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Client Relationships

 
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1. Veterinarians must interact with clients in a way that promotes effective communication and trust. This includes:
   1. Listening to clients, respecting their views, responding to their concerns and preferences and treating them with courtesy;
   2. Treating all client information and information related to the provision of veterinary services as the private information of the client except in circumstances where:
      1. The client's consent has been given, or;
      2. Disclosure of the information is made in accordance with the principles set out under the Privacy Act 1993, or;
      3. There is a requirement for disclosure of information made under the Veterinarians Act 2005.
   3. Not exploiting a client's lack of veterinary knowledge.
    
   [Show Explanatory Notes - Section 1]
   
    
   

   Understanding Section 1
    
   

   1. Trust
      1. Mutual trust is the cornerstone of the client-veterinarian relationship. Veterinarians trust that clients will be genuinely seeking veterinary care; that they will give a more or less accurate account of their animal's problems, and that they will be compliant with treatment recommendations. Clients trust that veterinarians are competent and honest. That trust leads to confidence that the veterinarian will be able to assist the client to choose the most appropriate veterinary care for their animals in the particular circumstances.
          
         
      2. In the client-veterinarian relationship the balance of power tends to favour the veterinarian. Veterinarians' knowledge and training allows them to potentially exercise influence over a client's animal healthcare decisions. Because of this, veterinarians have a greater responsibility to be trustworthy. Veterinarians must not abuse this position and exploit a client's relative lack of knowledge by encouraging them to undertake veterinary treatment or make healthcare decisions that are not in the client's or the animal's best interests.
         
       
      
   2. Communication
      1. For trust to exist open and honest communication between the parties is required. Veterinarians are expected to be able to communicate effectively with clients. They need to be able to elicit from clients what their veterinary needs and expectations are. Being able to listen to a client and identify their concerns are important skills. Being able to articulate treatment choices and options is essential.
          
         
      2. Most of VCNZ's expectations around the quality of veterinarians' communications with clients are set out in its Policy Document Competency Standards and Performance Indicators for Veterinarians. This section of the Code focuses on the ethical aspects of communication including consent issues and the confidentiality of information.
       
      
   3. Confidentiality
      1. There are longstanding ethical expectations that veterinarians will respect the privacy of their client's information collected and stored during the provision of veterinary services. Clients have the right to decide who should have access to this information and they trust that veterinarians will keep information pertaining to them, their animals, and their businesses confidential. Unless confidentiality is encouraged and maintained, clients may be less likely to provide important or relevant information in relation to their animals. This could lead to poorer healthcare outcomes for the animals concerned. Inappropriate disclosure by a veterinarian or their staff of a client's records may lead to adverse consequences affecting that individual's personal or business affairs.
          
         
      2. As well as the ethical obligations identified in this Code, there are statutory requirements under the Privacy Act 1993 (www.privacy.org.nz/a-thumbnail-sketch-of-the-privacy-principles) which govern how a person's personal information must be managed. Privacy principles 8 - 11 place restrictions on how organisations can use or disclose personal information.
          
         
      3. Situations may arise where a veterinarian is asked to disclose information about a client, or their animals in the context of an investigation (eg alleged breaches of the Animal Welfare Act 1999) by a recognised and authorised investigator. Privacy principle 11 provides the appropriate guidance on whether it is acceptable to comply with requests associated with such an investigation. Further advice can be sought from the Privacy Commissioner’s office if needed.
          
         
      4. Sections 41 and 42 of the Veterinarians Act 2005 identify situations where veterinarians may be asked to provide information as part of a Complaints Assessment Committee investigation. Veterinarians (and any other person) must comply unless the requested information would be considered privileged in a court of law, or the provision of the information would create a breach of an obligation of secrecy imposed by an enactment other than the Official Information Act 1982 or the Privacy Act 1993.
         
       
      

    
   
    
   

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2. Veterinarians must obtain appropriate consent before proceeding with a proposed treatment/course of action. Veterinarians must provide clients with the information that they need, in a way that enables the client to understand and give consent to the proposed treatment/course of action. Veterinarians must be satisfied that clients are authorised to provide that consent. Depending on the circumstances the information provided to clients may include:
   1. The condition of their animal(s);
   2. Treatment options, including likely outcomes, risks, side effects, complications, costs and benefits;
   3. Referral options where appropriate and how to access;
   4. The veterinarian's skills and experience in providing the proposed treatment (where appropriate);
   5. Post treatment requirements and costs.
   Note that the consent requirements may not apply in an animal welfare emergency where the client or owner is unable to be contacted and there is an immediate threat to the life of the animal, or there is an immediate need to relieve unreasonable or unnecessary pain (refer to Animal Welfare requirements of this code).
   
