Vet dilemma: The Caesarean Section night
This time, let me tell you a story in the life of a veterinarian.
Just like medical professionals, veterinary professionals are also faced daily with making difficult decisions that would affect the lives of both the animals and their owners. They have individual responsibilities towards themselves and collectively towards animals, clients, subordinates and to the general public. But at times, in sticky situations, decisions get to be tricky.
One Saturday night in Gobabis, I was faced with choosing between the life of a cow and a dog when I had to perform an immediate caesarean section (CS; or to surgically remove a newborn animal from its mother) on both animals with dystocia (difficult birth). One Saturday evening a certain Mr Farmer from Epukiro Village brought a cow for vet assistance.
State vet offices normally don’t work during weekends and I had to roam the location looking for any of our animal handlers. To my dismay, the two guys I managed to find were both “under the influence” and were under no obligation to work on weekends. The only motivating factor to assist me was the rewards I promised them.
Things were progressing slowly, while trying to pull the difficult calf out using all the tricks in the book. While having my arm way up the cow’s womb, a car stopped at the vet hospital. Here came this ‘affluent’ family with their little Dachshund doggie that was having a difficult birth. The little girl holding the dog said “Doc, please help Fluffie, she is going to die if you don’t”. And I was like “Ok, but you can see where my hands are, can you wait just a little bit?” But oh, no, she started crying and I melted there and then. I could also see how the little dog was in pain from trying to give birth.
By that time I had decided to rather do a CS on the cow because the calf was too difficult to remove manually even with my assistants “at-that- moment- less-than competent handlers”.
The two animal owners started arguing which animal I should operate first. Mr Farmer argued that he came first while Fluffie’s owner kept on saying “this is my baby’.
To cut a long story short, I eventually did a CS on the dog first and it survived with four beautiful puppies. On the other hand, the calf was already dead when they brought in the cow and whilst she survived the CS, she sadly died two days later.
The key dilemma was that both animals needed my immediate attention to survive as there was no other vet available. Furthermore, I had to manage my two drunken assistants and keep peace between the animal owners who expected immediate help. Time was a constraint and I was stressed to make a decision.
To choose which animal I had to operate first had consequence, and whatever outcome I chose, I had to take responsibility for the dilemma that had no obvious solution. The dog was a valuable part of the family and the cow was a source of income to the village farmer.
Even though my decision to operate on the dog first was based on professional calculations where the CS in small dogs usually takes a very short time while much longer in cows, ‘abandoning’ the cow was still taking a risk. Unfortunately to make matters worse, the CS in the dog ended up being complicated as I was forced to resuscitate the puppies and perform a complete spay (remove the uterus and ovaries) for the dogs to survive.
Maybe I should have stuck to evolutionary ethics where in our society the moral code was previously towards treating dogs as an inferior creature in comparison to livestock that are economically more important to humans. However, since I had to commit to a course of action and hoped for the best, I behaved like consequentialists who believe that all things or actions can be judged in relation to some end goal and I justified the outcome of my decision with my professional judgement, despite that, the cow later died.
According to management expertise, intense moral issues will help the individual to overcome situational pressures. However, when I had to decide to operate on one animal, my ethics and morality didn’t make it easy to overcome the difficult situation, because in animal welfare the justice principle prevail where all individuals/animals should be treated equally.
Since the animal owners were arguing about the importance of their respective animals, as a manager I was obligated to create a warmer interpersonal atmosphere between myself, the staff and the clients. However, I did not demonstrate emotional intelligence or non-defensiveness that is expected in a good communicator when the dog owner said after the operation “I knew you wouldn’t let Fluffie die over that cow!” I lost control and shouted at her. It was around 2 o’clock in the morning after a gruelling dog operation and I was stressed, tired and confused. I still had to go back to the kraal to operate on the poor cow.
Giving feedback to the owner that his cow had died was very devastating as I partly blamed myself. Somehow, I knew deep in my heart that if I had operated on that cow without the complication of attending to another patient, that cow would have survived.
Now let me hear from you, if you were faced with the same dilemma, how would you have handled it?