The appeal of ethics and the demand for ethical accountability have never been stronger and more prominent – witness the forceful assertion of rights by and for people, animals, and nature – yet an understanding of ethics has never been more tentative, and violations of ethics and their attendant scandals in business, science, government, and the professions have never been more conspicuous. There is probably more talk of ethics than ever; more endowed chairs, seminars, conferences, college courses, books, media coverage, and journals devoted to ethical matters than ever before. Yet, ironically, most people probably believe that they understand ethics far less than their predecessors did. Commonality of values has given way to plurality and diversity: traditions are being eroded.

In such a world it is exigent to understand the logical geography of ethics, and to possess the tools with which to negotiate reasonably what is often tortuous and slippery terrain. This is especially true for professionals, because to maintain their autonomy, professions must anticipate and accord with changing ethical thought. Our ensuing discussion will provide a conceptual map of the nature and role of ethics, and of veterinary ethics. Attempting to analyze difficult ethical cases or to debate complex ethical issues without such a map is analogous to attempting to do surgery without an understanding of the basic concepts of anatomy, anesthesia, and asepsis: one can do it, but one literally doesn’t know what one is doing and cannot, therefore, adapt to the unexpected. Conversely, once a person has mastered the relevant basic concepts, they can go well beyond what they had hitherto done by rote.

We are not saying that one cannot behave ethically without mastering the conceptual map we shall present. After all, few people make a study of ethics. Most of us just behave properly in an automatic way. Many of our ethical decisions are obvious, straightforward, and routine: we don’t overcharge a gullible client; we don’t attempt to steal another veterinarian’s patients; we don’t prescribe useless medication, etc. What we often cannot do, without a conceptual map and a reflective stance on ethics, is see the subtleties in variegated dimensions posed by complex cases: we tend to react to one obvious component and ignore others. Just as it takes training and practice and a conceptual map of medical possibilities to learn differential diagnosis of disease, it takes training and practice to dissect all the ethical nuances of many complex situations.

Detecting ethical questions is, in some ways, like detecting lameness. Prima facie, ordinary people not particularly knowledgeable about veterinary medicine would think that anyone can tell when a horse is lame and which leg is affected. In fact, when actually confronted with a lame horse, inexperienced laypeople, and even veterinary students, can at best detect that something is wrong (and sometimes not even that) but they can rarely pinpoint the problem. This is exactly analogous to the activity of identifying ethical problems. People (sometimes) know something is problematic, but they have trouble saying exactly what the problem is.

The study of ethics provides a way of forcing people, on ethical matters, to go beyond their mindset and expectations: indeed, that is why many people find it discomfiting. Of course, one can free oneself from the shackles of myopic perspective by seeking out people with strongly divergent opinions as discussion partners; we often recommend veterinarians orchestrate discussion of ethical matters with their hospital teams where they can hear a wide variety of viewpoints. But this alone will not fully assure a deepened perception in the absence of an understanding of what we have called the “logical geography” of ethical or moral questions. Hearing different opinions is not enough; one must also understand the criteria by which one judges and critically assesses divergent opinions, else one runs the risk of creating a Babel of incommensurable ethical voices – a chorus of individual opinions with no way to generate the consensus that viable ethics requires in a workplace or community, and no method for changing others’ opinions in a rational way. So, it is to an examination of the nature of ethics to which we must now turn.

As Plato noted, what we assume about right and wrong, good and bad, justice and injustice, fairness and unfairness, constitutes the most important assumptions we make as individuals and as societies including the professions. One sometimes encounters skepticism about philosophical ethics from people who assert that ethics is “just opinion” or “isn’t based on facts” and therefore can’t be rationally criticized or rationally taught.

Ethics is useful to:

• Understand, justify, and clarify your own and others’ positions.
  
• Improve awareness of the complexity of ethical issues.
  
• Be able to construct rational arguments.
  
• Develop a personal and professional identity.

The art of ethical resolution, on both a social and a personal level, is the art of finding a middle way between apparently irreconcilable differences. Before veterinarians can resolve ethical issues, they must be able to identify and dissect out all the relevant ethical components. This is not always easy given the human predilection to perceive with one’s expectations. Nor do most people have the time to engage in extensive dialogue to garner a multiplicity of perspectives on a given case. For these reasons, it is valuable to have a procedure for zeroing in on the relevant ethical components.

Veterinary Ethics

The main emphasis of veterinary education seems to be the mastery of techniques and facts. Until very recently, virtually no emphasis has been placed in veterinary curricula on the moral and social dimensions of veterinary medicine. The educational process is far too reductionist and mechanistic. The practice of veterinary medicine is taught as if it were value neutral, and it is assumed that students will simply pick up the moral and social implications of what they do when they are in practice. What in fact happens is that these problems are ignored. Indeed, veterinarians are literally starved for ethical discussion. In a recent report, 95% of veterinary students felt that veterinary ethics should be taught in the veterinary curriculum (Kipperman et al. 2020). Almost all veterinarians are “closet moral philosophers” whose philosophical interest is evident whenever they are given the opportunity to “come out of the closet.”

