Communication with clients

This guideline describes the minimum standard expected from a registered veterinary surgeon exercising reasonable skill and care in the course of practising veterinary science. It should be read in conjunction with relevant Queensland legislation and other guidelines and definitions.

Many of the complaints received by the Board arise because of a breakdown in communication. Veterinarians must make reasonable efforts to ensure that the client understands their communications.

Authority

Veterinarians must take reasonable steps to establish that the person presenting the animal has the authority to consent to a procedure or treatment. Examples of authority include:

• an established client associated with that animal
• the owner of the animal
• an authorised agent of the owner of the animal
• a person with day-to-day responsibility for the care of the animal.

Range of options

Veterinarians must:

• act in the best interest of their client and patient when formulating a list of options. This includes consideration of prognosis as well as financial circumstances and ethical considerations.
• give consideration to the appropriateness of referral, conservative treatment, second opinions and euthanasia when formulating a list of options.

Options need to be provided in a professional, unbiased and non-judgemental manner.

When offering treatment/procedure options, if relevant, the level of skill and experience of the veterinarian performing these should be discussed, regardless of how accessible another more experienced veterinarian or specialist may be, particularly where the level of skill or experience may impact the outcome for the patient.

All reasonable diagnostic options should be offered for a patient; however, this should not be limited to what is available in the practice, as there may be a more appropriate diagnostic option for the differential diagnoses and it is expected that this should be discussed as well.

Clients always have the option of taking a patient home untreated, even if it is not in the best interest of the patient’s welfare. The person in charge of the animal (e.g. animal owner, authorised agent of the owner) owes it a duty of care under the Animal Care and Protection Act 2001.

As a veterinarian, if you believe the appropriate care is not being given to the patient by taking it home, you may make an animal welfare complaint to the RSPCA (phone 1300 264 625) or the Department of Agriculture and Fisheries (phone 13 25 23).

Informed consent

Gaining informed consent involves getting permission from the client before undertaking a procedure or treatment. Informed consent means the client has a clear appreciation and understanding of the facts including:

• implications of the possible diagnoses,
• all reasonable treatment options,
• likely outcomes,
• potential complications,
• indicative costs, and
• the longer-term care requirements, health/welfare implications and ongoing costs for the animal.

In seeking consent the veterinarian must be confident that the client is reasonably able to understand the facts. It is important to consider factors that may impede this for example language proficiency, literacy, heightened levels of stress or emotion and cultural diversity.

Informed consent is an ongoing process throughout the veterinary management of an animal. The client must be updated and consent obtained if there is any material change in the animal’s condition, diagnostic and treatment options, prognosis or estimated costs.

A client should be informed as to the level of supervision of patients, especially outside of normal business hours. If a patient requires more supervision than that provided for by the practice, and it is a reasonable option to refer to a practice that does, this should be an option for the client.

It is expected that informed consent will be demonstrated in the patient records and the use of consent forms, as supporting evidence is recommended. Consent forms are no substitute for a comprehensive discussion between the client and veterinarian.

Informed consent needs to be documented when off-label medicines or chemicals are prescribed or administered to animals. See AVA Guidelines for Prescribing, Authorising and Dispensing Veterinary Medicines (2005).

Admission of patients

When nurses are admitting patients for routine surgeries, e.g. desexing, lump removals and dentistry, it is important that they go through the admission/consent form thoroughly and ensure that the client understands what they are signing and consenting too. Nurse admissions are only appropriate where there is a bona fide client relationship with the practice and the treatment plan is current.

The veterinarian treating the patient is still responsible for informed consent and should anything arise after admission that deviates from what the client has consented to, the veterinarian must contact the client to obtain informed consent and document accordingly.

Admissions by veterinarians treating are strongly encouraged to ensure informed consent is obtained.

Communication with veterinarians for clients

• Ask questions regarding the expected quality of life and life expectancy resulting from the veterinary management proposed for your animal. Ensure you discuss thoroughly with your veterinarian all options including palliative care and euthanasia.
• Enquire about the amount of supervision your animal will get out-of-business hours. Is more supervision recommended? Are there other practices that can provide more supervision reasonably accessible?
• Ask the veterinarian what level of experience and skills they have for the proposed veterinary management of your animal.
• Seek a second opinion if you are not comfortable or require more information.
• If you are admitting your animal and don’t see a veterinarian on admission, and you haven’t discussed or understand the veterinary management proposed for your animal, ask to speak to a veterinarian.
• Always ask about costs and likely chance of success of the proposed veterinary management of your animal.
• Ask about what ongoing management and follow-up is required including costs and the long-term implications for your animal.
• Animal welfare is your responsibility as the owner of the animal, and failure to provide treatment for illness or injury contravenes the Animal Care and Protection Act 2001. Providing pain relief is a minimum and euthanasia should be seriously considered when you are unable to provide for an animal financially, in the interest of their welfare.

More information

• Read more about duty of care for animals