Vetbridge's Obligation to Recognize Veterinary Ethics

This is intended as a mild pitting even thought it’s a little long. I realize that there is much that I don’t know about veterinary medicine, the ethics of that profession, and of vetbridge personally including gender. For this pitting, I am assuming male.

In his General Questions thread, vetbridge asked if he had an obligation to recognize mental illness in his human clients. He stressed that he is not a mental health worker and not qualified to spot those times when eccentricities may have become unhealthy.

He gives two examples. One is a woman who brought all of her pets in to be euthanized at one time. Then she went home and shot herself. He has had other patients do this without taking their own lives. So he did not question her mental state.

The other was an elderly client whose niece wrote that she was “obviously crazy” to spend so much money on her pets. (She was spending up to $800 a week on dozens of pets.)

Although vetbridge didn’t encourage these procedures, when the niece wrote the letter, he showed it to the aunt who then cut the niece out of her will.

I don’t know what kind of university would allow him to graduate without a core class in psychology as he indicated, but surely no vet school would let him out without a solid foundation in veterinary ethics.

From Pennsylvania’s Rules of Profession Conduct for Veteranarians:

Principle 7. Veterinarian/client relationships.

How can it be for the welfare of all of a woman’s pets to euthanize them? Did you charge a fee? Why didn’t you just refuse?

Did you protect the personal privacy of the elderly client by forwarding the letter from her niece? Obviously, it upset her and caused problems within the family. And certainly you violated the niece’s confidence when she wrote to you in your professional capacity.

Rules of Professional Conduct for Veterinarians.

Principle 2. Professional responsibility.
(a) The principle objectives of the veterinary profession are to render service to society, to conserve livestock resources and to prevent and relieve suffering of animals. Veterinarians should conduct themselves in relation to the public, their colleagues and the allied professions so as to merit their full confidence and respect.

In other discussions of veterinary ethics I kept running across mention of the vet’s obligation to the public. There was mention of a veterinary oath the pledged concern not only for the care of animals, but for the health of the public. The following are just two examples from one source:

PRINCIPLES OF VETERINARY MEDICAL ETHICS
OPINIONS AND REPORTS OF THE JUDICIAL COUNCIL

“Courteous verbal exchange”? Who knew! Maybe vets should be “PC,” as you like to call it, and not refer to the mentally ill as “nuts.” If I were you, I wouldn’t be bragging much about not having taken a psychology class. You might consider a remedy for that in your continuing education requirements.

Cite
The health of your clients at least deserves your concern and attention without the smirk. It isn’t a question of legalities. It’s a matter of professional ethics.

I’m a bit pissed off over the outrage shown over vetridge’s decision to forward a letter from a client’s neice concerning the client to the client. If someone is writing letters or talking to others about my private financial mattters, I damned sure want to know about it!

I guess I don’t necessarily see the point in this pitting. Castigating someone over their personal life doesn’t make much sense to me, as you have no direct evidence of Vetbridge’s personal conduct. Matter of fact, it’s a rather nasty thing to do, because it leaves him with the choice of either revealing things he might not want to in his own defense or else getting yelled at here for something that may be completely unreasonable.

He already explained why he’s willing to euthanize animals for no apparent reason - because the owners are liable to do it themselves if he doesn’t, in whic hcase he’s probably sparing the animals. It might behoove you, Zoe, to recognize that you don’t necessarily understand the situations in their fullest.

LOUD LOUD APPLAUSE!!! CHEERS!!!

In vetbridge’s defense, he had two choices. He could euthanize the animals so they could die a comfortable death, or he could refuse to do so and allow the owner to kill them in a painful manner, such as shooting them or worse. He cannot force the owner to relinquish the animals to a shelter, and by lying to the owner about having them euthanized, and then giving them to a shelter, performs a far worse breach of ethics.

In the second example, I think he did the right thing by showing the letter to his client. That letter put him squarely in the middle of a family issue where he did not belong. Perhaps the aunt did have some mental issues, perhaps she didn’t. But he recognized that the problem was not his to solve and turned it over to the interested party before it turned into a legal problem for him.

Finally, even if he had taken that psych class, it would not have given him nearly the information needed to recognize mental-health problems. I don’t have a lot of experience with vets, but I’m sure most contact with them is brief and focused on the animal. It would take much more training for vetbridge to be able to pick up on mental illness, even in casual contact.

Robin

I have a lot of trouble getting worked up over euthanization in the face of the thousands and thousand of animals that are put down by shelters: even if you talk someone into putting their animals into a shelter, it doesn’t increase the number of animals adopted out. Even if those particular animals get adopted, it means that some other animals that would have been adopted will be euthanized. All that changes is increased finacial pressure on the shelter.