    
   [Show Explanatory Notes - Section 2]
   
    
   

   Understanding Section 2
    
   

   1. The authority to consent to, or decline, a veterinary procedure on one's own animals is a right entitled through ownership. Harm to an owned animal arising from un-consented veterinary treatment can constitute an ethical and potentially a legal breach of the owner's rights. Veterinarians must not undertake any procedures on animals that have the potential to harm the animal or that will incur an economic cost to the owner, without the owner's consent.
       
      
   2. Because of their training and the trust bestowed on them by their clients veterinarians can influence a client's veterinary healthcare decisions. As such veterinarians have an attendant ethical obligation to provide clients with sufficient information so they can validly consent to treatment. Sufficient information is any information that a reasonable person in the client's position would use to be able to make a considered decision on whether to accept or reject a recommended medical procedure. The specific types of information required are identified in section 2 of this part of the Code.
       
      
   3. There is no obligation to disclose minor risks in common procedures when such procedures seldom result in serious ill effects or where the procedure is simple and the danger is remote and commonly understood, by the lay public, to be remote. However, when a procedure inherently involves a known risk of death or serious harm to the animal (e.g. anaesthesia or surgery), veterinarians must explain in lay terms any significant potential complications that might occur. The veterinarian is expected to ensure that this information is able to be understood by the client.
       
      
   4. Detailed technical explanations are not normally necessary. Some clients will be overwhelmed by technical jargon they are not able to understand or to use in reaching an animal health care decision. In providing the necessary information, the veterinarian should consider the nature of the information that they are providing and whether it enables the client to understand the proposed course of action. For example, a first-time owner may require more information from the veterinarian in order to make a valid decision than an experienced breeder with much greater animal experience. While the veterinarian is not expected to do a complete background check on clients, they are expected to tailor the presentation of information to the client's particular needs. Communication of information may be enhanced if the veterinarian supports their verbal explanations with written pamphlets (Samples of client information leaflets can be purchased from NZVA).
       
      
   5. Veterinarians are expected to exercise sound professional judgement in determining who is able to consent to treatment. The client may be the owner of the animal, someone acting with the authority of the owner, or someone with statutory or other appropriate authority. Veterinarians and practice staff should ensure they are satisfied that the person providing consent has both the authority and capacity to provide consent. For example, if the person providing consent is not the owner and has not confirmed his/her authority of the owner to act, then only in exceptional circumstances should any procedure be carried out.
       
      
   6. Where an owner is less than 18 years of age or has limited capacity to provide consent, veterinarians should consider whether someone else can provide the appropriate consent. It is particularly important to document the process if there is any question about the person not being the owner or being an authorised representative.
       
      
   7. In an emergency, obtaining informed consent may not be possible. Veterinarians are expected to exercise sound professional judgement in deciding how to treat an owned animal where the owner cannot be contacted. Veterinarians should consider whether there is an alternative contact person who could assume responsibility for the decision. The welfare of the animal is paramount and un-consented treatment decisions should be made in the best interests of the animal taking into account the seriousness of the situation and what is known about the client's likely acceptance of the treatment decision.
       
      
   8. In discussing alternative treatment options the veterinarian should not tailor the discussion because of their evaluation of the client's financial status. A veterinarian who fails to inform a client of a reasonable medical alternative (e.g. referral) because they think the client can't afford it will be considered to be in breach of the Code.
       
      
   9. Following disclosure of the required information, the client's consent must be obtained. Consent can be expressed orally or in writing. Obtaining consent is a process that should be documented and preferably validated with the client's signature. Sample forms are available from NZVA. Consent forms should be stored and kept as a part of the medical record. Obtaining consent may be delegated to staff, especially when consent relates to relatively straight forward procedures such as routine desexing of companion animals.
       
      
   10. Inadequately or incorrectly completed consent forms are unlikely to demonstrate that the consent process has taken place to an appropriate standard. Documentation of the process should ideally include a summary of the discussion that has taken place.
        
       
   11. Provision should be made when obtaining consent for uncertain or unexpected outcomes to the proposed treatment. Clients should be asked to provide contact telephone numbers to ensure discussions can take place at short notice. Provision for the veterinarian to act without the client's consent if necessary in the interests of the animal should be considered.
        
       
   12. Consideration should be given to obtaining the owner's signature to record any decision they make to decline to consent to a recommended procedure.
        
       

    
   
    
   

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3. Veterinarians must respect clients' rights to:
   1. Use the services of more than one veterinarian;
   2. Seek a second opinion or referral;
   3. Choose an alternate course of action to the one recommended by the veterinarian provided this does not conflict with the animal's welfare.
    
