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Decision making
Comments on the dilemma in the October issue: ‘Mammary mass in an overweight dog’
  1. Siobhan Mullan

Abstract

The dilemma in the October issue concerned an overweight labrador with a mammary mass (In Practice, October 2011, volume 33, pages 493–494), which required biopsy and removal of the mass. However, when the client was advised that the dog would need to lose weight before surgery, they become aggressive, said ‘the dog is on a diet and the weight problem is under control’ and refused to discuss attending weight clinics or changing the animal's food. Practice records showed that the client had previously taken the dog to two weight loss clinics and, at the last visit, it had weighed 27 kg. It was now 33 kg. Rachel Casey commented that there were three options for dealing with this scenario: to ignore the problem until the client returned; to report the owner to the RSPCA; or to contact the owner and try to convince them to reconsider weight loss options. By not taking action, the weight issue would probably not be addressed by the owner and the mass would inevitably grow bigger over time, resulting in a decline in the dog's welfare, while reporting the client to the RSPCA might breach client confidentiality. Consideration also needed to be given to whether the welfare of the dog would be better in kennels or with its owner. She suggested that the best option was to contact the owner and to take the time to consider why the owner was reluctant to address the dog's weight problem. In addition, focusing on the mass and the requirement for surgery rather than the weight of the animal, or suggesting alternative weight-loss options, such as a balanced home-made diet, might achieve good welfare outcomes for the dog.

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Siobhan Mullan works part-time in small animal practice, as well as at the University of Bristol. She holds the RCVS diploma in animal welfare science, ethics and law.

Siobhan Mullen comments: This case describes a situation where the relationship between the client and the veterinary surgeon had already broken down to some degree. I was interested to see that in advocating trying to re-engage with the client, Rachel Casey stated that a different approach would be needed. This seems obvious on the one hand, but made me wonder just how different we are able to be. I expect that there is little variation in the way a single vet deals with their clients, despite the range of client attitudes. Perhaps it might be helpful to actively look for other ways of trying to get clients on board.

There are many theories on approaches to persuasion [for one example, see Box 1 on page 550 of this issue], and you can be sure that this is a subject advertisers are well versed in. Even Aristotle observed that there are three routes by which people could be persuaded. First, we could draw attention to our own reputation and/or credentials. For example, we are recognised experts and we have had many successes by this route in the past. Secondly, we could appeal to the other person's emotions, through stories that relate to their values or beliefs. Thirdly, and perhaps most familiarly, we could appeal to their logic by presenting empirical evidence and rational reasoning. This might be the most effective form of persuasion for ourselves; after all, we chose a scientific path in life and then had our rational reasoning predication reinforced through training – but it might not be most appealing for everyone. While there is certainly a great ethical debate to be had about acceptable levels of persuasion in veterinary practice, it might be worth remembering that there are always other approaches. And, if you've tried your best, it might be more productive to ask someone else to have a go.

Have you faced a dilemma that you would like considered in a future instalment of Everyday Ethics? If so, e-mail a brief outline to inpractice{at}bva-edit.co.uk

Notes

THIS series gives readers the opportunity to consider and contribute to discussion of some of the ethical dilemmas that can arise in veterinary practice. Each month, a case scenario is presented, followed by discussion of some of the issues involved. In addition, a possible way forward is suggested; however, there is rarely a cut-and-dried answer in such cases, and readers may wish to suggest an alternative approach. This month's dilemma, ‘Owner access to isolation facility webcam images’, is presented and discussed by Susana Silva. Readers with comments to contribute are invited to send them as soon as possible, so that they can be considered for publication in the next issue. Discussion of the dilemma ‘Mammary mass in an overweight dog’, which was published in the October issue of In Practice, appears on page 559.

The series is being coordinated by Siobhan Mullan, of the University of Bristol. It is hoped it will provide a framework that will help practices find solutions when facing similar dilemmas.

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