The ethics of influencing clients

Abstract

Views: Commentary 263 I veterinary practice, clients often must make treatment choices for their animals, and the decisions they make can determine the outcome of treatment, in that owners can refuse to consent to a treatment option, choose not to follow treatment recommendations, or elect not to pursue any treatment at all. Clients do not make these decisions alone. Veterinarians work at the interface between owners and their animals and have an important role in the decisions owners make about their animals. They inform their clients about examination and test results, provide diagnoses, recommend possible treatment options, and advise on likely prognoses. They have an expertise, trustworthiness, and authority that make clients value their opinions about important and emotional issues. Veterinarians’ roles therefore afford them myriad opportunities to influence their clients’ choices. But is exercising such influence legitimate? On the one hand, it could be argued that any influence that benefits patients is acceptable, if not mandatory. But, the doctrine of informed consent suggests that influence is generally unacceptable. The Royal College of Veterinary Surgeons, in its Guide to Professional Conduct, states that veterinarians should “respect [clients’] views” and “recognize that the client has freedom of choice.” Similarly, the AVMA, in its Principles of Veterinary Medical Ethics, states that veterinarians “should not engage in fraud, misrepresentation, or deceit.” On the other hand, influence could be argued as intrinsically wrong. However, some prominent American ethicists have suggested that persuasion might be acceptable in some cases, although without suggesting criteria for determining which cases those are. The Royal College of Veterinary Surgeons also adds that “veterinarians must ... give due consideration to the client’s concerns and wishes where these do not conflict with the patient’s welfare.” How can a practitioner balance these extreme views? We believe that an approach based on reasonableness can provide a framework for practitioners to decide how much influence is legitimate. Drawing on US, Canadian, and United Kingdom legal precedent and ethical commentary, the present commentary examines possible forms of and reasons for influence and then The ethics of influencing clients