What does it mean to be humane?

How would you define the term humane? Can you state with a clear conscience that in your role as a provider of veterinary care that you are humane?

The term encompasses the best qualities of mankind. Examples of these qualities cited in Webster's Dictionary include kindness, tenderness and being considerate. Empathy and compassion could readily be added to this list of examples. Whereas antonyms for the term include unkindness and cruelty.

Dr. Carl A. Osborne

In context of this discussion, one who deliberately chooses to disregard available means to reduce injury or illness of an animal under his or her care could be thought of as inhumane or, in some circumstances, even cruel.

How would you define the term cruelty? Webster's Dictionary's definition of cruelty encompasses actions that are inhumane and without pity. The term pity encompasses compassion for the suffering, distress or troubles of another. By definition, cruelty appears to be an act or motivation limited to mankind. Whether an act is cruel depends not only on the act, but on what was the intent of the act. It is of interest that one of the first anti-cruelty laws established in the United States was designed to protect animals (New York State Legislature, Anticruelty Act of 1828, Section 28).

The term "welfare" signifies doing well—a state of being. The concept of animal welfare has been founded on the premise that humans have an obligation to act humanely toward animals. In the context of this essay, animal-welfare problems are most likely to encompass acts of omission rather than deliberate acts of cruelty.

Returning to the theme question, "What does it mean to be humane?" Is there a connection between being humane and the diagnosis and treatment of various diseases that affect animals? Although the answer to this question could fill a book, please consider the following applications, presented in the form of questions.

Am I striving to provide the type of care that I would choose if I were this patient?

Based on the knowledge of my own skill and experience, and the availability of support staff and equipment, would I consent to my proposed plan of diagnostic and therapeutic action if I were in this patient's exact situation? What diagnostic and/or therapeutic goals are likely to be achieved? In all probability will the overall benefits of this plan of action justify the associated benefits, risks and costs?

In providing care for my patients, have procedures been designed to avoid or minimize discomfort, distress and pain?

Unless the contrary has been established, veterinary staff members should consider that diagnostic and therapeutic procedures that cause discomfort, distress or pain in human beings may cause the same in animals. Therefore, is there agreement by all concerned that procedures that cause more than momentary discomfort, distress or pain will be performed with the aid of appropriate sedation, analgesia or anesthesia? What approach to discomfort would I choose if I were in this patient's exact situation?

What was the underlying basis for my fee schedule?

Have I taken appropriate precautions to avoid overcharging clients for my service, or have I been persuaded to develop profit schemes to market unnecessary diagnostic tests or treatments with the underlying motive of excessive monetary gain? There is an ethical difference between generating value-based fees for service to maintain the fiscal vitality of properly staffed and equipped veterinary hospitals and peddling unnecessary services and products to maximize revenue. Ethical advertising, sustained cash-flow and adequate net income are practice necessities. But when others try to convince us to think of our worth as veterinarians primarily in terms of the size of "the bottom line," we must be on guard not to lose sight of our role as advocates for patients. To do so to the extent that patients with potentially reversible diseases are often euthanized is inhumane.

Our conscience, guided by the Golden Rule, should prevent us from taking unfair financial advantage of those who turn to us when they need help. To this end, the humane elements of the practice of veterinary medicine are just as important, if not more so, than financial considerations. We must stay on guard to maintain our ethical balance so we don't tip the scales toward caring more about our profits than about our patients.

What does it mean to be humane?

The extent to which we are humane can only be measured by the action it prompts. To this end, we should take the initiative to put ourselves in others' shoes, paws, hooves or claws, so we can help them as we would want to be helped. Ultimately, the expression of our humanity should be measured in context of what it accomplishes on behalf of others, and not just in light of what it does for us by way of income or prestige.

Fortunately, thousands of veterinarians continue to show by word and deed that they are humane. They do not take the selfish view that the problems facing others are not their concern. They continue to uphold our profession's ethical tradition of "sharing and caring" by avoiding the new code of "making and taking" with indifference to the plight of others.

Dr. Osborne, a diplomate of the American College of Veterinary Internal Medicine, is professor of medicine in the Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Minnesota.