Lecture #5

CVM 714 Professional Ethics

Date and Presenter

  • Date: 6 January 2026

  • Presented by: Donald L. Noah, DVM, MPH, DACVPM

  • Quote: "The one who does the work does the learning."

Learning Objectives

  1. Identify Ethical Sources

    • Sources of ethical guidance for veterinarians, as discussed in class.

  2. Organizational Source

    • For each source of ethical guidance, identify its organizational source.

  3. State Veterinary Practice Act

    • Understand general guidelines in a state’s veterinary practice act and recognize the importance of applying its principles in practice.

  4. Veterinary-Client-Patient Relationship (VCPR)

    • Understand the significance of the VCPR, requirements for its establishment, and conditions under which it may be appropriately severed.

  5. Standard of Care

    • Define "standard of care" and identify who establishes that standard in veterinary medicine.

  6. Definitions

    • Recognize definitions of key terms: direct supervision, indirect supervision, medical incompetence, gross incompetence, negligence, gross negligence, and malpractice.

The Veterinary Profession

  • Veterinarians are members of a scholarly profession.

  • They practice medicine in various situations and circumstances.

  • Exemplary professional conduct upholds the dignity of the veterinary profession.

  • There exists a longstanding trust that reflects the high value placed by the general public on veterinarians.

Public Ethics Ratings of Professions

Honesty and Ethical Standards (as per Gallup Poll)

  • Date of Survey: 22 January 2024

  • Ratings for honesty and ethical standards across professions (2019, 2020, 2023)

    • Nurses: 85%, 79%, 78%

    • Veterinarians: 65%

    • Engineers: 66%, 60%

    • Dentists: 61%, 59%

    • Medical Doctors: 65%, 62%, 56%

    • Pharmacists: 64%, 58%, 55%

    • Police Officers: 54%, 50%, 45%

    • College Teachers: 49%, 42%

    • Psychiatrists: 43%, 36%

    • Clergy: 40%, 34%, 32%

    • Lawyers: 22%, 21%, 16%

    • Professions modification over years and references to when veterinarians were last included in 2006, where 71% rated them highly.

Honesty and Ethics by Educational Attainment

  • Survey showed discrepancies based on educational achievement

    • Graduated College vs. Did Not Graduate College

    • Scores for Veterinarians: 72% (graduated), 62% (not graduated).

Partisan Ratings for Honesty and Ethics

  • Differing ratings between Democratic and Republican leanings for various professions, including Veterinarians:

    • Democratic: 70% very high/high

    • Republican: 63% very high/high

    • Difference: 7 percentage points.

A Veterinarian’s Duty

  • Responsibilities:

    • Welfare of the patient

    • Needs of the client

    • Safety of the public

    • Uphold profession’s public vested trust

    • Avoid conflicts of interests or appearance.

Behavioral Ethics Considerations

  • Questions to Reflect On:

    • Am I doing the right thing?

    • Am I doing it in the right way?

    • Am I doing it for the right reason?

    • Am I utilizing the knowledge and skills I learned?

Sources of Ethical Guidance

  • Primary Sources:

    • The ‘Golden Rule’

    • The Veterinarian’s Oath

    • Principles of Veterinary Medical Ethics (PVME)

    • State Practice Act (General and Specific Levels)

    • Considerations regarding the role of Social Media in ethical guidance.

The Veterinarian's Oath

  • Oath Text:

    • "Being admitted to the profession of veterinary medicine, I solemnly swear to use my scientific knowledge and skills for the benefit of society through the protection of animal health, the relief of animal suffering, the 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 improvement of my professional knowledge and competence."

Principles of Veterinary Medical Ethics (PVME)

  • Key Sections:

    1. Provide competent medical care.

    2. Ensure patient welfare is balanced with client needs and public safety.

    3. Uphold standards of professionalism.

  • Core Principles:

    • Stewardship

    • Respect

    • Integrity.

Practice of Veterinary Medicine

  • Each state's veterinary practice act defines the practice of veterinary medicine; notably, these are state rather than federal regulations.

Requirements Outlined by the Practice Act

  • Activities that fall under this act include the ability to:

    • Diagnose or perform surgery.

    • Prescribe or administer drugs.

    • Perform various operations or treatments.

