Ethical issues in all categories of veterinary medicine commonly arise from inherent and unavoidable conflicts of interest (see Chapter 7). According to the American Veterinary Medical Association Principles of Veterinary Medical Ethics #1 (AVMA n.d.a): “A veterinarian shall be influenced only by the welfare of the patient, the needs of the client, the safety of the public, and the need to uphold the public trust vested in the veterinary profession, and shall avoid conflicts of interest or the appearance thereof.”

This principle commits veterinarians to at least three stakeholders – the patient, the client, and public safety and trust – but assumes that the interests of these stakeholders are seldom in conflict. This is a false assumption. A fourth important and competing interest pertains to the mental and financial well-being of veterinarians themselves. Conflicts of interest in veterinary medicine are unavoidable. Resolving these conflicts in a professional and ethical manner is the goal.

This leaves us with a landscape of veterinary ethics in which the veterinarian, with little training or guidance, must simultaneously balance the interests of at least four important stakeholders. The landscape becomes more complicated when we consider that the interests of individual animals may conflict with the interests of a group of animals, or the interest of one client, e.g. the seller of livestock, may conflict with the competing interests of other clients, e.g. the buyer of livestock being sold.

This complex ethical setting is common ground for veterinarians regardless of the species they serve. In this sense, food animal veterinary ethics walks the same ground as, for example, companion animal, equine, or laboratory animal ethics. The goal of this chapter is not to portray food animal practice as categorically different than all other practice types, but to highlight specific issues that are more commonly encountered, and uniquely manifested, in food animal practice. Most importantly, we hope to offer guidance on how such conflicts can be managed.

Ethical Perspectives Regarding Raising Animals for Food

There are those who believe that animal rights and food animal veterinary medicine are incompatible. These people, including some veterinarians, cannot comprehend ensuring the health and welfare of large herds or flocks so that they can be killed for human consumption. A vocal minority of activists and vegan business interests are calling for an end to animal agriculture (Reese 2019). Food animal veterinarians who dedicate their professional lives to ensuring the health and welfare of their patients find these beliefs naive, confused, and culturally contingent. Healthy animals are killed in many veterinary settings, including companion animal shelters and in laboratory and wildlife medicine. Food animal veterinarians are also criticized by some of the public, as well as some of their veterinary colleagues, for supporting and enabling the livestock industry to create ever more intensive animal rearing operations.

It is important for all veterinarians to understand the critical role that food animal veterinarians play in ensuring the health and welfare of animals raised for food. Likewise, it is important for non-food animal veterinarians to have a basic understanding of the importance of livestock production in any sustainable food system. Food animal veterinarians should play a vital role in protecting animal health and welfare on livestock farms. In addition, food animal veterinarians are key in protecting public health by ensuring the appropriate use of pharmaceutical products in livestock production and aiding in the control of food-borne and zoonotic diseases.

For veterinarians and nonveterinarians alike, the concepts of animal rights and animal welfare are not always clearly defined. There are those in the agricultural community who profess to support animal welfare but do not accept the concept of animal rights. Rights are established through laws. Therefore, in most jurisdictions, anticruelty legislation ensures all domestic animals have the right to food, water, shelter, and freedom from unnecessary suffering (Pask 2015). Some animals have these rights enshrined in law and these rights were created to protect their welfare. However, there may not always be a consensus regarding what constitutes adequate shelter or unnecessary suffering, and some animals may be considered exempt from specific protections in some states or municipalities. One cannot be in favor of protecting animal welfare while denying animal rights. Domestic animals have rights specifically to ensure that their welfare is protected.

There is disagreement on what specific rights animals should have. Debating the rights that animals should be given is important and appropriate. Many believe domestic animals have the right to express at least some natural behaviors (Bracke and Hopster 2006). The rights of animals should be debated by the society in which those animals are raised and used. All people are animal rightists if they adhere to the laws of a society that guarantees some basic rights for domestic animals. It is unlikely that people will ever all agree on what rights animals should have but the resulting debates and discussions are important, and veterinarians are well positioned to engage in such debates.

Legitimate animal welfare concerns exist for domestic pet animals, laboratory animals, zoo animals, and domestic animals raised for food. Veterinarians have the experience and education to remedy these animal welfare problems. No one group of veterinarians can claim the moral high ground on animal welfare. All classes of animals that veterinarians deal with have room for improvement when it comes to their welfare and all veterinarians take the same oath to ensure that welfare is appropriate and where it is not, endeavor to improve it.