What does this mean? How do I protect the privacy of party A by not telling them about party B’s statements? The niece is not vetbridge’s client and has no reason to believe that her communications are ‘priviledged’.

A vet considers the public health when animals are brought in with illnesses that are public health risks, not by performing a history and physical and mental status exam on the pet’s owner at each visit. When Little Jimmy brings in his puppy Spot and says that Spot got bit by a raccoon that was acting funny down by the park, a vet should ask Jimmy if he got bit, or saw anyone else get bit, and should notify animal control, etc. Your second cite seems to support boosterism more than anything else:

(new bolding mine) Join the Rotary. Sponsor a Little League team. Adopt a section of highway.

Absolutely. Because vetbridge’s use of the word ‘nuts’ on an Internet message board, complete with footnoted caveat, is exactly the same thing as calling a client ‘nuts’ to their face. And a CME course on human psychology is an excellent use of vetbridge’s time :rolleyes:

This is the oath he took when he became a vet:

(Veterinarian’s Oath – Adopted by the AVMA July, 1969)

Does he protect animal health when he kills them?

Does he relieve animal suffering when he keeps an old and sick animal alive to please a rich woman?

The Straight Dope is supposed to be about fighting ignorance. How is a vet advancing medical knowledge by calling the mentally ill “nuts” in General Questions?

So much for “the promotion of public health…”

Really? If I recognized that I don’t necessarily understand the situations in their fullest, would I post something like this in preface to my OP?:

It’s possible, I guess, that the niece has taken these animals to the vet herself. But even if she hasn’t, I doubt that she would have expected that the concerns that she expressed in her letter to the medical professional would be shared with anyone else! I would think that she was in for quite a surprise.

For one thing, what if the elderly lady really does have mental health problems and the niece was trying to explain that to him? Vetbridge has admitted that he is not good at recognizing mental illness. What is a family member to do when trying to held older members of the family make wise decisions?

We really don’t know the situation. Maybe the niece is not so interested in her aunt’s money as she is in cleaning up after two dozen animals. That doesn’t sound like a healthy environment for an elderly respiratory system.

And the older woman’s reaction is an over-reaction if that is the only thing this niece has done – especially if she is disturbed.

Finally, what purpose was served in showing the elderly woman the letter? The vet’s was to treat the animals brought to his clinic. If he thought that the niece was wrong, then he should have ignored the letter. If he thought that the niece might be right, then he should have considered other options. Under no circumstances should he have come between the niece and her aunt. That’s unprofessional.

Hang on a minute, Zoe, perhaps he does. Perhaps he keeps an unwanted animal from being abused or starved. I myself would prefer the Vet’s euthaniasia needle to abuse.

How in Og’s name can he keep her from picking up every little maimed kitty she passes on the street? The best he can do is fix them up and send them on their way.

Really, after reading the GQ, I was afraid of this. Vetbridge does NOT deserve a Pitting. His GQ did not speak to euthanasia directly, and you are being unfair to drag him into the Pit because of his position on it. If you would like to debate the finer points of euthanasia, then I gently suggest you take it to GD.

Shit happens.

Who cares how she was surprised? The ethical rule you quoted above clearly places the onus of privacy on the vet’s information about the CLIENT. The niece is not the client. When this is pointed out to you, you respond by wild speculation about whther the niece might have taken the animals to the vet herself, and then whine about how she’d be surprised to have her letter revealed. Nowhere do you simply acknowledge that you were wrong to quote this section and suggest that vetbridge live up to it. Why is that?

But you are unable to point to a codified ethical principle that is violated by this conduct.

PROFESSIONAL CONDUCT
§ 31.21. Rules of Professional Conduct for Veterinarians (Pennsylvania again)

Their obligations are not limited to their clients. The niece confided in a medical professional that she thought her relative – his client – was suffering from a mental illness.

The vet has admitted that he had no way of knowing if the niece was correct or not.

We do know that the woman had dozens of animals and that she was keeping seriously sick and injured animals alive.

Was the vet acting for the welfare of the animals in keeping them alive? Was he acting for the welfare of the public by betraying the niece’s confidence? Was he acting for the welfare of his client by letting her know that her niece thought she was crazy?

Since the vet was aware that he knew nothing of mental illness, should he have consulted a more experienced vet or someone in another field before acting?

He acted impulsively and without insight. That’s why it’s unprofessional. Some things are a given in the professions, Bricker. You know them and so do I. Do we really have to start with:

  1. Know stuff.
  2. Don’t cause problems within a family.
  3. Don’t be a tattletale.
  4. …?

It is because Zoe is either unethical or stupid or both. I chose what’ behind door C.

I think a case probably could have been made for animal cruelty, and the animals might have been able to be removed from the client’s home for that reason. But then, as other posters said, you have the problem of supporting them until they’re either adopted or put down.

