Wanted - untold stories of ethically challenging situations!

RE: Wanted - untold stories of ethically challenging situations!

Jill Macdonald — Wed, 26 Oct 2016 15:29:58 GMT

I second that this is a great idea for a discussion Jane - and I think it's great you're teaching this topic in more depth to your students. The first hurdle is getting them to see it for the fascinating, challenging and useful topic that it is - rather than just - ethics.... booooring!

One of my 'favourite' scenarios (for discussion!) is 'pregnant cat spay' as I think this is such a multi faceted situation - depending also on the circumstances of course.

It also has a parallel with the situaion raised above - as to whether a vet/VN has the 'right' to refuse to assist with or perform a pregnant cat spay.

In all of these situations, weighing up implications, and then benefits and detriment for all of the stakeholders - animal, (kittens), client, nurse, vet, practice, society (!) provides the first challenge. And point of view will of course depend on personal ethical stance too - as already proved by some of the reponses to the euth/cadaver scenario here.

Can you tell I love ethics?!

RE: Wanted - untold stories of ethically challenging situations!

Sal the 1st — Tue, 25 Oct 2016 19:34:44 GMT

[quote user="VetNurse Anon a/c"]

The unwilling nurse. I worked with an unqualified lay person who was working as a veterinary nurse. Due to her moral beliefs (not religious ones), she would not assist in ANY euthanasia. She would not even restrain the pet to allow a catheter to be placed so the vet could then PTS with no assistance. She also refused to do anything with any dead body - including even writing the private cremation paperwork! Myself and many of the other nurses found this infuriating as we had to fill in and pick up the slack. If she was working an evening or weekend then one of us would have to be on call as well to come in and assist with PTS / dead bodies if needed. I found this to be an ethical dilemma because although I could identify with the sadness of the PTS situation, I also thought (and still think) its a core part of our job and we are actually lucky to be able to end suffering and assist with the final kindness.

[/quote]

I agree with you - and I am surprised any practice allowed this. I have come across this before. Yes its not nice - nobody enjoys taking a life but this is part of our job, a small part maybe but a very important part non the less, its a privilege to be there at the end with the pet and its family member(s) and to help give it 'a good end'.

RE: Wanted - untold stories of ethically challenging situations!

Karen Carver — Tue, 25 Oct 2016 15:29:30 GMT

Massive shortage on cadavers at the moment. We run VS/VN dentistry courses and used to get a steady supply from a company. But they can't get them anymore and we are now asking people to bring a head with them or just try to source them locally.

Would be great if anyone knew of another source?

RE: Wanted - untold stories of ethically challenging situations!

VetNurse Anon a/c — Tue, 25 Oct 2016 14:58:22 GMT

[quote user="janie550"]Hi, I'm involved in writing some resources as part of a new Diploma VN programme in New Zealand. I'm putting together some scenario-based resources on ethical dilemma's that VNs may encounter and what actions they took, and the outcome.[/quote]

Great discussion idea Jane.

Ive had a few 'ethically challenging' moments in practice and will summarize a couple here. Feel free to use any that may be of interest.

1) The healthy PTS. Twice in my career I have been faced with having to assist the PTS of a perfectly healthy animal. The background story in both cases (different owners at different practices) have been where a recently registered owner has arrived for a PTS appointment with an animal we havnt seen before. In both cases, the owner was adamant from the start that a PTS was needed and if it wasnt done, then they would kill the animal themselves (one threatened to do this in the carpark by running over it!). The vets did a thorough health check (inc checking microchip details) and could not find any obvious issues and the owners refused to give any further info. They merely stated the pet was no longer wanted and as it was "their property" then it was "their right" to have a PTS. We were flabbergasted and tried every trick in the book to get the owners to surrender to a rescue, to surrender to us and to re think all to no avail. The first case - we managed to get the owner to agree to the PTS being done 'out the back' and they left the practice before the procedure was carried out. For this pet, the vet decided NOT to PTS and took on the animal home. Was this the right thing to do? I certainly was pleased that a healthy animal did not have to die that day for no reason - but legally, the owner had paid for a service that was not performed.

