THE ‘ONE MEDICINE’, VETERINARY BIOETHCS
AND PLANETARY HEALTH
By Dr. Michael W. Fox
RESOLVING THE VETERINARY DILEMMA: PEOPLE OR ANIMALS FIRST?
A major bioethical dilemma facing the veterinary profession today is how to respond to a growing public demand for improved treatment of animals in society, especially those who are exploited for commercial purposes, from biomedical research to food production, and the mass production of pure breed dogs in puppy mills, as well as the mistreatment of wild animals in circuses and many zoos. There would be no dilemma if economic concerns took second place to animal welfare, and if sectors of the veterinary profession were not aligned with those vested interests in maintaining and expanding an increasingly global market economy based on animal exploitation. Fundamentally it is the consequence of anthropocentrism that leads us to regard and treat other animals as inferior. This perception is now becoming more zoo-centric, where animals are appreciated and respected in their own right and light. This means that making interpretations of their emotional and motivational states that seem anthropomorphic are no longer taboo, (Balcome 2006, Bekoff 2007).
Human ignorance, customs and conventional attitudes toward animals not withstanding, the domestication and commoditization of once wild animals, who have not all lost their entire ethos or original natures, and are therefore not yet adapted to the kinds of environments and ways of treatment to which we subject them for pecuniary ends, is a long neglected bioethical issue: And a conundrum. How can we claim, as a society, to care for animals, when economic interests take precedence over animals’ welfare and overall well being?
That our domesticated animals’ ancestors were taken originally from the wild for the purpose of domestication is a fact that we must all consider when addressing animals’ adaptive capacities. The welfare and wellbeing of domesticated animals are compromised as when the highly productive varieties of pigs, cattle, poultry, fish, and other species, all genetically altered to varying degrees, are forced to live in totally unnatural, stressful conditions, (Webster 2005). These can range from almost total physical restriction and environmental impoverishment, as is the case for breeding sows and most veal calves, (ditto too many wild animals in zoo and circus cages), or extreme overcrowding, as is the case with battery caged laying hens, farmed salmon in floating net-cages, and piglets in confinement stalls and pens, (Fox 1997).
The narrow view of human health as being the absence of disease has been long redundant with the World Health Organization. Likewise the narrow view that the absence of disease in animals, especially those that are raised for human consumption, is a cardinal indicator of health and overall wellbeing is untenable. That their health depends so much on the use of vaccines and an armament of drugs that can have serious adverse environmental, public/consumer health, and long term economic consequences, is no longer tenable. Such treatments are not based on sound science, but on the animal productivity paradigm of agribusiness’ economism that is devoid of any bioethical framework. A blatant example of economic concerns trumping animal welfare concerns is in the transportation of pigs to slaughter, where the economies of transportation justify extreme overcrowding that can result in some economic losses when some pigs succumb to the stress and their carcasses become unfit for human consumption, ( so called ‘slimy cutters’). Likewise the economies of scale justify large dairy herds, huge hog and poultry factories, and massive beef and dairy feedlots. But the costs in animal welfare and health, as well as the environmental and increasing public health costs, (Hu and Willett 1998, Campbell 2005) have been too long discounted.
To reason that antibiotic and other drug and vaccination maintained confinement sheds containing thousands of pigs or poultry are acceptable from an animal welfare perspective because the animals are productive (the pigs and poultry grow quickly and the hens lay many eggs), and disease incidence is low, is patently absurd. Animal health determination includes psychological as well as physical well being, not simply the absence of disease. Animal health and animal welfare are co-dependent. One cannot be taken away without affecting the other. Likewise, animal welfare standards must consider not only animals’ physical needs and requirements, but also the related psychological/emotional/, behavioral, social, and environmental needs ( McMillan 2005, Webster 2005).
The labyrinth of animal cruelty and suffering, and ways we follow in the destruction of the natural world, differ from culture to culture and age to age, as likewise the recognition of human rights, social justice, and the ethical imperatives of animal and environmental protection. The deeper into this psycho-historical labyrinth of inhumanity toward animals we journey, the more we find it leading to no less indifference and cruelties toward our own kind---not the individual psychopathic aberrations of the animal mutilators and serial killers,---but in the collective acceptance and institutionalized execution of no less cruel and debasing, if not as immoral abuses like human slavery, political imprisonment and torture; animal experimentation, factory farming for fur, and flesh, milk and eggs; and cultural traditions like the bull fight, bear-baiting, whaling, and turning captive elephants, tigers, and other wild and endangered species, in to circus performers.
The concept of the ‘one medicine’ that is emerging as veterinary and human medical fields converge and collaborate with particular emphasis on environmental, indeed planetary health, will only succeed if equal consideration is given to the treatment and alleviation of the symptoms of dis-ease as it is to the prevention of harm and suffering to all sentient beings that contribute to the functional integrity of the Earth’s ecology, as well as to the life and beauty of the Earth. We have been slow to learn that when we harm the bacteria in our digestive systems and in the soil, we harm ourselves and our crops.
