Are veterinarians allowed to discontinue providing veterinary services to a client and their animal(s)?
In certain situations, a veterinarian-client-patient relationship (VCPR) may need to be terminated, despite attempts to address concerns. In the interests of optimal animal care, termination of the VCPR may be the most productive option for both the client and the veterinarian. The client must be provided with proper notice of the termination and allowed a reasonable opportunity to arrange for care with another veterinarian. The steps to follow to officially terminate a VCPR and no longer be professionally obligated to provide care to a client/patient(s) can be found in the Guide to the Professional Practice Standard: Veterinarian-Client-Patient Relationship (including a template letter).
How can a veterinarian ensure that ownership is clear in the medical records documentation to avoid potential ownership challenges or consent issues?
Informed client consent is valid only when given by a person who has the legal authority to give consent. Establishing and understanding legal ownership of the animal(s) is one component of the initial conversation with a potential client. In situations with multiple owners, each owner should be recorded (name, address, and contact information). All owners can give consent for veterinary services unless otherwise documented in the record. An authorized agent is a person authorized by the owner(s) to act on their behalf and whose decisions bind the owner as though they were themselves making the decisions. Authorized agents of the owner(s) should also be clearly documented, including their contact details. A veterinarian should also document what kinds of decisions the agent has been authorized by the owner to make, such as medical and financial decisions. Simply adding a name under “spouse” “other” or even “emergency contact” may cause confusion. It is also prudent to clarify whether an individual is an emergency contact for a specified time period, and whether an emergency contact is also an authorized agent. For a sample template to document information about owners and authorized agents see the Sample Form Client Patient Identification Companion Animal on the College’s website.
How does a veterinarian obtain consent in an emergency when the client is not available?
An exception to the requirement that a veterinarian-client-patient relationship (VCPR) must be established before a veterinarian can provide veterinary services includes where a veterinarian acting reasonably, determines that there is an emergency situation and that an animal or animals require(s) immediate veterinary services. The veterinarian can provide emergency care until the client is contacted at which time they will discuss further veterinary services and obtain consent to proceed.
The Provincial Animal Welfare Services (PAWS) Act includes the authority of a veterinarian to euthanize an animal without having to seek consent in specific circumstances. The criteria to assess this authority includes:
- The animal is suffering;
- The animal’s owner or custodian cannot be found promptly, or the veterinarian reasonably believes that
- The animal does not have an owner or custodian, or
- The animal has been abandoned by the owner or custodian, and
- Euthanasia is the most humane course of action (defined as where immediate veterinary treatment cannot prolong the animal’s life or prolonging the animal’s life would result in undue suffering for the animal).
For more information on the PAWS Act follow this link: https://www.ontario.ca/laws/statute/s19013
How does a veterinarian work with rescue groups or shelters to provide low-cost veterinary services?
The veterinarian’s regulatory obligations are the same for recue groups and shelters as for any other client.
The veterinarian must establish a veterinarian-client-patient relationship (VCPR) with the rescue group or shelter to provide veterinary services. The client is the person(s) who owns/runs the rescue group or shelter, and they may designate other people, such as fosters or shelter staff, to act as authorized agents. A veterinarian should also document what kinds of decisions the agent has been authorized by the owner to make, such as medical and financial decisions. This information needs to be clearly documented in the medical record.
Using a herd health model for companion animals, the prescribing and dispensing of drugs for disease conditions is performed only for the affected animals following the College’s standards related to prescribing and dispensing, as opposed to dispensing bulk drugs for the client to keep on hand in case more animals become affected with the same condition. For preventive healthcare (e.g., parasite control, infectious disease prevention) a standard operating procedure (SOP) can be implemented for the group of animals that includes dispensing drugs or products for multiple animals where appropriate.
Two owners are listed in an animal’s file. If one owner requests that the other owner’s name be removed from the file, what should a veterinarian do?
In order to remove an owner from a patient’s file, consent must be obtained from the individual whose name is being removed from the file. Alternatively, legal direction, such as a court order, may be provided to allow you to remove an owner from the file. The change to the medical record must then be made in such a way that original content is maintained.
When an animal is presented by someone who may not be the owner, should a veterinarian proceed with treatment?
Where a veterinarian believes that ownership of an animal is unclear or where there is a dispute over ownership, the veterinarian should only proceed if it is an emergency in order to prevent suffering and/or significant harm to the animal. In situations where the health and well-being of the animal is not at risk, a veterinarian can postpone treatment until ownership is confirmed.
When ownership is in question, a veterinarian must use his or her professional judgment to determine an appropriate process for identification in the circumstances. See the document Managing Questions of Ownership and Ownership Disputes of Companion Animals on the College’s website for further information.