Dr. Michael W. Fox

The Future of the Veterinary Profession

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THE FUTURE OF THE VETERINARY PROFESSION

By Dr. Michael W. Fox BVetMed, PhD, DSc, MRCVS*

 

COMPANION ANIMAL VETERINARIANS’ CHALLENGES

More women than men now graduate from veterinary colleges than when I graduated in 1962. My education in England, (after winning a County scholarship) was free. Today, graduates have student loan debts around $150,000 which is not secure way to start a professional life dedicated to providing the best and most cost-effective care for people’s beloved cats, dogs and other animals they keep, often inappropriately, as “pets”. The clinical challenge to help their animal patients are many and considerable, along with rising costs of medications and essential diagnostics. Most of their animal patients are neutered, variously confined and often living long hours alone, fed highly processed manufactured foods and given OTC anti-flea and other anti-parasite drugs on a routine basis. Many dogs and ever more cats also have genetic abnormalities because of selective and in-breeding that make them more prone to various diseases, to vaccinations and anesthesia which could mean frivolous malpractice suits and rising liability insurance costs. We can add having to address the consequences of de-clawing, lack of owner/care-giver understanding of animals’ basic needs and PTSD in abused and traumatized shelter animals. Highly trained and dedicated animal doctors are seeing a decline in patient-treatment hours as the foundering economy affects more and more people, the core middle-class and secure working class of a once relatively sustainable and equitable economic and political system. 

Pet health insurance, (for those who can afford) and franchised veterinary services are now a reality. But in my estimation the future would be more secure and the greater good better served by the professional veterinary sector that provides companion animal veterinary services in any given community to be more deeply involved in local animal shelter, animal rescue, cruelty and protection concerns: and in promoting preventive health care, animal behavioral counseling and even speaking to school children about animals and their proper, responsible care, humane ethics, animals’ interests and rights. The many dogs who bark for hours in my and other neighborhoods, and the free-roaming cats killing song birds and chipmunks in front of us while we sit out on our deck are symptomatic of some major animal health, welfare and care issues that have not been fully addressed and rectified, in part because of a lack of veterinary expertise being called for in community relations and the establishment of effective municipal animal care and protection regulations.

 A more socialized rather than over-capitalized companion animal veterinary medicine is called for, and many veterinarians are responding to that call. There is no group of professionals more qualified to share their experiences through volunteering and offering their expertise by beginning an ongoing educational dialog with animal lovers in their communities More veterinary students are also being exposed to this community-based orientation by helping in animal shelters and engaging in spay-neuter, vaccination, behavioral counseling and adoption programs. Others elect to invest in postgraduate specialist training and work in referral practices for those who can afford to see a veterinary dermatologist, neurologist or other specialist for their animal’s particular health issue. But many health issues may soon be greatly reduced in incidence as per the advances being made in veterinary preventive and holistic, integrative medicine: And in public education, such as to microchip cats and dogs, adopt a dog or cat rather than go on-line to purchase an inbred pure-breed or designer-bred, puppy or kitten from a live-commodity supplier, several of which have been prosecuted for animal cruelty and closed down. Many people now take their pups to puppy classes to socialize their animals and to learn animal communication and control, while those with cats learn how and why to make their cats enjoy life indoors and never need or be allowed to roam free off their property.

The best medicine is prevention which calls for annual wellness examinations for all animal companions and a more holistic, integrative approach to companion animal health in this 21st century. This has already lead to a re-evaluation of vaccination protocols, of feeding highly processed “junk” commercial pet foods, , the “necessity” of spaying and neutering and of over-medicating, especially with so-called preventive medications like those sold in pet and drug stores to kill fleas and ticks.  For further information, contact a holistic veterinarian in your area. A searchable list can be found at http://www.holisticvetlist.com. Veterinarians wishing to learn more are encouraged to become members of the American Holistic Veterinary Medical Association at http://ahvma.org

OPEN EXAMINATION OF POTENTIAL CONFLICTS OF INTEREST

I sent the following letter to the Editor of the Journal of the American Veterinary Medical Association concerning the close corporate ties of the Association with the pet food and pharmaceutical industries.

  Letter to the Editor,

Journal of the American Veterinary Medical Association,

Sent via e-mail May  2009

Dear Sir, Re: EXAMINING CONFLICTS OF INTEREST IN THE VETERINARY PROFESSION

The relationships between the corporate sector, and in particular with drug companies, and private medical practitioners, hospitals, and medical schools, are being called to question by the Institute of Medicine in the US (1).

Is a similar examination called for in the veterinary sector where comparable corporate interests may be at play and affect the quality of care and services animal patients receive? It would seem that there has been a lack of due diligence over the role of diet, specifically, highly processed pet foods (2) in many contemporary health problems of companion animals. The same may be said about the routine application and so called ‘preventive’ treatments with anti-flea and tick topical products that only now are being fully evaluated by the Environmental Protection Agency (3). Was due diligence also lacking, in part because of inadequate information and understanding, with dog and cat vaccinations? Until recently the universal protocol of giving dogs and cats annual ‘booster ’injections of multivalent  live and genetically engineered vaccines met resistance when ever questioned.

Corporate sector partnering in academia even includes chairs and professorships named after the donating company at many veterinary colleges. What role such partnering may play in contributing to the grave consequences of poor diets, over-medication, and hyperimmunization in companion animals by deferring to vested interests and by claiming lack of scientific proof of harm from such practices, is an open question. Academia should not be exploited to garner public credibility, nor should the market place become the final arbiter of what is acceptable.

Examining possible conflicts of interest may be difficult, considering the partnership of the American Veterinary Medical Association with Fort Dodge and Merial pharmaceutical companies, and Hill’s Pet Nutrition, who together have pledged $4.5 million in support of AVMA programs and services over the next four years (4). But this difficulty could become a confluence of interests once the health and well-being of companion animals are first and foremost on the agenda. The content of both the JAVMA, and its equivalent with the British Veterinary Association’s (BVA) Veterinary Record, increasingly addresses issues concerning animal health and welfare, including nutrition and vaccinations.

In the UK, the government and the BVA have chosen to focus on the health and welfare problems of a genetic origin, primarily in pedigree dogs. Some critics believe that this is a massive displacement, since it is the genetic susceptibilities to dietary diseases and vaccinoses (adverse vaccination reactions) in specific breeds make them the canaries for the canine population at large (5). The appropriate use of vaccines, (6), various ‘preventive’ veterinary drugs, prescription diets, and the adequacies of manufactured cat and dog foods, also need to be considered if the mandate of the British government is to protect the health and welfare of companion and other animals, not just better regulate breeding practices. British dog breeders feel they are the scapegoats and are taking all the blame for the myriad and costly health problems in today’s canine population. The same can be said for the major ailments in the feline population, where poor diets and adverse drug and vaccine reactions similarly take their toll according to Hill’s former Director of Technical Affairs, veterinarian Dr. Elizabeth Hodgkins Esq.(7) 

Of course there are confluences of interest that can benefit all, and this would be forthcoming I believe when there is a more integrated approach to animal health and welfare. This could be developed from a bioethical basis (8) by veterinary teachers, researchers and practitioners, a Council for Veterinary Bioethics being one response to the call for an examination of possible conflicts of interest within the profession.

References

(1) Sternbrook R.. Controlling Conflict of Interest---Proposals from the Institute of Medicine. Published at www.nejm.org  April 29th 2009  (10. 1056/NEJMp0810200).

(2) Fox M W, Elizabeth Hodgkins and Marion E. Smart. Not fit for a dog: the truth about manufactured dog and cat food. Fresno, CA, Quill Driver Books, 2009.

(3) AVMA News. Topical flea and tick products come under EPA scrutiny. J Am Vet Med Assoc 2009; 234: 1228.

(4) AVMA News. AVMA enters into multimillion-dollar partnership with companies. J Am Vet Med Assoc   2008; 233: 219.

(5) Dodds WJ. Vaccination protocols for dogs predisposed to vaccine reactions. J Am Animal Hosp Assoc 2001; 38: 1-4.

(6) Schultz RD, Ford RB, Olsen J. and Scott F. Titer testing and vaccination: a new look at traditional practices. Vet Med, 2002, 97: 1-13 (insert).

(7) Hodgkins EM., Your Cat: Simple New Secrets to a Longer, Stronger Life

 New York, Thomas Dunne Books, 2007.

(8) Fox MW. Veterinary bioethics, pp 673-678, in Complementary and alternative medicine, .Schoen AM and .Wynn SG. eds, St Lois, MO Mosby, 1998.

Michael W. Fox, BVetMed, PhD, DSc, MRCVS

e-mail ipan@erols.com Website  www.twobitdog.com/DrFox

Member of the British Veterinary Medical Association since 1962 and Honor Roll Member of the American Veterinary Medical Association.

*************************************************************

This letter was rejected for publication.

 

One reason for the veterinary profession’s current hard times and unclear future may be its historical double vision or conflicted mission.  The profession seems torn between serving the best interests of animals, and serving the interests of its animal-owning clients and its larger society—both of which may not be in accord with those of the animals.  The American Veterinary Medical Association was founded in 1863.  And yet, its Veterinarian’s Oath included no reference to animal welfare “as a priority of the profession” until 2011.  I have long seen the profession torn between two often conflicting, but I believe, resolvable forces and sets of values―concern and responsibility for animal suffering, health and welfare (the ‘calling’ of most veterinary school applicants), and economic realities such as the cost of services performed, and the monetary, rather than the emotional (and other) value of animals. However, I do find grounds for optimism in the emerging One Health movement 1, 2 where human health and well-being are at last being linked to animal health and welfare, as well as to environmental and ecological health. But for the One Health concept to be effectively implemented, the bioethics of equal consideration must be applied not only to humans but also to our treatment of animals and the environment. This is in accord with the moral imperatives of the animal rights and ‘deep’ ecology movements, long opposed by the biomedical, agricultural and other industries and business establishments 2.

THE PRACTICE OF HOLISTIC HEALTH CARE

From my bioethical perspective, holistic human and veterinary medicine addresses the diagnosis, treatment and prevention of disease/illness from an integrative mind-body and environment paradigm. The triune of psyche, soma and spirit—mind, body and the patient’s will to live, is especially important for the stressed, distressed and chronically ill and impaired physically and emotionally. Quality of life and quality of environment are paramount considerations. Far too many animals kept as “pets” lead socially and environmentally impoverished lives in crates, cages, even chains, as do elephants and other wild species kept for public entertainment. The ways in which most animals are raised for human consumption are a horrendous reflection of human insensitivity and instrumental rationalism, terms also used by HRH Prince Charles in reference to the destruction, depletion and desecration of ecosystems integral to the health of the biosphere and all who dwell within.