The second instance however, did not have a happy outcome. The owner was truly awful in describing what they would do to the pet if it was not PTS right there, infront of them and they were taking the body away. The vet decided that it was too big a risk to take and the best outcome for the poor pet was to go ahead with the PTS. This absolutely broke my heart to do, but as a student I felt I could not question the vets decision nor refuse to assist. So I cuddled that pet as hard as I could and told them they were loved. Im in tears recalling this memory. Was this the right thing to do? I dont know but it certainly didnt feel right to me then or now.

2) The unwilling nurse. I worked with an unqualified lay person who was working as a veterinary nurse. Due to her moral beliefs (not religious ones), she would not assist in ANY euthanasia. She would not even restrain the pet to allow a catheter to be placed so the vet could then PTS with no assistance. She also refused to do anything with any dead body - including even writing the private cremation paperwork! Myself and many of the other nurses found this infuriating as we had to fill in and pick up the slack. If she was working an evening or weekend then one of us would have to be on call as well to come in and assist with PTS / dead bodies if needed. I found this to be an ethical dilemma because although I could identify with the sadness of the PTS situation, I also thought (and still think) its a core part of our job and we are actually lucky to be able to end suffering and assist with the final kindness. Plus, rightly or wrongly, it grated on me that someone could pick and choose which parts of a job they were prepared to do which then placed extra pressure on the rest of the team.

Good luck with your project.

RE: Wanted - untold stories of ethically challenging situations!

janie550 — Tue, 25 Oct 2016 05:12:44 GMT

[quote user="Ian M"]

one of whom took delight in explaining to everyone that as she thought it unreasonable that she couldn't get a rescue dog and leave it alone for 13 hours a day while she was at vet school for the next 3 years, she had bought a puppy from Romania. [/quote]

Where is the face-palm icon??

It always astounds me how some of my students have really quite contorted personal animal ethics. It's part of the reason we have made it such a big component in the animal care/veterinary nursing modules we deliver. "Yeah I love animals, I have 4 dogs and breed Huskadoodles/Maltipoos/Cockerhuahuas etc and I've got 6 cats and two litters of kittens on the way". Bah!!

RE: Wanted - untold stories of ethically challenging situations!

Sal the 1st — Mon, 24 Oct 2016 23:30:02 GMT

[quote user="Ian M"]

I remember going to a meeting of the Association of Charity Vets where this was discussed. As ACV meetings are usually at a vet school, students are invited, one of whom took delight in explaining to everyone that as she thought it unreasonable that she couldn't get a rescue dog and leave it alone for 13 hours a day while she was at vet school for the next 3 years, she had bought a puppy from Romania. It didn't go down well at all.

[/quote]

ouch - that is a real bang head against brick wall

RE: Wanted - untold stories of ethically challenging situations!

KizzieB — Mon, 24 Oct 2016 23:06:18 GMT

I was involved recently in a case of tail docking gone wrong. A client came in with their new springer puppy who had a botched home docking. The boss avoided the exasperated and frustrated conversations between myself and the other staff because the new owner was a good client and was now doing the right thing by the puppy by getting his tail fixed. The client would only say the town that he got the puppy from but refused to give any further information. I felt that we should have involved the police as this was the only way to get further info out of the client and finding out who had done this but he was already concerned and cagey given our reaction. I felt that he thought we were blaming him and he seemed to feel that he would get into trouble if we took it any further. Tail was fixed and puppy has very little tail left but is happy and healthy and not in pain anymore!! Owners are spoiling him rotten and are happy to return to the practice. I know that I should be thinking of all the other puppies from this breeder who are going through similar problems but people have such distrust in the police here and the stigma that would be attached to the practice would be awful!! Unfortunately the general public would not see that we were trying to prevent further suffering but that we phoned the police and accused a client of docking his puppies tail even though we know the truth!! Clients need to trust us.

RE: Wanted - untold stories of ethically challenging situations!

Ian M — Mon, 24 Oct 2016 21:01:17 GMT

RE: Wanted - untold stories of ethically challenging situations!

Sal the 1st — Wed, 19 Oct 2016 01:03:55 GMT

added kudos I think is a big motivation for some people.

RE: Wanted - untold stories of ethically challenging situations!

janie550 — Tue, 18 Oct 2016 22:52:53 GMT

So what are people's motivation for getting a dog from a foreign country like Romania? Is it because there are no shelters there, so they think they are saving a dogs life? Or because they have seen the stray dogs on holiday and become attached? Or because the dogs are in worse condition?

