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Here you will find various publications covering broader aspects of animal ethics in the following categories:



























Digital opportunities to connect and complain – the use of Facebook in small animal practice

Springer, S., Lund, T. B., Sandøe, P., Corr, S. A., Kristensen, A. T., & Grimm, H. (2022) 
VetRecord Open. 
British Veterinary Association



Social media is increasingly used in small animal practice, enabling veterinarians to connect with clients and promote their business online. It can also be used by clients to quickly distribute complaints via online communities.


Using a questionnaire study we investigated Austrian, Danish and UK veterinarians’ attitudes towards Facebook, the contents of clients’ online complaints and how they were handled by veterinarians (N = 648).


In Denmark and the UK, around 90% of practices had a Facebook page, in contrast to 40% of Austrian practices. Most Danish and UK veterinarians agreed that the use of Facebook was relevant and expected by clients. Agreement was lower among Austrian veterinarians, probably reflecting the lower uptake of social media there. In particular, younger veterinarians and those who actively used Facebook for the practice, could see benefits. In all three countries, we found that clients most frequently complained about treatment costs. Most veterinarians preferred to actively deal with clients’ complaints, either replying online or discussing them directly.


We recommend future research focusing on veterinarians’ personal use of social media and on clients’ use of and attitudes towards social media in the veterinary context.

Digital opportunities to connect and complain – the use of Facebook in small animal practice (URL)

Comparing veterinarians’ attitudes to and the potential influence of pet health insurance in Austria, Denmark and the UK

By S. Springer, T. B. Lund, H. Grimm, A.T. Kristensen, S. A. Corr & P. Sandøe (2022). 
VetRecord. BVA



Health insurance offers many benefits to clients and veterinarians, such as the ability to perform necessary and possibly cost-intensive medical interventions without financial constraints, or to potentially prevent euthanasia based on financial challenges. However, concerns about negative consequences, such as the overuse of diagnostic tests or overtreatment, have also been raised.


Using an online questionnaire distributed via e-mail, which included a section on health insurance, we investigated the relative number of insured dogs and cats treated by Austrian, Danish and UK veterinarians (N = 636) and the attitudes of those veterinarians toward health insurance. Further, using a case vignette, we examined whether coverage by health insurance may influence treatment suggestions.


Even though veterinarians in all three countries believe that health insurance reduces stress since clients’ financial resources will be less important, we found that Austrian veterinarians are more likely to agree that health insurance is unnecessary compared to Danish and UK veterinarians. Further, many raised the concern that insurance policies influence clinical decisions; and less than half supported the idea of making insurance mandatory. A majority of veterinarians in Austria and the UK thought that insurance can lead to the overuse of diagnostic tests, and in the UK a majority also thought that it can lead to overtreatment. Using case vignettes, we found that veterinarians were significantly more likely to suggest a CT scan to a client with an insured animal, in contrast to a client with stated financial limitations. Further, UK veterinarians were more likely to suggest a CT scan to a client with an insured animal, in contrast to a client without insurance.


In conclusion, we found that veterinarians, in general, were in favour of health insurance, and that greater coverage may increase more cost-intensive veterinary care. Our findings also raise a potential ethical challenge of health insurance causing differential access to clinical care for patients.

Comparing veterinarians’ attitudes to and the potential influence of pet health insurance in Austria, Denmark and the UK (URL)

“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) 


Small veterinary practice is experiencing steady improvement in diagnostics and therapies which enable veterinarians to offer evermore advanced medical care for their patients. This focus group study of veterinarians (n = 32) examined the impact of these improvements and the potential challenges they introduce in small animal practice. It shows that while advanced diagnostics and therapies deliver benefits in patient care, they also add complexities to decision-making. Although the veterinarians participating in the study were aware of their duty to act in the best interests of the animal, their decisions were highly dependent on factors such as the client’s financial background and the emotional bond between client and animal, as well as the veterinarian’s place of work, and level and field of specialization, and certain economic aspects of the practice. The overall conclusion is that small animal veterinarians are increasingly torn between serving the best interests of the animal, medical feasibility and contextual factors related to the client, the veterinarian, and professional colleagues. Further, the findings suggest that services are not only oriented towards the provision of medical care in a strict medical sense. On top of this, veterinarians need to deal with various expectations and wishes of clients which influence their decision-making. As it will be shown, factors like the possibility of referring patients to specialist veterinarians or prompt diagnostic results influence their decision-making.

Austrian Veterinarians’ Attitudes to Moral Challenges in Modern Small Animal Practice (URL)

Encouraging Self-Reflection by Veterinary Clinicians: Ethics on the Clinic Floor

By S. A. Corr, C. Palmer & P. Sandøe (2018)
The American Journal of Bioethics.
Taylor & Francis


Rosoff and colleagues (2018) describe some difficult ethical decisions facing veterinarians in clinics treating dogs, cats, and other companion animals. They propose adapting the human clinical consultation committee model, and establishing clinical ethics committees (CECs) to assist in resolving such ethical challenges in the more advanced of these clinics, the so-called tertiary care veterinary specialty hospitals.

In this commentary, we agree that veterinarians often face troubling ethical decisions involving potential over- or undertreatment of their animal patients, the financial constraints of their clients, and, sometimes, the goals of the institutions that employ them. While we accept that a CEC may, in some contexts, be an appropriate structure in which to deal with such difficult decisions, we argue that this is not the only, or necessarily the best, approach. We suggest that the ethical problems facing veterinarians differ significantly in different countries; that many acute ethical issues typically arise before animals even arrive at the veterinary specialty hospital; and that even within such hospitals, approaches other than CECs might be more effective, especially at gaining acceptance by the veterinarians themselves.

Encouraging Self-Reflection by Veterinary Clinicians: Ethics on the Clinic Floor (pdf)

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.

A study of how Danish small animal practitioners handle financially limited clients (pdf)

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 active involvement of the veterinarian in the decision-making process, and this may challenge a veterinarian’s wish to respect client autonomy.

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 case there is a need to further explore the challenges these situations raise, and for the veterinary profession to engage in more formal and structured deliberation over the role of veterinarians in relation to clients’ decision-making.

Veterinarians’ role in clients’ decision-making regarding seriously ill companion animal patients (URL)

Looking After Chronically III Dogs: Impacts on the Caregiver's Life

S.B. Christiansen, A.T. Kristensen, P. Sandøe & J. Lassen (2013) 
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 care expected to affect the owner's life. Interviews were recorded, transcribed, and analyzed qualitatively. The dog owners reported several changes in their lives due to their dog's condition: practicalities like extra care, changes in use of the home, and restrictions relating to work, social life, and finances. These were time-consuming, tough, and annoying, but could often be dealt with through planning and prioritizing. Changes in the human–dog relationship and activities caused sadness and frustration, which in turn led to feelings of guilt, and in some cases created a feeling of loss. Also, concerns about the progress of the dog's condition, it's welfare, and euthanasia brought emotional distress and many doubts. The owners did, however, respond to the changes differently and as a result experienced different effects on their own life. This study confirms that the situations of caregivers with human and animal patients are in some ways similar, yet the study also identifies and reflects on some of the differences. These include the caregiver role and the options of assistance as well as euthanasia. Veterinary staff are urged to inform owners about possible impacts on their lives when considering careconsuming treatments, and to be aware of the need for support during treatment as well as in decisions about euthanasia.

Looking After Chronically Ill Dogs (limited access)