The dilemma in the June issue concerned a next door neighbour asking for advice about her grandson's rabbit, which had been taken to its local vet with a swelling on the side of its face (In Practice, June 2012, volume 34, page 366). The practice had diagnosed an abscess and offered to remove it at a cost of £300, but you were not sure you would have recommended this. David Williams commented that this was both a clinical issue and an ethical dilemma. Abscesses arising from an infected tooth root could be difficult to manage and the ways in which vets dealt with them varied. The ethical dilemma concerned whether advice offered over a garden fence could be classed as a second opinion. It was possible that your comments would have repercussions in terms of the management of the rabbit and the relationship between the client and their vet. One option was to refuse to give an opinion, which seemed hard-hearted. Another was to ask the owner to contact their vet before you gave your opinon. However, it was probably easier to preface any comments with a disclaimer that different vets had different views on treatment options and to emphasise that you were making suggestions without even having seen the animal. It was important to keep the RCVS Code of Professional Conduct at the forefront of your mind when offering advice in such circumstances.
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Siobhan Mullan comments: This case, which we've all no doubt faced, made me wonder whether virtue ethics may be useful here. Virtue ethics has had a resurgence in popularity in medical ethics recently and is based on the premise that if we have certain characteristics (virtues), the right action will naturally follow. Perhaps the relevant virtues in this situation might include helpfulness (towards your neighbour), compassion (for the rabbit), humility (in relation to your level of knowledge of the specific case and/or field in general) and respect (for your veterinary colleague). At first sight, some of these may appear to conflict. For example, by being very helpful to your neighbour through offering extensive advice, are you respecting your veterinary colleague fully? However, there's no manual as to how these elements should be balanced, except that in a virtuous person they would be balanced in the right way for a given situation. Often, by considering a situation in more detail some clarity may emerge. For example, maybe it's not actually very helpful to your neighbour to cause her some turmoil over the treatment of the rabbit or to cause her to lose faith in her vet unnecessarily. In an action-centred world, it can be useful to reflect on the virtues we would hope to possess and to try to cultivate them to ensure we take the right actions.
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. We pay a small honorarium for contributions that are published.
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, ‘Homeopathic vaccine’, was submitted by a reader and is presented and discussed by Martin Whiting. 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 ‘Offering neighbourly advice’, which was published in the June issue of In Practice, appears on page 431.
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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