Grimm Herwig, Bergadano Alessandra, Musk Gabrielle C, Otto Klaus, Taylor Polly M, Duncan Juliet Clare
Messerli Research Institute, University of Veterinary Medicine Vienna, Vienna, Austria.
Medical University of Vienna, Vienna, Austria.
Vet Rec. 2018 Jun 9;182(23):664. doi: 10.1136/vr.104559. Epub 2018 Mar 30.
Modern veterinary medicine offers numerous options for treatment and clinicians must decide on the best one to use. Interventions causing short-term harm but ultimately benefitting the animal are often justified as being in the animal's best interest. Highly invasive clinical veterinary procedures with high morbidity and low success rates may not be in the animal's best interest. A working party was set up by the European College of Veterinary Anaesthesia and Analgesia to discuss the ethics of clinical veterinary practice and improve the approach to ethically challenging clinical cases. Relevant literature was reviewed. The 'best interest principle' was translated into norms immanent to the clinic by means of the 'open question argument'. Clinical interventions with potential to cause harm need ethical justification, and suggest a comparable structure of ethical reflection to that used in the context of research should be applied to the clinical setting. To structure the ethical debate, pertinent questions for ethical decision-making were identified. These were incorporated into a prototype ethical tool developed to facilitate clinical ethical decision-making. The ethical question 'Where should the line on treatment be drawn' should be replaced by 'How should the line be drawn?'
现代兽医学提供了众多治疗选择，临床医生必须决定采用最佳的治疗方法。那些虽会造成短期伤害但最终能使动物受益的干预措施，通常被认为符合动物的最大利益而被证明是合理的。具有高发病率和低成功率的高度侵入性临床兽医程序可能不符合动物的最大利益。欧洲兽医麻醉与镇痛学院成立了一个工作小组，以讨论临床兽医实践的伦理问题，并改进处理具有伦理挑战性的临床病例的方法。对相关文献进行了综述。通过“开放问题论证”，将“最大利益原则”转化为临床内在的规范。具有潜在伤害性的临床干预措施需要伦理依据，并建议应将一种与研究背景下所使用的伦理思考结构类似的结构应用于临床环境。为构建伦理辩论，确定了伦理决策的相关问题。这些问题被纳入一个为促进临床伦理决策而开发的原型伦理工具中。伦理问题“治疗的界限应该划在哪里”应被替换为“应该如何划定界限？”