    • Provide instructions for animal care.

Arizona Veterinary Medical Licensing Board (AzVMLB)

  • Primary Duty:

    • Protect the public from unlawful, incompetent, unqualified, impaired, or unprofessional practitioners.

    • The board is not primarily responsible for protecting individual practitioners, at least not directly.

State Board Overview for Arizona

  • Composition:

    • Comprised of 9 members serving 4-year terms:

    • 5 DVMs

    • 2 non-DVMs from the public

    • 1 livestock representative (non-DVM)

    • 1 Certified Veterinary Technician.

  • Regulatory Role:

    • Regulates veterinarians, certified veterinary technicians, veterinary premises, and animal crematories.

Licensing and Disciplinary Actions

  • License Discipline Initiation:

    • Begins with a complaint regarding a veterinarian's conduct leading to an investigation.

  • Public License Directory:

    • Includes license number, status, dates of issue & expiration, and disciplinary actions taken.

Exceptions from Licensing Requirements

  • Not typically required for:

    • US military veterinarians on USG installations

    • USDA disease eradication officials

    • Consultants licensed in other states

    • Veterinary students under supervision

    • Veterinary assistants under direct supervision.

Emergency Aid Immunity

  • Licensed individuals providing emergency treatment in good faith will not be liable for damages in absence of gross negligence.

  • Considered analogous to the Good Samaritan Act for animals.

Definitions of Supervision

  • Direct Supervision:

    • Veterinarian physically present at the location of care.

  • Indirect Supervision:

    • Veterinarian not physically present but has provided written or oral instructions for client care.

Competence and Incompetence Definitions

  • Medical Incompetence:

    • Lacking the necessary medical knowledge or skills likely endangering patient health.

  • Gross Incompetence:

    • Professional misconduct or degree of skill lacking in professional standards.

  • Negligence:

    • Failure to exercise reasonable care in veterinary practice.

  • Gross Negligence:

    • Carelessness leading to injury or unnecessary suffering; disregard for established practices.

  • Malpractice:

    • Treatment contrary to accepted practices resulting in adverse effects.

Penalties from Veterinary Medical Boards

  • Possible disciplinary actions include:

    • Continuing education requirements

    • Probation

    • Suspension of license

    • Financial fines

    • Mental health evaluations

    • Enrollment in drug/alcohol programs

    • Random facility inspections.

Standard of Care in Veterinary Malpractice

  • Defined as the level of care a veterinarian with ordinary skill, care, and diligence would provide under similar circumstances.

  • Established by a veterinarian’s peers within the profession.

Communication and Complaint Prevention

  • Key actions to prevent complaints include clear client communication, confidence in abilities, and accurate medical records.

  • Avoid assumptions and angry outbursts, and ensure optimal clinical outcomes.

The Veterinary-Client-Patient Relationship (VCPR)

  • Definitions:

    • Responsibility of the veterinarian to make medical judgments regarding the animal's health.

    • Sufficient knowledge of the animal is needed for diagnosis, obtained through recent examinations and visits.

    • Availability for follow-up or arrangements for care by another veterinarian.

Severing a VCPR

  • Can occur for reasons including client threats/abuse, chronic non-payment, or lack of contact for over 12 months.

  • Should be performed in writing if done by the veterinarian.

Conditions Not Justifying Severance

  • Base on non-discrimination (race, gender, etc.) or during a treatment that would violate care standards.

Final Thoughts

  1. Veterinary entities’ roles:

    • AVMA, State Veterinary Associations, and the State Veterinary Board.

  2. Disciplinary Actions:

    • Board rarely suspends/revokes licenses; additional continuing education is the most common action.

  3. Encouragement for New Graduates:

    • Veterinarians are expected to innovate and expand skills, considering ethical frameworks and regulations as part of growth.

Conclusion

  • Knowledge of the ethical, legal, and practical aspects of veterinary medicine is essential for compliance and professional conduct, impacting not only individual practices but also the reputation of the veterinary profession as a whole.


Date and Presenter

  • Date: 6 January 2026

  • Presented by: Donald L. Noah, DVM, MPH, DACVPM

  • Quote: "The one who does the work does the learning."