There will be situations where food animal veterinarians as well as producers are intensively focused on animal profit and productivity at the expense of animal welfare. Developing and enforcing standards to ensure that farm animals are cared for to ensure their welfare in accordance with societal norms is the most effective way to improve the welfare of animals on all farms. Veterinarians, regardless of their personal animal welfare outlook, will remain a valuable resource in ensuring that societal norms are met while maintaining the economic sustainability of an operation.

A common criticism of livestock production is that animals are slaughtered at a young age, long before they have reached their average (or maximum) lifespan (Four Paws International n.d.). This argument is most common among those whose familiarity with animals is based primarily on companion animals. These individuals, veterinarians included, forget that all animal species whether wild or domestic, “overproduce.” This is nature’s way of attempting to fill a biological niche with the fittest individuals. Without this natural selection, our planet would soon be overpopulated with many more species besides humans. Similar to what occurs naturally, farms resemble stable ecosystems. Although mortality rates are similar between farmed populations and wild populations, domestic animals should not suffer painful deaths from exposure, starvation, predation, etc. as is common in nature.

If a cow–calf operation has a holding capacity of 500 cows producing 450 calves per year with a 30% replacement rate of the cow herd (the number of mature cows that exit the herd due to mortality or poor production), then approximately 300 of the offspring would either have to die or be sold each year to maintain a population within the limit of what the land can support. The difference between the cows and the wildlife that also live on and around the farm is that the farmer, with the assistance of the veterinarian, is responsible for ensuring that all the cattle have food, water, shelter, and freedom from unnecessary suffering. Wildlife do not have these rights or protections and often suffer deaths from starvation, predation, or disease. Farmers ensure that despite a near-identical mortality rate as occurs in stable wildlife ecosystems, death is humane. This enormous responsibility to ensure the health, safety, and welfare of herds and flocks is something that stockpeople and food animal veterinarians take great pride in, and rightly so.

It can be said then that domestic food animals often achieve better states of welfare than their wildlife counterparts. Indeed, those calling for an end to animal agriculture (and thus an end to food animal veterinary practice) have yet to identify a clear alternative plan for repurposing our food-producing animals under better welfare conditions. Calls to stop breeding them are unrealistic and have failed in other species as evidenced by the seemingly intractable feline and canine overpopulation problem. Calls to place these animals on farm “sanctuaries” would require billions of dollars of investment and there would be no guarantee of better animal welfare. While most food animal producers are evaluated and audited for welfare, there is, to our knowledge, no third-party oversight of welfare on farm animal sanctuaries. Mass depopulation of farm animals is theoretically the most effective way to “end” animal agriculture, but this option is likewise unrealistic, problematic from an animal welfare perspective, and is contrary to the very point that animal activists wish to make: that animals have a right not to be killed.

What’s left then for those who wish food animal production to end? The market must persuade consumers of animal products not to buy those products. Vegan ideology combined with tech and business interests urge consumers to abandon animal products in favor of diets based only on plants and lab-produced “alternative” proteins. Increasingly, such diets and products are promoted by scapegoating farm animals for causing climate change, thus deflecting attention from fossil fuels while ignoring the carbon sequestration capacities of regenerative agriculture and the importance of livestock manure to plant agriculture (Sims and Maguire 2005; Shober and Maguire 2018). Some veterinarians have joined this chorus for an end to food animal production. However, this approach fails to recognize the harm done to wild animals in plant agriculture (Davis 2003). This approach is also a call for gradual depopulation of food animals – for example, Impossible Food’s goal to end cattle production by 2035 (Greenfield 2021). Gradual depopulation of important domestic species is not a serious proposal to improve the welfare of food animals and conflicts with the veterinarian’s obligation toward “conservation of animal resources,” as specified in the Veterinary Oath (AVMA n.d.c). The broader discussion of food access, food equity, and whether it is even possible to feed the world’s population in a sustainable way on a purely plant-based diet is worthy of a chapter in and of itself. Suffice it to say it is our shared perspective that a single solution to global nutrition and sustainability is not tenable.

As veterinarians, we maintain that providing food animals with a good life and a good death is preferable to no life at all. Veterinarians are committed to protecting animal welfare and animal resources. Animal agriculture serves vital public health goals, like providing high-quality protein for human nutrition, just as companion animals serve a legitimate human need for companionship.

Food Safety and Animal Welfare

All veterinarians have an obligation to public health. For food animal veterinarians, this includes unique responsibilities toward food safety. It is important to make clear the deliberate reference to this section as specific to food animals rather than farm animals. It is critical that all veterinarians recognize and respect the qualification of animals as food. It is also worth noting that the only issues truly unique to food animal practice are the legal and regulatory limitations placed on treatment decisions as they relate to food safety.

