兽医如何影响您的决定？

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“如果是你的狗，你会怎么做？”

许多小动物实践中的兽医都从不确定选择某种治疗或安乐死的客户那里听到了这个问题。乍一看，答案似乎很容易。只需分享您的意见。但是，当您仔细研究情况时，它会变得更加复杂。

首先，兽医和客户的环境和道德价值观可能会有所不同，因此兽医的正确性可能不一定与客户正确或相关。其次，这个问题可能并不能真正反映出听到兽医会做什么的希望，而是呼吁为做出艰难决定提供帮助。但是，寻求这种帮助可能会使兽医与关于良好行为的想法发生冲突。

有人认为，兽医知道更好，并被允许决定动物的利益。其他人则认为应尊重客户自主权，即客户应该自己做出明智的决定，而兽医应做的就是提供相关信息。最后，其他一些人指出了共同的决策，在此方面交换信息和意见以达成协议。那么兽医应该如何回应呢？

决策的挑战 - 制定

我想仔细研究决策成为挑战的情况。什么时候很难决定？

几乎没有关于这种情况的研究，因此，作为起点，我想仔细研究决策成为挑战的情况。什么时候很难决定？客户如何发现兽医应对他们的犹豫和建议的要求？接下来，我想讨论兽医从事这种决策时角色的道德意义。

我采访的狗主人是一个选定的小组。他们选择照顾生病或老年狗，似乎将狗视为家庭的一部分。访谈还涉及在提供苛刻的护理时对自己生活的影响，他们感谢人们对面临的挑战的关注。

事实证明，在某些情况下，决策更容易（相对而言），例如，如果狗的福利真的很差，则尝试了所有治疗选择，或者客户筋疲力尽。其他情况创造了更多的灰色区域，并使客户犹豫。

Here the challenges included the lack of a clear cut-off point if, for example, there was a slow deterioration or if good days alternated with bad. Why then choose euthanasia on one specific day rather than next week or month, or perhaps a long time ago?

In some cases clients felt unsure if their dog was suffering, and some were struggling with how to balance different concerns about both the dog and their own situation. Finally, for some clients taking on the responsibility for ending the dog’s life could be hard. It made them feel like a bad person, and they wanted the vet to share that responsibility.

The vets could thus help clients both by assessing the dog’s welfare and by engaging in decision-making.

The vets could thus help clients both by assessing the dog’s welfare and by engaging in decision-making. Also, supporting the client’s nearly made decision, legitimizing concerns about the impact on their own life and providing specific guidance brought relief. Clients were aware though, that the vet could influence their decisions in the process.

Influencing a client’s decision

So, clients may want vets to engage in the decision-making and vets may influence clients’ decisions. This is a challenge if one believes that clients should make informed autonomous decisions, which is currently advocated as best practice amongst veterinarians.

第一个挑战是兽医可能需要选择性，简化给客户的信息，这样做可能会对他或她自己的首选选择造成偏见。

第一个挑战是兽医可能需要选择性，简化给客户的信息，这样做可能会对他或她自己的首选选择造成偏见。第二个挑战是，兽医可能没有与客户决策有关的所有信息。

I did this work as part of a larger project on drawing the line for veterinary treatment. Here I found thatfollow-up studies on veterinary treatment rarely consider welfare in a broader context。So the vet may know the success rate and medical complications of a treatment, but not how the animal is expected to cope in its everyday life.

此外，这些访谈的另一部分表明the impact on the clients’ own lives may be significant if they choose certain treatments。Clearly, these aspects need to be addressed, if the client should be fully informed before making a decision.

最后，我质疑简单的自主决策在所有情况下都是理想的选择。如果客户想分享决策或将决定完全留给兽医怎么办？似乎有时可能会发生这种情况，并且可能需要开发在实践中处理此类过程的模型。

不过，这引发了其他考虑的问题。如果兽医和客户在最佳前进方面或兽医在决策中的作用不同意，该怎么办？兽医如何避免将客户指向不必要的方向？兽医决策中的道德框架显然值得进一步关注。