On Oaths…

There is a joke told among veterinarians that physicians are essentially veterinarians that have limited their practice to a single species. It is true that great similarities exist between humans and animals physiologically, and much medicine overlaps. But there’s a big difference between the ethical practice of veterinary and human medicine. The Veterinarian’s Oath diverges from the Hippocratic Oath in its focus. Physicians are charged within their oath to a primary emphasis on healing and curing disease, the relief of suffering assumed secondary. Veterinarians, instead, are foundationally called to “protect animal health” and relieve suffering through their oath. These are important distinctions.
Nigel Cameron has chronicled the migration that human medicine, with its growing emphasis on the relief of suffering, has made toward the veterinary model. In The New Medicine: Life and Death after Hippocrates, he laments this change, finding the drift to be a source of double-minded tension which pits healing and relief of suffering against each other. Veterinarians must deal with some of this tension, where the cure for a disease process cannot create undue pain and cause substantial detriment to the quality of an animal’s life. For example, some of the stronger chemotherapy drugs, from which human patients may be willing to endure the more difficult side-effects (at a great loss of quality of life, at least temporarily) are not reasonable options for dogs or cats. The default position in veterinary medicine is avoidance of suffering. Additionally, the protection of animal health can entail taking one life for the betterment of another, an accepted fact within a profession that has multiple obligations and must make decisions from among animals and between the “non-equals” of animals and humans. Euthanasia in the face of pain or suffering is entirely consistent with the stated aims of the Veterinarian’s Oath. It is entirely inconsistent with the Hippocrtatic Oath and centuries of tradition in human medicine.
Some eschew the Hippocratic tradition in medicine as they favor an ethic that skews toward radical patient autonomy and perverse avoidance of anything that would be considered a burden or could negatively impact the perception of dignity, all in the name of compassion. Ironically, as some of human medicine migrates toward a veterinary model, veterinarians may be heading the other way. As advancements in drugs and technology intersect a stronger human-animal bond, treatments that would be burdensome to humans are increasingly used in companion animals. Some veterinarians can fall headlong into a vitalism that seeks to prolong animal life at any cost. We may find that physicians are becoming more like veterinarians just as veterinarians seem to become more like physicians, with both groups violating the underlying premises of their respective oaths.
But humans are different from animals. We must understand personhood ontologically, and the distinctions in moral status between humans and animals, to recognize the variation between the two oaths. With these blurred (or maybe even reversed in some cases) the risks to the integrity of human dignity, and the Hippocratic tradition, become great indeed.