Abstract
This article explores how the concept of consent to medical treatment applies in the veterinary context, and aims to evaluate normative justifications for owner consent to treatment of animal patients. We trace the evolution of the test for valid consent in human health decision-making, against a backdrop of increased recognition of the importance of patient rights and a gradual judicial espousal of a doctrine of informed consent grounded in a particular understanding of autonomy. We argue that, notwithstanding the adoption of a similar discourse of informed consent in professional veterinary codes, notions of autonomy and informed consent are not easily transferrable to the veterinary medicine context, given inter alia the tripartite relationship between veterinary professional, owner and animal patient. We suggest that a more appropriate, albeit inexact, analogy may be drawn with paediatric practice which is premised on a similarly tripartite relationship and where decisions must be reached in the best interests of the child. However, acknowledging the legal status of animals as property and how consent to veterinary treatment is predicated on the animal owner’s willingness and ability to pay, we propose that the appropriate response is for veterinary professionals generally to accept the client’s choice, provided this is informed. Yet such client autonomy must be limited where animal welfare concerns exist, so that beneficence continues to play an important role in the veterinary context. We suggest that this ‘middle road’ should be reflected in professional veterinary guidance.
Highlights
Veterinary surgeons must communicate effectively with clients and ensure informed consent is obtained before treatments or procedures are carried out. (Royal College of Veterinary Surgeons 2017a)In its Code of Professional Conduct, the Royal College of Veterinary Surgeons (RCVS), the governing body of the veterinary profession in the United Kingdom, stipulates that informed consent is required before treatment may be given to an animal patient
On admission to the profession in the UK, veterinary professionals declare an undertaking to “...ABOVE ALL... ensure the health and welfare of animals committed to my care” (RCVS 2017b), a statement reinforced by the profession’s Code of Conduct, which states that veterinary surgeons must make animal health and welfare their “first consideration when attending to animals.” (RCVS 2017a).10. Given these key differences between animal and human medical practice, we argue that caution is needed in importing the language of informed consent and autonomy into the veterinary context and that a new protocol is necessary to inform professional veterinary ethics and practice
Where welfare concerns exist, we propose a beneficence-based approach to decision-making. This “middle way” recognises the tensions that result from negotiating the veterinarian/owner/animal relationship, which calls into question standard models of patients and health professionals, given both the contested legal status of animals and the way in which veterinary practices effectively operate as businesses involved in delivering private healthcare to human clients who pay for their services
Summary
Veterinary surgeons must communicate effectively with clients and ensure informed consent is obtained before treatments or procedures are carried out. (Royal College of Veterinary Surgeons 2017a). Where welfare concerns exist, we propose a beneficence-based approach to decision-making This “middle way” recognises the tensions that result from negotiating the veterinarian/owner/animal relationship, which calls into question standard models of patients and health professionals, given both the contested legal status of animals and the way in which veterinary practices effectively operate as businesses involved in delivering private healthcare to human clients who pay for their services. The College advises its members to make decisions about treatment “based first and foremost on animal health and welfare considerations, and the needs and circumstances of the client” (RCVS 2017) and to “consider the welfare implications of any surgical or other procedure and advise or act appropriately.” notwithstanding certain commonalities in their position as patients, key differences exist between how animal/owner and child/parent relationships are regarded in law. When considering companion animals, it could be argued that the owner is in the best position to translate her partiality towards the individual animal (Yeates and Savalescu 2017), into reaching a decision on a “best interests” basis. Given the need to reconcile these interests, we turn to framing a proposal for veterinary decision-making which takes account of both the owner’s wishes and circumstances and the veterinary professional’s assessment of the animal’s welfare
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