Obligation to Advocate for Compassionate Care

 In the Codex Veterinarius drafted by the German Veterinary Association for the Protection of Animals we find this statement:

“Veterinary action for the welfare and protection of animals is guided by the principle of respect for life and the awareness that the animal has a dignity which is to be respected. Therefore protection and care for an animal cannot be dependent on its economical value. In situations of diverting interests between moral obligations and economical pressure it is essential to consider carefully the respect for life against the productive use of life in all its forms of existence… Considering carefully the opposing interests and needs, the interests of the human being should not automatically be considered to be more important than those of the animal... When in doubt veterinary surgeons should let themselves be guided by the principle: In dubio pro animale!”3 (This idiomatic Latin phrase can be roughly translated as, “When in doubt, support the animals!”)

Compassionate Care as a Basic Right and Responsibility

There is growing consensus that veterinarians have an ethical obligation to advocate for compassionate animal care regardless of the context in which their services are applied. This is because of an emerging recognition that compassionate care is our fundamental human responsibility and every animal’s deserved and basic right. Furthermore, compassionate care is vital to animals’ health, welfare, and physical and psychological well-being. It is as essential a component of contemporary veterinary medicine as caring for the land is a vital aspect of sustainable agriculture.

Among Animals, People and the Environment

Veterinarians have been seen as a unique association for millennia. As interlocutors among people, animals and their environments, veterinarians’ roles and knowledge, both empathic and scientific, have been highly valued by societies.  Indeed, according to Professor Calvin Schwabe in his book Cattle, Priests and Progress in Medicine, 4 the earliest veterinarians were priest-healer members of ancient Egypt's many dynasties.

Challenges of Situational Ethics

Today, gender-linked differences in moral philosophy may be factors associated with current shortages of veterinarians in the food animal and laboratory animal medicine sectors.5 Veterinarians in companion animal practice, and also those dealing with ‘exotic’ animals, face ethical dilemmas on a daily basis. One recent survey6 indicates “an urgent need for ethics educational tools and approaches specifically designed with veterinary surgeons in mind.” The influence of vested corporate interests in veterinary schools has also increased significantly in recent years and is now being questioned as a broader ethical issue.7

Student Debt Burden and Income-Challenged Community Access to Care

Lobbying for better funding from government, industry and non-profit sources for student scholarships or debt-forgiveness for pledging to work in much-needed sectors such as overseas aid and development, emergency services, and in low-income neighborhoods (like the People’s Dispensary for Sick Animals in the U.K.) may be considered enlightened professional self-interest.  However we know that at the community level within the U.S., as revealed in a recent report by The Humane Society of the United States entitled “Pets for Life―A New Community Understanding,” there is great need to remove cost barriers to animal care and veterinary services for economically blighted communities in order to improve their community animal health and reduce shelter overpopulation.

A New Professional Paradigm

Redefining the role of the veterinary profession in these times is critical to our profession’s future, and to civilization itself.  Putting animals and the environment first8 may be in the enlightened self-interest of civil society, but doing so would be an admittedly improbable paradigm shift, considering the nature of human psychology. Establishing a higher priority of concern for wild and domestic animals and the natural environment over trivial and harmful human needs and demands would be a significant step toward attaining a more sustainable economy and a better world for us all.  I believe it is our veterinary profession’s current challenge, and our duty, to apply our expertise in more effectively advocating for this new paradigm.

PREVENTIVE CARE FOR COMPANION ANIMALS: MAKING IMPROVEMENTS

The 2015 State of Pet Health Report from Banfield Pet Hospital, “Making Pet Care Personal: A Guide to Improving Preventive Care for Pets,”  released Aug. 12 seeks to answer this question: “What is the disconnect between how veterinarians position preventive care to pet owners and what pet owners truly believe?”

The report recommends expanding the definition of preventive care. For most veterinarians in the survey preventive care includes vaccines, neutering, and parasite control but pet owners are concerned about their animals’ diets, exercise, basic care, play, and emotional well-being. The report states: “For many pet owners, interactions with their veterinarian are not meeting their expectations and are seen as transactional,” according to the report. “They’re tied to specific services, like vaccines or parasite control. For advice on overall wellness of their animals, pet owners turn to groomers, boarders, breeders, day-care providers and trainers for advice. Also they look online to find additional information about behavior, health concerns, breeds and genetics, and food, nutrition, and diet.

This has been my concern and appeal for a more holistic and integrated approach to companion animal health and well-being expressed in my book Healing Animals & the Vision of One Health. The many questions that I receive from care-givers of dogs and cats over the past several decades along with statements about their experiences at some veterinary hospitals support the findings and recommendations of this report identifying where advances in preventive health care can be made for the good of all involved.

Preventing Disease, Respecting Animal Rights

The gulf between animal exploitation and animal kinship, and between animal abuse and animal liberation, is fundamentally a spiritual one. This gulf was created by human ignorance and egotism. It was sanctified by anthropocentric, patriarchal and fatalistic (karmic) religious traditions, both East and West, lacking in active compassion and responsive reverence toward all creatures and Creation. And it became the norm through the "Enlightenment" worldviews of dualistic (Manichean and Cartesian) and mechanistic (Newtonian) thinking, the empirical sciences of materialism, and through the perverted Darwinism of industrialism and colonialism and by contemporary scientific and economic determinism.

This same gulf lies between both our concepts of health and disease and of healthy or diseased conditions. A first step toward health is to examine our diseased relationships and to restore these sacred connections. Then our dis-ease will gradually become transformed into a condition of ease – of equanimity, openness, vitality, and spontaneity to fully experience the joys and tribulations of existence. In the wisdom of the open heart, where suffering and love are inter-twined, wellness means wholeness; oneness leads to wholeness; wholeness leads to holiness – the conscious apprehension of the Sacred.

Richard Brooks has translated a relevant passage from the TaoTe Ching written by the Chinese philosopher LaoTzu over 2,500 years ago:

I have three treasures that I hold and cherish:

The first is compassion (or deep love) (tz’u),

The second is frugality,

The third is not presuming to be first in the world.

Being compassionate, one can be courageous;

Being frugal, one can be generous;

Not presuming to be first in the world, one can become a leader (or minister).

Now, trying to be courageous without compassion,

Trying to be generous without frugality,

And trying to be a leader without humility

Is sure to end in death.

For compassion brings triumph in attack and strength in defense.

What Heaven wishes to preserve it surrounds with compassion. [Ch.67]

The absence of the Sacred, evident in a lack of reverence for life, is a societal norm today, and so long as this gulf persists between those who see life as a commodity, a means to an end for human gain, and those who would treat all life with respect, including the natural environment, and speak for animal rights, we and the world will never be well. And no amount of experimentation on animals in biomedical research laboratories will get rid of our dis-ease.

As we "evolved" from being gatherer-hunters, domesticating plants and animals and becoming sedentary, agrarian, and increasingly urban and industrial, we also became increasingly disconnected (and disoriented) from the natural world. As a consequence we began to devolve, as Charles Darwin implied in his book The Descent of Man, losing some of our sympathetic abilities and empathic wisdom that enabled us to engage in a degree of resonance or inter-subjective communication with other living beings that to our diminished sensibilities and rational empiricism of today seems mystical or psychic.

Anthropologist Prof. M. Guenther describes such resonance in the African Bushman that I believe is an innate or inborn ability of our species. Considering the fact that for some 95-98 percent of our time on Earth as humans we were gatherer-hunters, this ability may not be lost and could be restored. Sometimes while treating sick animals and in making a diagnosis I have felt pain or discomfort in parts of my own body that correspond to the animal’s illness or injury.

Prof. Guenther writes:

"Throughout the hunt the hunter would monitor his every thought, emotion and action, in order to sustain the bond of connectedness with the animal by which he felt he could steer the hunt towards an auspicious conclusion…The bond of sympathy was something set up in the hours or days preceding the hunt, when the hunters would attune themselves spiritually to one animal species or another and, in the process, attempt to gather whatever presentiments they could about the impending hunt: the animals they might encounter, the direction they could come from, the likely dangers, the duration of the hunt. These presentiments…activated the hunter’s entire body; they were felt at his ribs, his back, his calves, his face and eyes. His body would be astir with the ‘antelope sensation’, at places on his body corresponding with those of the antelope’s."

If we are to "evolve" we must regain a heightened sensitivity for fellow creatures and the living Earth, for when we harm others and the Earth, we harm ourselves. Part of our healing and wholeness therefore involves our nascent ability to empathize, and we must have the courage to suffer in the process, before we can put compassion into action and truly love.

References

1.Burns, Katie, Spreading the one-health concept  JAVMA 240:112-115, 2012

2.Fox, Michael W., Healing Animals &  Vision of One Health. CreateSpace books & Amazon.com, 2011

4. Burgermeister S, & Fikuart K., ALTEX. 15(4):209-212. 1998 Ethical guiding principles for veterinary behaviour with respect to the welfare and protection of animals. Tierärztliche Vereinigung für Tierschutz, D-Hamburg.

 5.Schwabe, Calvin, Cattle, Priests and Progress in Medicine, Minnesota, University of   Minnesota Press 1978

5. Narver, Heather Lyons, Demographics, moral orientation, and veterinary shortages in food animal and laboratory animal medicine. JAVMA 230:1798-1804, 2007

6.Batchelor, C.E.M. & McKeegan, D.E.F. Survey of frequency and perceived stressfulness of ethical dilemmas encountered in UK veterinary practice, Vet Rec 170: 19-20, 2012

7. Dally, Michelle, Ethical considerations raised by the provision of freebies to veterinary students. JAVMA 238:1551-1554, 2011.

 8. Fox, Michael W. Animals and Nature First. CreatSpace books and Amazon.com 20

The tripartite nature of integrative (holistic) medicine

The medical profession seems to have outdone the veterinary profession with a staggering incidence of adverse drug reactions (ADRs) in hospitalized patients. In one study, ADRs in the US ranked sixth in leading causes of death, with an estimated 2,216,000 ADRs, and 106,000 fatalities in hospitalized patients in 1994 (1). According to the FDA, 2 million people acquire bacterial infections while in hospital, and 90,000 die as a result. Alarmist as these figures may seem, they are symptomatic of the nemesis of modern medicine and of the urgent need for a more integrated, holistic approach to human illness that includes what we eat and how farmers farm (2)

The well-being of human patients’ spirits is most often left to nurses and visiting clergy, and that of animal patients to veterinary nurses and caretakers, all of whom may or may not have the needed time, or sensitivity and training to fulfill this basic patient need. By well-being of spirit we mean, in the vernacular, subjective sense, as being in good spirits, as distinct from being dispirited.

