Align-ju RESEARCH BITES
The veterinary nurse ' s perception of the ethics of major maxillofacial surgery in dogs
Rachel Gardiner , BSc ( Hons ), RVN Winner of Best Poster 2024
Introduction
The advancement of surgical techniques , as well as the ever-changing relationship between humans and animals , necessitates the continuous re-evaluation of ethical decision-making in modern veterinary practice . Every day in veterinary medicine decisions are made regarding ethical treatment , where reason and emotion are often at battle [ 1 ] . Canine major maxillofacial surgery ( MMS ) provides the opportunity for prolonged tumourfree remission for neoplasms of the oral cavity or maxillofacial composition [ 2 ] . Although this opportunity is a privilege , it does come with ethical implications : considering the view ‘ just because we can , does it mean we should ?’ Understanding the ethical viewpoints employed by veterinary professionals is fundamental to the maintenance of animal welfare . Therefore , this study examines the veterinary nurse ' s ( VN ' s ) perception of the ethics of MMS in dogs .
Materials and methods
A total of seven semi-structured interviews were conducted over Microsoft Teams with four RVNs and three student veterinary nurses ( SVNs ). A pilot study was conducted with two SVNs to ascertain the question relevance and order , and amendments were made before conducting further interviews . Participants were obtained via self-selection and purposive sampling via participation advertisement on social media platforms . Those known to meet the inclusion criteria were approached to be recruited . Interviews were digitally recorded and transcribed with the Microsoft Teams transcription feature . Data were anonymised and transcripts were analysed in NVIVO for thematic analysis .
Results
Findings demonstrated that multiple factors influenced whether VNs deemed MMS in dogs to be ethical . The most significant finding was that all participants stated that MMS was unethical when performed on geriatric animals . Two participants deemed MMS to be an unethical treatment choice irrespective of the patient ' s age . All participants stated that owner compliance would influence whether MMS was deemed ethical . The study found a correlation between number of years of experience and how life-altering MMS was perceived to be . Participants who had seen more cases had a more negative view of the surgery , with the two most experienced participants perceiving MMS to be entirely unethical . Four participants who had seen healed MMS patients expressed neutral or positive statements regarding the long-term outcome . Five out of the seven participants subconsciously adopted deontological principles for the reasoning behind whether they deemed MMS to be ethical .
Conclusions
Factors such as patient age , participant experience and owner compliance influenced how ethical the VNs perceived MMS to be . MMS was deemed unethical when performed on geriatric animals , which unfortunately account for the majority of those with oral neoplasms requiring curative-intent surgery . VNs with more experience viewed MMS as more unethical and negative than those with less experience . Could this negative perception be due to more exposure to postoperative outcomes , patient quality of life and owner compliance ?
The results indicate a need for further ethical understanding and perhaps a standardised protocol that considers all patient factors to improve animal welfare by optimising ethical decision-making . Ultimately , these ethical decisions lie in the hands of animal owners ; responsibility lies with veterinary professionals to advise and inform clients to encourage the formation of an ethical decision . Perhaps a deeper understanding of the ethical principles used for decision-making will enable VNs to adopt a more comprehensive approach regarding the appropriateness of MMS .
REFERENCES
1 Herzog H . Some We Love , Some We Hate , Some We Eat : Why It ' s So Hard to Think Straight About Animals . 2nd edn . 2011 . New York : Harper Perennial .
2 Lascelles BDX , Henderson RA , Seguin B , Liptak JM , Withrow SJ . Bilateral rostral maxillectomy and nasal planectomy for large rostral maxillofacial neoplasms in six dogs and one cat . Journal of the American Animal Hospital Association . 2004 ; 40 ( 2 ): 137 – 146 . Available from : https :// doi . org / 10.5326 / 0400137 .
Volume 40 ( 1 ) • February 2025
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