Editorial and Commentary
The rapid growth of veterinary specialty practices has created a number of vexatious ethical issues relevant to veterinary medicine. The preeminent question pertains to “the duty to refer.” Do primary care practitioners have such a moral duty? If so, when does this duty arise? Does it pertain in all cases where specialized knowledge is relevant to a disease?
This raises the fundamental question of “Veterinary Ethics” — namely, does the veterinarian ideally have primary obligation to the client/owner or the animal? (1) There are 2 possible ideal types that a veterinarian can aim for — the Garage Mechanic Model or the Pediatrician Model (1). On the Garage Mechanic Model, the practitioner has primary obligation to the animal owner, just as a car’s mechanic has primary obligation to the car’s owner. On the Pediatrician Model, the veterinarian is like the pediatrician, whose primary moral obligation is to the patient; at best, the owner or parent pays the bills.
Most veterinarians accept the Pediatrician Model, even though society does not as yet stand behind it, as it does with children. This is not surprising; Plato made a similar point over 2000 years ago. A shepherd he says, in his or her role as shepherd, has a primary duty to care for and better the sheep. Although they are paid for this, it is in their capacity as wage earner, which does not trump their primary obligation to the animal (2).
Rollin, B. (2006). The ethics of referral. The Canadian Veterinary Journal, 47(7), 717. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1482440/