PAWWS at Parliament: Advocating for medical pain alert dogs

Last month, on a cold sunny day on February 19, our researcher, Nona Borgström, part of the University of Helsinki’s (UH) veterinary science and social health section of project PAWWS, had the unique opportunity to visit the Finnish Parliament to advocate for medical pain alert dogs. This visit was timely, as discussions are underway on a legislative initiative to grant medical pain alert dogs an official status. The visit also aimed to highlight the current assistance dog situation in Finland, especially concerns about their availability and the processes involved.

The visit and presentations were initiated by MP Kristian Sheikki Laaksonen and hosted by his assistant Ukko Bamberg. The event brought together politicians, assistance dog and medical pain alert dog teams, healthcare professionals, and researchers to discuss how these dogs and their handlers can receive increased, standardized, and regulated recognition and the support they deserve—both on a societal and political level.

Members of Parliament and their assistants were invited to attend, arriving voluntarily over the course of four hours. There were participants from all political parties listening and engaging in discussions, and many asked questions in a relaxed and open setting.

The visit was officially represented by Avustajakoira ry (Jan Hänninen and his personal assistant Terhi Jyräs and her personal assistant, Innomedidogs (Juulia Turunen) and the dogs Vallu and Fiksu. Our UH researcher from project PAWWS was there in a supportive spirit—because this is the kind of societal impact we are committed to as part of our research.

Key issues discussed

  • Medical pain alert dogs lack legal recognition as medical aids: The proposal aims to bring certified medical alert dogs under the same legal and financial framework as assistance dogs.
  • Real-life impact on society: Medical alert dogs reduce emergency healthcare visits, improve well-being, and increase long-term employment rates.
  • Concerns about the wellbeing services county system: The shift in responsibility for assistance dog distribution through wellbeing services counties has led to confusion.

The legislative initiative to recognize medical alert dogs has been in the works for a while, with discussions initially taking place with MP Inka Hopsu. At the moment, medical alert dogs do not have public access rights when working with their handlers. Additionally, the event can be seen as a continuation of the work of MP Sofia Virta’s working group on animal-assisted interventions (Eduskunnan eläinavusteinen työryhmä),

On another front, changes are needed in how assistance dogs are provided in Finland through how wellbeing service counties have created uncertainty about access, making clearer policies and better communication is necessary.

What is especially promising is that the discussion is bringing together representatives from different political backgrounds, working toward a common goal.

Even though a multidisciplinary team of experts, organization representatives and handlers were presenting, the assistance dogs and medical pain alert dogs were able to impress the MPs with their skills and getting plenty of scratches, but it was also an opportunity of training for the dogs. Their presence helped create a warm atmosphere, sparking personal stories from MPs about the impact of dogs on their lives.

Assistance and medical alert dogs perform essential tasks that help their people navigate daily life. Medical alert dogs detect and alert individuals to oncoming pain episodes, allowing them to take preventive measures—which can result in fewer hospital visits, better pain management, and the ability to continue working or get more functional hours in their daily life.

Meanwhile, assistance dogs perform three or more tasks to mitigate the effects of an individual’s disability, helping with physical tasks and providing vital support for people with disabilities.

Following her visit to Parliament, Nona Borgström spoke with project PAWWS colleagues about it in more detail–they asked her questions, and the conversation is presented in a summarized form below.

What kind of tasks do medical pain alert dogs carry out and why are they important?

We have two different kinds of medical pain alert dogs in Finland. We have personal aid dogs that are living with patients with chronic pain. And then we have the other type of medical pain alert dogs that are working with a physiotherapist or occupational therapist as a clinical pain dog, with multiply patients with chronic pain.

Patients have identified several key benefits of the medical pain alert dog’s ability that they find most valuable. One of the most significant is that the dog provides validation, confirming that the pain is real and emerging. Another important advantage is the increased sense of safety, as patients feel confident going out alone, knowing the dog will alert them if necessary. Additionally, a crucial aspect of pain mitigation is that the dog can help patients discover personalized, non-medical pain management techniques, acting as a sensor to guide them toward effective solutions.

It is important to remember that the medical pain alert dog cannot be replaced with human help. Humans cannot alert to oncoming pain because we don’t sense the scent, nor do we have any medical devices as pain sensors for it yet.


Resting on Parliament’s marble floors, the assistance dog (right) and medical pain alert dog (left) who joined for the day—taking it easy, but always ready to advocate.

