Veterinary donation: To what extent can the ethical justifications for living human donation be applied to living animal donation?

This thesis develops the scant existing literature which explores the ethical justifications for living animal donation in the veterinary setting and contributes to the considerable research on social and ethical aspects of human living donation. The work argues that whilst some justifications for human living donation are not-transferable, others may be adapted and applied to the veterinary setting. The unique social context of veterinary donation is analysed, using novel empirical analysis to refine and contextualize the ethical arguments made. The research methods entail an innovative comparative ethical analysis and a qualitative empirical study which are integrated using an empirical bioethics approach. The main justificatory arguments for human living donation are identified as informed consent and donor best interest. These arguments stem from a human’s acknowledged rights to bodily integrity and the human medical professional’s duty not to harm their patients. The reduced capacity of animal donors means that donor consent arguments are not directly transferable to the veterinary setting and an animal owner’s informed consent is shown to have reduced moral authority. Whilst animal donors may lack comparable bodily rights, veterinary living donation practices can conflict with a veterinary surgeon’s professional obligations. A comparable justification for living animal donation is argued to exist only when the procedure is in the donor animal’s best interest. An empirical analysis of canine blood donation to a UK animal blood bank develops understanding of the social context of living animal donation. The analysis indicates that animal owners may not always be motivated by the best interest of donor animals; furthermore, consistent themes such as trust, optimism and human-animal comparisons have implications for the quality of a donor owner’s consent. These ethical and empirical findings are used to construct an ethical framework for living animal donation with detailed provisions for owner consent, donor best interest, donor harm and benefit, recipient benefit, fairness and transparency. The ethical framework is used to argue for the development of regulatory approaches to companion animal blood banking and feline renal transplantation in the UK. The work also has wider implications for veterinary ethics, veterinary policy and the social and ethical understanding of human living donation

Reducing Moral Stress in Veterinary Teams? Evaluating the Use of Ethical Discussion Groups in Charity Veterinary Hospitals

This study examines experiences of veterinary moral stress in charity veterinary practice and qualitatively evaluates the role of ethical discussion in reducing veterinary moral stress. Results are drawn from a thematic data analysis of 9 focus groups and 15 individual interviews with veterinary team members from 3 UK charity veterinary hospitals. Moral stress is described as an everyday experience by participants and is caused by uncertainty about their ability to fulfill their ethical obligations. Moral stress is shown to be cumulative and can interact with other forms of stress. Distinct practical and relational barriers to ethical action are identified and proposed as contributors to moral stress, and different team members experience different barriers within their roles. The potential impact of moral stress on team members’ quality of life and mental health is highlighted. Results show that regular facilitated ethical group discussions may reduce moral stress in the hospital setting, particularly through familiarization with others’ roles and ethical perspectives and through supporting one another’s ethical decision-making. The article concludes that moral stress is an important and poorly understood problem in veterinary practice and that further development of regular facilitated ethical group discussion may be of considerable benefit to team members

A Feminist Ethic of Care for the Veterinary Profession

I can still see the dog's face as its eyes connected with mine, framed by the black bin bag it had been carried in. I can still hear the clicking sound, louder than the animal's shrill cries, made by a mass of maggots moving against one another beneath the dogs matted fur, moistened by fluids leaking from its damaged flesh. My hands were shaking with panic and rage and I could hardly draw up the euthatal into the syringe quickly enough. I wanted to put an end to this, immediately. As the lethal fluid flowed into the tiny vein the dog's body finally relaxed. At my hand, like so many others, she had ceased to exist. Through the window I could see her owners waiting outside in the sunshine to pay me and I thought about the silky feel of the fur which covered an expensively shaped head. I knew this dog was loved once. This paper develops two neglected areas of veterinary thought; anthropological studies of the veterinary profession and feminist care approaches in veterinary ethics. I argue that the development of veterinary anthropology is crucial to advancing our understanding of veterinary lived experiences, through highlighting the previously under acknowledged emotional, relational and contextual realities of veterinary practice. I further propose that an ethic of care for the veterinary profession, which meaningfully connects with veterinary lived experiences, may provide a valuable approach through which to further develop veterinary ethical thinking. I share an autoethnographic account of a difficult veterinary encounter, which I then analyse using a novel feminist care approach. Through analyses centered on both emotional and relational aspects of veterinary care, I challenge the boundaries of traditional veterinary ethical approaches in terms of the scope, scale and complexity of veterinary ethical decision making. I describe the concept of emotional sponge work in veterinary practice and outline its potential impact for advancing understanding of both veterinary well-being and the profession's societal role. Finally, I propose that a feminist ethic of care might provide a framework for redefining the focus of veterinary professional responsibility, beyond animal health and toward the maintenance of healthy relationships between humans and animals

Kinship Health Relationships: Reconfiguring the ‘good death’ in mixed species families.

