Does the veterinarian owe primary allegiance to the client or to the animal? This is the question posed and discussed in this article. The question is especially important in geriatric animals for several reasons: our increased ability to treat chronic disease and prolong life, the increase in significance of pets as human companions, the willingness of people to spend more for veterinary treatment, and society's greater ethical concern for animals. However, we should not do something simply because we can. There is no reason for us to suppose animals can comprehend the notion of prolonged life, let alone trade the current suffering from our interventions to obtain a longer life. Owners may also ignore the differences between the animal and human minds and choose to prolong a pet's life despite a lack of quality of life. It is at this point that the veterinarian has a moral responsibility as the pet's advocate. Quality-of-life issues should be addressed early in the client-patient relationship, and the veterinarian has a moral obligation to ensure that, while a pet lives, it does not suffer. Animals do not appear to fear death, but they clearly fear pain, and death can be a merciful tool for escape from pain. In geriatric or chronically ill patients in which euthanasia is not required, the veterinarian must focus on controlling pain, suffering, and distress. It is therefore incumbent on veterinarians to know more about the signs of pain and distress and their alleviation, and to educate their clients to ensure a decent quality of life for their patients and the absence of suffering at life's end.

COMMENTARY: In this article, Dr. Rollin, a well known and respected ethicist, discusses the veterinarian's role in ensuring patients do not suffer as a consequence of an owner's reluctance to "let go." There are no earth-shattering revelations here-most of the suggestions Dr. Rollin presents are probably being used intuitively by practitioners already. However, what Dr. Rollin does do is provide the historical and ideological context from which our feelings and practices spring. The result is an interesting and highly readable article I would recommend to anyone involved in veterinary (or for that matter, human) medicine-particularly today, where a topic of heated debate is whether humans should be legally designated as "owners" or "guardians" of their pets.

Ethical issues in geriatric feline medicine. Rollin BE. J Fel Med Surg 9:326-334, 2007.