When does innovation go too far?

Abstract

SHOULD innovative veterinary procedures and practice be more regulated? This question was considered during a debate at the recent Animal Welfare Foundation discussion forum. One problem encountered in trying to answer the question is the number of variables that must be considered. First, what can be done under current regulations? Experimental procedures and research are licensed under the Animals (Scientific Procedures) Act 1986 (ASPA), and this can include research carried out on farms and in veterinary practices (for more details on the Act see In Practice, November 2020, vol 42, pp 488–496). However, most vets will be operating under the Veterinary Surgeons Act 1966 (VSA), conducting ‘recognised veterinary practice’. According to the RCVS: ‘The clinical investigation and management of the health or welfare of animals is generally considered to be recognised veterinary practice when it involves an intervention which is of direct benefit to the animal or its immediate peer group.‘ The RCVS gives more advice in the supporting guidance to the code of professional conduct on what actions fall within the ASPA, the VSA or the Veterinary Medicines Regulations 2011, but it is impossible to cover all situations, as the RCVS itself acknowledges. So another variable is what is considered innovative? And if something is considered to be new, should it be regarded as recognised veterinary practice? And who judges this? In many areas, those speaking on both sides of the debate during the discussion forum – Eddie Clutton, a specialist anaesthetist at Edinburgh university and the Roslin Institute, and Karen Humm, a critical care specialist at the Royal Veterinary College – were in agreement. For example, that euthanasia should be part of the discussion for cases being considered for innovative treatment; that humane endpoints should be set so there is no clinical ‘creep’ in outcome that becomes detrimental to welfare; and that certain areas where the evidence base is strong, such as using the medicines' cascade, are suitable for self-regulation. Another area on which there was agreement was that more uncertain ‘heroic’ treatment should be subject to greater ethical overview. Clutton argued that current arrangements were open to potential conflicts of interest and new arrangements should be put in place to create an independent mandatory ‘innovation panel’ to assess the ethics of a proposed treatment and whether it offered enough potential benefit to an animal (or its ‘immediate peer group’). There would need to be the ability to assess treatment after the event if it was conducted in an emergency. Procedures and treatments conducted ‘should not be at the whim of individuals’, said Clutton, and this would go some way to ensuring unproven methods had better scrutiny. Although there will be vets who push the limits for their own promotion or challenge, or because their employer rewards ‘firsts’, the biggest push for unethical treatment came from clients, according to Humm. Often, they had heard or read of a treatment or procedure offered in other countries, and, she said, in such situations, the most essential skill was the ability to explain to these clients why that option was not on offer, rather than the technical skill required to perform it. “Any change to improve regulation would likely be met with enthusiasm Independent ethical overview makes sense. It means new methods can be introduced but acknowledges the need to assess them for an animal's best interests. No one is arguing that veterinary practice should not develop and improve though innovation, but rather, by taking this course of action, evidence will be gathered on how effective new treatments are and ensure that, as a reason, ‘because we can’ is taken out of the equation. BVA grants editorial freedom to the Editor of Vet Record. The views expressed in the journal are those of the authors and may not necessarily comply with BVA policy