Too many schools fail to teach ethics, so practitioners and organized veterinary medicine get blindsided by concerns they do not see coming. Recent studies found that only 51% of US small animal practitioners reported having received ethics training (Kipperman et al. 2018), and only 29% of North American veterinarians received instruction in resolving conflicts about what is best care for patients (Moses et al. 2018). Veterinary educators should be teaching ethics throughout veterinary school curricula so that graduates are sensitized to the issues they will encounter as veterinarians. For example, we know that animal welfare issues are of increasing concern for the social ethic. We also know that society looks to veterinary medicine for answers. Thus, cognizance of animal welfare issues and recommendations for their resolution should be a top priority for organized veterinary medicine and veterinary practitioners.

Like all professionals, veterinarians are enmeshed in a web of moral duties and obligations that can and often do conflict. Veterinarians have obligations to their clients, to their peers in the profession, to society, to themselves, and finally, veterinarians have obligations to animals. Let us examine each of these in more detail.

Veterinarians have moral duties to their clients. For example, they have obligations to keep contracts, to tell the truth, to discuss options and obtain informed consent, to maintain confidentiality, etc. When stated in the abstract, these are self-evident truisms but in real life, these maxims are not so clear. For example, some veterinarians believe they are not morally obliged to euthanize a healthy animal if the client has refused to consider other options. Others believe that it is not necessary to tell the truth if the truth is very painful, as, for example, when an elderly couple asks if their terminal animal could have been saved if they had brought it in when they first observed symptoms instead of “hoping it would go away.” Some veterinarians argue that one should not explain all therapeutic options to a client if one believes the client will automatically choose the cheapest, not the best, option. Other practitioners believe they should impose their values on their clients who ask them, “What would you do, Doctor?”

Similar problems arise when one considers one’s obligations to peers. Veterinarians are obliged to protect the profession and treat other veterinarians in a collegial way. But how does this relate to the colleague who is incompetent? Although society expects all professionals, including veterinarians, to self-regulate in a way that accords with the social ethic, the profession, like all professions, feels inclined to band together and protect its own – which of course creates ethical conflict. Are you obliged to risk your position within the veterinary community by exposing a colleague engaged in blatantly unethical behavior that everyone else chooses to ignore?

And what of a veterinarian’s obligation to society? Society seems to expect veterinarians to lead in animal welfare. Yet it seems to many veterinarians that fulfilling these social obligations can well mean betrayal of their clients. As examples, the American Veterinary Medical Association (AVMA) rarely criticizes aspects of confinement agriculture (see Chapter 1) or breeding of unhealthy animals (see Chapter 10) that society finds increasingly objectionable – indeed, they often feel compelled to defend it! In many states, veterinarians are not mandated to report suspected animal abuse. Yet strong public health arguments can be made in favor of a moral obligation to report animal maltreatment (see Chapter 20).

The veterinarian’s obligation to themselves may seem straightforward, but here too there are problems. Every practitioner confronts the problem of people who cannot afford treatment (see Chapter 8). How much can, or should you, as a professional, do for free or at cost? Conversely, should a veterinarian advise tests or treatments because they will be compensated based on the generated revenues?

Finally, we must turn to the veterinarian’s obligations to animals. Veterinarians are often put in the position of attempting to advocate for the interests of patients whose desires are uncertain and whose consent they cannot directly acquire. Additionally, veterinarians need the consent, commitment, and financial support of animal owners to use their skills to help animals. Do I euthanize a healthy animal because a client requests it? Do I respect a client’s wish not to euthanize a suffering animal? Should I provide care that is likely to not be helpful to a suffering animal because the client will not consider humane euthanasia? How important is controlling animal pain, especially if the client declines suitable analgesia? What is my obligation to individual animals when my job is herd health? What of the claim that there is something morally odd about keeping animals healthy only to slaughter them? Then there is the fundamental question of veterinary ethics: to whom does the veterinarian owe primary obligation, the animal, or the owner (see Chapter 7)?

Practically speaking, veterinary ethics allows us to apply animal welfare science that provides information regarding what we could do to or for animals and address difficult questions about how we should treat animals including questions such as:

• What are we doing now?
  
• What should we be doing?
  
• Why should we be doing it?

The Anatomy of Making Ethical Decisions

Before one can resolve ethical problems, one must recognize all the relevant ethical questions and components of a challenging situation. When evaluating a situation, one should routinely ask: does it contain elements of obligation to client, peers, animals, society, or self? One then adduces all the relevant ethical principles that could be applied to the situation or its elements and, if necessary, appeals to ethical theories for ordering and prioritizing the principles. It is important to recall that principles do not change with differing situations – principles are like wrenches in one’s ethical toolbox. What does change in different situations is which principles apply to the case. In this way one is certain to have at least thought about all possible domains of ethical concern. Let us suppose that one has dissected a given situation into its morally relevant components. What happens next? Can we give a rational account of how one comes to a reasonable resolution? Equally important, what happens when two parties, both well intentioned, disagree about how ethical matters are to be resolved?

