The Business of Practice: The Ethics of Equine Emergency Care

In this episode of The Business of Practice podcast, we talked with Barb Crabbe, DVM, MA, about the ethics of emergency care in equine veterinary practice.

Many clients have unreasonable expectations for their veterinarians, and some even feel entitled to immediate service whenever they want or need it. Veterinarians have an ethical duty to provide emergency care, but they must also prioritize their personal health and wellness. Finding that balance is “one of the most difficult things in equine veterinary medicine,” Crabbe said.

She explained that professions such as veterinary medicine are granted the autonomy to self-regulate through a contract with society. “Society expects us to take care of animals,” she said, “but that contract doesn’t mean care for every animal by every veterinarian.”

Individual veterinarians must make decisions based on their personal ethical boundaries. Veterinarians who believe in utilitarianism might make decisions that give the largest benefit to the greatest number of patients. Other veterinarians reject the idea that “the ends justify the means,” regardless of the consequences. Some veterinarians follow virtue ethics, asking themselves, “What would a compassionate person do?” Most doctors also utilize case-based reasoning, drawing on previous experience or knowledge when making decisions. Crabbe explained that while most veterinarians will feel ethically obligated to respond to a horse hit by a car, the decision to attend a mild colic that is not currently painful will likely be more individual.

“Most importantly,” Crabbe summarized, “the practice culture needs to be aligned with your moral compass.”

About Dr. Barb Crabbe

Barb Crabbe, DVM, MA, is a graduate of the University of California, Davis, School of Veterinary Medicine. She also completed an internship in large animal medicine and surgery at Washington State University. While at UC Davis she did graduate work in biomechanics, studying patterns of locomotion in exercising horses. Crabbe spent 30 years as a private practitioner and the owner of Pacific Crest Sporthorse, a three-doctor general equine practice in Oregon, where she had a special interest in performance horse medicine. She is an FEI official veterinarian in dressage and jumping. In early 2023, Crabbe transitioned her practice to her two long-term associates to pursue her passion for ethics in veterinary medicine. She completed a master’s degree in bioethics from the Neiswanger Institute of Bioethics at the Stritch School of Medicine at Loyola University, Chicago, where she is on the home stretch of a doctoral program. She currently serves as the chairman of the AVMA’s Council on Veterinary Services, where she led the committee responsible for a recent overhaul of the AVMA’s Principles of Veterinary Medical Ethics. She is also a member of AAEP’s Ethics and Professional Conduct Committee.

Crabbe is a frequent contributor to a wide variety of horse publications, and her articles have won numerous American Horse Publications awards. Her book Comprehensive Guide to Equine Veterinary Medicine was published in 2007 by Sterling Publishing in New York. She is currently contracted with Wiley to write a Veterinary Bioethics textbook that will introduce basic ethical theory in the first sections and then draw from cases collected from veterinarians in a “narrative ethics” approach. She has developed a 10-step template to help veterinarians evaluate and resolve ethical dilemmas.

Crabbe is an avid dressage rider and USDF silver medalist. She lives on a farm outside Portland, Oregon, with her husband, Bob, a veterinary internal medicine specialist. They have two girls who are almost fully launched and currently focus their attention on four dogs, a cat, and two horses.

Related Reading

• The Business of Practice: How to Evaluate and Resolve Ethical Dilemmas
• The Business of Practice: How Equine Veterinarians Can Build Confidence
• The Business of Practice: Veterinary Well-Being Study Results

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