Ethical and Practical Considerations Associated with Companion Animal Euthanasia.

The reality that euthanasia in veterinary practice can end animal suffering but can also be used in circumstances that do not serve an animal's interest, can be a benefit for animals, and a burden for veterinary professionals, respectively. This essay addresses ethical and practical concerns associated with companion animal euthanasia, including defining euthanasia, why and when euthanasia should be performed, applying euthanasia in practice, contemporary methods, aftercare of deceased animals, and the consequences of euthanasia and dysthanasia for animals, animal owners, and veterinary professionals. We contend that an intention-based definition of euthanasia should be strictly applied in veterinary practice and that practitioners view euthanasia decisions as requests that can (and in some cases should) be declined, rather than as mandates.

The Rise of Heatstroke as a Method of Depopulating Pigs and Poultry: Implications for the US Veterinary Profession.

Depopulation of food-producing animals is becoming increasingly common in response to both disease outbreaks and supply chain disruptions. In 2019, the American Veterinary Medical Association released depopulation guidelines classifying certain heatstroke-based killing methods as "permitted in constrained circumstances", when circumstances of the emergency constrain reasonable implementation of "preferred" methods. Since then, tens of millions of birds and pigs have been killed by such methods, termed ventilation shutdown (VSD) Plus Heat and VSD Plus High Temperature and Humidity. While no research using validated measures of animal welfare assessment has been performed on these methods, their pathophysiology suggests that animals are likely to experience pain, anxiety, nausea, and heat distress prior to loss of consciousness. Heatstroke-based methods may result in prolonged suffering and often do not achieve 100% mortality. Potential and available alternative depopulation methods are briefly reviewed. The veterinary profession's ethical obligation to protect animal welfare in the context of depopulations is discussed.

Veterinary Student Opinions Regarding Ethical Dilemmas Encountered by Veterinarians and the Benefits of Ethics Instruction.

Recognizing and addressing ethical conflicts is an emerging concern for veterinarians. Veterinary students (N = 284) from four US schools were surveyed regarding their opinions on ethical dilemmas encountered by veterinarians and the benefits of ethics instruction. The majority of respondents had encountered all clinical scenarios that may be associated with ethical dilemmas that were provided. The most common ethical dilemma experienced was compromise of patient care because of financial limitations. Students with at least 12 months of experience were more likely to believe that practitioners encounter ethical dilemmas regularly. Although 92% of 271 respondents indicated that veterinarians should prioritize patient interests when the interests of clients and patients conflict, 84% of respondents reported that veterinarians most often prioritize client interests. Most (78%) respondents indicated having received training in ethical theories and approaches to address ethical dilemmas. The majority of respondents agreed that they feel better prepared to identify (80%) and address (55%) ethical dilemmas as a result of their ethics training. Most respondents (81%) identified experiencing moral stress in relation to how animals were treated. Only 46% of respondents reported receiving training in tools for coping with moral stress. Most of these respondents (54%) agreed that such training would be effective in helping to manage moral stress. Results suggested that educators should prepare students for the contrast in advocacy preferences they are apt to encounter when they enter practice. It is recommended that ethics training and tools for coping with moral stress be core components of the veterinary curriculum.

Reply to the Comment from Watson, K.M. "Letter to the Editor Re: Kipperman, B.S. and German, A.J. Animals 2018, 8, 143" Animals 2018, 8, 179.

We appreciate the interest [1] in our opinion paper [2] regarding companion animal obesity and, although there is limited published evidence, agree that some pet owners might respond negatively when this issue is addressed [...].

The Responsibility of Veterinarians to Address Companion Animal Obesity.

Obesity is a modern-day epidemic in both people and companion animals. A summary of the current research on the causes, risk factors, consequences, and implications of overweight and obesity, and the compliance of small-animal practitioners in recognizing and addressing pet obesity, is provided. Ethical and animal welfare concerns are raised regarding these findings. We argue that a patient advocacy posture compels the veterinary profession to confront this issue more reliably. Evidence is presented to support obesity as a One-Health problem, and discrete and practical recommendations for preventing and addressing companion animal obesity are proposed. The One-Health perspective encourages coordinated action by veterinary healthcare professionals in order to address overweight and obesity in companion animals as a public health concern.

Ethical dilemmas encountered by small animal veterinarians: characterisation, responses, consequences and beliefs regarding euthanasia.

Small animal veterinarians' opinions were investigated regarding the frequency and nature of ethical dilemmas encountered, beliefs regarding euthanasia and balancing client and animal interests, prevalence and value of ethics training and proposals to mitigate the stressful effects of ethical dilemmas. The majority (52 per cent) of 484 respondents in the USA indicated via an online survey experiencing an ethical dilemma regarding the interests of clients and those of their patients at least weekly. Scenarios involving client financial concerns were commonly reported causes of ethical conflicts. While only 20 per cent of respondents indicated that other practitioners prioritise patient interests, 50 per cent of respondents characterised their own behaviour as prioritising patients. Most respondents (52 per cent) reported that ethical dilemmas are the leading cause, or are one of many equal causes, of work-related stress. Less experienced practitioners, general practitioners and associate veterinarians were more likely to encounter situations they defined as ethical dilemmas, and female respondents were more likely to find ethical dilemmas stressful. Most small animal veterinarians experience ethical dilemmas regularly, which contribute to moral stress. Results suggested that most small animal practitioners believe that greater awareness of moral stress and providing training in ethical theories and tools for coping with ethical dilemmas can ameliorate moral stress.

Factors that influence small animal veterinarians' opinions and actions regarding cost of care and effects of economic limitations on patient care and outcome and professional career satisfaction and burnout.

OBJECTIVE To determine small animal veterinarians' opinions and actions regarding costs of care, obstacles to client education about veterinary care costs, and effects of economic limitations on patient care and outcome and professional career satisfaction and burnout. DESIGN Cross-sectional survey. SAMPLE 1,122 small animal practitioners in the United States and Canada. PROCEDURES An online survey was sent to 37,036 veterinarians. Respondents provided information regarding perceived effects of client awareness of costs and pet health insurance coverage on various aspects of practice, the influence of client economic limitations on professional satisfaction and burnout, and proposals for addressing those effects. RESULTS The majority (620/1,088 [57%]) of respondents indicated that client economic limitations affected their ability to provide the desired care for their patients on a daily basis. Approximately half (527/1,071 [49%]) of respondents reported a moderate-to-substantial level of burnout, and many cited client economic limitations as an important contributing factor to burnout. Only 31% and 23% of respondents routinely discussed veterinary costs and pet insurance, respectively, with clients before pets became ill, and lack of time was cited as a reason for forgoing those discussions. Most respondents felt improved client awareness of veterinary costs and pet health insurance would positively affect patient care and client and veterinarian satisfaction. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested most small animal practitioners believe the veterinary profession needs to take action at educational and organizational levels to inform pet owners and educate and train veterinary students and veterinarians about the costs of veterinary care.