I disagree. It is not the duty of the doctor to make the decisions for the patient/client as to whether or not the information is “official”, or make value judgements about what is being done by the other person based on whether or not they indicate they have a lawyer involved. The doctor’s duty is to give information to the patient/client, so they can make such judgements. Unless the patient/client has been adjudged incompetent, or is under court order, etc etc etc.
I’ve seen plenty of physicians get their ass in a sling for not sharing information with patients. I’ve been on hospital and university and even prison health peer reivew and ethics committees reviewing what appear to be similar situations. And the bottom line is always that the doctor must provide the patient with information so that the patient can make appropriate decisions. Otherwise the doctor is usurping the the patient’s prerogative to be an adult.
Now I’m just extrapolating the doc/patient relationship to the vet/client/pet relationship, but it seems to me to make sense. And frankly, it is the job the the professional to decide how, both legally and ethically, to behave in questionable situations. And it is up first to his peers to decide if the decision made was reasonable. Not if it was necessarily the correct decision as seen by hindsight, but if, in good faith, a reasonable doc could have decided to make that decision.
And if things really go to hell, then it is the courts that decide if any laws were broken.
Well, you’re the one who twisted what “the question” actually was. From Zoe’s post:
The fact that you wanted to change that question to "Instead, it’s “Is he required NOT to?” is irrelevant. My link supported my statement. No backstroke involved.
How does a letter saying that she is “obviously crazy” not effect the welfare of his client? Perhaps the neice was hoping for some form of agreement from vetbridge and by refusing treatment he would be implicitly agreeing with the neice. It is not his job to look for “official” information to back up the claim. And by entering into correspondence with the neice he could be opening himself to charges of disclosing confidential information. If it was a confirmed allegation he would have a duty to inform the proper authorities. If someone is writing to him making allegations about one of his clients then he has a duty to inform his client for her own welfare. He may not be the only one to receive such allegations and I don’t see how the client’s welfare is served by not informing her that someone is making allegations about her.
I agree that it is the doctor’s job to make those snap decisions, but what decision-making issues would have been hampered by his failure to share the letter? She was bringing her animals in for treatment, and I assume she continues to do so…either with Vetbridge or another vet. Simply passing the letter on only served to help her make decisions with regard to who she wanted to leave money to. It had no effect on his professional dealings; only on the family drama. I assume he already thought she wasn’t firing on all eight cylinders due to the amount of money she was spending. But he was still working with her professionally. Shouldn’t that judgement call have come long before the letter dilemma?
What judgement call? He was not in a position to judge her. He was in a position to decide whether or not he could or would render the services she requested of him. Her requests were not of the type that he was ethically or legally obligated to report to law enforcement. Nor were they requests that he was unwilling to carry out. Therefor his duty to her was the same as to any other patient/client.
Having someone write a letter to vetbridge declaring her to be crazy could affect the client’s future ability to care for her pets in the way she chose. True, it might have made it better, but it might not have been too. In any event, as the instigator of the vet/client/pet relationship, it was the client who had the responsibility to make the determination about the relationship, and to do so, the client needed the information that the vet had. IMHO he was ethically obliged to provide it.
So? I pass on information that doesn’t have positive impacts on my patients all the time, when I tell them they have HIV, or cancer, or even high blood pressure. They get depressed, they cry, they go into denial. Some few have even attempted suicide.
But they need to know this, so they can make informed choices.
We now have an actual medical doctor, who, while admittedly not a veterinarian, is in a profession where the ethical standards in this situation are at least comparable, telling you in his professional opinion the disclosure was ethically required.
I don’t know – I am only positive it wasn’t PROHIBITED. But here’s a guy who has professional experience in a simialr arena telling you in his view it was required.
Do you have any cite, other than your own gut feel, to contradict this claim?
It didn’t? All we got was vetbridge’s perspective and knowledge, and for all we know, he’s not telling us everything he knows. And for all we know, the neice may have been setting her aunt up to have her declared incompetent. If you were the aunt, wouldn’t you want to know about something like that?
I really don’t understand this statement. If someone in your family is questioning your ability to handle your own life with your own money, you wouldn’t want to know about it?
It allowed the woman to disinherit someone who was sneaking around behind her back making accusations. You may not want to know when people are attempting to damage your relationships with others, but I sure as hell do.
I’m glad that it is at least a topic of discussion and not something that is automatically done at the discretion of the client.
As for the niece and the elderly client:
It is obvious that some of you have never been responsible for curtailing the activities of an elderly demented person who is not aware that she or he has lost his mind. People who are mentally disturbed or mentally ill don’t just automatically cooperate and turn in their car keys and credit cards. They often grow more and more irritable, irrational and stubborn.
Someone may be looking after their best interests not out of greed but out of concern that the elderly person will still have enough money to pay for medications and assisted living. They may have been asked to do this when the elderly person was in better health.
The demented sometimes insist that you take them home to a house that doesn’t exist anymore. Or bring back their dead babies. And if you don’t do it, they will “write you out of their wills.”
One day they will give half of their things to someone else and the next day they will accuse “the gypsies” of stealing them – or accuse you.
They will take things that belong to you and hide them or not give them back to you or give them away or sell them.
Maybe some of these people take other people’s animals to the vet. Maybe some of them are put to sleep.
If I were a vet with such a client, I would want to know and I would want someone in the family to tell me so that I could at least keep an eye out for any signs of possible dementia.
They don’t always “look” like they are out of their minds.
I’m not a psychologist or a psychiatrist and I can’t diagnose dementia. Never have I suggested that a vet should! But at the same time neither should he turn a blind eye to the possibility that his client may not be able to make competent decisions. After all, his first obligation is to his PATIENTS – the animals. And that IS very clearly spelled out in the code.
I’m reasonably certain that neither Kalhoun nor I would object to a vet disclosing such information to any animal that is his patient.
You are forever reminding me of how different the legal profession is from those with ethical standards.
After reading his posts, I’m convinced that he should have made that call and didn’t. And I’m convinced that he did become embroiled in the family drama. I do find your thinking on this generally reasonable and clear.
Then they can work that out with the elderly person or with the courts, not by sneaking around trying to coerce (and sue, don’t forget sue) the elderly person’s contacts.
Well now you have an Architect saying he made the right decision. I would have disclosed any similar type letter to my client as well. My duty is to my client. Any professional has that duty. So which profession here—Doctor, Lawyer, Architect, Pyschologist–doesn’t meet the ‘ethical’ standards you have? Any Accountants, or Engineers want to step in here and give us your opinions on a letter from someone to you questioning your client’s capabilities and what your ethical obligations are?
Give it up sister–you are in the wrong here and you are only digging a bigger hole. As for the niece–she should have tried for power of attorney and done this correctly. Her intentions might have been good–but the ends don’t justify the means. And asking the licensed professional to do her dirty work is where she tried to cut corners.
That is a highly offensive and grossly ignorant thing to allege. I suggest that you crawl back into whatever hole you came from, and do not return until you can conduct yourself in a responsible manner. As I stated previously, you are truly an unethical and stupid person.
If the old woman is then truly suffering from dementia, or some other illness, then her niece needs to see about getting power of attourney and THEN dealing with it. Zoe, for god’s sake, surely you can understand why there are laws about this? Do you honestly think that there aren’t any nieces out there greedy enough and nasty enough to go behind a perfectly sane auntie’s back and try to screw her over?
