At first glance, veterinary medicine may appear unrelated to issues of social justice and inclusion. In reality, however, various aspects of the veterinary profession raise important and timely questions that are directly relevant to both inclusion and social justice.

Attempting to address all of these issues within the limited scope of this space would be both challenging and inappropriate. Therefore, we will focus on one particular open question to encourage reflection rather than propose a definitive solution.

In recent decades, veterinary medicine has undergone remarkable growth in the technical and scientific fields. Alongside clear advancements in therapeutic options, diagnostic capabilities, surgical techniques, and materials, there has been a notable increase in specialist expertise, supported by significant investment in postgraduate training and continuing professional development. However, this positive evolution has also led to a marked rise in costs, which, depending on the species in question, are ultimately borne by either the consumer or the animal’s owner.

Let us begin by considering companion animal medicine—not because the field of farm animal medicine is any less important, but because the analyses and reasoning relating to the two categories differ significantly. The status of companion animals in our society has changed profoundly over the past century; our grandparents would likely be astonished by the amount of time, attention, and resources we now devote to our pets. Even legislation—albeit partially and at times inconsistently—has evolved over the years. Today, the traditional legal classification of animals as res (property) is clearly outdated (at least in Italy); however, the new legal status intended for animals remains neither logically coherent nor clearly defined.

Setting legal considerations aside for a moment, and attempting instead to interpret public sentiment and expectations, it is likely that the majority of Italians do not subscribe to extreme positions—neither believing that animals should possess the same rights as humans, nor accepting the notion that animals are mere objects devoid of any rights. Most would likely agree that animals are entitled to certain rights, not equivalent to those of humans, but nevertheless meaningful. Definitions concerning animal welfare and the conditions necessary to ensure it have long been established. Animal welfare has been defined as “the state of complete physical and mental health that allows the animal to live in harmony with its environment” (WHO/Hughes, 1976).

Essential needs have been identified in the five freedoms outlined in the Brambell Report of 1965:

• Freedom from hunger, thirst, and malnutrition — ensured through easy access to fresh water and a diet that promotes health.
• Freedom to enjoy an adequate physical environment — including shelter and a comfortable resting area.
• Freedom from disease, injury, and trauma — achieved through prevention, early diagnosis, and prompt treatment.
• Freedom to express species-specific behaviours — by providing sufficient space, appropriate facilities, and the company of other animals of the same species.
• Freedom from fear and distress — by ensuring conditions that prevent mental suffering.

Each of these statements is as impeccable in its formulation as it is complex to define in unequivocal and achievable terms. Take, for example, the third freedom, which at first glance appears simple and straightforward: freedom from disease, injury, and trauma, ensured through prevention, early diagnosis, and prompt treatment. When this principle is applied to the field of companion animal medicine, the first and most pressing issue that arises is that of resources. While it is true, as previously noted, that treatment options today are far more advanced than they were thirty or forty years ago, it is equally true that the financial investment required to access these modern treatments has increased substantially.

The rise in the cost of veterinary services—driven by a radical transformation in the nature and quality of those services—has certainly not been matched by a corresponding increase in average wages. As a result, many veterinary treatments now represent a significant proportion of the average monthly income, and in numerous cases (such as emergencies, accidents, complex surgeries, or chronic illnesses), costs can even exceed it.

In a country that is fortunate enough, though often insufficiently appreciative of the fact, to have a public healthcare system that guarantees treatment for all humans, this situation often provokes feelings of astonishment, frustration, and anger. It is hardly surprising that individuals who find themselves in the distressing position of being unable to afford treatment for an animal with whom they have formed a strong emotional bond experience such negative emotions and perceive the situation as profoundly unjust. However, when examined from an ethical standpoint, the issue presents itself as a complex and far from easily resolvable problem.

What, then, is the right and balanced solution?

Should we accept the notion that owning a companion animal is a luxury, and therefore conclude that those without substantial economic means should forgo such a bond?

Or should we normalise, as is the case in some countries, the practice of euthanasia whenever an owner is unwilling or unable to care for a sick or unwanted animal?

Alternatively, should we openly acknowledge the existence of a “second-class” approach, whereby individuals must simply make do with what they can afford, without expecting access to gold-standard care?

Or, finally, should we consider the possibility that the public health system—already under strain—might in some way extend its responsibilities to include the care of companion animals?

Each of these possible choices, in fact, gives rise to a series of complex and unresolved questions. Accepting the idea that owning a companion animal is a luxury amounts to a social failure, as it is often the most vulnerable groups, such as the elderly and those who live alone, who benefit most from the bond with a pet. Furthermore, given the advances in veterinary medicine and the resulting increase in associated costs, it is far from straightforward to define an economic threshold that would reliably guarantee access to care in every circumstance.

Accepting that an animal receives only the care its owner can afford—and that, in the absence of financial means, euthanasia is performed—not only challenges our conscience, but also risks fostering a culture in which the elimination of sick beings for purely economic reasons becomes normalised.

Accepting a lower standard of care in cases of limited financial capacity, while undeniably a realistic and widespread practice—even in human healthcare across much of the world—is not always easy to comprehend. It demands careful and sensitive communication, particularly when addressing a population that has long benefited from the protections of a national health system.

Proposing that the public healthcare system should also assume responsibility for veterinary care, while ethically appealing to some, is unrealistic given current financial constraints and would raise a host of complex and unresolved questions. Would it be fair to require all citizens, including those who do not have and do not wish to have animals, to contribute through taxation to the healthcare of pets? How much public funding could reasonably be allocated to this sector, and should clear spending limits be established? Which animal species would be entitled to publicly funded care—dogs and cats? Horses? Pigs? Cattle? Sheep? Goats? Rabbits, birds, fish, reptiles, insects? And on what basis would some be included and others excluded?

As stated, we do not presume to offer ready-made answers—indeed, we believe that simple solutions to complex problems often appear effective at first glance, but quickly reveal their limitations when put into practice. Nonetheless, we maintain that these, like many other issues, are open questions that closely connect veterinary medicine to broader social concerns. Addressing them through open and inclusive debate may contribute both to the search for viable solutions and to the development of clear, accurate public communication.