Professional and legal issues: surgical misadventure

The status of the veterinary nurse is developing from that of a vocation towards that of a profession. One step towards this in the UK is the non-statutory register for veterinary nurses and the associated disciplinary committee. Accountability is a key area in this change (Hamlin, 2011) and veterinary nurses now need to be equipped with the necessary skills and knowledge to know what their professional responsibilities are. This article discusses a fictitious scenario which poses a number of professional legal and ethical issues that affect registered veterinary nurses (RVNs).

In the scenario (Box 1) there are several issues to consider. The primary concern is the validity of the action of euthanasia by the RVN, as authorised by the veterinarian, due to someone other than the owner giving consent over the telephone.

Box 1.A 1-year-old West Highland white terrier, presented without previous warning at 2100 hours following a road traffic collision (RTC) that had taken place approximately 4 hours earlier. He was brought in by the registered owner's daughter, as the elderly owner was too infirm and upset to come herself. The daughter explained she had six children at home to feed, bath and put to bed before seeking veterinary attention, hence the delay.The dog presented shocked, collapsed, hypothermic, with severe abdominal bruising and a fractured femur.Following a consultation (treatment or euthanasia were discussed, the patient was not insured and the owner was a pensioner with little money) the owners’ daughter signed the hospitalisation consent form to investigate. Conscious radiographs were taken and these confirmed a femoral fracture, with no evidence of bladder injury visible. The plan was treatment for shock and analgesia, with reassessment the next day.The owner's daughter telephoned 3 hours later and spoke to a RVN, now alone in the practice, stating that the matter had been discussed with her mother, the registered owner of the patient, and that euthanasia had been decided. The RVN telephoned the veterinarian and, using the authority of the consent provided over the telephone, the veterinarian agreed and the RVN euthanised the patient.The RVN took a call from the owner's other daughter who lived in America at 0600 hours, who stated that she would cover all costs incurred on behalf of her mother's dog. The situation was explained, resulting in verbal abuse to the RVN and accusing the practise of acting hastily.