College Connection Spring 2023 | Page 6

College Connection | Spring 2023

LEARNING IN PRACTICE

Panel provides advice on informed client consent

Veterinarians have a responsibility to provide safe , quality care . The College assists veterinarians in doing so when matters are reviewed by the Complaints Committee . The public has a right to ask questions about the care that was provided to their animal ( s ) and this process provides veterinarians with feedback on whether they have met the standards of practice or whether there are improvements needed to mitigate risks in practice . The Committee provides advice or may request a veterinarian enter into an undertaking when remediation would reduce risks and support a veterinarian in meeting the standard of practice . Only the most serious cases , where there is bad intent , incompetence , reckless behaviour , or a history of failure to remediate at-risk behaviour are referred to the Discipline Committee for a discipline hearing to determine if an act of professional misconduct or serious neglect may have occurred . This example is taken from a case that was reviewed by the Complaints Committee and is offered as a self-reflection tool to support veterinarians in understanding how to meet the standards of practice .

Case Summary

The member examined a dog with a swelling / mass under its eye . The dog had moderate dental tartar , moderate gingival disease , root exposure , moderate halitosis , and some missing teeth . The member ’ s differential diagnoses for the mass included a tooth root abscess , neoplasia , or other . The dog was prescribed antibiotics and an anti-inflammatory . Bloodwork was performed , and a dental procedure was planned . During the dental procedure , 11 teeth were extracted .

The clients were concerned as they didn ’ t consent for the number of extractions and the member didn ’ t contact them before the extractions .

Case Outcomes

The Complaints Committee panel decided the allegations made against the member did not warrant a referral to the Discipline Committee . The panel decided to provide advice to the member about the importance of obtaining informed client consent before any veterinary intervention is performed . The College ’ s Professional Practice Standard on Informed Client Consent states a veterinarian is required to provide comprehensive information to the client regarding a proposed veterinary procedure . The member is expected to explain and document the various scenarios for extractions in the procedure , including a conversation about the potential extractions , even if unpredictable , the client ’ s wishes regarding extractions , and documentation about whether the client consents to any number of teeth being extracted if deemed necessary during surgery .

Advice , as provided in this case , is a remedial tool to educate licensed members to correct problematic areas of their practice .

Case Considerations

In consideration of this complaint , a panel of the Complaints Committee reviewed the medical records and written submissions from the client , the technician and the member . As is standard for all investigations , the panel considered previous proceedings , if any .

The panel noted a discrepancy about how many extractions the clients and the member believed were consented to . An estimate was provided and a surgical / anesthesia consent form was signed , but there was no documentation of a discussion about various scenarios , including the number of extractions .

The evidence suggested the member may have considered the dental estimate form as sufficient information for the scenarios regarding extraction . The estimate form included a quote range based on time , but there was no mention of potential for additional teeth to be extracted . There was also no reference to possible scenarios regarding extractions on the surgical / anesthesia consent form .

The panel did not have sufficient evidence of informed consent . Although the 11 teeth were best removed before causing further medical issues , this does not excuse the requirement to obtain informed consent for all extractions .

Providing advice to the member , the panel underscored the deficiencies identified so the member can make changes to their practice to prevent these concerns from arising again .

Informed Client Consent

• Professional Practice Standard

• Guide to the Standard

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