DIFFICULT MORAL QUESTIONS
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Question 92: Should a veterinarian provide futile treatment demanded by pet owners?
I am bothered by a problem that comes up regularly in my practice as a veterinarian. A pet, usually a cat or dog, becomes seriously ill or is badly injured, and the owner brings it to me for treatment. If I think there is any chance of success, I offer a treatment plan and estimate its cost, then let the owner decide. When I am certain that medical treatment and/or surgery would be futile, I say so and suggest putting the animal out of its misery. This is where the problem arises. Many owners are so attached to their pets that they cannot bear losing them; quite a few simply refuse to listen to reason and demand that everything possible be done, including complex and difficult surgery. Some people also think that, since they own their pets, they have the right to have done to them whatever they want, and that, as long as they are willing to pay, I should carry out their wishes despite my misgivings.
Nothing in the law or my code of professional ethics forbids giving treatment I know to be futile. From a purely business point of view, it would be to my advantage in such cases simply to warn the owner of the virtually certain outcome, make sure of payment, and go ahead. Many of my colleagues do that. However, it goes against the grain, not only because futile treatment is wasteful, but because the animal is my patient and has the right to be treated properly. My duty is to provide that patient with good care, including putting it out of its misery when appropriate. But if I refuse to do what owners want, they are likely to find someone else who will, while I lose customers and income.
Analysis:
This question calls for the derivation of a specific moral norm. Though animals, not being persons, have no rights, they ought to be treated with respect. A veterinarian should provide animals with the medical treatment and surgery reasonably desired by their owners, but should not cooperate with an owner’s unreasonable demands. To provide futile treatment is wrong not only because it is wasteful but because it is cruel to the animal. Therefore, the questioner ought to try to dissuade owners who want futile treatment for their pets and should decline to carry out such requests even at the sacrifice of some income and future business. However, the duty to decline is not a moral absolute.
The reply could be along the following lines:
You say “the animal is my patient and has the right to be treated properly.” You are right to take a serious view of your profession, but that way of describing your relationship to the animals you treat is not, strictly speaking, correct, for it implies that pets are like children and your veterinary practice little different from a pediatrician’s. Animals, however, not being persons, have no rights, and their lives lack the dignity of human life. That is precisely why it can be appropriate deliberately to kill them, not only to put them out of their misery but to serve any significant human interest.289
Nevertheless, animals do have their own special value. Like everything else God created, they are good in themselves; like beautiful features of the natural landscape and flowers, they arouse our wonder and lead us to admire, praise, and thank their creator (see Ps 148). Reverence toward God requires us to respect their value. Just as it would be wrong wantonly to pollute a stream or crush a wild flower, so it is wrong wantonly to injure any animal (see CCC, 2415–16). Indeed, since animals are creatures of a higher metaphysical order than streams and flowers, the wrong is greater, other things being equal.290
Moreover, since we human beings, though rational, also are sentient creatures, we have natural sympathy toward animals, as is especially obvious in small children’s feeling for any baby animal that seems to be separated from its parent, sick, injured, hungry, or thirsty. By the same token, people who treat animals cruelly display a flaw of personality that also will vitiate their relationships with other people. The natural sympathy toward animals underlies the close emotional bonds people develop with their pets. This sympathy is good in itself, and an individual’s or family’s affection for a pet also can be good, provided it is well integrated with practical reason so that it never interferes with fulfilling responsibilities toward God and human persons, including oneself.
Your work as a veterinarian primarily is to provide appropriate medical treatment and surgery for animals. What is appropriate, however, depends not only on an animal’s condition but on its owner’s reasonable choice, and owners rightly exercise far greater discretion in dealing with pets than parents in dealing with children. For example, owners who prefer that their pets not reproduce rightly have them sterilized, and unwanted animals, including even healthy newborns, can rightly be killed painlessly. Still, pet owners sometimes are unreasonable, and then you should not cooperate with them. Therefore, veterinarians must try to establish good relationships with the owners of the pets they treat and try to encourage the owners and their families to form sound attitudes and make reasonable decisions. In fulfilling this element of your professional responsibility, you will help many of the people you deal with, especially children, develop the relevant facet of good character.
The preceding explanation makes clear how mistaken people are in thinking owners have the right to have done to their pets whatever they wish. Like owners of any other property, pet owners are entitled only to the reasonable enjoyment and use of their animals. And like other professionals, veterinarians must shape their work by relevant moral norms, not do whatever people are prepared to pay for.
Having sketched out the necessary presuppositions, I now turn to your question. May you comply with owners’ unreasonable demands to do everything possible, often including complex and difficult surgery, to sustain a pet’s life? You say that “goes against the grain”—which I take to mean disturbs your conscience—and offer two reasons.
First, you mention waste, presumably of people’s money and your work, and perhaps also of facilities and materials that could be put to other uses. In my judgment, this consideration is valid and in many cases will be sufficient in itself to make it gravely wrong to provide futile treatment to animals. In passing, however, it is worth noting that some animals would never have come to be or would long since have passed away were they not kept as pets by people with no good reason for having them, and the goods and services used for such animals are wasted. So, even some of your work that really benefits a particular animal is wasted.291
The second reason you mention is the point I began with. You regard the animal as a patient with a right to be treated properly. As I have explained, I consider that reason, understood strictly, to be unsound. However, it seems to me to point to a valid and profound moral consideration, which can be articulated more accurately by focusing on the owner’s unreasonable attachment to the pet. In one way, that attachment is excessive affection, which makes it difficult to part with the pet even though that would be reasonable. In another way, paradoxically, it is lack of respect for the animal, which ought to be put out of its misery, but is made to suffer pointlessly in order to satisfy the owner’s feelings. In this way, the owner’s unreasonable attachment results in cruelty to the animal.292
If you give in to the demand for futile treatment, you assist in disrespectfully using the animal to satisfy the owner’s unreasonable feelings. That morally injures the owner, something not only wrong in itself but inconsistent with your professional responsibility to teach and encourage people to adopt sound attitudes toward animals. Your obligation is especially strong when children are involved, since wrongly using animals to satisfy affectionate feelings is likely to misshape a child’s attitudes toward his or her friends and partners in human relationships, not least eventual intimate ones.
Consequently, when owners insist on treatment you judge futile, you should not acquiesce. Often, vividly describing the suffering the treatment is likely to impose on the pet should suffice to dissuade the owner, but I assume you already make as much use of that tactic as you can. When it fails, I think you should decline to carry out the request for unreasonable treatment, and not only pass by that opportunity for income but risk losing some future business.
Nevertheless, since animals have no rights and you need not intend their owners’ unreasonableness, your obligation to withhold futile treatment is not a moral absolute, such that you would have to do without necessities or give up your profession if that were the only way to avoid providing such treatment. I gather from your letter, though, that only a portion of your potential income is at stake. Moreover, you may stand to lose less than you suppose. With sensible pet owners, refusing to provide futile care will gain you a reputation for competence and trustworthiness that probably will help you build a good clientele. But even if a principled approach involves some financial sacrifice, you will retain your professional integrity, help people you serve develop a facet of good character through upright attitudes toward animals, and exercise reverence toward God, the creator of animals and the Lord who made humankind responsible for them.