The dilemma in the March issue concerned a principal of a practice who was considering introducing a profit incentive scheme (In Practice, March 2011, volume 33, pages 142–143). There were preliminary discussions with employees, some of whom were unsure about how such a scheme would affect the way they performed their duties. Glen Cousquer commented that profit-sharing, either explicitly or implicitly, provided vets with an incentive to work for financial gain. For some, this would be their main (or only) motivation, whereas for others it remained secondary to other values such as public service or an interest in animal welfare and veterinary medicine. A possible way forward would be to remember that vets had a duty to the greater good, society, the profession, the client and the patient, as well as their employer. As such, their remuneration should be fair but not tip the balance in favour of exploitation of vulnerable clients and insurance companies. Vets should feel comfortable explaining the reasons why they were recommending a particular course of action, especially where cheaper options were available.
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Siobhan Mullan is based at the University of Bristol. She holds the RCVS diploma in animal welfare science, ethics and law.
Siobhan Mullan comments: Veterinary ethics and business ethics can be a very tangled web indeed at times. Our moral duties towards our patients, as well as our clients, and the ‘sub-free market’ that private veterinary practice operates in, resulting from the inequity of knowledge between the veterinary surgeon and client, add a particular twist.
Apart from the harm done to individual patients when profit begins to dictate practice, it seems that the collective harm to the trust in the profession could be the most serious for animal welfare. When we lose our collective and individual voices, we erode the valid influence we can have. If you have anything but absolute trust in advice given by others operating in a similarly ‘sub-free market’, such as financial advisers or lawyers, then you'll see just what's at stake, and there are already no shortage of grievous stories in the public domain of veterinary profiteering.
So what would be the best system to operate in practice? During a participatory workshop I was recently reminded of the value of defining the Utopian ideal and identifying what we would need to do to get there. It seems to me that there could be two Utopian scenarios: either veterinary advice is disassociated from individual profit making, or practitioners are morally robust enough to withstand any thought of personal gain that would influence their advice. Even this latter scenario may not be enough to prevent an erosion of trust if vets were not perceived as being as virtuous as they were. So, maybe in the real world we should aim to have a system that encourages only those vets that have both a strong moral compass and good business sense having a direct stake in the profit of a veterinary practice. How we identify these individuals, though, is another matter!
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
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, ‘Social media menace?’, is presented and discussed by Anne Fawcett. 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 ‘Principled profit-sharing?’, which was published in the March issue of In Practice, appears on page 191.
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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