The rules in cases of food safety are very clear; all veterinarians, regardless of practice type or patient, are bound to follow the law, specifically the Federal Food, Drug and Cosmetic Act (FD&C Act) (n.d.), established in 1938 to protect the public from pesticide and drug residues in food and water. The use of drugs in food animal medicine has delivered many benefits to the food industry but their use presents potential public health concerns. Historically, the primary concern was the risk of drug residues with the potential to cause human disease or allergic reactions. Today that concern has grown to include the risk of the development of, selection for, and dissemination of antibiotic resistance (Koch et al. 2017). The Food and Drug Administration can limit the use of drugs or an entire class of drugs in any food-producing animal. It is important that all veterinarians accept that any “farm animal” whether considered a “pet” or “production unit” must be treated as if it will end up in the food supply and for this reason every veterinarian should be familiar with or know where to find guidance on making proper treatment recommendations for food animals (Case Study 12.1 ).

Individual Animal Care and Welfare in the Practice of Population and Production Medicine

Issues of care and individual medicine within the practice of population medicine are common in practices serving food animals, animal shelters, horse farms, zoos, and wildlife populations.

Animal welfare problems in food animal production can be broadly classified into whole-herd or flock concerns and individual animal problems. Some herd or flock problems result from currently accepted standards of housing and management. Examples of such are gestation stalls for housing pregnant sows or battery cages for laying hens. Although currently accepted by many livestock organizations, these restrictive housing systems are seen as inhumane by the public because of the severe limitations they exert on the expression of normal behavior (Humane Society of the United States 2012). Another category of herd or flock welfare concerns relates to procedures such as castration, dehorning, tail docking, branding, etc. that are commonly performed by stockpeople, may be considered unnecessary, and are often done without the use of effective anesthetics or analgesics.

Individual animal welfare concerns generally involve the suffering of distinct animals within a large production system where appropriate attention to address the suffering of a few animals is not prioritized due to the demands of caring for the remainder of the herd or flock. While this is an important ethical issue for population medicine, it should also be noted that the utilitarian ethics of population medicine – to bring about the greatest good for the greatest number – sometimes results in the sacrifice of some individuals to benefit a larger group of individuals. For example, we may euthanize a dog with rabies, a cow with tuberculosis, or mink with SARS-CoV-2.

Still, food animal veterinarians are sometimes asked how they can work in environments where the welfare of entire herds or flocks as well as of individual animals appears to be of low priority in relation to farm profitability. Case Study 12.2 reflects a scenario where veterinarians may experience conflicts in balancing their professional responsibilities to protect animal welfare.

Ensuring Individual Animal Care in a Herd Setting

One difference between practicing individual animal medicine and population medicine involves the care of the individual. In single-patient practice, the totality of care is focused on the individual. In population medicine, by definition, the emphasis is on the herd or flock. Production parameters such as preweaning mortality, culling rate, conception rate, average daily gain, etc. are a major focus of food animal practitioners. These parameters are considered indicative of the combined health and welfare of the individuals in the herd or flock. However, individual animals may be overlooked if the herd or flock is performing up to expectations. This can lead to unintended animal welfare problems.

The problem arises from the fact that a herd or flock may be healthy and thriving while a small percentage of individual animals are suffering from lameness, respiratory disease, diarrhea, or other ailments. Provided these individuals represent a small proportion of the population, they have no noticeable effect on the production values that are closely monitored. Nevertheless, there is real animal suffering that must be attended to but may be overlooked.

There are several reasons why the suffering of individual animals is not adequately attended to in a large-group environment. The very concept of herd health implies a lack of focus on outliers. The greatest returns on time and effort come from managing the group. If feed and water consumption are appropriate, production parameters are hitting preset targets, and the great majority of animals are bright and alert, then “herd health” is good. A much larger effort is required to ensure that every single individual is examined. Unfortunately, when an unfit animal is identified, pens may not be designed for easy separation, examination, and treatment, particularly when only a single caretaker is present. As a result, a wait and see approach is often used hoping that the animal’s condition improves on its own. This is seldom in the best interest of the individual animal and can lead to desensitization of the caretaker regarding animal suffering.

In large production settings, the return on treating an individual that is not representative of a larger herd or flock problem is limited. For example, in swine many causes of lameness are challenging to diagnose and even more difficult to treat effectively. It can be equally difficult to identify the reason why an individual animal appears gaunt with no obvious clinical signs, while the remainder of the herd appears healthy and to be eating normally.