Learning Objectives

  1. Identify Ethical Sources - Sources of ethical guidance for veterinarians, as discussed in class.

  2. Organizational Source - For each source of ethical guidance, identify its organizational source.

  3. State Veterinary Practice Act - Understand general guidelines in a state’s veterinary practice act and recognize the importance of applying its principles in practice.

  4. Veterinary-Client-Patient Relationship (VCPR) - Understand the significance of the VCPR, requirements for its establishment, and conditions under which it may be appropriately severed.

  5. Standard of Care - Define "standard of care" and identify who establishes that standard in veterinary medicine.

  6. Definitions - Recognize definitions of key terms: direct supervision, indirect supervision, medical incompetence, gross incompetence, negligence, gross negligence, and malpractice.

The Veterinary Profession

  • Veterinarians are members of a scholarly profession.

  • Society is the main determinant for the need for veterinarians.

  • Public Perspective:

    • Public view is what determines the level of trust and success that a veterinarian receives.

    • Exemplary professional conduct upholds the dignity of the veterinary profession.

    • There exists a longstanding trust that reflects the high value placed by the general public on veterinarians.

Public Ethics Ratings of Professions
Honesty and Ethical Standards (as per Gallup Poll)

  • Date of Survey: 22 January 2024

  • Ratings for honesty and ethical standards across professions (20192019, 20202020, 20232023):

    • Nurses: 85%85\%, 79%79\%, 78%78\%

    • Veterinarians: 65%65\%

    • Engineers: 66%66\%, 60%60\%

    • Dentists: 61%61\%, 59%59\%

    • Medical Doctors: 65%65\%, 62%62\%, 56%56\%

    • Pharmacists: 64%64\%, 58%58\%, 55%55\%

    • Police Officers: 54%54\%, 50%50\%, 45%45\%

    • College Teachers: 49%49\%, 42%42\%

    • Psychiatrists: 43%43\%, 36%36\%

    • Clergy: 40%40\%, 34%34\%, 32%32\%

    • Lawyers: 22%22\%, 21%21\%, 16%16\%

  • Professions modification over years and references to when veterinarians were last included in 20062006, where 71%71\% rated them highly.

Honesty and Ethics by Educational Attainment

  • Survey showed discrepancies based on educational achievement - Graduated College vs. Did Not Graduate College

    • Scores for Veterinarians: 72%72\% (graduated), 62%62\% (not graduated).

Partisan Ratings for Honesty and Ethics

  • Political factors also affect veterinarians and their public perception.

  • Differing ratings between Democratic and Republican leanings for various professions, including Veterinarians:

    • Democratic: 70%70\% very high/high

    • Republican: 63%63\% very high/high

    • Difference: 77 percentage points.

A Veterinarian’s Duty

  • Responsibilities (in order of priority):

    1. Welfare of the patient - This is the top priority.

    2. Needs of the client - A close second priority.

    3. Safety of the public

    4. Uphold profession’s public vested trust

    5. Avoid conflicts of interests or appearance.

Behavioral Ethics Considerations

  • Questions to Reflect On:

    • Am I doing the right thing?

    • Am I doing it in the right way?

    • Am I doing it for the right reason?

    • Am I utilizing the knowledge and skills I learned?

Sources of Ethical Guidance

  • Primary Sources:

    • The ‘Golden Rule’

    • The Veterinarian’s Oath

    • Principles of Veterinary Medical Ethics (PVME)

    • State Practice Act (General and Specific Levels)

    • Considerations regarding the role of Social Media in ethical guidance.

The Veterinarian's Oath

  • Oath Text: "Being admitted to the profession of veterinary medicine, I solemnly swear to use my scientific knowledge and skills for the benefit of society through the protection of animal health, the relief of animal suffering, the 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 improvement of my professional knowledge and competence."

Principles of Veterinary Medical Ethics (PVME)

  • Key Sections:

    1. Provide competent medical care.

    2. Ensure patient welfare is balanced with client needs and public safety.

    3. Uphold standards of professionalism.

  • Core Principles:

    • Stewardship

    • Integrity

    • Respect

Practice of Veterinary Medicine

  • Each state's veterinary practice act defines the practice of veterinary medicine.

  • Regulatory Authority:

    • These are strictly state regulations.