It does seem unfair to the dogs in UK shelters. Maybe we need an 'adopt a British dog' campaign!!

RE: Wanted - untold stories of ethically challenging situations!

Selena Carnell — Tue, 18 Oct 2016 17:56:06 GMT

agree totally, why are masses of dogs imported from ireland and other countries to be rehomed when our shelters are already full. The transportation alone sounds horrific, crated, transported, not even checked for a period of time, just rehired within 24 hrs.. talk about stress. our locum vet got a pup from romania.

RE: Wanted - untold stories of ethically challenging situations!

janie550 — Mon, 17 Oct 2016 20:43:44 GMT

That is a great question. I know I do sometimes question the actions of people who make headlines because they rescue dogs abroad, especially when the money spent trying to get one dog back could be used for many dogs at a rescue centre back home. You could say the same for children who get adopted from abroad too - same ethics really. I'm a bit on the fence I think but I do think about this quote.

“Saving one dog will not change the world, but for that one dog, the world will change forever.”

RE: Wanted - untold stories of ethically challenging situations!

Sal the 1st — Mon, 17 Oct 2016 20:05:37 GMT

more of a question than providing any answers but here goes. Ethical dilemma?

Is it ethical to actively participate in/promote the bringing of foreign animal(s) into the country who may be sick or 'damaged' knowing that a healthy animal who is already in this country may lose its chance of a home/lose its life as a result?

RE: Wanted - untold stories of ethically challenging situations!

Sal the 1st — Tue, 11 Oct 2016 21:43:10 GMT

I agree - remember the Frenchay Scandal ? where the retention of body organs against parents wishes or without permission received greater newspaper coverage and appeared to cause greater distress than the actual increased mortality rate in the cardiac unit.

I have known cases where permission has been sought from owners - it has always been done very tactfully and generally by the surgeon - rather than it being a box ticking exercise. It has usually gone along the lines of -'this is a very unusual case/rare disease process and although it wont help ..... now it would help me and others to find out how we may save other animals with this condition in the future. We are all very sorry for your loss and we understand absolutely how upsetting this is for you.....

RE: Wanted - untold stories of ethically challenging situations!

Selena Carnell — Tue, 11 Oct 2016 18:19:26 GMT

I'm sure i heard of a case many years ago, where a great dane was euthanised, it wouldn't fit in to the freezer or a bag. so the dog was cut up. The owners changed their mind and wanted the dog buried on their farm or something like that. it doesn't happen very often but would be one of the most damaging for trusting the profession. My gut feeling is that it is wrong to do that without informed consent. Most owners would be devastated to find out a beloved bet has been mutliated to practice on.

RE: Wanted - untold stories of ethically challenging situations!

Sal the 1st — Sat, 08 Oct 2016 21:22:55 GMT

in other words pets will soon have more rights than we do over what happens to their bodies

https://www.theguardian.com/society/2016/jun/22/doctors-to-lobby-for-opt-out-organ-donor-system

RE: Wanted - untold stories of ethically challenging situations!

sananbaz — Sat, 08 Oct 2016 14:26:04 GMT

The RCVS Guide to Professional Conduct is very clear about the need for informed consent - this applies to animals that are alive or dead (this even includes parts of animals, even biopsy samples). If the owners had been asked if their pet could be used for this purpose and agreed, there would be no problem. In my experience, most owners would not agree to practicing ops on deceased pets - some are squeamish about them being kept in a freezer until collection! They want their pet to be treated with kindness and respect, despite their death - similar to how they would want human relatives to be treated. The point about this dilemma is not that the owners would be unlikely to ask for the pet back, and therefore not find out. The dilemma is that they have the right to decline consent to this, and by not being given the opportunity, is against the Code of Conduct.

Additionally, the validly of using a cadaver for practicing surgical techniques is, in alot of cases, not proven. The lack of living tissue, with the inherent risks of vessel or nerve damage, reduces the accuracy of the technique. Also, all the tissues change colour, texture, shape and diameter after death, which reduces the relevance for practicing. Irrespective of that consideration though, the use of owned pets for surgical practice, without informed consent, is against the Code of Professional Conduct. This is a perfect example for discussion in an ethics class.