Through an innovative interspecies analysis, this article explores narratives surrounding the medical treatment of humans and pet animals at the end of life among UK veterinary surgeons, medical practitioners and members of the public. Contrasting the care options open to pet owners with those available to human patients, and through a thematic focus on treatments and medicines, euthanasia and palliation, this article pays close attention to the ways that practitioners and members of the public make sense of - and express ideas about - interspecies family kinship at the end of a life. We highlight the utility of interactionist approaches for understanding microsocial human-animal kinship ties and argue that health policy and practice during end-of-life care should better reflect the lived reality of the multispecies family. In so doing, we highlight the significance and complexities of interspecies conversations for the development of contemporary end-of-life care debates. Keywords: ‘good death’, end-of-life care, clinical responsibility, euthanasia, palliative care, animal-human relations; pets; posthumanism; kinship

Reconciling autonomy and beneficence in treatment decision-making for animal patients

This article explores how the concept of consent to medical treatment applies in the veterinary context, and aims to evaluate normative justifications for owner consent to treatment of animal patients. We trace the evolution of the test for valid consent in human health decision-making, against a backdrop of increased recognition of the importance of patient rights and a gradual judicial espousal of a doctrine of informed consent grounded in a particular understanding of autonomy. We argue that, notwithstanding the adoption of a similar discourse of informed consent in professional veterinary codes, notions of autonomy and informed consent are not easily transferrable to the veterinary medicine context, given inter alia the tripartite relationship between veterinary professional, owner and animal patient. We suggest that a more appropriate, albeit inexact, analogy may be drawn with paediatric practice which is premised on a similarly tripartite relationship and where decisions must be reached in the best interests of the child. However, acknowledging the legal status of animals as property and how consent to veterinary treatment is predicated on the animal owner’s willingness and ability to pay, we propose that the appropriate response is for veterinary professionals generally to accept the client’s choice, provided this is informed. Yet such client autonomy must be limited where animal welfare concerns exist, so that beneficence continues to play an important role in the veterinary context. We suggest that this ‘middle road’ should be reflected in professional veterinary guidance

Veterinary donation: To what extent can the ethical justifications for living human donation be applied to living animal donation?

This thesis develops the scant existing literature which explores the ethical justifications for living animal donation in the veterinary setting and contributes to the considerable research on social and ethical aspects of human living donation. The work argues that whilst some justifications for human living donation are not-transferable, others may be adapted and applied to the veterinary setting. The unique social context of veterinary donation is analysed, using novel empirical analysis to refine and contextualize the ethical arguments made. The research methods entail an innovative comparative ethical analysis and a qualitative empirical study which are integrated using an empirical bioethics approach. The main justificatory arguments for human living donation are identified as informed consent and donor best interest. These arguments stem from a human’s acknowledged rights to bodily integrity and the human medical professional’s duty not to harm their patients. The reduced capacity of animal donors means that donor consent arguments are not directly transferable to the veterinary setting and an animal owner’s informed consent is shown to have reduced moral authority. Whilst animal donors may lack comparable bodily rights, veterinary living donation practices can conflict with a veterinary surgeon’s professional obligations. A comparable justification for living animal donation is argued to exist only when the procedure is in the donor animal’s best interest. An empirical analysis of canine blood donation to a UK animal blood bank develops understanding of the social context of living animal donation. The analysis indicates that animal owners may not always be motivated by the best interest of donor animals; furthermore, consistent themes such as trust, optimism and human-animal comparisons have implications for the quality of a donor owner’s consent. These ethical and empirical findings are used to construct an ethical framework for living animal donation with detailed provisions for owner consent, donor best interest, donor harm and benefit, recipient benefit, fairness and transparency. The ethical framework is used to argue for the development of regulatory approaches to companion animal blood banking and feline renal transplantation in the UK. The work also has wider implications for veterinary ethics, veterinary policy and the social and ethical understanding of human living donation

The good death and discovering a posthuman medical practice

In this paper I explore preliminary research ideas on the urgency and challenges of embedding a medical posthumanities in practice. I first reflect on my experiences of the deaths of non-human animals through the production and consumption of medicine. Using vignettes from real life experiences of working with animals in the laboratory and the veterinary clinic, I test Donna Haraway's perspective that ‘we have never been human’. I show that emotional ties between humans and non-human animals have always existed in such settings and that they create friction for workers who are constrained by humanist expectations in their roles. This paper tentatively explores the questions: What does the developing field of medical post humanities offer to those working with non-human animals in the field? Conversely, what might the practical experiences and problems which are being encountered in multispecies science and medicine mean for the development of a medical posthumanities

‘Doing good by proxy’: Human-animal kinship and the ‘donation’ of canine blood

This paper demonstrates the relevance of animals to medical sociology by arguing that pet owners’ accounts of veterinary decision-making can highlight key sociological themes which have important relevance to both human and animal health. Based on semi-structured interviews, the paper argues that interspecies ‘kinship’ allows for the extension of sociological claims regarding altruism, self-interest and mutuality from human blood donation to companion animal blood ‘donors’. Furthermore, this study extends sociological understanding of the human-animal bond by showing how the dog’s status as kin meant they were expected to donate blood, and that the act of donation itself represents an important opportunity for family ‘display’. However, owners who do not or cannot donate blood themselves describe pet blood donation as an opportunity to lessen associated feelings of guilt or obligation through ‘doing good by proxy’. These findings raise critical sociological and ethical questions concerning the risks and benefits of donation, and for how we understand third-party decision making. Finally, the paper argues for the close entanglement of human and animal health, and concludes that sociologists of health and medicine should explore the radical possibility that decision-making in healthcare more generally might be influenced by experiences at the veterinary clinic, and vice versa