Despite these “reasons” for not responding to individual animal ailments within a large herd or flock setting, neither veterinarians nor producers should become complacent regarding the suffering of individuals. It is contrary to the Veterinary Oath and the opposite of what the public expects from veterinarians. Unfortunately, veterinarians focused on food animals receive extensive training in maximizing herd health and productivity but much less practical instruction in addressing individual animal problems within the herd setting. Veterinary curricula should address this deficiency.

Veterinarians should emphasize the importance of maintaining at least one specifically designed hospital pen on every farm. Depending on the size and type of operation, more than one hospital pen may be required. Hospital pens should be designed with the specific needs of animals requiring individual care in mind. They should not be a gated-off corner in the barn or alleyway. Hospital pens should have sound footing, supplemental heat, easy access to appropriate pharmaceuticals, and be placed in a high-traffic area so hospitalized animals are regularly viewed. Provided the reason for using the hospital pen is not a highly infectious disease, most animals will have an increased chance of recovery if not housed alone in a pen. Pen mates often improve the appetite of the sick individual. Care should be taken to ensure the hospital pen mate is not a source of irritation for the compromised individual. Often smaller, more submissive individuals make suitable hospital pen mates for compromised animals.

Veterinarians should ensure that hospital pens do not become hospice pens. Clear, written treatment protocols should be included with every hospital pen. Equally important are stop treatment protocols to ensure that individuals who do not respond to appropriate therapy are euthanized in a timely manner. To ensure that euthanasia is timely and appropriate, veterinarians should train the appropriate stockpeople to recognize suffering, appreciate the importance and responsibility of timely euthanasia, and be competent to perform euthanasia when indicated. This must include ensuring that death has occurred.

Preventing Individual Animal Welfare Problems

Avoiding individual animal suffering is preferred to treating problems after the fact. Most barns are designed to provide optimal housing for the great majority of animals. However, in any large population there will be a percentage of individuals that are smaller, weaker, or less aggressive and that do not adapt as rapidly to a housing arrangement that is suitable for most of their herd or flock mates. Most of these high-risk individuals are not suffering from a specific disease process. For various reasons, they are not inclined to aggressively compete for the available resources in the pen and this puts them at a significant disadvantage in a large-group situation. Good stockpeople recognize these individuals early but may have limited options to provide the extra attention they require to compete with their herd or flock mates.

It is impractical to design a barn that provides an ideal environment for 100% of the incoming animals when 98% of the animals do not require the extra amenities. However, it is economically sound and welfare appropriate to provide special temporary accommodations for high-risk individuals that need a few days of extra care to adjust to their new environment. Special penning for this group of weaker animals may be similar in design to hospital penning and, on some farms, the same pens can serve both purposes. Specially designed starter penning for weaker individuals should provide less competitive access to feed and water, better footing, additional heat, and more comfortable lying areas. Providing the less competitive animals assistance at the start means less time spent on sick animals later. The weaker cohort in the special needs pen should be able to see and hear the remainder of the herd or flock so that their reintroduction to the large group will be a more seamless transition. These special care pens often have a higher success rate than when they function as hospital pens. Preventing disease in the smaller, weaker cohort is more satisfying and provides greater returns than treating these animals once they succumb to infections.

Understanding the cost effectiveness of both therapeutic and prophylactic pharmaceuticals is critical in ensuring that animal welfare is maximized on modern livestock farms. Veterinarians may struggle to comprehend the reluctance of some producers to use effective vaccinations in their herds. Why would a producer be reluctant to spend $2 on a preventative vaccination program to protect finishing pigs that are worth $190 apiece at market? The reluctance is not as irrational as some may think. If the producer’s current cost of production is $180 in a $190 market, adding a $2 vaccination will reduce the farmer’s profit on every pig sold by 20%. Few veterinarians would be eager to adopt a strategy that would reduce their income by 20% unless it proved necessary.

Veterinarians as well as producers often misjudge the value of treating individuals. In the above example, if a pig required an additional $40 of care (labor, pharmaceuticals, and feed) to recover from an ailment, some would conclude that adding $40 to the existing $180 cost of production is pointless if the pig is only worth $190. However, if the pig is left untreated and dies, the farmer loses close to $180. If the pig is left untreated but can be sent to a salvage market where they return $90, the farmer may suffer a loss of up to $90. However, if the pig fully responds to the $40 treatment, the farmer loses only $30 ($220 minus $190). It is often cost effective on even the largest production units to build effective hospital pens and to invest appropriate time and resources in helping individuals recover. Ensuring that stockpeople appreciate the importance of individual animal care make them more effective and responsible animal caretakers. Stockpeople feel a sense of pride and accomplishment in identifying ailing individuals and returning them to health and productivity. This increases job satisfaction, often leads to retention of good employees, and improves the bottom line on many farms (Hemsworth and Coleman 2011). Telling a dedicated stockperson that an animal is not worth treating is often both economically and ethically wrong.

