How should ethical, legal, and technical considerations be addressed to prevent iatrogenic complications in high-quality, high-volume, government-funded spay-and-neuter programs?

Abstract Colombian Law 2374 of 2024 established a National Surgical Sterilization Program, expanding longstanding municipal initiatives such as those in Medellín, Colombia, which have sterilized up to 35,000 animals annually. However, limited research on the effects of frequent sterilization sessions and potential injuries raises concerns that large-scale public programs may compromise care quality and animal welfare. This Viewpoint examines iatrogenic harm and collateral suffering linked to high-volume spay-neuter campaigns from bioethical, regulatory, and technical perspectives. It analyzes structural factors that contribute to preventable harm to animals and veterinary personnel, assesses occupational safety measures, and proposes rigorous implementation criteria to ensure safe control of animal populations.