The RCVS codes of conduct: What's in a word?

Abstract

In 2012, the RCVS introduced a new Code of Professional Conduct for Veterinary Surgeons, replacing the Guide to Professional Conduct which had existed until then. Is a common Code relevant for the veterinarian's many roles? There's more to think about here than just the change of name, write Steven McCulloch, Michael Reiss, Peter Jinman and Christopher Wathes.

Full text

January 18, 2014 | Veterinary Record | 71
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THE Code introduced in 2012 is an
important document with substantial moral
significance. Ethical codes are important
in all professions because they provide a
framework for right action, and because
they can also promote public confidence in
the profession as a body. The Code is more
concise than the previous Guide. The Code
is principles- and duties-based, whereas the
Guide was duties-based. Both the Code
and the Guide are therefore examples of
a deontological ethical framework. This
classification is important since different
types of ethical framework can prescribe
different courses of action. For instance,
a utilitarian framework prescribes the
maximisation of happiness (or welfare)
of all parties concerned. In contrast, a
deontological framework can prioritise the
interests of certain parties. The Code (RCVS
2012a) and the Guide (RCVS 2010) both
state that a veterinary surgeon should act so
as to prioritise animal welfare. For instance,
in the Code, the declaration made by
veterinary surgeons on being admitted to the
RCVS includes the statement: ‘... ABOVE
ALL, my constant endeavour will be to
ensure the health and welfare of animals
committed to my care.’ (RCVS 2012a, p4)
The Guide stated that veterinary
surgeons were ‘to make animal welfare
their overriding consideration at all times.’
Furthermore, the Guide’s ‘ten guiding
principles’ included first, animal welfare,
and second, respect for animals, before
listing duties to other parties (RVCS 2010,
p5). The Code states ‘Veterinary Surgeons
must make animal health and welfare their
first consideration when
attending to animals.’
(RCVS 2012a, p8).
In the Code, five
‘principles of practice’ replaced
the ‘ten guiding principles’
(which were in fact better
described as duties) of the Guide.
The five principles of practice are
professional competence; honesty
and integrity; independence and
impartiality; client confidentiality
and trust; and professional
accountability. The Code and
supporting guidance should be
considered in the context of these
principles (RCVS 2012a, p6).
The advantage of deontological
frameworks is that they provide direction
in terms of priority of duties to different
parties in situations where conflicts may
arise. This is particularly important for the
veterinary surgeon, who may have many
roles, for example, companion, farm or
laboratory animal veterinarian. In most
cases, for a companion animal veterinarian,
the optimal act for one party is the optimal
act for all. A treatment which makes the
pet feel better and extends its life is in
the interests of the pet, the client and the
veterinarian alike. However, a dairy cow will
be culled when she cannot produce a calf
within a timeframe decided by the farmer
and influenced by the herd health plan of
the veterinarian. The Code’s guidance to a
Named Veterinary Surgeon is particularly
problematic, since an experimental rabbit
may have been bred simply to be harmed
for others’ greater good. Such considerations
make one to wonder whether a common
Code can apply to the many roles of a
veterinarian.
The Code recognises potential
conflicts: ‘On occasions, the professional
responsibilities in the Code may conflict with
each other and veterinary surgeons may be
presented with a dilemma. In such situations,
veterinary surgeons should balance the
professional responsibilities, having regard
first to animal welfare.’ (RCVS 2012a, p5)
As set out in the Code, the responsibilities
of a veterinary surgeon are (in order as
written): animals; clients; the profession;
the veterinary team; the RCVS; and the
public (RCVS 2012a, p7). Whether these
responsibilities (and the ‘ten guiding
principles’ of the old Guide) are intended
to be in order of priority is uncertain. The
legal academic Mike Radford wrote ‘This
emphasis on welfare is reinforced in the
RCVS Guide to Professional Conduct, by
giving precedence, in what are described as
the profession’s “ten guiding principles”, to a
client’s entitlement to expect that a veterinary
surgeon will make animal welfare their first
consideration’ (Radford 2001). However,
it seems unlikely that the intention in the
Code is for hierarchical responsibilities. This
is particularly because the responsibility to
Viewpoint
The RCVS codes of conduct:
what’s in a word?
In 2012, the RCVS introduced a new Code of Professional Conduct for Veterinary Surgeons, replac-
ing the Guide to Professional Conduct which had existed until then. Is a common Code relevant
for the veterinarian’s many roles? There’s more to think about here than just the change of name,
write Steven McCulloch, Michael Reiss, Peter Jinman and Christopher Wathes
‘The Code makes animal welfare
the overriding duty of a veterinary
surgeon. Despite this laudable
objective, there is a tension with
what could be called “veterinary
reality”.’
Steven McCulloch, BVSc, BA, MRCVS, Royal
Veterinary College, University of London
Michael Reiss, MA, PhD, PGCE, MBA, FIBiol, FRSA,
Institute of Education, University of London
Peter Jinman, OBE, BVetMed, DipArb, FCIArb,
MRCVS
Christopher Wathes, OBE, BSc, PhD, FIAgrE
e-mail: smcculloch@rvc.ac.uk

