings also raise a potential ethical challenge of health insurance causing differential access to clinical care for patients.

Recumbency as an Equine Welfare Indicator in Geriatric Horses and Horses with Chronic Orthopaedic Disease.

Recumbency is a prerequisite for horses achieving rapid eye movement (REM) sleep and completing a full sleep cycle. An inability to lie down due to environmental insecurities or pain results in REM sleep deficiency, which can cause substantial impairment of welfare and health. Therefore, the present study used wearable automated sensor technology on 83 horses housed in an animal sanctuary to measure and compare the recumbency, locomotion, and standing time budgets of geriatric horses with and without chronic lameness to younger adult sound and lame horses. Recumbency times ranged from 0 to 319 min per day with an overall mean of 67.4 (±61.9) minutes; the time budget for locomotion was 19.1% (±11.2% s.d.) and for standing 75.6% (±13.1 s.d.). Interestingly, neither age nor lameness due to chronic orthopedic disease had a significant influence on recumbency times in this study. Eight horses showed symptoms of REM deficit. These horses had significantly shorter lying times (7.99 ± 11.4 min) and smaller locomotion time budgets than the other horses enrolled in this study (73.8 ± 61.8 min), indicating a general compromise of well-being. Thus, wearable sensor technology can be used to identify horses with low recumbency times at risk for REM sleep deficiency and to assess and monitor equine welfare objectively.

Equine Activity Time Budgets: The Effect of Housing and Management Conditions on Geriatric Horses and Horses with Chronic Orthopaedic Disease.

Housing and management conditions strongly influence the health, welfare and behaviour of horses. Consequently, objective and quantifiable comparisons between domestic environments and their influence on different equine demographics are needed to establish evidence-based criteria to assess and optimize horse welfare. Therefore, the present study aimed to measure and compare the time budgets (=percentage of time spent on specific activities) of horses with chronic orthopaedic disease and geriatric (≥20 years) horses living in different husbandry systems using an automated tracking device. Horses spent 42% (range 38.3-44.8%) of their day eating, 39% (range 36.87-44.9%) resting, and 19% (range 17-20.4%) in movement, demonstrating that geriatric horses and horses suffering from chronic orthopaedic disease can exhibit behaviour time budgets equivalent to healthy controls. Time budget analysis revealed significant differences between farms, turn-out conditions and time of day, and could identify potential areas for improvement. Horses living in open-air group housing on a paddock had a more uniform temporal distribution of feeding and movement activities with less pronounced peaks compared to horses living in more restricted husbandry systems.

Managing conflicting ethical concerns in modern small animal practice-A comparative study of veterinarian's decision ethics in Austria, Denmark and the UK.

Small animal veterinarians frequently have to manage conflicting interests. Beside the key consideration of the patient's interests, small animal veterinarians are often challenged to consider not only client's emotional needs, but also their own personal aspirations to provide quality patient care and to make a good living as a professional. Further, veterinarians have an interest in continuous professional development and the use of the newest treatments, which may influence their decision-making process. Based on published work, we hypothesize the existence of four decision ethics orientations that veterinarians can use to manage potentially conflicting concerns. These are: the patient-focused, the client-empathetic, the client-devolved and the development-oriented decision ethics orientations. We surveyed small animal veterinarians in Austria, Denmark, and the UK using a questionnaire (N = 648), and successfully identified the four decision ethics orientations in all three countries. The patient-focused and client-empathetic decision ethics orientations are salient in all countries, whereas Danish and UK veterinarians are slightly more client-empathetic and client-devolved compared to their Austrian colleagues. Across countries our findings show that experienced and older veterinarians tend to be more client-empathetic. Younger and less experienced professionals are more development-oriented compared to their older and more experienced colleagues. In contrast to other studies investigating ethical issues in small animal practice, we found no evidence that gender plays a decisive role in the tendency towards any decision ethics orientation. We also show that veterinarians with a higher client-empathetic orientation and development-orientation more often discuss the possibility of health insurance with clients who do not have it. The present study provides a first empirical insight into how veterinarians manage challenging expectations and ethical concerns as part of decision making in modern small animal practice.

Navigating Uncertainties: How to Assess Welfare and Harm in Genetically Altered Animals Responsibly-A Practical Guideline.

The use of animals in research requires careful ethical consideration of whether the burden on the animals is justified. As one important part of the project evaluation, a harm-benefit analysis (HBA) must be carried out in order to approve projects in line with the EU Directive 2010/63/EU. This implies that harms and benefits must be assessed prospectively beforehand in order to weigh them. Although there are different methods of weighing, it is clear that an assessment of prospective harms and benefits is a precondition for any weighing procedure. In this context, projects that use genetically altered (GA) lines raise new issues. A unique challenge when using GA lines is the significant lack of knowledge in this context, making it difficult and sometimes impossible to estimate harm prospectively with sufficient certainty, since it is not predictable what sort of harm-if at all-the animals are going to experience. Therefore, this contribution aims to deal with the challenges of harm assessment in GA animals and their implications for welfare assessment and the HBA. A practical guideline is presented herein to serve as guidance for relevant harm factors and address the main challenges, particularly when dealing with uncertainties in the process of HBA.