Such prevention goes way beyond better vaccinations and diagnostics, to examining our values and relationships, as in how the land and farmed animals are treated, along with the crops and foods we and they consume. Preventive medicine must also examine, like the shamans and healers of past civilizations, the icons and totems associated with the more destructive and harmful dimensions of the cultural ethos and human psyche. Physician Albert Schweitzer’s (1965) remedy that he prescribed for many of the world’s ills was based on such a holistic view of human well-being, namely, reverence for all life. But if reverence is conditional or partial rather than absolute and all embracing, it can be no more than feel-good paternalism, and a sentimentalist illusion.
GLOBAL ISSUES AND BIOETHICAL PERSPECTIVES
Part of the now global, systemic pathology of increasingly dysfunctional terrestrial and aquatic ecosystems parallels the condition of local and national resources and economies (Goodland 1997, Imhoff and Baumgartner 2006). The catalysts and vectors of this pathology are multiple and synergistic, (Diamond 2005). These include consumerism, industrialism, and human and domestic animal population expansion and concentration that combine to accelerate climate change, the loss of biodiversity, and the undermining of water and food quantity, quality, safety, and security ( Korten 1995, Fox 1997).
The new ‘life science’ of genetic engineering biotechnology with its patented genetically modified (GM) seeds and transgenic and cloned livestock, seeking to capitalize on the world hunger and climate change crises, is more likely to worsen the situation. This is not only because GM crops are genetically unstable and so can spontaneously mutate to produce potentially toxic new protein compounds, ( Wilson et al 2006, Domingo 2007): The application of this biotechnology is not consonant with ethics, and practices of more sustainable and humane farming systems (Fox 2004), many of which, in contrast to conventional agricultural practices, are economically more viable (Badgley et al 2007) , and produce more nutritious food with less harmful, and generally beneficial, environmental consequences, ( Cooper et al 2007).
The contributions by some segments of the veterinary profession have a disastrous legacy. By direct and indirect association globally with the livestock industry and commodity crop producers, they are in part responsible for global warming/climate change, loss of biodiversity, and zoonotic diseases like swine and avian flu, E coli and Salmonella. Their combined roles in contaminating the food chain, oceans and rainwater with petrochemical fertilizers, pesticides, GMOs (genetically modified crops) and veterinary pharmaceuticals, are a matter of biological record---a legacy that will endure for generations, (Fox 2001, Steinfeld et al 2006). Many of these contaminants and pollutants are endocrine disrupting, carcinogenic, teratogenic, mutagenic, neuro- and cytotoxic immunosuppressants.
Not all modern medical science and veterinary practices are ill informed. Both conventional and complementary, holistic, alternative, and traditional (indigenous/native) agricultural, veterinary and comparative medical disciplines and traditions are being utilized as valuable resources of knowledge and application to address some of the aforementioned concerns and issues. Other scientific disciplines and practices are being resourced also, such as environmental toxicology, immunology, reproductive, and molecular biology. Nutritional genomics for companion and farmed animals, and applied ethology/animal behavior, essential to insure optimal well-being (health and welfare) for all captive wild, and confined domestic animals, especially those used in food production, biomedical research, and for other commercial purposes, are being integrated into veterinary practice and undergraduate veterinary education. As Einstein cautioned, (1954) ‘ The problems that exist in the world today cannot be solved by the level of thinking that created them.’
EVOLUTIONARY ADAPTATION OR EXTINCTION
From a holistic perspective it would be accurate to say that we and the world are one, being embedded in a co-creative matrix of mutually enhancing symbioses, (Margulis 1998) from the bacteria in our soils and digestive and dermal systems, to the sustainable economies of natural ecosystems and organic and biodynamic farming practices. Some scientists name this evolutionary period the Anthropocene epoch, since we discovered how to make fire, tools, and weapons to alter and exploit the world’s habitats. This epoch is chronicled by the ages of pyrotechnology, mechanical, chemical, atomic and genetic engineering technologies and industries. The global crises that we face today can be seen optimistically as evolutionary challenges to our biology and psychology, shaping human nature for better or for worse, and for generations to come. When we harm the Earth we harm ourselves, and when we demean other sentient beings we demean our own humanity.
The lack of any unified sensibility in our regard for and treatment of animals and Nature, ---the natural creation---means, in terms of child development, a schizophrenogenic environment for character formation and personality development. This may result in ethically inconsistent, morally compromised or inverted, and emotionally conflicted perception and treatment of other sentient beings in adulthood. Totemic and iconic values and perceptions of animals and Nature range from the instrumental to the sentimental; from being objects of property, exploitation, and commerce, or subjects of affection, concern, and communion; and from treating others as ends in themselves, or to using them a means to one’s own exclusive ends. Animals once feared or revered are now regarded variously as commodities, test-subjects, objects of scientific curiosity and potential economic or medical utility; as indicator and flagship species of ecological well-being, and as beloved companions and family members.
