Rollin Uncensored

Euthanasia and adequate control of pain top the list of ethical dilemmas for this decade.

It is about deciding life and death. Consider this: Veterinary medicine is the only medical profession sanctioned to humanely kill. And as technology's advancement and medical delivery systems march forward, veterinarians are faced with an ever-increasing ethical dilemma on when to recommend euthanasia and when to deny it.

Dr. Bernard E. Rollin, considered one of the foremost experts in animal ethics and distinguished professor of philosophy at Colorado State University's Departments of Philosophy and Biomedical Sciences, talked with DVM Newsmagazine about the ethical questions faced by veterinarians on issues like euthanasia, control of pain and distress, and animal welfare.

Bernard Rollin, philosopher and ethicist, wants veterinarians and lawmakers to "re-appropriate common sense" when it comes to animal welfare.

Rollin won the Henry Spira Award last fall, one of only three recipients in the world to achieve such an honor from the Johns Hopkins Center for Alternatives to Animal Testing. And while the flamboyant, sometimes outspoken Rollin attests that advancements in all three areas are transparent, there's still plenty of room to improve.

"I think that an animal can't value life in itself. If you and I, God forbid, were stricken with cancer, we can say, 'Well, I will go through six months of chemo hell because it might buy me five or 10 more years. An animal doesn't seem to have the intellectual apparatus to form that notion. It cannot postpone future benefits for its current pain." But humans do.

With it comes the inherent responsibility of choosing the risk/benefits of treatment versus quality of life, Rollin says.

"When an animal is subjected to lots of surgeries, radiation and chemotherapy, it isn't because the animal wants to live longer," he says. "So, there is an issue of how much you are doing it for the animal and how much you are doing it for the owner's own selfish needs."

A doctor takes an oath to save and extend life. It's the ethical dilemma that every veterinarian and pet owner must face when treating a sick or injured animal. How far do you go with medical treatment?

While Rollin dubs it an ethical judgment call in each case, the dilemma should be focused on alleviating pain and suffering and improving the patient's quality of life no matter which option is pursued.

Rollin recalls an example. "A friend of mine came up to me and said, 'My dog was just diagnosed with cancer.' He asked: 'How do I know when to pull the plug? I am willing to spend the money on treatment.' I told him to go and talk it over with his wife and family and write down as many things that you can about when the dog is happy. Then, I told them to put it away. As treatment progresses, pull it out and use it as a measure of whether or not that animal has a decent life."

His friend later thanked him because the test made him and his family realize that even though the animal's quality of life had diminished so greatly, they held on to the emotions that they couldn't bear to lose the dog.

And yet another segment of society is far too quick to shed it ownership responsibilities.

Why are we, as a society, still killing millions of healthy animals a year? Rollin asks.

"Spay/neuter hasn't worked. What is our next approach? What is the answer?

"I think people should be forced to demonstrate that they know what they are getting into before they purchase or adopt an animal. You know damn well that someone sees Turner and Hooch and they decide they want a Tibetan Mastiff or whatever breed it was. They go to the store and buy it, and they discover that this is a high-maintenance aimal... They just take it to the pound and hope it gets a good home."

And while veterinarians might not have made the decision to purchase the animal, they can certainly help stave off relinquishment in other ways, such as offering behavioral training or client counseling on the realities of pet ownership, yet another philosophical consideration.

"There are plenty of ethical issues in veterinary medicine, and the teaching and discussion has not kept up with the proliferation of issues," he adds.

Take animal welfare, for example. In recent years, concerns about traditionally accepted agriculture practices are being challenged, and it puts veterinary medicine squarely in the middle. "The phrase I used in front of Congress once: I just want to re-appropriate common sense."

Rollin adamantly believes that veterinary medicine must unite in its message, even if it alienates traditionally strong allied groups, like agriculture or even the biomedical research community.

Foie gras production, which faces a worldwide assault from animal rights groups, sow housing and use of gestation crates are all symptomatic of where the welfare debate has transcended. It started on animal pain. The buzzword is now distress.

What is occurring is the divergence between traditional husbandry practices and a "return to fairer treatment," he says.

"Husbandry was being practiced before the 20th Century. You wanted your animals to be productive, you put in the best possible environment, augment their ability to survive and thrive by preventing food during famine, water during drought, medical intervention during birthing and protection from predation. Those were the basics. We developed these technological standards like antibiotics, vaccines and air-handling systems that really allow us to force square pegs in round holes. The animals might be productive, but they aren't really that well off. I think societies around the world are demanding a return to fairer treatment. It is a huge issue."

Rollin adds that organized veterinary medicine needs to step up to the plate.

"And not enough of organized veterinary medicine is taking strong ethical positions on issues that society expects them to lead in. They are trying to satisfy everybody. When you do that, you satisfy nobody. They are not alone. The human medical community has been delinquent in addressing medical ethics in the same ways."

While attitudes are changing, he says, it's not fast enough. "Now, there is a lot more ethics being taught in veterinary schools than what used to be. But still, it's not enough."

Consider, how we view pain, Rollin says.

"One issue is the undertreatment of pain in human medicine. Back in the '80s, they were doing open-heart surgery on infants without anesthetic, just paralytic drugs. We have come a long way, but it has taken public pressure. Right now, you have the medical community condemning morphine use for terminally ill patients on the grounds they might be clinically addicted. That's stupid. And it shows inadequate ethics, especially if people are actually suffering. It also shows they don't understand addiction."

Rollin adds that the discussion about animal pain and strategies to control pain are very healthy. Ethics discussions, according to Rollin, should not simply address intraprofessional etiquette. Instead it should take on meaningful scientific and moral questions that are important to veterinary medicine and its role in society.