Veterinary medical ethics with legal implications (Proceedings)

Most self-governing professions are also guided by rules of ethics in their practices so as to further ensure the protection of the public from the unscrupulous or incompetent practitioner. In many instances, a breach of the rules of ethics will usually lead to a similar breach in the laws and regulations governing the profession. In some cases some of these canons of ethics are mirrored in the applicable law.

As you can appreciate, your moral guide in practice is grounded in the words of the Veterinarians Oath. Every reader should review the oath in detail as it serves as a clear statement of the moral obligations you must fulfill in your professional practice. Among other things, the requirement to treat an animal to the best of your ability can often give rise to many practical problems in practice. Much of this text has been directed at making your clinic more profitable. How then should you deal with the client who refuses to pay? Does a refusal to treat until receiving payment for your services breach your code of conduct?

In this article we will review some selected ethical requirements.

Making Services Available

The regulations and bylaws under most veterinary legislation specifically state that all veterinarians in private practice are responsible for providing reasonably prompt services outside or regular hours if the services are medically necessary for animals that the veterinarian has recently treated or that the veterinarian treats regularly. This appears to be a two-fold test: medically necessary and, recently treated or regular client.

The ethical obligation can also be discharged by referring the treatment to another veterinarian who has agreed to cover your practice for a period or by referring to an emergency clinic provided the veterinarian is responsible for promptly continuing the service after discharge from the emergency clinic until the services are no longer necessary or the client has a reasonable opportunity to engage the services of another veterinarian.

Conflict of Interest

Another legislated breach of what would otherwise be an ethical issue is that relating to practicing with a conflict of interest. In fact, the Veterinarians Act of Ontario specifically dictates that continuing to practice in a situation where a conflict is evident is deemed to be professional misconduct which could give rise to disciplinary proceedings. A conflict of interest arises when certain actions involve a "related person" of the veterinarian which is, generally, anyone with whom the veterinarian is connected with by blood, marriage or adoption. A veterinarian has a conflict of interest if he or she, or a related person, or an employee or employer of the veterinarian enters into any agreement, including a lease of premises, under which any amount payable by or to the veterinarian or a related person is related to the fees charged by the veterinarian. In addition a conflict arises if the agreement makes or confers a fee, credit or other benefit by reason of a referral from or to any person. The general exception to these types of agreements would be a partnership agreement with another veterinarian whereby the drawings of the partners or other partnership interest is tied directly to the amount billed by the respective partners.

Further conflicts arise if a veterinarian assesses an animal on behalf of both the vendor and purchaser of an animal or if the practitioner is regularly engaged by one of the vendor or purchaser and inspects the animal of behalf of the other party in the transaction. The exception to this conflict is that such an assessment may be carried out for both parties if they both consent to the engagement prior to actually conducting the examination after being informed of the conflict which would otherwise arise. The clear obligation on the veterinarian in these cases is to ensure that both parties recognize that any information obtained by the veterinarian cannot be maintained confidentially from the other party.

Statutory Codes of Ethics

In some states and provinces the legislation governing the practice of veterinary medicine include Codes of Ethics in the statute or regulations thereunder which govern many of the ethical decisions of day-to-day practice management. In some cases the statutory codes form the basis of misconduct proceedings for breach of these rules.

Professional Courtesy and Non-Veterinarians

Most state veterinary associations require the practitioner to treat his or her colleagues with professional courtesy and not to make statements which are intended to injure or belittle another veterinarian. As well, one must not act in any way to assist a non-veterinarian to practice veterinary medicine - this becomes particularly critical in cases relating to alternative or complementary therapies.

Continuing Education

Quite apart from the necessity for the practitioner to maintain levels of competence so as to discharge his or her legal liability to a client and avoid negligence claim is the ethical demands to ensure competence through continuing education.

Reporting of Suspected Abuse and Confidentiality

Some state veterinary legislation requires the veterinary surgeon to report to appropriate authorities for the protection of animals that an animal has been subject to mistreatment.

In most other jurisdictions though, the notion of reporting is one that is legislated as a permitted exception to the rule relating to confidentiality.

Most practitioners are aware of the obligation to keep client and animal information confidential subject to a few exceptions as follows:

1. When the practitioner has the consent of the client;

2. When the matter is a legislated reportable disesase;

3. When the practitioner is under a legal obligation by way of a warrant or subpoena; or,

4. When the information is necessary to protect the health of an animal or human.

Some states also permit the disclosure of information without the consent of the client when the information is provided to another veterinarian for the purpose of treating the same animal.

Legal Consequences for Ethical Breaches

As a member of a self-governed profession the veterinarian who breaches an ethical tenet is subject to sanctions set out in the state or provincial veterinary legislation. In most cases, the state licensing board or provincial discipline committee is empowered by statute to sanction members of the profession for ethical breaches with penalties that include a verbal or written reprimand, the levying of a monetary fine, the suspension or revocation of the license to practice or the placement of restrictions on the veterinarian's license. The nature of the penalty will be determined based on precedent and the severity of the conduct that is complained of.