RE: Wanted - untold stories of ethically challenging situations!

Sal the 1st — Sat, 08 Oct 2016 13:43:35 GMT

[quote user="Arlo Guthrie"]

What normally happens to dead animals if an owner asks the practice to dispose of the body without specifying that they want the ashes or a burial or something? Presumably in that situation, the owner wouldn't be able to come back and ask for the pet back?

[/quote]

a very small number - but it happens

I can recall a much loved rabbit brought in by one partner who wanted cremation - no ashes returned and the phone call from a distraught spouse who wanted the rabbit back for individual cremation with a full service. Luckily we were able to sort this one out

A very large dog who sadly died whilst the owner was on holiday and we didn't know it wasn't the owner who brought it in - we just did what we were requested to do. Very upsetting for everybody involved.

[quote user="Arlo Guthrie"]

In other words, is there a shortage of cadavers to practice on?

[/quote]

the vet school local to a practice I used to work in used to regularly collect any euthanised greyhounds we had (we were close to a greyhound track) and there were never a shortage of those. I was happier when they started dealing directly with the trainers at least then we didn't have to be involved.

There are thousands of stray animals euthanised every year in this country so a shortage of bodies ? - no.

RE: Wanted - untold stories of ethically challenging situations!

steph fursland — Sat, 08 Oct 2016 13:03:18 GMT

We were discussing this at my practice yesterday. It would be very helpful for us to have cadavers as we have a lot of relatively new vets who need practice on spays, dentals etc, but waiting for the cases to come in (and to have the time/staff to teach during op time) is difficult.

All our animals who are put to sleep will be either taken home for burial, communally cremated, or individually cremated and their ashes returned to the owners. If we used cadavers, they would then be cremated, so the owners could still have ashes or whatever.

I wouldn't feel comfortable using an animal as a cadaver unless the owner had consented. Yes they would probably not ever find out, but I don't think owners would like it, and in human medicine I am pretty sure consent has to be given for things like that.

We have discussed putting a box on the consent form (for euthanasia) saying 'I consent for my animals' body to be used for teaching and learning purposes prior to cremation'......but I think even discussing it might be quite distressing for some owners at the time of putting their animal to sleep.

RE: Wanted - untold stories of ethically challenging situations!

Arlo Guthrie — Fri, 07 Oct 2016 08:58:04 GMT

Hi Selena,

Interesting one, the euthanised pets question. My first thought is that it isn't something with any real bad intent. I mean, there's no financial gain, and the cadaver is being used to improve the skills of the VS, and thereby help other animals.

I presume the risk of the owner asking for the body back is very small, and even if they did, wouldn't it be perfectly reasonable to explain that it has been disposed of without saying how?

I wonder also how many owners, if asked, would give their consent for the body to be used for practice? In other words, is there a shortage of cadavers to practice on?

RE: Wanted - untold stories of ethically challenging situations!

Selena Carnell — Thu, 06 Oct 2016 18:05:24 GMT

I have worked with a vet who has used peoples euthanised pets for operation practice without owners consent. the person saw no problem with it. we all shared our concerns... like what if the owners change their minds and want their pet back. we refused to be part of the procedure. operated with a vet who openly admitted to not really knowing what he was doing but wasn't loosing money to a referral centre - i left the practice.

RE: Wanted - untold stories of ethically challenging situations!

janie550 — Thu, 06 Oct 2016 11:04:40 GMT

Thanks Arlo! Yes would be great to get a discussion going here out of interest. If you did share any anecdotes here I would not use them until I had written permission from you, so don't let that put you off. Where I worked in the UK one of our vets agreed to dock the tails of a litter or JRTs that belonged to a local farmer, just after the ban. I refused to be involved and the vet enlisted the help of another vet instead, but it put me in am awkward position. If I had been a newly qualified VN I probably wouldn't have had the balls to say no, but I'm glad I did as I feel it made my position clear (which was also the legal position). We certainly do find ourselves in some difficult situations!

RE: Wanted - untold stories of ethically challenging situations!

Arlo Guthrie — Thu, 06 Oct 2016 07:56:16 GMT

How interesting! If anyone would like to share them here (please do, would be very interesting to discuss), do remember you can post using the anonymous login: https://www.vetnurse.co.uk/w/help/1043.anonymous-posts.aspx