There are two very different senses of “ethics” that are often confused and conflated and that must be distinguished to allow for viable discussion of these matters. The first sense of ethics we shall call Ethics₁. In this sense, ethics is the set of principles or beliefs that govern views of right and wrong, good and bad, fair and unfair, just and unjust. Whenever one asserts that “killing is wrong,” or that “discrimination is unfair,” one is explicitly or implicitly appealing to Ethics₁, moral rules that one believes ought to bind society, oneself, and/or some subgroup of society, such as veterinarians.

Under Ethics₁ falls a distinction between social ethics, personal ethics, and professional ethics. Of these, social ethics is the most basic and most objective, to be explained shortly. People, especially scientists, are tempted sometimes to assert that unlike scientific judgments, which are “objective,” ethical judgments are “subjective” opinion and not “fact,” and thus they are not subject to rational discussion and adjudication. Although it is true that one cannot conduct experiments or gather data to decide what is right and wrong, ethics, nevertheless, cannot be based upon personal whim and caprice. If anyone doubts this, let that person go out and rob a bank in front of witnesses, then argue before a court that in their ethical opinion, bank robbery is morally acceptable if one needs money.

The fact that ethical judgments are not validated by gathering data or doing experiments does not mean that they are simply a matter of individual subjective opinion. If one thinks about it, one will quickly realize that in real life very little socially important ethics is left to one’s subjective opinion. Consensus rules about rightness and wrongness of actions that have an impact on others are in fact articulated in clear social principles, which are in turn encoded in laws and policies. All public regulations, including laws against insider trading and murder, are examples of consensus ethical principles “writ large” in Plato’s felicitous phrase, in public policy. This is not to say that, in every case, law and ethics are congruent. We can all think of examples of things that are legal yet considered immoral (tax dodges for the ultra-wealthy) and of things we consider perfectly moral that are illegal (parking one’s car for longer than two hours in a two-hour zone).

But, by and large, there must be a close fit between our morality and our social policy. When people attempt to legislate policy that most people do not consider morally acceptable, the law simply does not work. Those portions of ethical rules that we believe to be universally binding on all members of society and socially objective, are part of the social-consensus ethic. A moment’s reflection reveals that without some such consensus ethic, we could not live together: we would have chaos and anarchy, and a functioning society would be impossible. This is true for any society that intends to persist – there must be rules governing everyone’s behavior, and they must be objectively encoded in laws. Do the rules need to be the same for all societies? Obviously not – we all know that there are endless ethical variations across societies. Does there need to be at least a common core in all these ethics? That is a rather profound question we shall address later. For now, we only need to agree that there exists an identifiable social-consensus ethic in our society by which we are all bound.

Now, the social-consensus ethic does not regulate all areas of life that have ethical relevance – certain areas of behavior are left to the discretion of the individual, or, more accurately, to their personal ethic. Such matters as what one reads, what religion one practices or does not practice, and how much charity one gives and to whom are all matters left in our society to one’s personal beliefs about right and wrong and good and bad. This has not always been the case; all these examples, during the Middle Ages, were appropriated by a theologically based social-consensus ethic. And this illustrates a very important point about the relationship between social-consensus ethics and personal ethics; as a society evolves and changes over time, certain areas of conduct may move from the concern of the social-consensus ethic to the concern of the personal ethic, and vice versa.

An excellent example of a matter that has moved from the concern of the social ethic, and from the laws that mirror that ethic, to the purview of the personal ethic is the area of sexual behavior. Whereas once laws constrained activities like homosexual behavior, adultery, and cohabitation, these are now increasingly left to one’s personal ethic in Western democracies. With the advent during the 1960s of the view that sexual behavior that does not hurt others is not a matter for social regulation but rather, for personal choice, social regulation of such activity withered away. Some years ago, the mass media reported, with much hilarity, that there was still a law on the books in Greeley, Colorado, a university town, making cohabitation a crime. Radio and TV reporters chortled as they remarked that, if the law were to be enforced, a good portion of the Greeley citizenry would have to be jailed! Homosexual preferences are also rapidly moving away from social or legal condemnation – witness the increasing social and legal acceptance of gay marriage.

On the other hand, many areas of behavior once left to one’s personal ethic have since been appropriated by the social ethic. When we were growing up, paradigm cases of what society left to one’s personal choice were represented by the kind of person to whom one chose to rent or sell one’s property and whom one hired for jobs. The prevailing attitude was that these decisions were your own damned business. This, of course, is no longer the case. Federal law now governs renting and selling of property and hiring and firing to prevent discrimination.

As such examples illustrate, conduct becomes appropriated by the social-consensus ethic when how it is dealt with by personal ethics is widely perceived to be unfair or unjust. The widespread failure to rent to, sell to, or hire minorities, which resulted from leaving these matters to individual ethics, evolved into a situation viewed by society as unjust, and this led to the passage of strong social-ethical rules against such unfairness. The treatment of animals in society is also moving into the purview of the social-consensus ethic, as society begins to question the injustice that results from leaving such matters to individual discretion.

The third component of Ethics₁, in addition to social-consensus ethics and personal ethics, is professional

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