Dying like a dog?

Convergences and divergences in the human and veterinary ethical discourse on the end of life of humans and pets and consequences for the relationship between medical and animal ethics

Dying a dog's death? Converging and diverging ethical discourses in human and veterinary medicine about the end of life care for humans and pets and some consequences for the relations between medical and animal ethics

Project description

The numerous links between human and veterinary medicine are evident both in clinical research and in therapy: drugs and surgical procedures developed for use in humans are first tested on animals; treatments (diagnostics, prostheses, drugs, surgical techniques, etc.) that are established for human use are adapted for veterinary medicine; drugs that have been admitted for human use are repurposed for pets, etc. This does not even touch on the fact that ethical discourses in human and veterinary medicine about end-of-life care for humans and pets are diverging. This does not even touch on the fact that healthcare for humans overlaps with healthcare for animals in many areas (see zoonoses, antibiotic resistance, "One Health" initiative, etc.).

While human and veterinary medicine have long been closely interlinked at the level of research and therapy, the ethical discussions about the sensible use of available diagnostics, medicines and techniques are only intertwined at certain points. If we take the question of end-of-life treatment goals for humans and pets or animal companions[1] as an example, there are very extensive debates in each case. An interlinking of the discourses has hardly taken place, at least in the academic discussion, but is currently emerging (for individual advances, see Coombes 2005, Mikuła et al. 2015, Rothenburger 2015, Stafleu 2016; see also, for example, Knesl et al. 2017, Sandøe et al. 2016a, Williams et al. 2017). On the one hand, the very broad debate on euthanasia, therapeutic goals and the allocation of resources when there is little prospect of success in humans; on the other hand, the debate on euthanasia or therapeutic goals and the scope of therapies. therapy goals and the scope of therapies for sick pets (see, among others, Binder 2011, Bobbert 2017, Bundesärztekammer 2011, Christiansen et al. 2016, Goldberg 2016, Janssens et al. 2013, Jox 2015, Marckmann 2015, Meijboom & Stassen 2009, Rollin 2016, Sandøe et al. 2016b, van Herten 2016).

This may come as a surprise, not only in view of the close links between human and veterinary medicine, but also in view of cultural and social science observations on the relationship between humans and pets. Pets have become so-called family members and humane practices are transferred to pets, as coaching or day care centers for dogs, wellness hotels for small animals, fashion and boutiques for four-legged friends, etc. prove. In addition, experiences in dealing with animals are also transferred to human-human interaction; for example, mourning behavior is learned in dealing with the deceased animal or the assumption of responsibility in keeping pets is practiced in order to then presumably find application in the interpersonal sphere (see Julius et al. 2014, Mars 2013, Preuß 2016, Sandøe et al. 2016b).

The far-reaching separation of the discourses of classical medical and veterinary ethics is also remarkable insofar as demands for equal rights, claims or evaluations for humans and animals have long been established in animal ethics, and here in particular in the context of animal experiments and livestock farming, which are apparently gaining plausibility for many people. There are currently several prominent approaches and proposals to identify a common ethic towards humans and animals, even if these differ in terms of extension, justification, etc. (classic examples include Singer 2011, Regan 2004, Taylor 1986).

Against the background and state of research outlined above, the overarching aim of the proposed project is to determine the relationship and classification of medical ethics and veterinary ethics within normative ethics. It will contribute to answering the question of whether we should assume a common ethics for humans and animals: Should ethics for humans and animals be integrated into a comprehensive bioethics, which may recognize individual fields such as medical, business or research ethics? Or should two largely independent fields of moral-philosophical reasoning and research be assumed? Should animal ethics and medical ethics be separate fields within applied ethics? (Cf. on the different positions, e.g. Grimm & Wild 2016, Baranzke 2002, Sturma & Heinrichs 2015, Trampota 2017.) However, it would also be conceivable, for example, to designate a common ethics for humans and their companions and to treat wild animals, farm animals etc. according to their own ethical standards. or to assign humans together with their domesticated animals to a field of ethics, while wild animals, for example, fall within the scope of nature and environmental ethics (see also Yeates & Savulescu 2017).

This guiding metaethical question will be addressed using the topic of end-of-life treatment goals in humans and pets as an example. The end-of-life discussions are suitable for a detailed examination insofar as the diseases and treatment options of humans and pets are very similar in many cases and thus make it easier to relate the discussions from medical and veterinary ethics on the basis of a central medical or veterinary field of action using a broad spectrum of therapies. Furthermore, the moral-philosophical relationship between humans and animals can be discussed more easily using the example of the death of humans and pets than on the socially more controversial topics of livestock and laboratory animal husbandry.

Below the metaethical central question, two levels will be fanned out in the project: On the one hand, convergences and divergences in the medical and veterinary ethics debate will be worked out and categorized at the level of academic normative ethics. This concerns above all the category apparatuses of ethical evaluation. Secondly, at the level of morality, interactions between the respective ideas of how we should deal with people and pets at the end of life will be identified. This concerns in particular the images of dying and the lifeworld transfer of argumentation patterns from humans to animals, but above all from animals to humans.

With regard to the latter level of morality, there are clear links between the perception and assessment of animal and human death that have hardly been systematically traced to date. These references can, unsurprisingly, be pronounced in a first direction to the effect that there is a decided differentiation between human death and animal death ("he should not suffer like an animal") (see e.g. Allmark 2002). However, they can also take place as a new and increasingly manifesting trend in the direction of emphasizing the commonality of human and animal death ("you wouldn't let an animal suffer like that either"). The aim of a dissertation project will therefore be to uncover these everyday practical references and interactions and to show whether and, if so, to what extent and in what form the experiences of dealing with the dying animal influence the assessment of human dying and vice versa, or how a practice is constituted here that pre-reflexively shapes thinking about animals (cf. Diamond 2012). The categories of moral evaluation and decision-making used in the lifeworld, the images of dying and their functions in a context of discovery and justification are analysed and systematized.

The question of the alignment of medical and veterinary ethics will also have to be answered at the level of normative ethics, but now the scientific discussion surrounding the shaping of the end of life will be the subject of investigation: Which categories of ethical evaluation can be found in both the medical-ethical and the animal-ethical debate, with what intensity and extension are they used? How does this differ according to fundamental ethical premises, such as the consequentialist, deontological, virtue ethical approach, etc.? Which relevant categories, if any, are specific to human or veterinary ethics? In addition to the ethical discourse, the legal categories and regulations that can differ significantly in the legal discourses of other countries (e.g. Anglo-Saxon countries, Poland, the Netherlands), both for human and veterinary medicine, will also have to be taken into account here and will have a lasting impact on the respective national moral and ethical debates. Answering these questions will not only help to define the relationship between animal and medical ethics, but will also serve to sharpen the content of the categories within their respective discourses - what does "dying with dignity" or acting in the interests of the human or animal patient mean?

The demarcation and intertwining of animal and medical ethics are thus shown on three levels - morality, normative ethics, metaethics - exemplarily for the end of life and may also reveal mutually convergent, divergent or time-delayed developments. The studies will thus contribute to the understanding of possibly divergent assessments, for example in everyday morality, clinical ethics counseling and university ethics.