How did the opportunity to speak at parliament come up? How did that develop?

It was probably from many years of collaboration with assistance dogs in different settings. We have had one assistance dog with the ability to alert pain and that dog and handler encountered MP Sheikki Laaksonen. They talked about big concerns about the assistance dog process and the issues with finances and with the new regulations of the assistance dogs that they really wanted to highlight in the Parliament.

But when he [the MP] met the dog he was very astonished over the dog’s abilities to alert pain and at that point they started thinking: what about if we would make this visit a multidisciplinary one where we could have both the assistance dogs [Avustajakoira ry] and the pain dogs [Innomedidogs] which really makes me happy because a visit like this just serves everybody’s purposes.

What was the purpose of the visit?

It started out with a lecture for a working group in the Parliament Eduskunnan kipu- ja migreenityöryhmä invited by MP Inka Hopsu—she’s representing the Green party. She said that she would really like us to do a Finnish citizens’ initiative. During a period of time of developing that idea and text, we decided in the working group to change direction and make it a law proposal instead.

So, the assistance dogs were presented by Jan Hanninen and Terhi Jyräs. And the medical pain alert dogs were presented by Juulia Turunen and me (Nona Borgström). Jan Hänninen presented the assistance dog talks and then Terhi Jyräs answered the questions for the practicalities in assistance dog benefits from a client perspective and for having a special skill of medical pain alerting as well.

So, it was an open event in a nicely and centrally located big room, where people could attend at different times to listen to what they were interested in. Most of the people attending gave their time to observe the dogs, to talk about the benefits, and to ask why we were there. Most people engaged in an overall discussion about the topics asking about the dogs and were pleased to see us at the parliament.


“You brought the sun with you, when you came to visit us today,” someone said. A day of meaningful discussions and a shared commitment to change across party lines at Parliament.

How did people respond to pain dogs versus assistance dogs?

I think you could see that the pain dogs are novel. So, it was important to explain and show videos on how the dogs work and help people.

So, I talked about the patients with chronic pain and their need for help. This is especially relevant for the marginal group of patients that need a medical pain alert dog and really can have benefits of a medical pain alert dog. For example, if a patient has rapidly emerging pain that fluctuates, they are individuals who could benefit from a medical pain alert dog. If the patient cannot notice when the pain starts to rise, a dog can be of help. The dog alerts the patient that a change is happening in the biomarkers in the body, and the person has time to rapidly take care of the emerging pain with non-medical pain treatment, or other actions that are needed.

The One Health perspective is important, so the dog’s welfare and needs are as important for this entangled partnership to work. Often the patients describe this help from a dog through social, functional, mitigation and safety perspectives. This kind of help gives the patient a possibility to have a better quality of life, at its best.

Inter-professional work is highly important and a sign of safety for all humans and non-humans involved. In project PAWWS’ pilot with the medical pain alert dogs, we have been working to build a model of a non-human coworker with the ability to mitigate and support for the patient with chronic pain. It has been a path for many new understandings and also some great success stories but mostly gathering a lot of new knowledge and humility.

The important ingredient for a functioning team is a well-prepared dog, a good educational, peer and inter-professional support team and a great deal of understanding the human animal bond. You also need new thinking as you need to rely on the help of a non-human friend and take care of everybody’s well-being involved.

Also, we talked in parliament about the enormous possibilities and capacities of dogs mitigating patients’ health issues. Juulia Turunen and I have noticed that the medical alert dogs can distinguish between arousal of pain, stress and bodily trauma. This is so fascinating, and we are eager to see where this is going to lead in the future.

What is the key takeaway of this day and biggest benefit if you think about the future?

Well, we were really grateful to have a big audience and great interest. And I think we had important take-away messages for the parliament. I was really honored to get time like this in the parliament. It felt really wonderful that they said that they would really like us to come again after two years so that we would continue promoting this.

What’s the future of this topic as it relates to your visit to parliament?

I think the next step is moving forward with the law proposal. So that’s a practical thing that we’re going to do. And I hope that this visit will inspire more people working in Parliament to actually sign the law proposal.

The PAWWS project will continue researching and advocating for these issues to support that policy decisions are guided by real-world experiences and research-backed insights, while keeping both human and canine well-being at the center of future developments.

As one MP put it during the visit: “You should come back every week.” While that might not be possible, there is a deep commitment to continue the conversation.

Authors

The project PAWWS research team