A team from the US have developed a first-of-its-kind veterinary ethics committee to help care providers navigate complex situations.
A paper describing the committee’s formation is published in this month’s The American Journal of Bioethics.
Advances in veterinary technology provide pet owners with an ever-increasing array of treatment options for their pets. However, more options can lead to complex situations and difficult questions about care goals and quality of life that must be navigated by veterinary caregivers and pet owners.
“Even though everyone involved in an animal’s case is trying to act in the animal’s best interest, determining the best course moving forward can lead to conflicts and that can be distressing for the people involved,” veterinary social worker at NC State Jeannine Moga said.
“I wanted to find an ethics-based way to help our hospital staff address differences and form consensus in these cases.”
To this end Moga contacted Dr Philip Rosoff, pediatric oncologist and director of the clinical ethics program at Duke University Hospital, for guidance and advice on how to proceed.
“The establishment and growth of veterinary specialty hospitals for very sick animals is a relatively recent phenomenon,” Dr Rosoff said.
“It’s not surprising that veterinary hospitals also now see the need for ethics committees to mediate and adjudicate disputes about care.”
Together Moga, Dr Rosoff and Bruce Keene, a professor of Companion Animal Medicine at NC State, adapted human ethics committee guidelines currently in use to address issues in a veterinary hospital, to create NC State’s first Clinical Ethics Committee (CEC).
“The pediatric model works very well for our situation in veterinary medicine,” Keene said. “In both cases, you’re dealing with a patient who cannot advocate for him or herself, and a decision-maker who is very involved in the process. However, we do deal with some thorny issues —such as euthanasia—that human hospitals do not.”
The CEC consists of seven people: three doctors, three veterinary technicians and a social worker. When cases arise, as many as four or as few as two members of the committee meet with the veterinary patient’s care team to serve as a resource or a sounding board. The entire process operates independently from the academic and business aspects of the NC State veterinary hospital to avoid conflicts of interest.
The CEC formed in late 2016 and as of December 2017 had worked on seven cases. While the CEC currently serves veterinary clinicians, staff and students, Moga hopes to expand its availability to hospital clients in the near future.
“Our job is not to make treatment recommendations,” Moga said. “We are there to make sure that any ethical issues raised are dealt with openly and fairly. Sometimes it’s as simple as just getting everyone in the same room to hash things out.
“Figuring out which medical options are feasible and ethical in a way that also respects client autonomy can be difficult but dealing with ethical issues pre-emptively rather than reactively is in everyone’s best interest.”