LOCAL FRONTIERS: Here Come the Dogs

Irina deFischer, MD

Do you love dogs? Ever wish you could take your dog with you wherever you go? I sure do. Those of us who have traveled on the Continent may have noticed that Europeans bring their dogs everywhere. I remember going out to eat with my aunt and uncle (and their dachshund) in Switzerland with my husband Scott and daughter Jeanne-Marie when she was a toddler. Jeanne-Marie was getting restless at the table, so my aunt suggested we let her sit on the floor. She and the dachshund happily shared a bowl of spaghetti under the table while the rest of us finished our meal in peace.

Our family later had a lovely yellow Labrador named Tassel who was a Guide Dog breeder. She brought us great joy and helped us get through the children’s teen years with her unconditional love. She was always happy to see us when we came home from work, and she made sure we got out for regular walks. I miss her, and I hope to have another dog someday.

What are the rules for dogs in the workplace and other public places? That depends on whether they are pets, service dogs, emotional support animals or therapy animals.  

Service dogs are individually trained to perform a specific task for people who have disabilities. The disabilities can vary greatly, and so do the tasks that service dogs perform. Service dogs can aid in navigation for people who are hearing- or visually impaired, assist a person who is having a seizure, calm a person who suffers from post-traumatic stress disorder, and even dial 911 in the event of an emergency.  

Under the Americans with Disabilities Act (ADA), a person with a disability is entitled to a service dog to help them live their lives normally. The ADA protects disabled people by allowing them to bring their service dog with them to most places where the public is permitted, including restaurants, hotels, medical facilities, housing complexes and airplanes. Any dog can be a service dog, and service dogs do not have to be professionally trained. The important thing is that the dog is trained to be a working animal and not a pet. Service dogs are often identified by wearing a service dog vest or tag. You are not allowed to ask a person with a service dog what type of disability they have: only if it is a service dog, and what tasks the service dog is trained to perform for them.

What about emotional support animals, also known as ESAs? A growing number of people are requesting letters from physicians certifying that they need an ESA. For a recent New Yorker article titled “Pets Allowed,” author Patricia Marx obtained ESA certification for a series of animals, including a turtle, an alpaca, a snake, a turkey and a pig. She was able to bring them along everywhere she went, including museums, boutiques, delis, restaurants, trains and luxury tour buses. When questioned, she merely produced the ESA certification she had obtained for $150 online after completing a questionnaire about her emotional condition.  

Emotional support dogs provide affection and companionship for a person suffering from various mental and emotional conditions. Unlike service dogs, emotional support dogs are not required to perform any specific tasks for a disabled person. They are meant solely for emotional stability and unconditional love, and they can assist with anxiety, depression, bipolar and mood disorders, panic attacks, phobias, and other psychological and emotional conditions. Any dog can be an emotional support dog, and they do not have to be professionally trained.

Emotional support dogs are also protected under federal law. Under the Fair Housing Amendments Act (FHAA) and the Air Carrier Access Act (ACAA), a person who meets the proper criteria is entitled to an emotional support dog to assist them with their life. The FHAA allows emotional support dogs to live with people, even if their housing unit has a no-pet policy. The ACAA allows emotional support dogs to fly in the cabin of an airplane without having to pay any additional fees.  

According to the National Institute of Mental Health, at least one in four American adults has some form of mental disorder. Many of these people are entitled to an emotional support dog and will be consulting with their physicians for documentation. How should a physician respond when asked for such documentation? First, you need to determine if the person does indeed have one or more of the qualifying disabilities. Second, do you think the dog or other animal would really benefit them? And lastly, do you feel the patient is capable of properly caring for the animal and controlling it when out in public? This might be the most difficult piece to determine. It is important to remember that, unlike service dogs, emotional support animals may not be allowed in food establishments and many other businesses. 

Therapy dogs are used to bring comfort and joy to people who are ill or in dire circumstances, such as being affected by a natural disaster. Many people are able to connect with dogs and to feel the love that they provide, which has a therapeutic effect. Therapy dogs are generally calm and well behaved, and they are often found in hospitals and nursing homes. They generally don’t have any special training, and they don’t perform specific tasks for disabled people.

A doctor’s letter is not required for a therapy dog. Since these dogs are not covered under any specific federal laws, their owners have to receive permission before taking them to a facility. Many places are welcoming to therapy dogs if the dog is trained and obedient, does not pose a threat to others, can benefit those present at the facility, and does not adversely affect the facility’s operations.

Then there are companion animals, or pets. They have no legal status but can also provide a multitude of benefits. According to the Centers for Disease Control and Prevention (CDC), pets can decrease blood pressure, cholesterol and triglyceride levels, and feelings of loneliness, while increasing the opportunities for exercise, outdoor activities and socialization.  

Even unabashed animal lovers have to admit that there can be problems with dogs in public places: they can make messes, shed, bark, bite, and fight amongst themselves. They may help themselves to unattended food and potentially spread diseases. They can also knock down frail elders and intimidate children.

In a perfect world, service and emotional support animals would always be on their best behavior, as would pets and children. Since we live in an imperfect world, it is reasonable to ask a person to remove their animal if it is misbehaving or inconveniencing someone. Meanwhile, we can expect to see more and more dogs and other animals out and about.

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Dr. deFischer, a family physician at Kaiser Petaluma, serves on the MMS Editorial Board.
Email: irina.defischer@kp.org