The ‘golden mean’ of mutually enhancing symbiotic and commensal relationships is the iconic template for humane and responsible planetary trusteeship, and we have far to go ethically and legally before this state of being, where love and duty are one, is achieved. Such an achievement would herald the coming of what Thomas Berry (1988) calls the Ecozoic age, or, in the sense of this essay, the Ethicozoic age, where bioethics temper the anthropocentrism of the earlier industrial age of this Anthropozoic epoch.
Reverence for all life, in practice, means equalitarianism---giving all living beings equally fair consideration, especially in terms of the consequences of human values, appetites, actions, demands, and aspirations. It is synonymous with eco-justice. The new animal welfare legislation in the UK that mandates the ‘duty of care’ to animals under our dominion is a positive sign of the dawning of the Ethicozoic age.
Physician V.R. Potter ( 1971) first coined the term bioethics to link the biological sciences with ethics to demonstrate how bioethics can serve as a bridge linking ecology, environmental issues, medicine and public health. He was concerned that medical ethics was too narrowly focused. The same may be said of veterinary ethics (Rollin 2006) when there is no linkage with ecological and environmental science and consideration in the practice and teaching of veterinary medicine. Integrating the veterinary teaching curriculum with an empathy-based bioethical template (Fox, 1998 and 2006) would do much to meet the above challenges and issues related to the environment, animal health and welfare, and to the ultimate advancement of civilization.
Every human enterprise and activity that affects animals and the environment and causes harm, is in the domain of veterinary concern and professional responsibility. As Socrates, who advocated social democracy, cautioned, ‘a life unexamined is a life unlived’. So we are called upon to examine how our lives cause harm to others, and how we might avoid such adverse consequences. This is the realm of ethics, of making informed choices in our lives, that calls for a broader bioethics that includes consideration of how we might harm not only our own species, but also all other species that make up the life community of this living, but increasingly dysfunctional, human infested, and poisoned planet.
Veterinary bioethics calls on every veterinarian to apply the bioethical principle of compassionate care in their treatment of animal patients and in the advice given to client-owners and care-givers. This helps override the situational ethics of treating animals kept as commodities on factory farms where optimal care of animals on an individual basis is not normally provided for reasons of cost; and where a companion animal is not given optimal care because the owner is of limited financial means or does not feel that the animal is worth the expense of costly diagnostic and treatment procedures.
Rather than compromising their professional standards and integrity in such situations, veterinarians have a moral obligation to advocate compassionate care regardless of the context and situational ethics in which their services are required. This is because the bioethic of compassionate care is a fundamental human responsibility and every animal’s basic right. Furthermore, compassionate care is vital to animals’ health, welfare, and physical and psychological well being. It is therefore as essential a component of holistic and preventive veterinary medicine as caring for the land is a vital aspect of sutainable agriculture.
Other professions and business enterprises are similarly being called to accountability and responsibility, just as all of us in our personal lives must find ways to cause less harm to the natural world and to animals domesticated and wild, in the process of satisfying our basic needs. To realize the long term benefits of applying bioethics in our decision-making and consumer-choices, to our own health, to the economy, and to the entire life community of this living earth, means living mindfully, and by the guiding principle of compassionate care.
No new laws, government oversight, or international conventions can equal the profound benefits that will come from the incorporation of the bioethics of compassionate care into every level of society from business and education to health care and care of the elderly and the poor, as well as in our everyday lives, and in all our relationships, most especially with animals who continue to serve our needs in countless ways, and contribute more to the greater good than all of us combined.
SYNOPSIS OF GLOBAL BIOETHICS (FROM FOX, 2001)
1 Global bioethics calls us to give equally fair consideration to three spheres of moral concern:
human well-being (rights and interests)
nonhuman (animal and plant) well-being (rights and interests)
environmental well-being (biodiversity and ecosystemic integrity).
2 Global bioethics calls us to be accountable for our actions and appetites in relation to these three spheres; and to examine how well society, our politics, laws, economies (industry and commerce), religious, educational and other traditions and institutions, as well as our own personal lives, are in accord with the bioethical principles that unify these three spheres in the light and language of compassion, humility, and reverence for the sanctity of life.
3 Global bioethics calls us to actualize our natural, innate empathic sensitivity, moral sensibility and powers of reason, reflection, and also self-control by embracing the precautionary principle.
4 Global bioethics calls us to consider the purpose and potentials of human existence, the significance of the virtues that make us humane beings, and our duties and responsibilities for the Earth community, and for the integrity and future of Creation.
5 Global bioethics calls us to understand and respect the cultural ecology of moral pluralism, and from this diversity of human beliefs, opinions, and desires, create a common ground of equalitarianism and respect for all life.
6 Global bioethics calls us to develop a unity of spirit for more effective and immediate crisis management, conflict resolution, and humane intervention where the compass of compassion directs reason and action toward world peace, justice, environmental and animal protection, conservation and restoration of biological and cultural diversity for the security and fulfillment of all sentient beings.
Global bioethics promotes and unifies an interdisciplinary, holistic approach to Health Care as the sum of Earth Care + People Care + Animal Care.
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