Well-being in spirit is linked in part to the spiritual sensitivity, awareness, and depth of concern of healers and care-givers. Maximizing both should be an integral part of veterinary and human medical practice and teaching curricula. Attention to patients’ well-being can be problematic for those who care but whose time is limited and treatments restricted due to the low reimbursements and dictates of seemingly one size fits all insurance directives.

 Some veterinary practitioners have told me that they rigorously avoided having to hospitalize their patients because the adverse impact on animals’ spirits was detrimental to recovery. They deplored some of their peers who over-hospitalized clients’ animals, often for minor, ambulatory conditions for which more in-hospital tests and monitoring were advised.

The first duty is to make the patient as comfortable as possible by alleviating physical discomfort such as pain, and addressing compromising physiological states like fever and inflammation. Alleviation of fear, anxiety, agitation, and depression, all of which can aggravate physical signs of illness and compromise recovery, are also important responsibilities that good healers traditionally address.

The patient’s vitality and condition of spirit have great prognostic value, since they are  the manifest expression of the body-mind connection as evidenced in the patient’s demeanor and changes therein during the course of the illness and treatment. The well-being of the spirit, an indicator of the will to live, is in part determined by physical and mental health. Sickness of the spirit, in extremis, the giving up of the will to live, has profound psychological and physiological consequences.

 These concerns are gaining recognition today especially where elderly patients develop hospital psychosis or the hospitalism syndrome within a few days, becoming increasingly confused, disoriented, agitated, dispirited, anorexic, incontinent, and even hallucinatory. Comparable reactions may be seen in animals confined for treatment and either separated from their owners, regular care-takers, or from their own species-companions. Animals in some no-kill shelters become dispirited with inadequate human contact and environmental stimulation, becoming increasingly difficult to rehabilitate/re-socialize due to almost psychotic neophobia and fear of strangers. The cage-depression of such institutionalized animals, like those in poorly managed zoos and menageries, is often associated with stereotypic, obsessive-compulsive behaviors.

 The well-being of the whole patient is addressed by the holistically oriented human and animal doctor who practices what I term integrated medicine. The cardinal signs of illness are closely evaluated, and diagnosis and treatment determined by considering the ways in which the illness in question is manifested. Physical and behavioral signs, called symptoms, may be treated directly, even in the absence of a formal diagnosis. Symptom-based treatments are supported by evidence-based medicine, drawing on prior experience with known remedies, not necessarily scientifically proven in terms of how the treatment actually works at the cellular level. When we, and the animals we care for, become ill, it always for some reason, most often a multiplicity thereof. Elucidating the causes is half the cure, and the ultimate prevention.

The holistic healer intuitively senses and feels, through empathy, close observation, and communication with the patient, the condition of the spirit. Reasons for being dispirited are identified as well as possible, especially social and environmental influences, in addition to physical and mental factors. Of these there may be many that have a synergistic effect throughout every disease process that includes dis-ease, from the onset of symptoms to ultimate recovery or death.

Concern for the patient’s spirit elevates medical and veterinary bioethics by incorporating values of compassion and empathy in patient treatment, care, and rehabilitation therapy. Decisions such as euthanasia, or discontinuing life-sustaining treatments, and evaluation of quality of life, can then be better made since the patient’s quality of life and prognosis cannot always be determined on the basis of physical indices alone.

Conventional practitioners of allopathic animal and human medicine primarily base their healing practices on the use of various drugs (and surgeries).  Western medical practice has separated the patient’s body from the mind by obeying paradigms of a dualistic, mechanistic and reductionist nature that have guided the approach to diagnosis and treatment. This has lead to some significant medical progress.

A further consequence has been the development of separate disciplines, beginning with psychiatry and internal medicine, and ending in oncology and dermatology, in part due to an exponential knowledge burden and demand for specialized skills. This development may contribute to the lack of conceptual and administrative integration, communication, and collaboration. The unforeseen sequelae  of the birth of these specialized branches are breakdowns in public health and health-care services. The cost has been astronomical, despite miraculous breakthroughs in treatments and cures.

 A similar breakdown secondary to this specialization-compartmentalization has been evolving in the veterinary profession. For example, some veterinary dermatology specialists and allergists, as well as general practitioners, fail to fully consider the role of manufactured pet foods in contributing to their patients’ condition. Many over-prescribe steroid drugs, and even prescribe expensive manufactured ‘prescription’ diets that have been especially formulated ostensibly to treat various health problems from diabetes to dermatitis. Yet they often contain the very same food ingredients that were in the pet foods that caused or contributed to their patients’ illness in the first place. (3)

INTEGRATED HEALING

Holistic veterinary and human doctors have gone beyond the false mind-body dichotomy in their approach to both diagnosis and treatment. The textbook edited by Dr. Frank McMillan entitled Mental Health and Well-Being In Animals,(4) and Schoen and Wynn’s Complementary and Alternative Veterinary Medicine,(5) are part of this revolution/evolution of Western veterinary medicine toward an integrated approach in addressing animal health and disease prevention, and animal welfare and well-being.

One integrative approach is to encourage the ability to regard the patient’s mind and body as his or her soul.   One assumes that spirit is the animating principle of every living soul, whereby we will surely have a very different medical paradigm and approach to disease prevention and treatment. Once the separation of mind and body is rejected   by conventional medical and veterinary practitioners, there is an opening for the integration of various alternative and supportive/adjunctive therapies.

 Historically, the first breaking away from the dualistic dichotomy of psyche and soma came with the recognition of psychosomatic diseases in human patients, and subsequently in animal patients, (6). More recently, a major advance in integrative medicine has come with the recognition of epigenetic processes (7). These processes were inconceivable until the dualisms of organism and environment, genomes, nutrition and other prenatal influences, were overcome, along with the science-based fiction of genetic determinism.

The late Prof. Konrad Lorenz, MD, Nobel laureate and a founding father of ethology, asserted that before one can really study and animal, one must first love it. By extension, before one can heal, one must first love the patient in the spiritual sense of agape.  Within the clinical setting this means compassion and empathy, innate qualities rarely taught through example nor encouraged in either medical or veterinary schools, with a few recent exceptions. This is regrettable because most human-socialized animals, like children, sense when they are loved, and whether someone is genuine or not. As with pediatricians, veterinarians who feign affection for their patients do not get very far.

The science of ethology helps resolve the artificial mind-body duality since it provides the tools to objectively determine the highly subjective condition of the animal's ethos, its spirit, sentiment, character, or disposition. The addition of applied animal ethology to the veterinary  teaching curriculum has done much to dispel the long-held view that animals do not have feelings, cannot suffer psychologically or become dispirited.

The collective ethos of society in terms of how animals are perceived and ought to be treated has changed significantly over the past 3-4 decades.   Humane concerns are being raised about how and why animals are being treated in certain ways.  The veterinary profession is being called upon by society to address many of these concerns as they affect animals’ health and well-being.  In the eyes of some critics, the profession has taken more reactive and defensive roles than proactive initiatives in order to protect the vested interests of their animal industry and commercial clients.  This conventional view has deep cultural roots. The veterinary, medical, and medical research disciplines need to disentangle themselves from such corporate entities. They must refocus conceptually, perceptually, ideologically, and ethically on animal health and well-being for animals’ sake as well as for the public health and other community benefits. 

The cultural blindness toward animals as living souls who are sentient beings is still very much in evidence today, reflected in the dispirited eyes of self-mutilating primates and purpose-bred dogs who spend most if not all of their lives in small laboratory cages or pens;  in the eyes of arthritis-crippled breeding sows in factory farms who are so confined as to be unable to walk or turn around their entire lives; and in the eyes of  performing circus elephants who spend most of their lives in chains and usually die from chronic foot infections and osteomyelitis.

The inability of animals to express their ethos, the normal range of behaviors essential for their physical and psychological well-being, because of the conditions under which we keep them, is to deny them expression of their natures, their spirits. To what ends and to what degree we chose to inhibit, even crush their spirits, is a bioethical issue that society has yet to fully address. But, along with the veterinary profession, society cannot address this issue with impartial objectivity until the chauvinistic notion of human superiority that puts people before other animals is tempered by humility and equalitarianism---giving all sentient beings equally fair consideration.

 Charles Darwin asserted that ‘The difference in mind between man and higher animals, great as it is, certainly is one of degree and not of kind,”. (8). He wrote these words over a century ago, contrary to the prevailing anthropocentrism of the time, based upon his studies of comparative morphology and behavior.  In a similar vein, the late Loren Eiseley, a professor of anthropology and paleontology, (9) observed, “One does not meet oneself until one catches the reflection from an eye other than human.” Such self-discovery would do much, I believe, to improve the health and well-being of our own kind, and the animals under our care.

References

1. Lazarou J, Pomeranz BH, Corey PN. Incidence of adverse drug reactions in hospitalized patients: a meta-analysis of prospective studies. JAMA.1998; 279:1200-1205.

 2.  Cox S, Sick Planet: Corporate Food and Medicine. Ann Arbor, Michigan, 2008.

3. .Fox MW, Hodgkins HE, Smart M. Not Fit For a Dog: The Truth About Manufactured Dog And Cat Food. Sanger, CA QuillDriver Books 2008

4. .McMillan FD. (ed) Mental Health and Well-Being in Animals. Ames, Iowa, Blackwell, 2005

5. Schoen AM, S.G.Wynn SG. (eds) Complementary and Alternative Medicine: Principles in Practice. St Louis, MO, Mosby, 1998

6. Fox MW. (ed)  Abnormal Behavior in Animals. Philadelphia, PA, W.B.Saunders,  1968

7. Fox MW. Integrative Development of Brain and Behavior in the Dog. Chicago, IL, University of Chicago Press, 1971

8.    Darwin C. The Descent of Man and Selection in Relation to Sex.  New York, J.A..Hill & Co., 1904

9. Eiseley L. The Unexpected Universe New York, Harcourt, Brace and World, 1964,  p.24

 

                 THE VETERINARY PROFESSION: LEADING SOCIETY TOWARD ONE HEALTH

The significance, value and role of animals wild and domesticated in various cultures include spiritual (totemic and symbolic), biological and ecological (scientific), emotional (affection/aversion) and commercial (including consumptive) perspectives. Such diversity in perception and related treatment is the antithesis of a unified sensibility based on respect for all life and according all living beings equal and fair consideration---an essential extension of the Golden Rule to temper the harmful consequences and historical legacy of anthropocentrism’s limited and self-limiting world view.

