Relationships and corresponding factors to consider in ethical clinical decision-making

Clinician-patient (clinical responsibility)A. Legitimate aim: Is the clinical intervention in the best interest of the animal?
A1. Will the proposed treatment improve the patient’s health?
A2. Will the proposed treatment improve the patient’s quality of life (immediately/long term)?
B. Alternative measures: Is the proposed treatment the one with the least potential to cause harm and suffering while still achieving the intended clinical goal?
C. Reducing harm and suffering: Have measures been taken to minimise the potential for harm and suffering?
D. Proportionality test: Do the expected benefits outweigh the potential harm and suffering inflicted on the animal or are they at least in balance?
Clinician-profession (professional responsibility)E. Clinician experience: Does the primary clinician/team have experience in carrying out the proposed treatment and/or is it a well-documented recognised treatment?
F. Ethical decision-making: Is this case an example of good ethical decision-making for students/trainees/colleagues?
G. Professional justification: Would you feel comfortable justifying the proposed treatment to professional colleagues?
Client-patientH. Treatment impact: Would proceeding with the proposed treatment have a positive impact on the owner–animal relationship?
I. Benefit to client: Would proceeding with the proposed treatment have a positive impact on the client’s quality of life and/or financial benefits (eg, the proposed treatment will allow breeding from a valuable animal)?
Clinician-clientJ. Cost: Is the proposed treatment financially viable for the client?
K. Recovery: Is the client capable of providing a suitable home environment and/or administrating medication during the recovery period?
Priority of justification (moral v non-moral)L. Moral proportionality test: Are answers to E–K more influential in your clinical decision than the A–D?