Recent technological developments show great promise in helping to quickly identify individual animals in need of medical attention before the onset of overt clinical illness. On dairy farms it is becoming increasingly common to equip animals with wearable bio-monitors able to record resting time, rumination or eating time, body temperature, and other measures important to health and welfare. Additionally, the daily collection of milk from dairy cows allows us to identify milk contents – such as somatic cells – important to cow health. The continued development and implementation of such technology will be of great benefit to producers and veterinarians working to identify individual animals in need of medical care.

Appropriate Follow-Up Care

An area of ethical concern pertinent to food animal practice is ensuring appropriate follow-up care. Food animal practice has the potential to create these ethical challenges due to the increased demand on a practitioner’s time associated with clients who live many miles away. This is less of a problem in practices where the patients come to the clinic. However, when a herd or flock under care is an hour or more away, careful follow-up evaluation of the success or failure of interventions puts an added demand on the practitioner’s time. These travel-associated time constraints increase the risk of insufficient follow-up and unnecessary adverse outcomes. Practitioners cannot always expect clients to accurately assess the success of interventions, particularly in cases where they are unfamiliar with disease processes (Sumner et al. 2018). Producers, like veterinarians, have their own daily crises to manage and due to their own time constraints may not critically assess the progress or lack thereof of a veterinary treatment. To avoid moral stress, food animal practitioners should develop a system for monitoring their recommended interventions.

For acutely ill animals, a call or text message the following day emphasizes to the producer that the animal’s condition requires close monitoring. In addition, it demonstrates the veterinarian’s sincere interest in a positive outcome. For busy practitioners, this next-day check-in can be done by a suitably trained receptionist or technician. For less acute situations, e.g. changing a feeding program for young animals, scheduling a follow-up visit either in person or by phone before you leave the farm has two positive effects. First, it demonstrates your sincere interest in improving the situation on the farm. Second, it provides an incentive for the producer to implement the intervention since they know you will be checking in on their progress at a set date in the future.

Recent developments in telemedicine will be an important tool for case follow-up by food animal practitioners (Patterson n.d.).

Financial Conflicts of Interest

Financial conflicts of interest are ubiquitous in veterinary medicine. Any practice model where the veterinarian’s livelihood is dependent on the income of clients paying for care on behalf of the patient presents the conflict of serving the best interest of the patient while protecting the income stream of the veterinarian. This conflict may be amplified in food animal practice, where it is typical for an individual veterinarian to serve a small number of clients, making the loss of any one client a significant financial risk. Customer dissatisfaction is an ever-present risk to the food animal practitioner’s livelihood.

While many companion animal practitioners face similar challenges with the advent of cyberbullying and negative reviews having the potential to negatively impact the business, an important financial conflict in companion animal practice is the profit taken from drug sales. The American Animal Hospital Association (AAHA) Veterinary Fee Reference reports mark-ups ranging from 65 to 113% depending on the type of drug (AAHA 2018). The typical US food animal practitioner may mark up drugs by 2–5%. The reason for the difference is in the volume of drugs a food animal practitioner may sell. Food animal practices that choose to manage distribution of drugs to clients stand to generate significant income if the volume of drug sales is high.

Profit from the sale of drugs therefore represents a clear conflict of interest for all veterinarians. Some food animal practitioners manage this conflict by limiting the sale of drugs on an as-needed basis to those with limited access or use, or by opting to write prescriptions for clients so that they can buy direct from a licensed distributor, effectively limiting any negligible profit to the relatively small number of clients that choose not to buy pharmaceuticals directly. But this does not remove the conflict altogether. Unlike human medicine where, under the Affordable Care Act of 2021 (aka the “Sunshine Act”¹), the influence of drug companies on treatment decisions has been hampered, veterinarians may accept incentives (hats, jackets, rebates, meals, paid vacations, and other “reimbursements”) with impunity. Many veterinarians may not recognize the conflict of interest such “gifts” represent for their practice (Case Study 12.3). The influence of “gifts” on treatment decisions has been well documented. One study suggested that small gifts caused doctors to change their prescription writing behavior (Wood et al. 2017). Still, many veterinarians insist that they are above the sway of fancy dinners and paid fishing trips, and certainly a free pen!