    • The federal government has no power over veterinary licensing.

Requirements Outlined by the Practice Act

  • Activities that fall under this act include the ability to:

    • Diagnose or perform surgery.

    • Prescribe or administer drugs.

    • Perform various operations or treatments.

    • Provide instructions for animal care.

Arizona Veterinary Medical Licensing Board (AzVMLB)

  • Primary Duty:

    • To protect the public from unlawful, incompetent, unqualified, impaired, or unprofessional practitioners.

    • The board is not primarily responsible for protecting individual practitioners, at least not directly.

  • State Board Scope:

    • Regulates veterinarians, certified veterinary technicians, veterinary premises, and animal crematories.

Licensing and Disciplinary Actions

  • License Discipline Initiation:

    • Begins with a complaint regarding a veterinarian's conduct leading to an investigation.

    • Sources of Complaints: Peers (other veterinarians) and clients view are incredibly important; other veterinarians can and do file complaints on others.

  • Mandatory Euthanasia Protocols:

    • Licensed practitioners can face licensing trouble if they attempt to treat an animal with rabies. Protocol states that the animal must be euthanized ASAP.

  • Public License Directory:

    • Includes license number, status, dates of issue & expiration, and disciplinary actions taken.

Exceptions from Licensing Requirements

  • Not typically required for:

    • US military veterinarians on USG installations

    • USDA disease eradication officials

    • Consultants licensed in other states

    • Veterinary students under supervision

    • Veterinary assistants under direct supervision.

Emergency Aid Immunity

  • Licensed individuals providing emergency treatment in good faith will not be liable for damages in absence of gross negligence.

  • Considered analogous to the Good Samaritan Act for animals.

Definitions of Supervision

  • Direct Supervision:

    • Veterinarian is physically present at the location/premises where health care is being performed.

  • Indirect Supervision:

    • Veterinarian is not physically present but has provided written or oral instructions for care.

Competence and Incompetence Definitions

  • Medical Incompetence: Lacking the necessary medical knowledge or skills likely endangering patient health.

  • Gross Incompetence: Professional misconduct or degree of skill lacking in professional standards.

  • Negligence: Failure to exercise reasonable care in veterinary practice.

  • Gross Negligence: Carelessness leading to injury or unnecessary suffering; disregard for established practices.

  • Malpractice: Treatment contrary to accepted practices resulting in adverse effects.

Penalties from Veterinary Medical Boards

  • Possible disciplinary actions include:

    • Continuing education requirements

    • Probation

    • Suspension of license

    • Financial fines

    • Mental health evaluations

    • Enrollment in drug/alcohol programs

    • Random facility inspections.

Standard of Care in Veterinary Malpractice

  • Defined as the level of care a veterinarian with ordinary skill, care, and diligence would provide under similar circumstances.

  • Established by a veterinarian’s peers within the profession.

Communication and Complaint Prevention

  • Key actions to prevent complaints include clear client communication, confidence in abilities, and accurate medical records.

  • Avoid assumptions and angry outbursts, and ensure optimal clinical outcomes.

The Veterinary-Client-Patient Relationship (VCPR)

  • Definitions:

    • Responsibility of the veterinarian to make medical judgments regarding the animal's health.

    • Sufficient knowledge of the animal is needed for diagnosis, obtained through recent examinations and visits.

    • Availability for follow-up or arrangements for care by another veterinarian.

Severing a VCPR

  • Can occur for reasons including client threats/abuse, chronic non-payment, or lack of contact for over 1212 months.

  • Should be performed in writing if done by the veterinarian.

Conditions Not Justifying Severance

  • Base on non-discrimination (race, gender, etc.) or during a treatment that would violate care standards.

Final Thoughts

  1. Veterinary entities’ roles: AVMA, State Veterinary Associations, and the State Veterinary Board.

  2. Disciplinary Actions: Board rarely suspends/revokes licenses; additional continuing education is the most common action.

  3. Encouragement for New Graduates: Veterinarians are expected to innovate and expand skills, considering ethical frameworks and regulations as part of growth.

Conclusion

  • Knowledge of the ethical, legal, and practical aspects of veterinary medicine is essential for compliance and professional conduct, impacting not only individual practices but also the reputation of the veterinary profession as a whole.