Veterinary professionals are often faced with Ethical dilemmas in the field and during
these times they often experience moral distress. “Moral distress is often triggered by
situations that challenge how they think they ought to practice Veterinary Medicine, how
patients ought to be treated and how they ought to meet their percieved profesionals
obligations (Crane et al, 2015). Research even shows that these challenges occur frequently
and with significant impacts on them.
In recent years, Veterinary Doctors, Nurses and technicians Education costs have risen,
with the debts to income ratio on the rise. Many Graduating Students owe in excess of
$300,000 in student loans and this has even made the situation of ethical dilemma more
problematic.
Now, should Veterinary health care givers opt for plans B and C even when
they have been taught to offer the gold standard (plan A) for medical services and
treatment for their patients because of their very own financial constraints? Should they
stick to the gold standard of treatment(plan A), regardless?
I will like to use the following scenario as a case study and thereafter will take a stand
on the topic above.
Tobi studied Veterinary Medicine in the U.S. All the tuition fee that he paid throughout
his study years were from loans.
In the U.S, Veterinary tuition fees are usually expensive. So, by the time Tobi completed
Veterinary School, He already owed so much money. Now, that Dr. Tobi has graduated,
His greatest concern is to get a job that pays relatively high salary so he could pay off
his loans in good time.
Dr. Tobi resumed work one morning and was presented with a case of oblique femoral
fracture in a cat. The gold standard for managing an oblique fracture is internal fixation
(plan A). The next best option is to apply a POP cast (plan B). The least best is to apply
simple bandage (plan C). However, Dr. Tobi cannot perform internal fixation, would it
therefore be ethical for Him to perform plans B and C even when it is not the best
treatment for His Patient?
ABSOLUTELY NOT! I will state my reasons later.
C.S Lewis stated in his book, the great divorce “ a sum can be put right; but only by
going back till you find the error and working it afresh from that point, never by
simply going on’. Therefore at this juncture, I will be explaining what fracture is, its
types and possible ways of managing fracture.
A broken thigh bone is also known as Femur Fracture is a serious and painful injury.
The femur is one of the strongest bone in the body, and a break or fracture in the
femur bone is often caused by a severe injury such as trauma.
The types of femoral fracture can be classified based on the location of the fracture. This
include:
1. Proximal femur fracture; upper portion of the thigh bone.
2. Femoral shaft fracture; middle portion of the bone.
3. Supracondylar femur fracture; distal portion of the bone, that is, area just above
the kneel.
Femoral fracture can also be categorized by the type of injury sustained.
Just as Betty Williams said “there is no use talking about a problem unless you talk about
the solution”. On this note, I will move on to the possible ways of managing fractures.
1. Internal fixation: Bone fragments are first repositioned or reduced into their normal
allignment. They are held together with special implants such as plates, screws,
nails and wires. It allows for shorter hospital stay, enables patient to return to
function earlier and reduces incience for non union, that is, improper healing and
malunion, that is, healing in improper positions of broken bones.
2. Plaster of Paris, POP; quick setting gypsum plaster consisting of a fine white
powder, which hardens when moistened is allowed to dry. It is so called because
of its preparation from the abundant gypsum near Paris. The biggest advantage of
POP is the property that allows itself to moulden. However, prolonged
immobilization in a POP makes the skin under the cast vulnerable. The dead skin
is not removed and leads to scaling. Other complications like ulceration,
maceration, itching, burns can result.
3. Soft Bandages; these are pieces of materiaals used either to support a medical
device such as a dressing or splint or on its own to provide support to or to restrict the movement of a part of the body. They’re rarely used solely for
fracture management.
NOW, UNTO THE BIG QUESTION!
ARE PLANS B AND C ETHICAL?
ABSOLUTELY NOT!
Although Dr. Tobi’s productivity will be measured by how many Veterinary cases he is
able to attend to and resolve, that is, the more cases Dr. Tobi attends to, the more
productive Dr. Tobi is, the more money he earns for his veterinary employer, then the
higher his salary and therefore the quicker he pays his loans and attains fiinancial
stability, I still strongly believe that it will be ethically wrong if he chooses either plan B
or C because of the following reasons;
Firstly, Dr. Tobi (and every other Veterinarian out there) must have sworn an oath which
states that “ Being admitted into the profession of Veterinary Medicine, I solemnly
swear to use my scientific knowledge and skills for the benefit of the society through
the protection of animal health and welfare, the prevention and relief of animal suufering,
conservation of animal resources, the promotion of public health and the advancement of
medical knowledge.
I will practice my profession conscientiously, with dignity, and in keeping with the
principles of veterinary medical ethics. I accept as a lifelong obligation the continual
improvemet of my professional knowledge and competence” before been inducted into
the veterinary profession.
Therefore, I feel that Every Veterinary professional who has sworn should make sure he
or she do accordingly regardless of the kind of condition he or she is faced with , for
the sake of conscience and humanity.
Secondly, Dr. Tobi is a certified Veterinarian and not a quack and as such I expected to
always remember that exemplary professional conduct upholds the dignity of the
Veterinary profession. All Veterianarians are expected to adhere to a progressive code of
ethical conducts known as the Principles of Veterinary Medical Ethics (PVME).
The term Veterinary Ethics means application of ethical theories, principles and rules by
professionals and paraprofessionals in resolving in resolving ethical dilemmas in the
practice of veterinary care.
Some of the Principles of Veterinary Medical Ethics Veterinary professionals must always
consider when they are faced with these challenges include the following:
1. A Veterinarian shall be influenced only by the welfare of the patient, the needs
of the client, the safety of the public, and the need to uphold the public trust vested in the veterinary profession, and shall avoid conflict of interest or the
appearance thereof.
This means that a Veterinarian shall not allow any interests, especially Financial
Interests influence the choice of treatment or animal care.
2. A Veterinarian shall provide competent Veterinary Medical care under the terms of
a Veterinarian-Client-Patient Relationship (VCPR), with compassion and respect for
Animal welfare and Human Health.
This means that every single Veterinarian in our society is expected to consider
the medical recommendations of the patient in the prevention and relieve of
disease, suffering, or disability while minimizing pain or fear.
3. A Veterinarian shall uphold the standards of professionalism, be honest in all
professional interactions and report Veterinarians who are deficient in characters or
competence to the appropriate entities.
This means that Veterinarians should be completely honest and ethical regardless
of what the situation or dilemma is.
Dr. Tobi may only opt for option B or C if and only if the Client (that is, the owner
of the cat) gives the nod after He must have explained the processes to the Client.
The client may not be financially buoyant to pay for the services of the Veterinary
Doctor if he was to render the golden service and in this kind of situation, He may opt
for plan B or C.
I am aware that the sanity of the Veterinarians is very important and cannot be
overemphasized but nevertheless Honesty is said to be the best policy. Veterinarians
should be encouraged and hold Honesty in high esteem. With honesty, we can achieve
what we may never imagine. Honesty will always retain clients and these clients bring
more clients.
In conclusion, I will like to reiterate that medical recommendations should be considered
over Financial consideration. It is simply ethical to do so.
I hope that the Government will deem it fit to help alleviate the financial burdens of
Veterinary professionals as this will go a long way to help them make good judgements
and will also help them to uphold very good ethical conducts. This may only change if the Client cannot pay for the procedure.