Applied Animal Physiotherapy Ethics

Original Editor - Ansi van der Walt Top Contributors - Jess Bell, Kim Jackson, Tarina van der Stockt, Olajumoke Ogunleye and Robin Tacchetti

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Introduction

Jurisprudence is defined as "the study, knowledge, or science of law" and it refers to all legislation, rules, regulations and guidelines that are relevant to veterinary practice. Veterinary professions are required to provide good care for the animals that they assess and treat and they have legal, moral and ethical obligations to their clients, patients and veterinary colleagues. A knowledge of the legal frameworks within which they work is, therefore, essential to ensure they are able to practise in a safe, effective manner.

However, in some instances, there may be conflict between the interests of the veterinary professional, client (or owner) and the animal. The veterinary professional must, therefore, also be equipped with knowledge of the ethical challenges that surround animal practice.

Norms

In any social interaction or contact between people, certain norms apply. Norms are defined as "standards of behaviour which have been accepted by the community.” Social structures are determined by behavioural norms, which have developed over many generations. Norms are not fixed across cultures, religions and countries - they are often varied, but they are generally intended to enhance social cohesion.

Norms which determine behaviour include:

• Morals
  • Norms that have right or wrong associated with a behaviour, such as envy, anger, pride, lust, dishonesty, vindictiveness, cruelty, and infidelity, etc. These thoughts / acts can result in harm.
• Social norms
  • The “informal rules that govern behavior in groups and societies.” Social norms have an impact on various behaviours, including fashion, courtesy and convention

• Aesthetic norms
  • “Norms of appreciation of beauty and the morally good things in life.” Examples of aesthetic norms include urban design, tidy veterinary clinics, well-kept gardens

• Ethical norms
  • “Ethics are principles or beliefs, that govern a person’s view of right/wrong, good/bad, just/unjust etc. of a situation":
    • Personal ethics - depend on the individual (religion, charity)
    • Professional / ethical norms - are used to manage behaviour across a profession

Laws

Laws are defined as “norms which the whole community accepts as binding and are obeyed by the whole society.” Laws can be changed to fit the requirements of the community that they serve. Thus, laws should govern human behaviour and be obeyed by everyone. They formalise specific rights and are enforced by organisations of the state. When laws are disobeyed, the involved parties are typically prosecuted / punished.

It is important that animal physiotherapists have an understanding of the practical implications of relevant laws and to consider how these laws:

• Apply to animal physiotherapists as business managers and employers
• Apply to animal physiotherapists in the context of their relationship with their clients
• Apply to animal physiotherapists in the context of their relationship with other veterinary professionals
• Apply to animal physiotherapists in terms of their responsibilities to the patient (the animal)

Ethics

Veterinary Ethics

Veterinary ethics refers to the “practical application of ethical theories, principles and moral standards to the conduct of individuals involved in veterinary service delivery systems that are meant to benefit animals, owners, and the public”. The public generally believe that veterinary professionals have a “moral duty” to look after animals. This trust is based on the acceptance of or belief in the following:

• Sapiental Authority - i.e. the public believes in the perceived wisdom and superior knowledge of veterinarians
• Moral Authority - i.e society expects veterinarians to always act in the best interest of their patients and clients
• Charismatic Authority - i.e. relates to the historical socially conditioned belief that healers have the powers to dispel disease

Most statutory codes of veterinary practice make reference to the following:

• Veterinary ethics
• Professional ethics
• Standards of practice
• Code of conduct
• A commitment to uphold animal welfare and / or reduce suffering

Statutory bodies are government authorities established to regulate the veterinary profession and enforce codes of professional conduct.

Ethical Reasoning

Because it is not possible to be fully prepared for every ethical challenge that you may face as a veterinary professional, the animal physiotherapist needs to have the skills to apply ethical reasoning to complex situations.

• Ethical rules: specific statements that concern ethical behaviour

• Ethical principles: broader models of behaviour that provide a basis for rules
• Ethical theories: are used to justify ethical decisions that are made and help to resolve any conflict between rules

Normative Ethics

Normative ethics essentially provide a set of principles that can be used to solve ethical dilemmas. Bernard Rollin said of regulating professions (including the veterinary profession):

“you regulate yourselves the way we [society] would regulate you if we understood what you do, which we don't. But we will know if you don't self-regulate properly and then we will regulate you, despite our lack of understanding.”

A well-known example of a normative ethics principle is the idea that: “People should do to others what they would want others to do to them.”

The three most well-known ethical theories are:

• Virtue Ethical Theories
  • Emphasise the role of a person’s character in an interaction
• Deontological Theories (i.e. duty or obligation)
  • These relate to the duties of individuals towards other people and to the rights of individuals in an agreement
• Teleological Theories (i.e. consequences)
  • Consequences should be more favourable than unfavourable and they must not use individuals as a means to an end

Applied Ethics

An applied ethical issue will involve choosing between a number of conflicting normative principles, all of which might result in different outcomes. Applied ethical issues are commonly approached through the application of the following four principles:

• Beneficence - the duty to do good (maximise benefit)
• Non-maleficence - the necessity to do no harm
• Autonomy - the freedom to choose
• Justice - the right to due process in interactions with other veterinary professionals, owners, public and animals

Fundamental challenges in veterinary ethics include:

• Is the veterinary professional's primary responsibility to the animal or the owner?
• The responsibility of the professional to the animal patient as a sentient being - related to the notion that veterinary professionals work in the medical field
• Economic consideration to the client in that the patient is property - related to the notion that veterinary professionals work in the agricultural field
• The tripartite relationship in veterinary ethics between the veterinary professional–patient–owner. This is a significant source of ethical dilemmas when perceptions of the best outcome for the patient differ.
• Additional challenge of public health considerations (e.g. rabies in South Africa)