Reevaluating Benefits in the Moral Justification of Animal Research: A Comment on "Necessary Conditions for Morally Responsible Animal Research".

In a recent paper in Cambridge Quarterly of Healthcare Ethics on the necessary conditions for morally responsible animal research David DeGrazia and Jeff Sebo claim that the key requirements for morally responsible animal research are (1) an assertion of sufficient net benefit, (2) a worthwhile-life condition, and (3) a no-unnecessary-harm condition. With regards to the assertion (or expectation) of sufficient net benefit (ASNB), the authors claim that morally responsible research offers unique benefits to humans that outweigh the costs and harms to humans and animals. In this commentary we will raise epistemic, practical, and ethical challenges to DeGrazia and Sebo's emphasis on benefits in the prospective assessment of research studies involving animals. We do not disagree with DeGrazia and Sebo that, at the theoretical level, the benefits of research justify our using animals. Our contribution intends to clarify, at the practical level, how we should understand benefits in the prospective assessment and moral justification of animal research. We argue that ASNB should be understood as an assessment of Expectation of Knowledge Production (EKP) in the prospective assessment and justification of animal research. EKP breaks down into two further claims: (1) that morally responsible research generates knowledge worth having and (2) that morally responsible research is designed and executed to produce generalizable knowledge. We understand the condition called knowledge worth having as scientists' testing a hypothesis that, whether verified or falsified, advances an important interest, and production of generalizable knowledge in terms of scientific integrity. Generalizable knowledge refers to experimental results that generalize to a larger population beyond the animals studied. Generalizable scientific knowledge is reliable, replicable, and accurately descriptive. In sum, morally responsible research will be designed and carefully executed to successfully test a hypothesis that, whether verified or falsified, advances important interests. Our formulation of EKP, crucially, does not require further showing that an experiment involving animals will produce societal benefits.

An Alternative to the Orthodoxy in Animal Ethics? Limits and Merits of the Wittgensteinian Critique of Moral Individualism.

In this paper, we analyse the Wittgensteinian critique of the orthodoxy in animal ethics that has been championed by Cora Diamond and Alice Crary. While Crary frames it as a critique of "moral individualism", we show that their criticism applies most prominently to certain forms of moral individualism (namely, those that follow hedonistic or preference-satisfaction axiologies), and not to moral individualism in itself. Indeed, there is a concrete sense in which the moral individualistic stance cannot be escaped, and we believe that it is this particular limitation that justified Crary's later move to a qualified version of moral individualism. At the same time, we also argue that there are significant merits to the Wittgensteinian critique of moral individualism, which pertain to its attack on the rationalism, naturalism, and reductionism that characterise orthodox approaches to animal ethics. We show that there is much of value in the Wittgensteinians' call for an ethics that is more human; an ethics that fully embraces the capacities we are endowed with and one that pays heed to the richness and complexity of our moral lives.

"Patients' interests first, but "⁻Austrian Veterinarians' Attitudes to Moral Challenges in Modern Small Animal Practice.

Small veterinary practice is experiencing steady improvement in diagnostics and therapies which enable veterinarians to offer evermore advanced medical care for their patients. This focus group study of veterinarians (n = 32) examined the impact of these improvements and the potential challenges they introduce in small animal practice. It shows that while advanced diagnostics and therapies deliver benefits in patient care, they also add complexities to decision-making. Although the veterinarians participating in the study were aware of their duty to act in the best interests of the animal, their decisions were highly dependent on factors such as the client's financial background and the emotional bond between client and animal, as well as the veterinarian's place of work, and level and field of specialization, and certain economic aspects of the practice. The overall conclusion is that small animal veterinarians are increasingly torn between serving the best interests of the animal, medical feasibility and contextual factors related to the client, the veterinarian, and professional colleagues. Further, the findings suggest that services are not only oriented towards the provision of medical care in a strict medical sense. On top of this, veterinarians need to deal with various expectations and wishes of clients which influence their decision-making. As it will be shown, factors like the possibility of referring patients to specialist veterinarians or prompt diagnostic results influence their decision-making.

Austrian Veterinarians' Attitudes to Euthanasia in Equine Practice.

Euthanasia of companion animals is a challenging responsibility in the veterinary profession since veterinarians have to consider not only medical, but also legal, economic, emotional, social, and ethical factors in decision-making. To this end; an anonymous questionnaire-based survey of Austrian equine veterinarians examines the attitudes to the euthanasia of equine patients in a range of scenarios; to identify factors which may influence decisions on the ending of a horse's life. This paper describes the distributions of demographic and attitude variables. Mann-Whitney U tests were used to test the associations of gender, work experience, and equine workload with attitudes in relation to euthanasia statements and case scenarios. In total, 64 respondents (response rate = 23.4%) completed the questionnaire. The study showed that veterinarians consider contextual and relational factors in their decision-making. They are aware of owners' emotional bonds with their horses and financial background, however, requests for convenience euthanasia are typically rejected. Although some significant differences between the tested variables emerged, the attitudes of the veterinarians were shown to be largely shared. In conclusion, veterinarians are aware of the multiple factors that influence their decision-making and gave indications as to the weight of animal- and owner-related factors in the handling of euthanasia.