In the dilemma discussed in the June issue of In Practice, you were presented with a lively, 60 kg dog with an obvious anterior cruciate rupture that required surgical repair. Published evidence indicated that osteotomy procedures had a higher success rate in large dogs, but in your own, self-audited experience, a lateral fabellar suture carried a high success rate. Your clinic did not offer osteotomy procedures but the owner could afford referral. Which should you chose? (IP, June 2016, vol 38, pp 310-311). David Mills noted that published evidence, with its large sample size and strong conclusions, had a sense of objectivity. However, he questioned what objectivity really meant and how useful it actually was in a medical discipline, where subjective aspects were involved, such as pain, emotion and suffering. He suggested that changing the perception of evidence-based veterinary medicine or modifying it to a repository of external evidence to be referred to if required rather than obligatorily might help to clear the ethical waters in decision making in cases such as this.