“Patients’ interests first, but . . . ” – Austrian Veterinarians’ Attitudes to Moral Challenges in Modern Small Animal Practice
By S. Springer, P. Sandøe, T. B. Lund & H. Grimm (2019)
The veterinarian's dilemma: a study of how Danish small animal practitioners handle financially limited clients
By S. V. Kondrup, K. P. Anhøj, C. Rødsgaard-Rosenbeck, T. B. Lund, M. H. Nissen, & P. Sandøe (2016)
Veterinary Record. BMJ Publishing Group
This study examined the extent to which Danish veterinary practices encounter financially limited clients and how different factors relating to the animal, the client and the veterinarian affect decisions to provide treatment for these clients. 300 small animal practices were invited to participate in an online survey. 195 participated, giving a response rate of 65 per cent. The results show that Danish small animal veterinary practices encounter clients with limited finances regularly: 33.8 per cent of them 3–4 times, 24.6 per cent 5–10 times and 19.5 per cent 1–2 times a month. Only around 9 per cent reported having a written practice policy on handling financially limited clients. Factors affecting decisions to treat include the severity and type of the animal’s condition, the medical care needed and the client’s expressed emotions. The propensity to treat is significantly higher in female veterinarians and in situations involving unborn animals. The overall conclusion is that small animal veterinary practices often provide treatment to clients who are not able to pay—far beyond what is legally required. This can be considered a major economic and psychological challenge for the practising veterinarians.
Veterinarians’ role in clients’ decision-making regarding seriously ill companion animal patients
S.B. Christiansen, A.T. Kristensen, J. Lassen & P. Sandøe (2016)
Acta Veterinaria Scandinavica.BioMed Central
Background - When companion animals become seriously ill clients may have doubts about treatment choices, if any, and turn to veterinarians for help. But how should veterinarians reply? Influence on clients’ decision-making may or may not be acceptable—depending on one’s attitude to principles such as ‘paternalism’, ‘respect for autonomy’ and ‘shared decision-making’. This study takes as a starting point a situation where the animal is chronically ill, or aged, with potentially reduced animal welfare and client quality of life, and thus where clients need to consider treatment options or euthanasia. It is assumed throughout that both veterinarians and clients have the animals’ best interest at heart. The purpose of the study was to explore the challenges these situations hold and to investigate how clients experience veterinary influence. A second aim was to reflect on the ethical implications of the role of veterinarians in these situations. Qualitative interviews were conducted with 12 dog owners considering treatment or euthanasia of their chronically ill or aged dogs.
Results - Challenges relating to the dog and to the client were identified. Some situations left the interviewees hesitant, e.g. if lacking a clear cut-off point, the dog appeared normal, the interviewee felt uncertain about treatments or animal welfare, or experienced conflicting concerns. Some interviewees found that veterinarians could influence their decisions. Such influence was received in different ways by the interviewees. Some interviewees wanted
Conclusions - Different preferences are likely to exist amongst both veterinarians and clients about veterinary involvement in clients’ decision-making, and such preferences may vary according to the situation. It is suggested, that one way to handle this challenge is to include respect for client preference on veterinary involvement under a wider understanding of respect for autonomy, and to apply models of shared decision-making to veterinary practice. In any
Looking After Chronically III Dogs: Impacts on the Caregiver's Life
S.B. Christiansen, A.T. Kristensen, P. Sandøe & J. Lassen (2013)
Anthrozoos. Taylor & Francis
Studies in human medicine show that care of chronically ill family members can affect the caregiver's life in several ways and cause “caregiver burden.” Companion animals are offered increasingly advanced veterinary treatments, sometimes involving home care. Owners choosing such treatments could thus face similar challenges when caring for their animals. This qualitative study uncovers impacts on an owner's life, when attending to the care of an aged or chronically ill dog and reflects on the differing roles of caregivers with animal and human patients. Twelve dog owners were selected for in-depth interviews based on the dogs' diagnoses, and the choice of treatments and