Saturday, 24 May 2014

The Ethics of Behavioral Medications 2: The Appeal to Nature

Many people believe that if you live with an anxious or fearful dog, it�s best to try dietary supplements first, before starting down a medical route that could include prescriptions for behavioral medications.  As a result, there are literally hundreds of different calming supplements available for dogs, most of which claim somewhere in the attending marketing spiel that they contain natural ingredients.  The fact that they are natural is often taken as a reason to prefer these supplements to behavioral medications. In this article, I�m going to argue that we can�t formulate a strong argument for the claim that calming supplements are in any way better than behavioral medications because they are natural.  

This claim has a practical and a moral component; I�ll dispense with the former before moving on to the latter.  

Practical

The practical part of the idea that natural is better is the claim that natural supplements are safer, with fewer side effects than �unnatural� medicines.  Leaving aside the fact that there are a great many natural plants that will kill you, the comparative safety of calming supplements is largely an empirical issue.  At the present time, there are no studies on the long-term side effects of any of the most common calming supplements; in fact, there are only a few studies specifically looking at the efficacy of using these supplements in dogs at all.  Furthermore, supplements generally are subject to fewer safety standards; US federal law does not require dietary supplements to be proven safe by the FDA before they go on sale.  

There are, however, well-documented side-effect profiles for all drugs approved for veterinary use by the FDA.  A drug has to be proven safe and effective before it reaches the market.  This difference in the amount of data in itself can skew the argument - prescription drugs can appear to be more dangerous just because we can read about their side effects and can only obtain them from a professional. But this isn�t necessarily true; side effects have been measured with many different supplements, even though there is no law that they must be labelled.    

Prescription drugs can indeed have side-effects, and knowing what to look for is a huge plus.  They are known to contain an element of risk that we choose to take on if we choose to give them to our dogs.  However, there is also an element of risk with supplements, which is aggravated by not knowing as much about them.  In the third part of this series, I will talk about the related risks of choosing supplements instead of prescription medications in more detail.  

Moral

The second component to this claim is that, other things being equal, natural things are morally better than unnatural things - that the more humans interfere with an animal, or a process, or a system, the less �good� it will be.  

This isn�t to say that anyone who argues supplements are a better option than prescription medications must believe that all natural things are good and all unnatural things are bad - we could never classify this consistently, because things like fire, clothing, all petrol are unnatural for humans, but all undeniably useful.*  But the underlying belief is that generally, if something is natural it is better than an unnatural alternative. 

One problem with with is with how we can sort natural things from unnatural things. Behavioral medications can�t be easily sorted into natural and unnatural for two reasons.  The first is that both supplements and prescription drugs are designed to do basically the same thing. In order for any effect to take place, the blood-brain barrier must crossed by whatever chemical is contained in the pill. And, in all cases, the chemicals in the pill work on existing neural chemical pathways; the brain architecture that is responsible for producing and reabsorbing the chemicals that cause emotional responses like fear and joy. These are the same pathways, by the way, that dog trainers use to build a reinforcement history for any behavior - see my last article. So the natural and unnatural chemicals are working in the same area.   

To be more specific, everything marketed as a calming supplement is designed to work on serotonin and on the GABAergic systems.  Prozac is designed to stop the brain from reabsorbing serotonin that it creates, meaning that overall levels of available serotonin in the brain will go up.  Tryptophan, a common supplement, is metabolized into serotonin, meaning levels in the brain will go up. Alprazolam and Lactium (also called Zylkene) are both meant to work on the GABA receptors. My point here is, whatever you�re putting into your dog to calm him, prescription or supplement, is going to be doing one of only a few possible things.  The difference is whether it will be doing these things effectively and safely.  Therefore it is not easy to divide natural and unnatural medications along these lines.  

The second reason sorting of natural and unnatural calming medications doesn�t work is because all supplements are processed in some way.  We don�t find any of these pills growing in the wild. 

Two of these are supplements, two are prescription.

There�s no clear cut way to say that one pill is natural and another is unnatural just by looking at it, or even at the processes used to make it. We still discover a lot of �unnatural� drugs from natural sources, for example, cancer drugs, aspirin, statins, anti-malarials, and opiates - many are easier and cheaper to synthesize than derive directly thanks to modern techniques, but they all come from plants.  Are they natural, and, if they are, does this give them any extra moral goodness?  These difficulties make it very difficult to hold on to the idea that natural is better.

I would contend that the only thing that matters morally here is whether what we�re doing works, and is worth the risk.  When faced with a dog who is suffering, we ought to go straight to the science, because we don�t want to be faced with a long process of trial and error.   Often finding the right prescription behavioral medications involves trial and error too, so there is already the potential for the dog to have to wait a long time before feeling any respite.  

If we combine the practical claim that it is better to use something that we know works, and whose side-effects have been fully studied, with the moral claim that there�s no reason to believe that we can isolate the property of naturalness and justify why it is good, we have compelling reason to reject the appeal to nature here.  People wishing to hold on to the moral difference between natural and unnatural things are faced with a burden of proof; they need to justify what it is about natural things that make them better, and to explain a clear way to distinguish natural from unnatural.  

Besides which, dogs themselves are inherently unnatural. There�s an air of irony when people talk about natural being better for dogs, because we humans haven�t interfered as much with any other species on the planet.  What is natural about humans choosing to create a chihuahua and a Great Dane out of the common ancestor of the European gray wolf?  Human artifice has created every breed of dog, designed for human purposes.  If humans are agents of the unnatural, then, dogs are our finest creation.



*Unless you�re a nudist on a raw diet, of course.  But every rule has its exceptions!  


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