Quality of life model 'consults' the patient

If Dr. Franklin McMillan, companion animal practitioner in Los Angeles,had his wishes, he would never hurt an animal's feelings.

Based on a "leap of faith" that animals have feelings, McMillanis developing a one-of-a-kind quality of life model.

He describes it as a balancing scale of the range of feelings animalshave.

"These feelings are physically based - nausea, pain associated withdisease, or emotionally based - fear, anxieties," says McMillan.

Don't tip the scales

The goal of the model is to balance the pleasant and unpleasant feelingsin an animal's life.

"As a goal of medical care, quantity of life has value in its abilityto marshal the strongest efforts at effective treatment, but it has becomeincreasingly clear that the benefits to the patient are best judged by adifferent yardstick: the preferences of the patient themselves," saysMcMillan.

McMillan first presented his findings in a paper published in the Journalof the American Veterinary Medical Association in 2000. He has since modifiedthe model to include the balance of the scales and unpleasant feelings.

A review of other veterinary medical literature demonstrates that qualityof life is currently only being equated to health status in veterinary patients,according to McMillan.

"Quality of life addresses all spheres of one's life, health issuesbeing just one of these," he says.

No thermometer

His revised quality of life model is not a revelation, says McMillan,just an explanatory view on how to improve life overall.

"I don't have a quality of life thermometer that I can offer youto take home. You're still left with making your best estimations as a doctorand a pet owner of all these pleasant and unpleasant feelings," saysMcMillan.

He adds, "Compounding the complexity of quality of life is its subjectivenature, which renders it elusive of precise measurement and quantification."

Lone researcher

At this time, McMillan claims no one has written on this specific matterfor veterinary medicine.

In human medicine in the last 20 years, research on quality of life hasmade great strides. Additionally, papers on animal welfare have overlappedhis model of weighing animals' feelings.

"As of right now, other than my animal model in the veterinary literature,there's nothing else to go on. What I'm trying to achieve is to have a betterconceptual model, which can be amended or rejected with further researchand debate," says McMillan.

The newer model is designed to have more take-home value for pet ownersand practitioners to get an overview of the pet's quality of life. He'snow working to incorporate euthanasia into the model.

"These ideas are not in a complete vacuum. I draw all my writingsstrongly from what's been done in people, such as human infants, where thepatient can't communicate what they're feeling. Then I formulate my ownmodels."

The applicability to practitioners and pet owners is for them to seemore clearly how quality of life is affected, what factors contribute toit, and what's going on in an animal's life to increase or decrease thequality of life.

For example, McMillan says unpleasant feelings appear to have evolvedto be associated with threats to well-being and life.

"These feelings alert the animal to threats, focus attention onimportant stimuli, and motivate the animal to take self-protective actionto lessen the threat," he says.

"The feelings that push you and me in every possible direction areguiding us to do the right thing for our wellbeing. Animals have those sameneeds. The belief that animals have feelings is based on a tremendous amountof research on how they behave during certain circumstances," saysMcMillan.`