We live in an age in which scientific medicine is challenged on all sides by so-called alternative therapies and, thanks to the internet, by out-and-out quackery. Some of these alternatives take the form of cultural traditions that are either new to the West, or newly swaddled in the cloak of anti-colonialism. Our current climate of cultural relativism makes rigorous critique of such traditions difficult, in polite company at least, which may explain why only the most preposterous alt-medical subcultures—homeopathy, for example—are taken to task. As for the rest, even though Canadians (and others) face a crisis of healthcare funding driven at least in part by the escalating costs of new diagnostic and therapeutic techniques, our culture of inclusion and accommodation precludes us from conversing freely about our healthcare priorities.
Last week our national broadcaster ran an op-ed advocating the elevation of "pet therapy" (a.k.a. animal-assisted therapy, or AAT) to the category of standard medical practice in Canada. The authors, Naila Kassam and Adam Kassam, are MDs connected with Western University, whose own dog Freddy is newly certified as a St. John Ambulance therapy dog. They note, quite correctly, that AAT can "reduce anxiety and stress for individuals undergoing medical treatment, as well as decrease the prevalence of loneliness and depression among elderly, isolated and palliative patients." This summer, Torontonians have seen pet therapy in action in the wake of the Yonge Street and Danforth murder sprees. And as any dog person will tell you, the emotional salve provided by our beloved pets in times of loss or loneliness is real.
Kassam and Kassam argue that pet therapy is "is one of those complementary approaches that should absolutely become integrated in standard practice." The other complementary approaches they cite explicitly are physiotherapy, occupational therapy and psychology. Pet therapy should be state-supported, the authors conclude, notwithstanding the reality that "doctor shortages, wait times and changing pharmacare coverage seem much more important."
But should it?
The associations that govern the activities of physiotherapists, occupational therapists and psychologists might have something to say about that. So might our overworked oncologists, radiologists and cardiologists, our medical researchers and lab technicians, our nurses, and medical associations like the OMA (which is currently lobbying for OHIP-covered home care). So, indeed, might the millions of ordinary citizens who benefit from, but also fund, the public healthcare system in Canada, and bear witness daily to its myriad challenges.
The point is not that pet therapy is unworthy, but rather that its recent appearance as one of many new, non-traditional approaches deserving "standard practice" certification requires public debate—unfettered, unsentimental debate based upon the best clinical data we have at hand, and triaged in a context in which we acknowledge that, now more than ever, we have to make hard choices.
"Modern medicine is often hyper-focused on pharmacological and procedural interventions," Kassam and Kassam lament. They're right about this. And until any alternative therapy can demonstrate its worth in the hard currency of lives saved, the funding of pharmacological and procedural interventions should remain our top priority.