72 | Veterinary Record | January 18, 2014
Viewpoint Viewpoint
was that the Guide had become ‘unwieldy
in places’ and that ‘the way regulators in
general publish professional conduct rules
has changed.’ (RCVS 2012b, p2). No doubt
the Guide needed review after a decade or
so in existence, but there is a real danger
of important information being lost in
producing such a concise document.
The RCVS also introduced a Code
of Professional Conduct for Veterinary
Nurses (RCVS 2012c). This is substantially
the same as the Code of Professional
Conduct for Veterinary Surgeons, save for
the substitution of ‘veterinary nurse’ for
‘veterinary surgeon’.
Examination of the General Medical
Council’s Good Medical Practice (2013)
is instructive here. First, although it has
also been shortened recently, it still has
substantially more content than the RCVS
Code. Secondly, it uses both the words
‘must’ and ‘should’ in its main text. Thirdly,
the GMC Good Medical Practice (2013)
and The Code: Standards of Conduct,
Performance and ethics for nurses and
midwives (Nursing and Midwifery Council
2010) are substantially different, as might be
expected for distinct, but related, professions.
References
GENERAL MEDICAL COUNCIL (2013) Good Medical
Practice. www.gmc-uk.org/static/documents/content/
GMP_2013.pdf_51447599.pdf Accessed January 14,
2014
NURSING AND MIDWIFERY COUNCIL (2010)
The Code: Standards of Conduct, Performance and
ethics for nurses and midwives. www.nmc-uk.org/
Documents/Standards/nmcTheCodeStandardsofCon-
ductPerformanceAndEthicsForNursesAndMidwives_
LargePrintVersion.PDF Accessed January 14, 2014
RADFORD, M. (2001) Animal Welfare Law in Britain:
Regulation and Responsibility. OUP Oxford
RCVS (2010) Guide to Professional Conduct for
Veterinary Surgeons. RCVS
RCVS (2012a) Code of Professional Conduct for
Veterinary Surgeons. www.rcvs.org.uk/advice-and-
guidance/code-of-professional-conduct-for-veterinary-
surgeons/ Accessed January 14, 2014
RCVS (2012b) RCVS News: A Special Report from the
Royal College of Veterinary Surgeons – Introducing our
new Codes of Professional Conduct. RCVS
RCVS (2012c) Code of Professional Conduct for Veterinary
Nurses. www.rcvs.org.uk/advice-and-guidance/code-
of-professional-conduct-for-veterinary-nurses/ Accessed
January 14, 2014
doi: 10.1136/vr.f7520
When sent to veterinary surgeons, the
new Code was accompanied by a special
edition of RCVS News highlighting the
main differences between the Guide and
Code (RCVS 2012b). One of these was
replacing the word ‘should’ with ‘must’.
The RCVS claimed that this ‘key change
in language’ achieved ‘clearer obligations’
(RCVS 2012b, p4). However, the difficulty
with this approach is that the purpose
of the Code is to provide direction with
flexibility, given a messy world. An
improvement of the Code over the Guide
is its recognition of the conflict of duties
that veterinarians often face. However, the
choice of language is unfortunate: the word
‘must’ is imperatival, whereas the word
‘should’ is normative. ‘Should’ is therefore
more appropriate to describe the context
of the professional veterinary surgeon
weighing duties to arrive at considered
moral judgements (for example, a clinical
decision). The distinction may seem
semantic, but in a profession with high
levels of stress and high rates of suicide,
we ought to avoid unnecessary dilemmas.
When on the horns of a dilemma, the
veterinary surgeon is gored by one horn
no matter which option they follow. True
dilemmas are insoluble and the agent
cannot make a morally right decision. Such
dilemmatic and imperatival language in the
Code can tie veterinary surgeons’ hands
and lead them into a dark place where they
can do no right.
The current Code of Professional
Conduct is much shorter than the old
Guide. Granted, there is much supporting
guidance on the RCVS website, but the
core ethical material, about the nature and
duties of a professional veterinary surgeon,
is contained in a few pages of a laminated
A5 booklet. The motivation behind this
the public comes in at sixth and final place.
A professional code of ethics for veterinary
surgeons must be compatible with public
morality at large. And public morality
generally places human interests above those
of non-humans. Furthermore, some would
argue that the most fundamental role of the
veterinary profession is to safeguard public
health, for example, by preventing zoonoses
in the agricultural sector.
Indeed, this raises the issue of the clear
priority of animal welfare in both the new
Code and the old Guide. The Code makes
animal welfare the overriding duty of a
veterinary surgeon. Despite this laudable
objective, there is a tension with what
could be called ‘veterinary reality’. We live
in a world where human interests almost
always trump those of other sentient beings.
Consider the early days of the BSE crisis.
Cows were showing unusual progressive
neurological symptoms. In the later stages
of disease, cows clearly suffered as a result
of this new disease. According to the Code,
in similar situations (ie, novel diseases of
food animals), animal welfare must be
the overriding consideration. In suffering
animals without any known cure, this would
necessitate euthanasia to safeguard their
welfare. In practice, this would be unlikely
because some animals would be kept alive to
learn more about the disease. One could argue
that in this scenario, treatment would come
under the Animals (Scientific Procedures)
Act 1986 (ASPA). This might be true, but the
welfare of the animals would still be relegated
below that of public health, and the decision
to move to a research framework under
ASPA would have to be made by a veterinary
surgeon under the framework of the Code.
This is but one scenario where it becomes
apparent that animal welfare often doesn’t
trump the interests of other parties.
Perhaps then the words of the Code are
intended to instil a spirit of idealism, a world
to aim for rather than live in. But this could
be a dangerous ploy. Whatever their role,
practising veterinarians require direction
in the real world, which can manifest a
multiplicity of competing but mutually
exclusive demands.
‘Whatever their role, practising
veterinarians require direction in
the real world, which can manifest
a multiplicity of competing but
mutually exclusive demands.’
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