Ethical consistency in our treatment of all beings based on the wisdom of the Golden Rule to avoid causing harm to others which we would not wish for ourselves is enlightened self-interest because when we harm others we ultimately harm ourselves. For example, the sciences of ecology and molecular biology have revealed the vital importance of bacteria and other microorganisms in the living soil and in our digestive systems, the former being essential for plant growth and health and the latter being intimately connected to our immune, endocrine, neurological, cognitive and other systems and functions. The complexities and interdependencies of living systems and life processes are challenges to the sciences and to human understanding; and to holistic, integrative medicine as well as to farming practices (including aquaculture and agroforestry) and all other industries and human activities that affect these systems and processes. Proceeding with the precautionary principle as our compass directing us away from hubris, rationalized selfishness and denial, human progress is a possibility and not a false hope.

Until the recent adoption of applied animal behavior, animal welfare science and the One Health concept, how well has the veterinary profession helped prevent the harms of anthropocentrism to animals and the environment and thus indirectly to ourselves, and to what degree does it continue to serve those interests causing more harm than good nationally and internationally?

Contemporary society has intensified the conflict of interest for the veterinary profession by first endorsing as accepted norms various extremes in selective animal breeding ( with genetic anomalies and compromised phenotypes); in keeping wild animals as “pets” and exploiting them for circus and other commercial purposes; and in animal husbandry practices, especially in factory farms/concentrated animal feeding operations that are contrary to the best interests of the animals and to their health and well-being. These are the primary concerns and responsibilities of the veterinary profession to promote, yet the various animal industries and animal-owning public essentially dismiss these concerns of veterinary bioethics (Fox 2011 ) as contrary to the accepted norms of animal use. The underlying economic and cultural justifications of what often amounts to abusive animal exploitation have put the veterinary profession in a double bind. By not asserting the core principles of veterinary bioethics and animal welfare science and ethics and being a guiding influence in society, the profession has become increasingly marginalized by the economics of the livestock industry. While it strives to serve this and the pet, exotic species and other animal industries it is seeing revenues decline as the industrial economy seeks more ‘efficiencies’ and continues to founder.

Millions of rural families in India and other developing countries, including some who are forced to move into urban slums, are in part sustained by an often shared milk cow and by a few goats and chickens. Few are fortunate to have access to grazing land, much communal land being overgrazed as per ecologist Garret Hardin’s (1977) predicted global “tragedy of the commons”. Without urgently needed subsidized veterinary services and supplies of animal feed and water (rather than scavenging off garbage) this sector’s farmed animal population (including bovines and equines used for draft work) continues to be a neglected and significant incubator of diseases harmful to other farmed animals, to wildlife and to the human populace locally, nationally and internationally. These problems are being compounded by the proliferation of intensive methods of livestock and poultry production using imported breeds. These operations become epicenters of pollution and disease, and, along with imported varieties of commercial crops, accelerate the loss of biological diversity as indigenous breeds are marginalized from the agricultural system.

The veterinary profession can be a significant contributor of expertise to the One Health approach to the rising public health issues of foodborne illnesses, zoonotic diseases including those arising from disrupted and endangered biotic communities and wildlife species. After having played a not insignificant role in contributing to these problems by its unquestioned service to the livestock industry in the industrialized and developing sectors of the world, organized government veterinary services and private practitioners are not alone in having to make amends and rectify the ultimate human and environmental costs of decades of animal exploitation, documented suffering and ecological harm.

We must all make amends in the name of respect for all life, compassion and justice being the foundation of a more civilized world community with a new vision of health arising from enlightened altruism: When we care for the land, the land will care for us, and when we care for animals wild and domesticated, we care for ourselves because our health and well-being is a reflection of theirs. This is affirmed by the science and ethics of One Health (Fox 2011).

 A substantial percentage of the annual profits of the pharmaceutical industry should be provided to support public health and preventive medicine initiatives and also independent research in alternative, complementary and integrative veterinary and human medicine with especial emphasis on nutrition and epigenetics. The dominance of conventional/allopathic practice relying on synthetic pharmaceuticals and new generation genetically engineered biologics to treat various human and non-human medical and psychological/behavioral conditions is facilitated by alignment with the health insurance industry. Coupled with rising costs of prescription drugs and limited ability of the government to effectively guarantee drug safety and efficacy with fast-track approval of U.S. -developed and patented pharmaceuticals and others imported from countries like India and China with endemic problems of corruption and price-fixing, this scenario is a major obstacle to real progress in One Health.

History informs, as the contemporary healing professions will confirm, contrived sympathy for patients is no substitute for empathy. But the burden of empathy is too often avoided at the expense of the intuitive, subjective, healer-patient relationship. This relationship is part of the “art” of human and veterinary medicine. In its absence, which objective detachment facilitates, the impersonal and impartial science of medicine becomes blind to its own limitations. This is because the emotional, existential, phenomenological and ecological/environmental dynamics of dis-ease etiology and symptomatology are oversimplified and marginalized. They are reduced to fit the moralistic, mechanistic and economistic imperialism of conventional diagnostics and treatments in the health insurance and drug industry-dominated main-stream human and animal care professions as predicted almost forty years ago by Ivan Illich (1977).

 This anthropocene epoch with its evident anthropogenic contributions to disease, climate change and loss of biodiversity will be either one of intensifying global strife and dis-ease or transition into what the late Thomas Berry (1988) called the ecozoic age; the age of ecological consciousness.  A new social, or more correctly a biosocial contract or covenant between society and animals and our shared environment is called for based on the principles of an egalitarian respect for all life, eco-justice and planetary CPR----conservation, preservation and restoration of both cultural and biological diversity.

An integral aspect of One Health is the saving not only indigenous crop varieties and breeds of domestic animal, which are generally better adapted climatically and more disease-resistant than imported varieties, but also indigenous knowledge. This includes tried and true methods of animal husbandry and disease prevention and traditional medicinal treatments especially with botanicals which, as several authors have documented, ( Lans 2011, Lans et al 2007, Mathias 2004) should not be dismissed as being scientifically unproven and abandoned in favor of synthetic pharmaceutical products which are often too costly if even available in many rural communities.

The veterinary and other professional organizations, multinational corporations and governments alike, as well as the consumer-populace, have the power and responsibility to determine what the future quality of life will be on planet Earth. This will be more for the better than for the worse when improving the health and well-being of animals wild and domesticated is recognized as a trans-cultural ethical imperative. This auspicious beginning heralded by veterinarians’ commitment to the One Health movement, (which is more than promoting vaccinations and various pharmaceuticals); to wildlife and endangered species conservation, and to making long overdue improvements in animal care and well-being though a holistic, integrative approach as advocated by the American Holistic Veterinary Medical Association and other organizations and individuals of like mind.

References

Berry, Thomas. (1988). The Dream of the Earth. San Francisco Sierra Books. See also www.ecozoicstudies.org

Fox, Michael W.  Healing Animals & The Vision of One Health. ( 2011). CreateSpace Publications/Amazon.com* See also Bringing Life to Ethics: Global Bioethics for a Humane Society. Albany NY, State University of New York Press. See also Fox, M.W.!1995). Veterinary bioethics: ecoveterinary and ethnoveterinary perspectives. Veterinary Research Communications, 19: 9-16  and Fox, M.W. (2006.) Principles of Veterinary Bioethics. Journal of the American Veterinary Medical Association 229: 666-667

 Hardin, Garrett, (1977). The Limits of Altruism: An Ecologist’s View of Survival. Bloomington, Indiana University Press

Illich, Ivan, (1977). Medical Nemesis: The Expropriation of Health. New York, Bantam.

Lans, Cheryl. (2011). Validation of ethnoveterinary medicinal treatments. Vet. Parasitology 178 (3-4): 389-90

Lans, Cheryl et al. (2007). Ethnoveterinary Medicine: Potential Solutions for Large-Scale Problems. In Veterinary Herbal Medicine, eds. Susan G. Wynn and Barbara J. Fougere, 17-32. St. Louis, Mo.: Mosby Elsevier

Mathias, E. (2004). "Ethnoveterinary medicine: Harnessing its potential." Vet Bull 74 (8): 27N – 37N.

See also: Barry S. Kipperman (2015) The role of the veterinary profession in promoting animal welfare, JAVMA 246: 502-504, and Manuel Magalhães Sant'Ana, (2014).  PhD Dissertation: Why, What & How To Teach Ethics to Veterinary Students in Europe. http://repositorio-aberto.up.pt/bitstream/10216/74139/2/99742.pdf

*This book is available gratis from the American Holistic Veterinary Medical Association as a PDF to all veterinary students joining the Association.

END NOTE

After a fortuitous meeting with oncologist the late Van Rensselaer Potter, MD,* who first coined the term bioethics to extend the scope of medical ethics from its primary focus on professional conduct and standards of care/practice to embrace environmental, population and epidemiological dimensions of human health and disease prevention, I realized that a similar application of bioethics was needed for the practice of veterinary medicine.

The vision I had shared with my friend and colleague the late Prof. Calvin W. Schwabe, DVM,* (who was the first in modern times to link veterinary epidemiology and comparative medicine with the concept of One Health) was for the veterinary profession to serve as the interlocutor between animals and society/civilization for the benefit of both. Applied bioethics provides the essential template for progress in One Health to be realized.

 In modern parlance this role of the veterinarian in society is one of symbiogenesis (facilitating mutually benefiting symbiotic relationships between humans and non-humans, wild and domesticated, which are ecologically and environmentally neutral or enhancing) rather than one of pathogenesis as per the plethora of agricologenic, domesticogenic and iatrogenic diseases that afflict selected plant and animal species subjected to human manipulation and exploitation.

 This role of interlocutor/intermediary has its roots in the shamanic and other animistic customs, rituals and ethical traditions of past indigenous cultures and economies, few of which survive today. One remnant, almost archaic term survives from that epoch in Western industrial society, namely “Animal Husbandry”. Like rare seeds and breeds, indigenous cultures need to be saved from extinction/assimilation, their indigenous knowledge being an invaluable resource for conservation and restoration of the ecosystems they inhabit and where veterinary services, too often not provided by corrupt and indifferent government agencies, are of critical importance for both the wildlife and the domestic animals upon whom these people rely. Planetary CPR (conservation, restoration and preservation) must include the protection and enhancement of both cultural and biological diversity.

