September 15, 2014

 

 Delegates reject proposed ethics changes

Posted Sept. 3, 2014

AVMA delegates rejected a proposal that would have made the Association’s ethics principles more definitive by replacing many instances of the word “should” with “shall.” 

The House of Delegates instead approved, in a nearly even vote, a motion to refer the proposal back to the AVMA Board of Directors for reconsideration, despite statements from a board member that such action would be unproductive. 

Dr. Lori Teller, alternate delegate for Texas, shown speaking during a House of Delegates reference committee meeting in July, was among those who spoke to the full HOD against a proposal to change the AVMA Principles of Veterinary Medical Ethics. (Photo by R. Scott Nolen)
 

The proposal would have made the AVMA Principles of Veterinary Medical Ethics more prescriptive as well as edited the document to increase clarity and remove redundancy.

Some of the changes developed by the AVMA Judicial Council and proposed by the board would have stated, for example, that veterinarians “shall first consider the needs of the patient,” their medical judgment “shall not be influenced by contracts or agreements made by their associations or societies,” and that, in a referral, a receiving veterinarian “shall provide only those services or treatments necessary to address the condition for which the patient was referred and shall consult the referring veterinarian if other services or treatments are indicated.”

Board member Dr. Mark Helfat said prior to the vote that the board members were happy with the document, and he did not expect further changes if delegates sent the proposal back.

“This is their final document,” he said. “They have voted to approve this.”

Dr. Lori Teller, alternate delegate for Texas, said that, while most of the proposed document could be considered to describe best practices, violating one or more parts of the principles is not always an unethical or illegal act. She expressed concern that the prescriptive language could be adopted in state practice acts and applied against veterinarians in an unfair manner.

Dr. Mark Cox, delegate for Texas, described the changes as “top-down,” “heavy-handed,” and “dictatorial.” He introduced the motion to refer the revisions back to the board.

Dr. Helfat said in a later interview he expects the board will return the document to the Judicial Council for review, and the council could choose to edit it or resubmit it as is, in the hope the council’s members could better explain to delegates why they recommended the changes.

Dr. Helfat also said he would support the council if it were to make a few changes, although he thinks the word “should” is improper in an ethics document because it suggests an option, weakening the intent of documenting a group’s shared rules or philosophy.

He questioned how useful the Ten Commandments would be if they said, for example, that a person “should not” kill. The principles are meant to set a high standard for AVMA members.

“That is your aspiration,” he said.

Dr. Helfat expects veterinarians’ own values usually impose ethical standards at higher levels than required by state practice acts. And he noted that the word “shall” is used in the ethics documents of other professional associations, including the American Medical Association.