Time for rational discussion of issues raised - Veterinary Practice
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InFocus

Time for rational discussion of issues raised

PERISCOPE continues the series of reflections on issues of current concern

A FLURRY of letters in another
publication from apoplectic vets
condemning the “rogue vet”
Matthew Watkinson makes
interesting and frankly riveting
reading.

To my shame, I like to watch a
good punch-up (verbal or physical) as
much as the next man. It brings out the
pack instinct, which I find makes one
feel momentarily excited and alive.

I say momentarily because with the
passage of just a short period of time I
am usually left feeling bewildered and
not a little ashamed by my willingness
to be caught up with the “mob”.

I shudder to think
what I might be capable
of given the right
(wrong) set of
circumstances, and
history shows us that I
(and I suggest most of
you) would do well to be
worried. Dreadful things have been
done by perfectly “normal” people
caught up in the frenzy of the pack.

That’s why I am loath to start
sounding off about Mr Watkinson’s
somewhat polarised view of the
profession. I don’t fully understand his
motives but I suspect they are a mixture of genuine concern at what he sees is a
profession that has foregone its
principles for the sake of money, and
his desire for a bit of free publicity to
try and sell his book.

Most of us behave the way we do
for a variety of reasons, some of which
are more noble than others, and there
are few totally altruistic saints amongst
us.

Trying to look at the brouhaha
objectively, I conclude that Mr
Watkinson has raised some valid points.
It is a pity that they have largely been
lost in the ensuing row because of the
way in which he chose to air them.

Having been young
once myself (and I do
not mean this to be as
condescending as it
will undoubtedly
sound), I have been
less than diplomatic in the past.
Age leads one to be slightly more circumspect, which I admit is not
always to the good. To change some
things requires the determined self-
belief of someone young enough not
to understand or perhaps fear the
consequences of a backlash to his or
her views. Sometimes, though, a little diplomacy can achieve what the threat
of violence has failed to deliver.

Now I don’t for a moment believe
that many vets are trying to deliberately
rip-off clients or recommend
treatments that are not in the interests
of the animals themselves, and I’m not
certain that Mr Watkinson is saying this
either. Of course there are a few bad
apples but that is inevitable and
unavoidable and one would be naïve to
think otherwise.

And I don’t wholeheartedly buy Mr
Watkinson’s assertion that the medical
profession goes searching for the “bad
eggs”. Don’t forget that Harold
Shipman was convicted only 10 years
ago after years of his colleagues failing
to spot and/or question what was really
going on. And whilst there have been
changes in the medical profession as a
direct result of his activities, we can
never be sure that there isn’t another
Shipman out there, similarly going
unchallenged by those who might
already have suspicions.

I do, though, believe that Mr
Watkinson is quite right when he says
that there is a conflict of interest
between business and animal welfare.
This is not necessarily of our making
but it is a real ethical dilemma and one
that I think deserves cool, calm debate
in order to try and thrash out an ethical
and practical approach.

Vets have historically been passive
about many animal welfare issues,
which has not shown the profession in
the best light in my view. Perhaps this is
a chance to make amends.

Let’s start the debate then by stating
what I perceive to be the obvious: most
vets became vets because they were
interested in animals and wanted to
spend their lives working with animals
and helping them to live healthy,
“happy” and/or productive lives.

Reasonably lucrative

Most vets also became vets because
they thought it was a way to make a
reasonably lucrative living (everybody
who knew no better complained to
them about the huge amounts of
money vets earned!), thereby giving
them a decent lifestyle.

Most vets became vets without any
clue about the general public’s
perception of their pets and how that
was to change over the last 10 or 15
years.

Most vets became vets not realising
that veterinary practice does, by
necessity, involve trying to keep clients
happy at the same time as treating their
animals.

Most companion animal vets now
find themselves needing to offer high-
tech treatments to satisfy a certain
percentage of their clients’ demands

and find that this requires expensive
equipment that has somehow got to be
paid for.

Most vets also have clients who
require little more than first-aid for
their pets and would rather have them
euthanased than spend “vast” sums of
money on them.

You can already see from the above
statements where some of the
dilemmas will occur through no fault of
the vet, but which could be perceived
to be the fault of the vet in certain
circumstances if they misread the
desires and intentions of a particular
client.

Managing shades of grey

Finally, to try and answer the question,
should vets always put animal welfare
first? Generally speaking, I would say
yes but with some caveats. And if that
puts me in breach of the oath I took
on entry to the RCVS, then so be it. I
have learnt that life is rarely black and
white and that the skill in getting
through it with any sense of satisfaction
is in learning how to manage the shades
of grey. So in what situations might
these shades of grey arise?

Well, there are undoubtedly clinical
cases where what is in the best interests
of the animal just isn’t clear. Sometimes
it is very difficult to decide whether
recommending euthanasia is preferable
to offering treatment. We are not God
with an all-seeing, all-knowing
appreciation of how every particular
case is likely to turn out.

I have certainly had cases where in
retrospect I wished I had recommended
euthanasia far sooner. This leads me to
conclude that there are other cases
where the euthanasia I performed
would have proven in retrospect to
have denied the animal in question the
chance to recover.

And as another example I can
categorically state that there are
occasions when for compassionate
reasons human welfare should be put
ahead of animal welfare. Of course one
should do all one can to guide the
owner to the decision that one believes
is best but I repeat we are not God and
we are not infallible.

Sometimes, owners (as is usually the
case with mothers of young children)
know best. But even in cases where our
best thought-out advice is ignored, we
can still do all in our power to alleviate
an animal’s suffering.

In summary, I would ask Mr
Watkinson to come down a little way
from his high horse and see things
from a dedicated practitioner’s
viewpoint. I would ask the rest of us to
stop choking on our indignation and to
start rationally discussing the real issue
that Mr Watkinson has raised.

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