*Van Rensselaer Potter (1988). Global Bioethics: Building on the Leopold Legacy. East Lansing: Michigan State University Press

* Calvin W. Schwabe (1978). Cattle, Priests and Progress in Medicine. Minneapolis, University of Minnesota Press

 

 

THE FUTURE OF THE VETERINARY PROFESSION

By Dr. Michael W. Fox BVetMed, PhD, DSc, MRCVS*

 

COMPANION ANIMAL VETERINARIANS’ CHALLENGES

More women than men now graduate from veterinary colleges than when I graduated in 1962. My education in England, (after winning a County scholarship) was free. Today, graduates have student loan debts around $150,000 which is not secure way to start a professional life dedicated to providing the best and most cost-effective care for people’s beloved cats, dogs and other animals they keep, often inappropriately, as “pets”. The clinical challenge to help their animal patients are many and considerable, along with rising costs of medications and essential diagnostics. Most of their animal patients are neutered, variously confined and often living long hours alone, fed highly processed manufactured foods and given OTC anti-flea and other anti-parasite drugs on a routine basis. Many dogs and ever more cats also have genetic abnormalities because of selective and in-breeding that make them more prone to various diseases, to vaccinations and anesthesia which could mean frivolous malpractice suits and rising liability insurance costs. We can add having to address the consequences of de-clawing, lack of owner/care-giver understanding of animals’ basic needs and PTSD in abused and traumatized shelter animals. Highly trained and dedicated animal doctors are seeing a decline in patient-treatment hours as the foundering economy affects more and more people, the core middle-class and secure working class of a once relatively sustainable and equitable economic and political system. 

Pet health insurance, (for those who can afford) and franchised veterinary services are now a reality. But in my estimation the future would be more secure and the greater good better served by the professional veterinary sector that provides companion animal veterinary services in any given community to be more deeply involved in local animal shelter, animal rescue, cruelty and protection concerns: and in promoting preventive health care, animal behavioral counseling and even speaking to school children about animals and their proper, responsible care, humane ethics, animals’ interests and rights. The many dogs who bark for hours in my and other neighborhoods, and the free-roaming cats killing song birds and chipmunks in front of us while we sit out on our deck are symptomatic of some major animal health, welfare and care issues that have not been fully addressed and rectified, in part because of a lack of veterinary expertise being called for in community relations and the establishment of effective municipal animal care and protection regulations.

 A more socialized rather than over-capitalized companion animal veterinary medicine is called for, and many veterinarians are responding to that call. There is no group of professionals more qualified to share their experiences through volunteering and offering their expertise by beginning an ongoing educational dialog with animal lovers in their communities More veterinary students are also being exposed to this community-based orientation by helping in animal shelters and engaging in spay-neuter, vaccination, behavioral counseling and adoption programs. Others elect to invest in postgraduate specialist training and work in referral practices for those who can afford to see a veterinary dermatologist, neurologist or other specialist for their animal’s particular health issue. But many health issues may soon be greatly reduced in incidence as per the advances being made in veterinary preventive and holistic, integrative medicine: And in public education, such as to microchip cats and dogs, adopt a dog or cat rather than go on-line to purchase an inbred pure-breed or designer-bred, puppy or kitten from a live-commodity supplier, several of which have been prosecuted for animal cruelty and closed down. Many people now take their pups to puppy classes to socialize their animals and to learn animal communication and control, while those with cats learn how and why to make their cats enjoy life indoors and never need or be allowed to roam free off their property.

The best medicine is prevention which calls for annual wellness examinations for all animal companions and a more holistic, integrative approach to companion animal health in this 21st century. This has already lead to a re-evaluation of vaccination protocols, of feeding highly processed “junk” commercial pet foods, , the “necessity” of spaying and neutering and of over-medicating, especially with so-called preventive medications like those sold in pet and drug stores to kill fleas and ticks.  For further information, contact a holistic veterinarian in your area. A searchable list can be found at http://www.holisticvetlist.com. Veterinarians wishing to learn more are encouraged to become members of the American Holistic Veterinary Medical Association at http://ahvma.org

OPEN EXAMINATION OF POTENTIAL CONFLICTS OF INTEREST

I sent the following letter to the Editor of the Journal of the American Veterinary Medical Association concerning the close corporate ties of the Association with the pet food and pharmaceutical industries.

  Letter to the Editor,

Journal of the American Veterinary Medical Association,

Sent via e-mail May  2009

Dear Sir, Re: EXAMINING CONFLICTS OF INTEREST IN THE VETERINARY PROFESSION

The relationships between the corporate sector, and in particular with drug companies, and private medical practitioners, hospitals, and medical schools, are being called to question by the Institute of Medicine in the US (1).

Is a similar examination called for in the veterinary sector where comparable corporate interests may be at play and affect the quality of care and services animal patients receive? It would seem that there has been a lack of due diligence over the role of diet, specifically, highly processed pet foods (2) in many contemporary health problems of companion animals. The same may be said about the routine application and so called ‘preventive’ treatments with anti-flea and tick topical products that only now are being fully evaluated by the Environmental Protection Agency (3). Was due diligence also lacking, in part because of inadequate information and understanding, with dog and cat vaccinations? Until recently the universal protocol of giving dogs and cats annual ‘booster ’injections of multivalent  live and genetically engineered vaccines met resistance when ever questioned.

Corporate sector partnering in academia even includes chairs and professorships named after the donating company at many veterinary colleges. What role such partnering may play in contributing to the grave consequences of poor diets, over-medication, and hyperimmunization in companion animals by deferring to vested interests and by claiming lack of scientific proof of harm from such practices, is an open question. Academia should not be exploited to garner public credibility, nor should the market place become the final arbiter of what is acceptable.

Examining possible conflicts of interest may be difficult, considering the partnership of the American Veterinary Medical Association with Fort Dodge and Merial pharmaceutical companies, and Hill’s Pet Nutrition, who together have pledged $4.5 million in support of AVMA programs and services over the next four years (4). But this difficulty could become a confluence of interests once the health and well-being of companion animals are first and foremost on the agenda. The content of both the JAVMA, and its equivalent with the British Veterinary Association’s (BVA) Veterinary Record, increasingly addresses issues concerning animal health and welfare, including nutrition and vaccinations.

In the UK, the government and the BVA have chosen to focus on the health and welfare problems of a genetic origin, primarily in pedigree dogs. Some critics believe that this is a massive displacement, since it is the genetic susceptibilities to dietary diseases and vaccinoses (adverse vaccination reactions) in specific breeds make them the canaries for the canine population at large (5). The appropriate use of vaccines, (6), various ‘preventive’ veterinary drugs, prescription diets, and the adequacies of manufactured cat and dog foods, also need to be considered if the mandate of the British government is to protect the health and welfare of companion and other animals, not just better regulate breeding practices. British dog breeders feel they are the scapegoats and are taking all the blame for the myriad and costly health problems in today’s canine population. The same can be said for the major ailments in the feline population, where poor diets and adverse drug and vaccine reactions similarly take their toll according to Hill’s former Director of Technical Affairs, veterinarian Dr. Elizabeth Hodgkins Esq.(7) 

Of course there are confluences of interest that can benefit all, and this would be forthcoming I believe when there is a more integrated approach to animal health and welfare. This could be developed from a bioethical basis (8) by veterinary teachers, researchers and practitioners, a Council for Veterinary Bioethics being one response to the call for an examination of possible conflicts of interest within the profession.

References

(1) Sternbrook R.. Controlling Conflict of Interest---Proposals from the Institute of Medicine. Published at www.nejm.org  April 29th 2009  (10. 1056/NEJMp0810200).

(2) Fox M W, Elizabeth Hodgkins and Marion E. Smart. Not fit for a dog: the truth about manufactured dog and cat food. Fresno, CA, Quill Driver Books, 2009.

(3) AVMA News. Topical flea and tick products come under EPA scrutiny. J Am Vet Med Assoc 2009; 234: 1228.

(4) AVMA News. AVMA enters into multimillion-dollar partnership with companies. J Am Vet Med Assoc   2008; 233: 219.

(5) Dodds WJ. Vaccination protocols for dogs predisposed to vaccine reactions. J Am Animal Hosp Assoc 2001; 38: 1-4.

(6) Schultz RD, Ford RB, Olsen J. and Scott F. Titer testing and vaccination: a new look at traditional practices. Vet Med, 2002, 97: 1-13 (insert).

(7) Hodgkins EM., Your Cat: Simple New Secrets to a Longer, Stronger Life

 New York, Thomas Dunne Books, 2007.

(8) Fox MW. Veterinary bioethics, pp 673-678, in Complementary and alternative medicine, .Schoen AM and .Wynn SG. eds, St Lois, MO Mosby, 1998.

Michael W. Fox, BVetMed, PhD, DSc, MRCVS

e-mail ipan@erols.com Website  www.twobitdog.com/DrFox

Member of the British Veterinary Medical Association since 1962 and Honor Roll Member of the American Veterinary Medical Association.

*************************************************************

This letter was rejected for publication.

 

One reason for the veterinary profession’s current hard times and unclear future may be its historical double vision or conflicted mission.  The profession seems torn between serving the best interests of animals, and serving the interests of its animal-owning clients and its larger society—both of which may not be in accord with those of the animals.  The American Veterinary Medical Association was founded in 1863.  And yet, its Veterinarian’s Oath included no reference to animal welfare “as a priority of the profession” until 2011.  I have long seen the profession torn between two often conflicting, but I believe, resolvable forces and sets of values―concern and responsibility for animal suffering, health and welfare (the ‘calling’ of most veterinary school applicants), and economic realities such as the cost of services performed, and the monetary, rather than the emotional (and other) value of animals. However, I do find grounds for optimism in the emerging One Health movement 1, 2 where human health and well-being are at last being linked to animal health and welfare, as well as to environmental and ecological health. But for the One Health concept to be effectively implemented, the bioethics of equal consideration must be applied not only to humans but also to our treatment of animals and the environment. This is in accord with the moral imperatives of the animal rights and ‘deep’ ecology movements, long opposed by the biomedical, agricultural and other industries and business establishments 2.

THE PRACTICE OF HOLISTIC HEALTH CARE

From my bioethical perspective, holistic human and veterinary medicine addresses the diagnosis, treatment and prevention of disease/illness from an integrative mind-body and environment paradigm. The triune of psyche, soma and spirit—mind, body and the patient’s will to live, is especially important for the stressed, distressed and chronically ill and impaired physically and emotionally. Quality of life and quality of environment are paramount considerations. Far too many animals kept as “pets” lead socially and environmentally impoverished lives in crates, cages, even chains, as do elephants and other wild species kept for public entertainment. The ways in which most animals are raised for human consumption are a horrendous reflection of human insensitivity and instrumental rationalism, terms also used by HRH Prince Charles in reference to the destruction, depletion and desecration of ecosystems integral to the health of the biosphere and all who dwell within.

Obligation to Advocate for Compassionate Care

 In the Codex Veterinarius drafted by the German Veterinary Association for the Protection of Animals we find this statement:

“Veterinary action for the welfare and protection of animals is guided by the principle of respect for life and the awareness that the animal has a dignity which is to be respected. Therefore protection and care for an animal cannot be dependent on its economical value. In situations of diverting interests between moral obligations and economical pressure it is essential to consider carefully the respect for life against the productive use of life in all its forms of existence… Considering carefully the opposing interests and needs, the interests of the human being should not automatically be considered to be more important than those of the animal... When in doubt veterinary surgeons should let themselves be guided by the principle: In dubio pro animale!”3 (This idiomatic Latin phrase can be roughly translated as, “When in doubt, support the animals!”)

