...The Ethics of Pain Management!

In photo: Author, Kathryn Spadaro

(This paper has been written as a Special Project for the 6th Term Ethics and Jurisprudence Course. The views and opinions of the author do not necessarily represent those of the School of Veterinary Medicine or of St. Georges University.)

"The question is not can they reason? Can they talk? But can they suffer?” quoted by English Philosopher Jeremy Bentham (1748 -1832).  It has only been in recent years that pain management has become an important topic in veterinary medicine. In the 19th century, Charles Darwin refused to accept that infants experienced pain. He did not believe that cries, movements, changes in facial expressions or respiratory rates were signs of pain, but simply, an involuntary reflex. In his book "The Expression of Emotions in Man and Animals," Darwin stated that these changes in ‘animals, children, savages and the insane’ should not imply the perception of pain. However, with the help of such books as the Origin of Species and the more recent publications by Jane Goodall and Jane Fossey, the topic of evolution opened eyes to the close connection between humans and beasts. Can animals sense pain as humans do?

Today there is a better understanding of the physiological aspects of pain and perception. “It is now well established that animals and humans have similar neural pathways for the development, conduction, and modulation of pain. According to the principle of analogy, because cats and dogs have neural pathways and neurotransmitters that are similar, if not identical, to those of humans, it is highly likely animals experience pain similarly (1).”  With that said, is pain management in animals an ethical question or a medical question?

There is no doubt that pain management is a medical question. It was once believed that pain in animals following surgery, was beneficial to wound healing, because it limited movement of the animal which prevented further stress on injured tissues. This, however, is not the case. As in humans, pain induces a ‘stress response’ which stimulates the sympathetic nervous system and prepares the animal for the “fight or flight” response. This sympathetic response causes an increase in heart rate and blood pressure as well as the release of stress hormones such as cortisol, catecholamines, growth hormones and glucagons. These hormones are all catabolic, in that they break down energy stores for the increased metabolism. As a result there is increased tissue breakdown leading to prolonged wound healing. Furthermore, cortisol is a glucocorticoid which can cause significant immune suppression allowing the animal to become more susceptible to infection and sepsis.

On a more personal note, I believe that pain management is also an ethical question. When we entered into veterinary school we committed ourselves to the words of the Veterinarians' Oath, “Being admitted to the profession of veterinary medicine, I solemnly swear to use my scientific knowledge and skills for the benefit of society through the protection of animal health, the relief of animal suffering, the conservation of animal resources, the promotion of public health, and the advancement of medical knowledge" (AVMA). With these advances in medical knowledge and the understanding of the physiology of pain, relieving animal suffering within our own clinics is not only a possibility, but our responsibility. Read Full Story...