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A veterinary blog for pet lovers, vet voyeurs and the medically curious...
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OK so I did a bad thing last Saturday…a very bad thing.
A client I know well from years of stray cat care brought in a stray six month-old kitten so I could treat its ostensibly broken leg. Instead, I determined that a small abscess (probably from a bite wound) was the cause of his lameness.
Because the kitten was a tad on the wild side, I sedated him and proceeded to clean the area and debride the wound. While the kitten was out I had the bright idea of neutering him. To obtain proper consent I called the client to inform her of the slight alteration in our plans.
Unfortunately the owner was unavailable. I neutered the kitten anyway, figuring I’d sterilized so many of her cats already it’d be a shoe-in for consent. And it would be a shame to have to knock the kitten out again—or maybe not at all, since the wild guy might never go near a trap again after the current unpleasant experience.
At pick-up time the owner didn’t show. It was her daughter instead. Said daughter proceeded to berate me for the neutering transgression, arguing that she could have obtained the procedure more cheaply elsewhere and that she was absolutely shocked that I would undertake a procedure without express intent.
She was right, of course. Though offended at being called out so rudely (she could have been nice about it, right?) I apologized profusely and explained that I’d not only attempted to seek consent but that I hadn’t charged her for the procedure (since her mom was such a great client—and because I was looking out for the cat’s best interests, after all).
This attitude merits some explanation: Where I work we do things a little bit differently than elsewhere. Partly that’s because I’ve known a large number of my clients for well over twenty years—since before the world became such a litigious place.
For my thirty-something age I know that’s rare but this hospital has been my “home” of sorts since I’d started here as a volunteer at the tender age of ten. And I guess I’ve come to expect my long-term clients to always respond to my best efforts with the understanding and trust such a long-term relationship typically confers.
….wrong!
So it was that I finished up my Saturday with a bit of resentment. “I mean, she was such a bitch!” I explained over a late lunch with my also-vet boyfriend.
But if I was looking for any sympathy I was not about to get any from him. “You got exactly what you deserved,” he offered, “for not using consent forms.”
Though I fail to see how a consent form would have helped me out in this kitty’s case, I held my tongue. Yeah, he was right (mostly). Nonetheless, I fumed at my egg-white omelet for being berated, yet again, for my stupidity and naiveté… and for the frustration of knowing that consent forms are anathema to the culture of my place of work.
Our hospital has no consent forms and last time I tried to implement them (about five years ago) the staff and clients rebelled: “But I’ve been coming here for thirty years, how can you insult me with this legalese!” And that was the end of that.
But this last episode—though it might not have solved the problem in that instance—left me feeling creative. I would alter the estimate forms to include a consent immediately preceding the signature. And while the other docs might forego signatures on their forms, I wouldn’t.
So far it’s worked (yesterday went swimmingly). But I still can’t help thinking about the kitten and Saturday’s fiasco. Who doesn’t want a stray cat neutered? For free! No harm, no foul right? I guess what they say is true: No good deed ever goes unpunished.
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"The greatness of a nation can be judged by the way its animals are treated."
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- Mohandas Gandhi
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I had a very sick baby ferret once -- he was a rescue, and god only knows what had happened before I got him, because within a few weeks of bringing him home he got very, very ill -- kidney stones & bladder stones. Worse, I'd just moved to a new city and (my bad) hadn't sussed out a new, ferret-friendly vet yet. So I took him to the local animal ER.
They diagnosed the kidney & bladder stones, took him in for surgery, and while he was out, neutered him. I was livid. He was barely 3 months old, and I don't fix my ferrets until they're at *least* six months old for health reasons. (Ferrets fixed later in life tend to be much larger, healthier, and live longer -- something I definitely thought this little guy needed since he was already off to such a bad start.)
In the end, the poor little guy couldn't handle all of the crap he'd been through, and he died when he was 5 months old. The neutering ended up being totally unnecessary, and just one more thing that his body had to try to recover from while he was already very sick.
Anyway. Client permission? Always a good thing. :)
By the way - has the mother called or come in and had her say in the matter? I'd be curious to know if she agreed with the daughter.
Wrong schwrong...please ... Incognito-ally yours...
No Name
I trust my Vet completely to do the right thing for any of my animals that I take to her. If she felt that a procedure was necessary/warranted and I could not be reached I would expect her to do it.
In fact my Vet knows that if I am away and my dogs are with the pet sitter and require veterinary care that I trust her to make any and all decisions regarding their health care. I know that she will make the decision that is in their best interest. I don't think anyone can ask for more than that.
I have never signed anything to that effect but unfortunately I can see the day coming, even in Canada... <sigh>
Probably you're just stung mostly from the boot in the arse from her daughter. I've done things like that where I was in the midst of giving myself a pat on the back for doing this awesome thing only to be handed my head back to me unexpectedly, so yeah, it sucks. Chin up! :)
I could only see the daughters reaction being justified if you had charged her for the procedure.
In this particular case, I'm surprised the client was so upset. As the cat was a stray -- and you'd neutered cats for her before, it is a bit shocking how they reacted.
But there are other cases in which consent forms could be much more important, so perhaps it is good that you came to this realization in a relatively benign situation like this one.
And, FWIW, the consent forms will help you and your hospital in the future if issues arise and you are questioned. I am surprised they are not doing it. Failure to obtain consent has occastionally been mentioned in vet board decisions.
For years, I made lots of verbal "ifs" when in for a procedure to check this or that, and walked away with an "understanding". Absolutely, regular clients would view a "piece of paper" as insulting,or put off, if they have not been accustomed to it. But it isn't the same, as if you asked those same people, for money "up front". I would then be highly insulted about that, as a known & good client.
Truly, no good deed goes unpunished.
I'm reminded of this fact almost daily, as I try to do good deeds all the time, and still-surprisingly-frequently they come back to haunt me. When will I learn? ;-)
Long story short, the owner later declined the ultrasound. I will pay for it out of my paycheck (another point of honor). In all, a rather low price for a big lesson learned.