Compassionate Care as a Basic Right and Responsibility

There is growing consensus that veterinarians have an ethical obligation to advocate for compassionate animal care regardless of the context in which their services are applied. This is because of an emerging recognition that compassionate care is our fundamental human responsibility and every animal’s deserved and basic right. Furthermore, compassionate care is vital to animals’ health, welfare, and physical and psychological well-being. It is as essential a component of contemporary veterinary medicine as caring for the land is a vital aspect of sustainable agriculture.

Among Animals, People and the Environment

Veterinarians have been seen as a unique association for millennia. As interlocutors among people, animals and their environments, veterinarians’ roles and knowledge, both empathic and scientific, have been highly valued by societies.  Indeed, according to Professor Calvin Schwabe in his book Cattle, Priests and Progress in Medicine, 4 the earliest veterinarians were priest-healer members of ancient Egypt's many dynasties.

Challenges of Situational Ethics

Today, gender-linked differences in moral philosophy may be factors associated with current shortages of veterinarians in the food animal and laboratory animal medicine sectors.5 Veterinarians in companion animal practice, and also those dealing with ‘exotic’ animals, face ethical dilemmas on a daily basis. One recent survey6 indicates “an urgent need for ethics educational tools and approaches specifically designed with veterinary surgeons in mind.” The influence of vested corporate interests in veterinary schools has also increased significantly in recent years and is now being questioned as a broader ethical issue.7

Student Debt Burden and Income-Challenged Community Access to Care

Lobbying for better funding from government, industry and non-profit sources for student scholarships or debt-forgiveness for pledging to work in much-needed sectors such as overseas aid and development, emergency services, and in low-income neighborhoods (like the People’s Dispensary for Sick Animals in the U.K.) may be considered enlightened professional self-interest.  However we know that at the community level within the U.S., as revealed in a recent report by The Humane Society of the United States entitled “Pets for Life―A New Community Understanding,” there is great need to remove cost barriers to animal care and veterinary services for economically blighted communities in order to improve their community animal health and reduce shelter overpopulation.

A New Professional Paradigm

Redefining the role of the veterinary profession in these times is critical to our profession’s future, and to civilization itself.  Putting animals and the environment first8 may be in the enlightened self-interest of civil society, but doing so would be an admittedly improbable paradigm shift, considering the nature of human psychology. Establishing a higher priority of concern for wild and domestic animals and the natural environment over trivial and harmful human needs and demands would be a significant step toward attaining a more sustainable economy and a better world for us all.  I believe it is our veterinary profession’s current challenge, and our duty, to apply our expertise in more effectively advocating for this new paradigm.

PREVENTIVE CARE FOR COMPANION ANIMALS: MAKING IMPROVEMENTS

The 2015 State of Pet Health Report from Banfield Pet Hospital, “Making Pet Care Personal: A Guide to Improving Preventive Care for Pets,”  released Aug. 12 seeks to answer this question: “What is the disconnect between how veterinarians position preventive care to pet owners and what pet owners truly believe?”

The report recommends expanding the definition of preventive care. For most veterinarians in the survey preventive care includes vaccines, neutering, and parasite control but pet owners are concerned about their animals’ diets, exercise, basic care, play, and emotional well-being. The report states: “For many pet owners, interactions with their veterinarian are not meeting their expectations and are seen as transactional,” according to the report. “They’re tied to specific services, like vaccines or parasite control. For advice on overall wellness of their animals, pet owners turn to groomers, boarders, breeders, day-care providers and trainers for advice. Also they look online to find additional information about behavior, health concerns, breeds and genetics, and food, nutrition, and diet.

This has been my concern and appeal for a more holistic and integrated approach to companion animal health and well-being expressed in my book Healing Animals & the Vision of One Health. The many questions that I receive from care-givers of dogs and cats over the past several decades along with statements about their experiences at some veterinary hospitals support the findings and recommendations of this report identifying where advances in preventive health care can be made for the good of all involved.

Preventing Disease, Respecting Animal Rights

The gulf between animal exploitation and animal kinship, and between animal abuse and animal liberation, is fundamentally a spiritual one. This gulf was created by human ignorance and egotism. It was sanctified by anthropocentric, patriarchal and fatalistic (karmic) religious traditions, both East and West, lacking in active compassion and responsive reverence toward all creatures and Creation. And it became the norm through the "Enlightenment" worldviews of dualistic (Manichean and Cartesian) and mechanistic (Newtonian) thinking, the empirical sciences of materialism, and through the perverted Darwinism of industrialism and colonialism and by contemporary scientific and economic determinism.

This same gulf lies between both our concepts of health and disease and of healthy or diseased conditions. A first step toward health is to examine our diseased relationships and to restore these sacred connections. Then our dis-ease will gradually become transformed into a condition of ease – of equanimity, openness, vitality, and spontaneity to fully experience the joys and tribulations of existence. In the wisdom of the open heart, where suffering and love are inter-twined, wellness means wholeness; oneness leads to wholeness; wholeness leads to holiness – the conscious apprehension of the Sacred.

Richard Brooks has translated a relevant passage from the TaoTe Ching written by the Chinese philosopher LaoTzu over 2,500 years ago:

I have three treasures that I hold and cherish:

The first is compassion (or deep love) (tz’u),

The second is frugality,

The third is not presuming to be first in the world.

Being compassionate, one can be courageous;

Being frugal, one can be generous;

Not presuming to be first in the world, one can become a leader (or minister).

Now, trying to be courageous without compassion,

Trying to be generous without frugality,

And trying to be a leader without humility

Is sure to end in death.

For compassion brings triumph in attack and strength in defense.

What Heaven wishes to preserve it surrounds with compassion. [Ch.67]

The absence of the Sacred, evident in a lack of reverence for life, is a societal norm today, and so long as this gulf persists between those who see life as a commodity, a means to an end for human gain, and those who would treat all life with respect, including the natural environment, and speak for animal rights, we and the world will never be well. And no amount of experimentation on animals in biomedical research laboratories will get rid of our dis-ease.

As we "evolved" from being gatherer-hunters, domesticating plants and animals and becoming sedentary, agrarian, and increasingly urban and industrial, we also became increasingly disconnected (and disoriented) from the natural world. As a consequence we began to devolve, as Charles Darwin implied in his book The Descent of Man, losing some of our sympathetic abilities and empathic wisdom that enabled us to engage in a degree of resonance or inter-subjective communication with other living beings that to our diminished sensibilities and rational empiricism of today seems mystical or psychic.

Anthropologist Prof. M. Guenther describes such resonance in the African Bushman that I believe is an innate or inborn ability of our species. Considering the fact that for some 95-98 percent of our time on Earth as humans we were gatherer-hunters, this ability may not be lost and could be restored. Sometimes while treating sick animals and in making a diagnosis I have felt pain or discomfort in parts of my own body that correspond to the animal’s illness or injury.

Prof. Guenther writes:

"Throughout the hunt the hunter would monitor his every thought, emotion and action, in order to sustain the bond of connectedness with the animal by which he felt he could steer the hunt towards an auspicious conclusion…The bond of sympathy was something set up in the hours or days preceding the hunt, when the hunters would attune themselves spiritually to one animal species or another and, in the process, attempt to gather whatever presentiments they could about the impending hunt: the animals they might encounter, the direction they could come from, the likely dangers, the duration of the hunt. These presentiments…activated the hunter’s entire body; they were felt at his ribs, his back, his calves, his face and eyes. His body would be astir with the ‘antelope sensation’, at places on his body corresponding with those of the antelope’s."

If we are to "evolve" we must regain a heightened sensitivity for fellow creatures and the living Earth, for when we harm others and the Earth, we harm ourselves. Part of our healing and wholeness therefore involves our nascent ability to empathize, and we must have the courage to suffer in the process, before we can put compassion into action and truly love.

References

1.Burns, Katie, Spreading the one-health concept  JAVMA 240:112-115, 2012

2.Fox, Michael W., Healing Animals &  Vision of One Health. CreateSpace books & Amazon.com, 2011

4. Burgermeister S, & Fikuart K., ALTEX. 15(4):209-212. 1998 Ethical guiding principles for veterinary behaviour with respect to the welfare and protection of animals. Tierärztliche Vereinigung für Tierschutz, D-Hamburg.

 5.Schwabe, Calvin, Cattle, Priests and Progress in Medicine, Minnesota, University of   Minnesota Press 1978

5. Narver, Heather Lyons, Demographics, moral orientation, and veterinary shortages in food animal and laboratory animal medicine. JAVMA 230:1798-1804, 2007

6.Batchelor, C.E.M. & McKeegan, D.E.F. Survey of frequency and perceived stressfulness of ethical dilemmas encountered in UK veterinary practice, Vet Rec 170: 19-20, 2012

7. Dally, Michelle, Ethical considerations raised by the provision of freebies to veterinary students. JAVMA 238:1551-1554, 2011.

 8. Fox, Michael W. Animals and Nature First. CreatSpace books and Amazon.com 20

The tripartite nature of integrative (holistic) medicine

The medical profession seems to have outdone the veterinary profession with a staggering incidence of adverse drug reactions (ADRs) in hospitalized patients. In one study, ADRs in the US ranked sixth in leading causes of death, with an estimated 2,216,000 ADRs, and 106,000 fatalities in hospitalized patients in 1994 (1). According to the FDA, 2 million people acquire bacterial infections while in hospital, and 90,000 die as a result. Alarmist as these figures may seem, they are symptomatic of the nemesis of modern medicine and of the urgent need for a more integrated, holistic approach to human illness that includes what we eat and how farmers farm (2)

The well-being of human patients’ spirits is most often left to nurses and visiting clergy, and that of animal patients to veterinary nurses and caretakers, all of whom may or may not have the needed time, or sensitivity and training to fulfill this basic patient need. By well-being of spirit we mean, in the vernacular, subjective sense, as being in good spirits, as distinct from being dispirited.

Well-being in spirit is linked in part to the spiritual sensitivity, awareness, and depth of concern of healers and care-givers. Maximizing both should be an integral part of veterinary and human medical practice and teaching curricula. Attention to patients’ well-being can be problematic for those who care but whose time is limited and treatments restricted due to the low reimbursements and dictates of seemingly one size fits all insurance directives.

 Some veterinary practitioners have told me that they rigorously avoided having to hospitalize their patients because the adverse impact on animals’ spirits was detrimental to recovery. They deplored some of their peers who over-hospitalized clients’ animals, often for minor, ambulatory conditions for which more in-hospital tests and monitoring were advised.