But the bigger problem is that as a society, we don’t, and can’t protect animals to the degree they deserve because of overpopulation, cost, and the fact that they are legally considered lesser creatures than you and I.

I can see Zoe’s point that** Vetbridge ** could have handled the situations differently (and in my opinion, better) but I can also see where he made the best decision he could at the time. The standards appear to be vague. He probably feels overwhelmed after seeing this kind of thing day in and day out and may or may not have chosen a different route on a different day.

For the record, Zoe is neither unethical nor stupid. A quick perusal of her posts would make that evident. Pit or no pit, that was a cheap shot.

No, but on the other hand, this pitting does seem like a kidney shot to the guy, when he seems to be a professional attempting to handle ethically difficult circumstances as best he can. She is just plain wrong on the matter of whether the aunt or the niece should expect him to be responsible for the privacy of their records. Why should he put himself in a triangulated position between the niece and the aunt - it’s his client who would be pissed off to discover that he was having correspondence about her with someone else (even if he had nothing to do with it).

Based on Vetbridges’s past posts and his carefully weighed and informative responses, I’d tend to trust his ethical and professional decisions made IRL vs the second guessing by someone pissed that he doesn’t expend every fiber of his being, and every iota of his time and resources to avoid euthanizing animals if there is any possibly in the universe they can be saved. People with money and resources that are attached to animals tend not to make financially optimal decisions. How many hundreds of posts have I read on this board alone over the years where posters are straining every resource to make sure their beloved Fully or Mr. Whiskers is getting hundreds or thousands of dollars in treatment to alleviate immediate distress even if they only have a limited time left.

Secondly, the notion that he should withhold the nieces letter from the client is simply asinine beyond imagining. The niece is not in any way, shape or form his client. The old lady, whatever her infirmities might be, is his client, and the niece is attemting to jam herself into the middle of that relationship, and effectively take control of it, by convincing the client’s doctor that his client is nuts. By withholding the letter he would be effectively taking the niece’s confidence and winding himself into the middle of drama that he should not be involved with in any way, shape or form. Releasing the letter was the right, proper and professional thing to do.

This pitting (IMO) obviously has less to do with codes of ethics and more to do with emotional outrage over the practical realities of how vets have to deal with often impractical clients with pets in hand in the day in - day out real world, not some “what if” fantasy land of armchair ethicists and wannabe veterinarians.

The thing is, pets are an extension of us emotionally; but cannot be dealt with as you would a human. I think she was coming from that standpoint – which is the dilemma we all face when dealing with the little critters we love. As a society, we’re told on one hand to treat them as we do our own offspring, but logically and legally, it simply can’t be done in some circumstances. It’s a tough decision for a vet, but I can understand how his response simply does not compute in the mind of an animal lover.

The family thing…Hmmmm…I wouldn’t have shared that information with my client if I was in Vetbridge’s shoes. It wasn’t his place. It had nothing directly to do with his job. He should have ignored it.

Medical professional? Since when is a vet a ‘medical professional’ in the widely understood sense of the word? I always understood this to refer exclusively to people who deal with human medicine.

If I wrote a letter to my auntie’s plastic surgeon expressing concern at the fact she was squandering her retirement fund on chin tucks and whatnot, I might expect that to remain confidential, because doctors are widely understood to be under an obligation to respect confidentiality under almost all circumstances, and also to to take unusual regard regarding the best interests of their patients. If I write a letter to her accountant saying I think my auntie is a nutter for donating thousands to the Green Party, I wouldn’t be desperately surprised if she ended up hearing about it.

As far as I can see, vetbridge is under no more obligation than a pilot, accountant or other highly educated professional would be - if he genuinely feels auntie is mentally competent to decide how to spend her own money, his duties consist of doing a good job at a fair price while following the law and the rules of his profession. His ethical obligation seems from the quotes cited to be concerned primarily with the welfare of the animals and their impact on the persons and commuity around them, not with accommodating the personal concerns of all and sundry.

As far as the whole thing about putting animals down, that’s a matter of personal belief and morality. Some people think its wrong, others think it’s kinder than stressing an animal by subjecting it to a change of owner or surroundings. I’m kinda ambivalent, but I can’t fault a vet for doing so when an owner asks them to, since a painless and stress-free exit from life is certainly in the animal’s best interest.

Really? Imagine this scenario. His client comes to him and says “I understand you think I’m crazy? My niece (or nephew or some other family member) told me you were keeping correspondence from me a secret because it has to do with my mental status.” Do you contend that will have nothing to do with his job? It will cause the termination of his professional relationship with the aunt, or at least damage it. Whatever the aunt’s capacity, it is very unlikely that she will think “Oh, he withheld that information from me because it had nothing to do with his job, and wasn’t his place to share with me.”