Pets are routinely denied basic veterinary care and this is not okay!
From stem cell transplants, to prosthetic limbs, to linear accelerators and radiotherapy cancer treatments, the range of veterinary services available to sick or disabled animals is growing exponentially. On the face of it, the expansion of services and treatments is a good thing, for animals and caregivers and veterinarians alike. Yet as we’ve seen in human medicine, the expansion of options is not an unalloyed good.
Perhaps most obviously, more treatment options translate into more yes-or-no decisions that must be made by clients. There is a saying in medicine: Just because you can, doesn’t mean you should. But as we know from our experiences in human medicine, it is much harder to decline an available treatment than not to have the treatment available in the first place. A deliberate “no” may feel like a failure, or the lack of love or caring. It is worth reminding clients that sometimes declining a treatment is the most compassionate choice, and that saying no to a particular treatment is not saying no to care.
A greater range of treatment options—particularly those that are expensive and complex—also means that some people will be able to offer their animals a great deal, while others will not. More and more pet owners will be “priced out,” and will decline treatments that might benefit their animal. In human medicine, there is broad consensus that no one has a right to access every single possible medical treatment. There will be differences in what people can afford and what they are willing to pay—and there is nothing inherently unfair about this. There is, however, a threshold of care below which it is considered indecent to fall. Policy makers agree, for example, that basic life-saving treatments (e.g. antibiotics) that are widely available and inexpensive must ethically be provided to all patients, as must adequate medication for pain.
Is there an “indecency line” for animals? At this time, no—at least not legally. Pet owners can choose to forego even antibiotics and pain pills for their ailing animals. Without broad-scale pet insurance, without some government subsidized care, and without laws enforcing basic standards of veterinary care, there is no safety net for animals. Disparities in access to care are inevitable within veterinary medicine, as well, and are not inherently unethical. Still, as a matter of fairness, all animals should have access to a decent minimum of care.
Veterinarians–including hospice veterinarians–will invariably be asked to euthanize animals who they judge to still have good quality of life and reasonable life expectancy. A large number of animals will meet an untimely end because the costs of keeping them healthy are “too much,” whatever this nebulous number happens to be for an individual pet owner. Animals are often euthanized in lieu of veterinary treatments, to keep costs down, either when an animal needs acute veterinary attention or is diagnosed with a chronic condition and veterinary bills start adding up. Owners are allowed a great deal of discretion, and although some people might consider you distasteful if you throw your animal under the bus at the first sign of financial pain, it is common enough and quite legal.
A veterinarian may refuse to perform euthanasia in situations where he or she feels that the request is inappropriate and not in the best interests of the animal.There has been some push to make convenience euthanasia—the killing of a healthy animal without reasonable justification—challengeable under animal cruelty laws. Courts have found ways to invalidate requests to euthanize a healthy animal, when it is part of a dead person’s will. But they have not yet challenged euthanasia at the request of a living, present client. It is high time for this to happen.
Animal law scholar Susan Hankin suggests that anti-cruelty statutes could also become a viable way to challenge owner discretion in providing—or failing to provide—needed veterinary care. If animal cruelty statutes were to require “proper veterinary care” this may allow a mechanism for challenging egregious owner choices, such as euthanasia of a healthy animal for the sake of convenience, or failure to provide basic pain relief. This kind of legislative protection for animals will be difficult to achieve as long as they have essentially no legal standing and are merely ‘property.’ But companion animals desperately need better care. (And they need professional groups such as the American Veterinary Medical Association to endorse greater legal protections for animals.)
The increasing range of options for caregivers of companion animals should be celebrated. And it should also remind us that although there can be too much of a good thing, there can also be too little. Although some companion animals are receiving better care than some people in our country, far too many are denied basic care like dental hygeine, antibiotics, and treatment for pain. Pet owners should not have full discretion over veterinary choices, or non-choices, for their animals.