The first duty is to make the patient as comfortable as possible by alleviating physical discomfort such as pain, and addressing compromising physiological states like fever and inflammation. Alleviation of fear, anxiety, agitation, and depression, all of which can aggravate physical signs of illness and compromise recovery, are also important responsibilities that good healers traditionally address.

The patient’s vitality and condition of spirit have great prognostic value, since they are  the manifest expression of the body-mind connection as evidenced in the patient’s demeanor and changes therein during the course of the illness and treatment. The well-being of the spirit, an indicator of the will to live, is in part determined by physical and mental health. Sickness of the spirit, in extremis, the giving up of the will to live, has profound psychological and physiological consequences.

 These concerns are gaining recognition today especially where elderly patients develop hospital psychosis or the hospitalism syndrome within a few days, becoming increasingly confused, disoriented, agitated, dispirited, anorexic, incontinent, and even hallucinatory. Comparable reactions may be seen in animals confined for treatment and either separated from their owners, regular care-takers, or from their own species-companions. Animals in some no-kill shelters become dispirited with inadequate human contact and environmental stimulation, becoming increasingly difficult to rehabilitate/re-socialize due to almost psychotic neophobia and fear of strangers. The cage-depression of such institutionalized animals, like those in poorly managed zoos and menageries, is often associated with stereotypic, obsessive-compulsive behaviors.

 The well-being of the whole patient is addressed by the holistically oriented human and animal doctor who practices what I term integrated medicine. The cardinal signs of illness are closely evaluated, and diagnosis and treatment determined by considering the ways in which the illness in question is manifested. Physical and behavioral signs, called symptoms, may be treated directly, even in the absence of a formal diagnosis. Symptom-based treatments are supported by evidence-based medicine, drawing on prior experience with known remedies, not necessarily scientifically proven in terms of how the treatment actually works at the cellular level. When we, and the animals we care for, become ill, it always for some reason, most often a multiplicity thereof. Elucidating the causes is half the cure, and the ultimate prevention.

The holistic healer intuitively senses and feels, through empathy, close observation, and communication with the patient, the condition of the spirit. Reasons for being dispirited are identified as well as possible, especially social and environmental influences, in addition to physical and mental factors. Of these there may be many that have a synergistic effect throughout every disease process that includes dis-ease, from the onset of symptoms to ultimate recovery or death.

Concern for the patient’s spirit elevates medical and veterinary bioethics by incorporating values of compassion and empathy in patient treatment, care, and rehabilitation therapy. Decisions such as euthanasia, or discontinuing life-sustaining treatments, and evaluation of quality of life, can then be better made since the patient’s quality of life and prognosis cannot always be determined on the basis of physical indices alone.

Conventional practitioners of allopathic animal and human medicine primarily base their healing practices on the use of various drugs (and surgeries).  Western medical practice has separated the patient’s body from the mind by obeying paradigms of a dualistic, mechanistic and reductionist nature that have guided the approach to diagnosis and treatment. This has lead to some significant medical progress.

A further consequence has been the development of separate disciplines, beginning with psychiatry and internal medicine, and ending in oncology and dermatology, in part due to an exponential knowledge burden and demand for specialized skills. This development may contribute to the lack of conceptual and administrative integration, communication, and collaboration. The unforeseen sequelae  of the birth of these specialized branches are breakdowns in public health and health-care services. The cost has been astronomical, despite miraculous breakthroughs in treatments and cures.

 A similar breakdown secondary to this specialization-compartmentalization has been evolving in the veterinary profession. For example, some veterinary dermatology specialists and allergists, as well as general practitioners, fail to fully consider the role of manufactured pet foods in contributing to their patients’ condition. Many over-prescribe steroid drugs, and even prescribe expensive manufactured ‘prescription’ diets that have been especially formulated ostensibly to treat various health problems from diabetes to dermatitis. Yet they often contain the very same food ingredients that were in the pet foods that caused or contributed to their patients’ illness in the first place. (3)

INTEGRATED HEALING

Holistic veterinary and human doctors have gone beyond the false mind-body dichotomy in their approach to both diagnosis and treatment. The textbook edited by Dr. Frank McMillan entitled Mental Health and Well-Being In Animals,(4) and Schoen and Wynn’s Complementary and Alternative Veterinary Medicine,(5) are part of this revolution/evolution of Western veterinary medicine toward an integrated approach in addressing animal health and disease prevention, and animal welfare and well-being.

One integrative approach is to encourage the ability to regard the patient’s mind and body as his or her soul.   One assumes that spirit is the animating principle of every living soul, whereby we will surely have a very different medical paradigm and approach to disease prevention and treatment. Once the separation of mind and body is rejected   by conventional medical and veterinary practitioners, there is an opening for the integration of various alternative and supportive/adjunctive therapies.

 Historically, the first breaking away from the dualistic dichotomy of psyche and soma came with the recognition of psychosomatic diseases in human patients, and subsequently in animal patients, (6). More recently, a major advance in integrative medicine has come with the recognition of epigenetic processes (7). These processes were inconceivable until the dualisms of organism and environment, genomes, nutrition and other prenatal influences, were overcome, along with the science-based fiction of genetic determinism.

The late Prof. Konrad Lorenz, MD, Nobel laureate and a founding father of ethology, asserted that before one can really study and animal, one must first love it. By extension, before one can heal, one must first love the patient in the spiritual sense of agape.  Within the clinical setting this means compassion and empathy, innate qualities rarely taught through example nor encouraged in either medical or veterinary schools, with a few recent exceptions. This is regrettable because most human-socialized animals, like children, sense when they are loved, and whether someone is genuine or not. As with pediatricians, veterinarians who feign affection for their patients do not get very far.

The science of ethology helps resolve the artificial mind-body duality since it provides the tools to objectively determine the highly subjective condition of the animal's ethos, its spirit, sentiment, character, or disposition. The addition of applied animal ethology to the veterinary  teaching curriculum has done much to dispel the long-held view that animals do not have feelings, cannot suffer psychologically or become dispirited.

The collective ethos of society in terms of how animals are perceived and ought to be treated has changed significantly over the past 3-4 decades.   Humane concerns are being raised about how and why animals are being treated in certain ways.  The veterinary profession is being called upon by society to address many of these concerns as they affect animals’ health and well-being.  In the eyes of some critics, the profession has taken more reactive and defensive roles than proactive initiatives in order to protect the vested interests of their animal industry and commercial clients.  This conventional view has deep cultural roots. The veterinary, medical, and medical research disciplines need to disentangle themselves from such corporate entities. They must refocus conceptually, perceptually, ideologically, and ethically on animal health and well-being for animals’ sake as well as for the public health and other community benefits. 

The cultural blindness toward animals as living souls who are sentient beings is still very much in evidence today, reflected in the dispirited eyes of self-mutilating primates and purpose-bred dogs who spend most if not all of their lives in small laboratory cages or pens;  in the eyes of arthritis-crippled breeding sows in factory farms who are so confined as to be unable to walk or turn around their entire lives; and in the eyes of  performing circus elephants who spend most of their lives in chains and usually die from chronic foot infections and osteomyelitis.

The inability of animals to express their ethos, the normal range of behaviors essential for their physical and psychological well-being, because of the conditions under which we keep them, is to deny them expression of their natures, their spirits. To what ends and to what degree we chose to inhibit, even crush their spirits, is a bioethical issue that society has yet to fully address. But, along with the veterinary profession, society cannot address this issue with impartial objectivity until the chauvinistic notion of human superiority that puts people before other animals is tempered by humility and equalitarianism---giving all sentient beings equally fair consideration.

 Charles Darwin asserted that ‘The difference in mind between man and higher animals, great as it is, certainly is one of degree and not of kind,”. (8). He wrote these words over a century ago, contrary to the prevailing anthropocentrism of the time, based upon his studies of comparative morphology and behavior.  In a similar vein, the late Loren Eiseley, a professor of anthropology and paleontology, (9) observed, “One does not meet oneself until one catches the reflection from an eye other than human.” Such self-discovery would do much, I believe, to improve the health and well-being of our own kind, and the animals under our care.

References

1. Lazarou J, Pomeranz BH, Corey PN. Incidence of adverse drug reactions in hospitalized patients: a meta-analysis of prospective studies. JAMA.1998; 279:1200-1205.

 2.  Cox S, Sick Planet: Corporate Food and Medicine. Ann Arbor, Michigan, 2008.

3. .Fox MW, Hodgkins HE, Smart M. Not Fit For a Dog: The Truth About Manufactured Dog And Cat Food. Sanger, CA QuillDriver Books 2008

4. .McMillan FD. (ed) Mental Health and Well-Being in Animals. Ames, Iowa, Blackwell, 2005

5. Schoen AM, S.G.Wynn SG. (eds) Complementary and Alternative Medicine: Principles in Practice. St Louis, MO, Mosby, 1998

6. Fox MW. (ed)  Abnormal Behavior in Animals. Philadelphia, PA, W.B.Saunders,  1968

7. Fox MW. Integrative Development of Brain and Behavior in the Dog. Chicago, IL, University of Chicago Press, 1971

8.    Darwin C. The Descent of Man and Selection in Relation to Sex.  New York, J.A..Hill & Co., 1904

9. Eiseley L. The Unexpected Universe New York, Harcourt, Brace and World, 1964,  p.24

 

                 THE VETERINARY PROFESSION: LEADING SOCIETY TOWARD ONE HEALTH

The significance, value and role of animals wild and domesticated in various cultures include spiritual (totemic and symbolic), biological and ecological (scientific), emotional (affection/aversion) and commercial (including consumptive) perspectives. Such diversity in perception and related treatment is the antithesis of a unified sensibility based on respect for all life and according all living beings equal and fair consideration---an essential extension of the Golden Rule to temper the harmful consequences and historical legacy of anthropocentrism’s limited and self-limiting world view.

Ethical consistency in our treatment of all beings based on the wisdom of the Golden Rule to avoid causing harm to others which we would not wish for ourselves is enlightened self-interest because when we harm others we ultimately harm ourselves. For example, the sciences of ecology and molecular biology have revealed the vital importance of bacteria and other microorganisms in the living soil and in our digestive systems, the former being essential for plant growth and health and the latter being intimately connected to our immune, endocrine, neurological, cognitive and other systems and functions. The complexities and interdependencies of living systems and life processes are challenges to the sciences and to human understanding; and to holistic, integrative medicine as well as to farming practices (including aquaculture and agroforestry) and all other industries and human activities that affect these systems and processes. Proceeding with the precautionary principle as our compass directing us away from hubris, rationalized selfishness and denial, human progress is a possibility and not a false hope.

Until the recent adoption of applied animal behavior, animal welfare science and the One Health concept, how well has the veterinary profession helped prevent the harms of anthropocentrism to animals and the environment and thus indirectly to ourselves, and to what degree does it continue to serve those interests causing more harm than good nationally and internationally?

Contemporary society has intensified the conflict of interest for the veterinary profession by first endorsing as accepted norms various extremes in selective animal breeding ( with genetic anomalies and compromised phenotypes); in keeping wild animals as “pets” and exploiting them for circus and other commercial purposes; and in animal husbandry practices, especially in factory farms/concentrated animal feeding operations that are contrary to the best interests of the animals and to their health and well-being. These are the primary concerns and responsibilities of the veterinary profession to promote, yet the various animal industries and animal-owning public essentially dismiss these concerns of veterinary bioethics (Fox 2011 ) as contrary to the accepted norms of animal use. The underlying economic and cultural justifications of what often amounts to abusive animal exploitation have put the veterinary profession in a double bind. By not asserting the core principles of veterinary bioethics and animal welfare science and ethics and being a guiding influence in society, the profession has become increasingly marginalized by the economics of the livestock industry. While it strives to serve this and the pet, exotic species and other animal industries it is seeing revenues decline as the industrial economy seeks more ‘efficiencies’ and continues to founder.

Millions of rural families in India and other developing countries, including some who are forced to move into urban slums, are in part sustained by an often shared milk cow and by a few goats and chickens. Few are fortunate to have access to grazing land, much communal land being overgrazed as per ecologist Garret Hardin’s (1977) predicted global “tragedy of the commons”. Without urgently needed subsidized veterinary services and supplies of animal feed and water (rather than scavenging off garbage) this sector’s farmed animal population (including bovines and equines used for draft work) continues to be a neglected and significant incubator of diseases harmful to other farmed animals, to wildlife and to the human populace locally, nationally and internationally. These problems are being compounded by the proliferation of intensive methods of livestock and poultry production using imported breeds. These operations become epicenters of pollution and disease, and, along with imported varieties of commercial crops, accelerate the loss of biological diversity as indigenous breeds are marginalized from the agricultural system.

The veterinary profession can be a significant contributor of expertise to the One Health approach to the rising public health issues of foodborne illnesses, zoonotic diseases including those arising from disrupted and endangered biotic communities and wildlife species. After having played a not insignificant role in contributing to these problems by its unquestioned service to the livestock industry in the industrialized and developing sectors of the world, organized government veterinary services and private practitioners are not alone in having to make amends and rectify the ultimate human and environmental costs of decades of animal exploitation, documented suffering and ecological harm.

We must all make amends in the name of respect for all life, compassion and justice being the foundation of a more civilized world community with a new vision of health arising from enlightened altruism: When we care for the land, the land will care for us, and when we care for animals wild and domesticated, we care for ourselves because our health and well-being is a reflection of theirs. This is affirmed by the science and ethics of One Health (Fox 2011).

 A substantial percentage of the annual profits of the pharmaceutical industry should be provided to support public health and preventive medicine initiatives and also independent research in alternative, complementary and integrative veterinary and human medicine with especial emphasis on nutrition and epigenetics. The dominance of conventional/allopathic practice relying on synthetic pharmaceuticals and new generation genetically engineered biologics to treat various human and non-human medical and psychological/behavioral conditions is facilitated by alignment with the health insurance industry. Coupled with rising costs of prescription drugs and limited ability of the government to effectively guarantee drug safety and efficacy with fast-track approval of U.S. -developed and patented pharmaceuticals and others imported from countries like India and China with endemic problems of corruption and price-fixing, this scenario is a major obstacle to real progress in One Health.

History informs, as the contemporary healing professions will confirm, contrived sympathy for patients is no substitute for empathy. But the burden of empathy is too often avoided at the expense of the intuitive, subjective, healer-patient relationship. This relationship is part of the “art” of human and veterinary medicine. In its absence, which objective detachment facilitates, the impersonal and impartial science of medicine becomes blind to its own limitations. This is because the emotional, existential, phenomenological and ecological/environmental dynamics of dis-ease etiology and symptomatology are oversimplified and marginalized. They are reduced to fit the moralistic, mechanistic and economistic imperialism of conventional diagnostics and treatments in the health insurance and drug industry-dominated main-stream human and animal care professions as predicted almost forty years ago by Ivan Illich (1977).

 This anthropocene epoch with its evident anthropogenic contributions to disease, climate change and loss of biodiversity will be either one of intensifying global strife and dis-ease or transition into what the late Thomas Berry (1988) called the ecozoic age; the age of ecological consciousness.  A new social, or more correctly a biosocial contract or covenant between society and animals and our shared environment is called for based on the principles of an egalitarian respect for all life, eco-justice and planetary CPR----conservation, preservation and restoration of both cultural and biological diversity.

An integral aspect of One Health is the saving not only indigenous crop varieties and breeds of domestic animal, which are generally better adapted climatically and more disease-resistant than imported varieties, but also indigenous knowledge. This includes tried and true methods of animal husbandry and disease prevention and traditional medicinal treatments especially with botanicals which, as several authors have documented, ( Lans 2011, Lans et al 2007, Mathias 2004) should not be dismissed as being scientifically unproven and abandoned in favor of synthetic pharmaceutical products which are often too costly if even available in many rural communities.

The veterinary and other professional organizations, multinational corporations and governments alike, as well as the consumer-populace, have the power and responsibility to determine what the future quality of life will be on planet Earth. This will be more for the better than for the worse when improving the health and well-being of animals wild and domesticated is recognized as a trans-cultural ethical imperative. This auspicious beginning heralded by veterinarians’ commitment to the One Health movement, (which is more than promoting vaccinations and various pharmaceuticals); to wildlife and endangered species conservation, and to making long overdue improvements in animal care and well-being though a holistic, integrative approach as advocated by the American Holistic Veterinary Medical Association and other organizations and individuals of like mind.

References

Berry, Thomas. (1988). The Dream of the Earth. San Francisco Sierra Books. See also www.ecozoicstudies.org

Fox, Michael W.  Healing Animals & The Vision of One Health. ( 2011). CreateSpace Publications/Amazon.com* See also Bringing Life to Ethics: Global Bioethics for a Humane Society. Albany NY, State University of New York Press. See also Fox, M.W.!1995). Veterinary bioethics: ecoveterinary and ethnoveterinary perspectives. Veterinary Research Communications, 19: 9-16  and Fox, M.W. (2006.) Principles of Veterinary Bioethics. Journal of the American Veterinary Medical Association 229: 666-667

 Hardin, Garrett, (1977). The Limits of Altruism: An Ecologist’s View of Survival. Bloomington, Indiana University Press

Illich, Ivan, (1977). Medical Nemesis: The Expropriation of Health. New York, Bantam.

Lans, Cheryl. (2011). Validation of ethnoveterinary medicinal treatments. Vet. Parasitology 178 (3-4): 389-90

Lans, Cheryl et al. (2007). Ethnoveterinary Medicine: Potential Solutions for Large-Scale Problems. In Veterinary Herbal Medicine, eds. Susan G. Wynn and Barbara J. Fougere, 17-32. St. Louis, Mo.: Mosby Elsevier

Mathias, E. (2004). "Ethnoveterinary medicine: Harnessing its potential." Vet Bull 74 (8): 27N – 37N.

See also: Barry S. Kipperman (2015) The role of the veterinary profession in promoting animal welfare, JAVMA 246: 502-504, and Manuel Magalhães Sant'Ana, (2014).  PhD Dissertation: Why, What & How To Teach Ethics to Veterinary Students in Europe. http://repositorio-aberto.up.pt/bitstream/10216/74139/2/99742.pdf

*This book is available gratis from the American Holistic Veterinary Medical Association as a PDF to all veterinary students joining the Association.

END NOTE

After a fortuitous meeting with oncologist the late Van Rensselaer Potter, MD,* who first coined the term bioethics to extend the scope of medical ethics from its primary focus on professional conduct and standards of care/practice to embrace environmental, population and epidemiological dimensions of human health and disease prevention, I realized that a similar application of bioethics was needed for the practice of veterinary medicine.

The vision I had shared with my friend and colleague the late Prof. Calvin W. Schwabe, DVM,* (who was the first in modern times to link veterinary epidemiology and comparative medicine with the concept of One Health) was for the veterinary profession to serve as the interlocutor between animals and society/civilization for the benefit of both. Applied bioethics provides the essential template for progress in One Health to be realized.

 In modern parlance this role of the veterinarian in society is one of symbiogenesis (facilitating mutually benefiting symbiotic relationships between humans and non-humans, wild and domesticated, which are ecologically and environmentally neutral or enhancing) rather than one of pathogenesis as per the plethora of agricologenic, domesticogenic and iatrogenic diseases that afflict selected plant and animal species subjected to human manipulation and exploitation.

 This role of interlocutor/intermediary has its roots in the shamanic and other animistic customs, rituals and ethical traditions of past indigenous cultures and economies, few of which survive today. One remnant, almost archaic term survives from that epoch in Western industrial society, namely “Animal Husbandry”. Like rare seeds and breeds, indigenous cultures need to be saved from extinction/assimilation, their indigenous knowledge being an invaluable resource for conservation and restoration of the ecosystems they inhabit and where veterinary services, too often not provided by corrupt and indifferent government agencies, are of critical importance for both the wildlife and the domestic animals upon whom these people rely. Planetary CPR (conservation, restoration and preservation) must include the protection and enhancement of both cultural and biological diversity.

*Van Rensselaer Potter (1988). Global Bioethics: Building on the Leopold Legacy. East Lansing: Michigan State University Press

* Calvin W. Schwabe (1978). Cattle, Priests and Progress in Medicine. Minneapolis, University of Minnesota Press 

 

 

 

 

 

 

 

 

Check the link below for a Dr. Fox C-Span feature concerning "Animal Testing"

Dr. Michael W. Fox on C-Span



--Video Link--

OUR ANIMAL RELATIONSHIPS: THE MOMENTS OF TRUTH PROJECT
Dr. Michael W. Fox

What right do we humans have to exploit other animals?  Where does that right come from and what are the limits if any?  What duties or obligations do we have in our relationships with our dogs, cats and other animals domesticated and wild?

          Follow and support Caroline Kraus and her Moments of Truth Project documentary film as she travels across the U.S. asking people, who variously live, work with and care for animals, these and other relevant questions.

Is there an overriding consensus and what are the reasons why people respond very differently to these questions, which in part examine our character, culture and future?

The viewing and discussion of this kind of documentary should be part of every school curriculum and will be of interest to all who work with, profit from and care for animals. Project Home Page: http://momentsoftruthproject.com/  To see the interview with Dr. Fox go to http://momentsoftruthproject.com/dr-michael-fox/