   [Show Explanatory Notes - Section 3]
   
    
   

   Understanding Section 3
    
   

   1. Clients are entitled to use the services of more than one veterinarian. Over and above the situations where a client is seeking a second opinion or referral, clients may choose to use additional veterinarians who are able to provide particular skills in order to meet specific needs e.g. reproductive services, nutrition, herd health consultancy etc. When it is known that a number of veterinarians are involved with the same client, there is a strong need for those veterinarians to communicate and co-ordinate their services.
       
      
   2. Clients are entitled to request a second opinion or a referral.
       
      
   3. A second opinion is the process of seeking an evaluation by another veterinarian to confirm the diagnosis and treatment plan, or potentially to offer an alternative diagnosis and/or treatment approach.
       
      
   4. A referral is the handing over of the case to another veterinarian (either a registered specialist, or a veterinarian recognised as having particular skills) in order that they will apply their expertise to manage the case.
       
      
   5. Veterinarians are expected to:
      1. Comply with client requests for a second opinion or referral
      2. Facilitate the request in a timely manner by helping to identify veterinarians who could act in this capacity; providing case histories and records as appropriate; and communicating with the alternative provider as needed.
       
      
   6. Veterinarians must give due consideration when a client wishes to choose a course of action for their animal which may not be the course recommended by the veterinarian. The veterinarian must be satisfied that such a decision complies with sections 10, 11 and 12 of the Animal Welfare Act 1999.
       
      
   7. For further information on second opinions and referrals refer to the Professional Relationships section of the Code and explanatory notes.
       
      

    
   
    
   

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4. Veterinarians are not obliged to accept new clients, continue to provide services to existing clients, or provide a requested treatment, providing animal welfare and professional standards are met.
   
    
   [Show Explanatory Notes - Section 4]
   
    
   

   Understanding Section 4
    
   

   1. Veterinarians are not obliged to provide veterinary services requested by clients as long as animal welfare is not compromised. Whether a veterinarian should provide a particular requested veterinary treatment (surgical or medical), or undertake any requested diagnostic investigation depends on their professional judgement, taking into account all of the relevant circumstances at the time.
       
      
   2. Veterinarians can end their relationship with a client as long as this decision doesn't conflict with any current responsibility that may exist associated with previous consultations. Veterinarians are advised to notify the client in writing of this decision.
       
      
   3. Veterinarians must comply with all of the requirements in this Code irrespective of whether they are charging fees for the services provided, i.e. if veterinary services are provided pro bono, this does not waive the veterinarian's obligations.
       
      

    
   
    
   
Printable page
Glossary
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Adverse event:
An adverse event is considered to have occurred if any one (or more) of the following takes place after the administration of a veterinary medicine:
1. an unexpected reaction;
2. unreasonable pain or distress;
3. lack of efficacy;
4. the production of residues in primary products when the product has been used as recommended.
An adverse event is considered to have occurred if any one (or more) of the following takes
place after the administration of a veterinary medicine:
1. an unexpected reaction;
2. unreasonable pain or distress;
3. lack of efficacy;
4. the production of residues in primary products when the product
   has been used as recommended.
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Advertise: To publicise to the community or to any section of the community using any words, whether written, printed, spoken, or in any electronic form, or of any pictorial representation or design or device used to promote the sale of any agricultural compound; and 'to advertise' has a corresponding meaning (ref: section 2 ACVM Act). Advertising does not include general information transfer about animal health, animal welfare, or food safety status or management.

To publicise to the community or to any section of the community using any words,
whether written, printed, spoken, or in any electronic form, or of any pictorial
representation or design or device used to promote the sale of any agricultural
compound; and 'to advertise' has a corresponding meaning (ref: section 2 ACVM Act).
Advertising does not include general information transfer about animal health,
animal welfare, or food safety status or management.
 

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Attending a veterinary emergency means to physically assess the animal(s) and as a minimum provide relief from unreasonable or unnecessary pain or distress.

Attending a veterinary emergency means to physically assess the animal(s)
and as a minimum provide relief from unreasonable or unnecessary pain or distress.
 

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Authorising, dispensing, recommending, selling and using veterinary medicines:

• Authorising: A veterinarian creating a documented approval allowing a client to purchase a particular restricted veterinary medicine to administer to a particular animal(s) in accordance with the instructions of the veterinarian.
  
  A veterinarian creating a documented approval allowing a client to purchase
  a particular restricted veterinary medicine to administer to a particular
  animal(s) in accordance with the instructions of the veterinarian.
   
  

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• Dispensing: Supplying veterinary medicines strictly in accordance with a written veterinary authorisation. Products must be dispensed in their registered packaging unless otherwise specified in the authorisation.
  
  Supplying veterinary medicines strictly in accordance with a written
  veterinary authorisation. Products must be dispensed in their
  registered packaging unless otherwise specified in the authorisation.
   
  

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• Recommending: Advising a client to use a particular veterinary medicine.
  
  Advising a client to use a particular veterinary medicine.
   
  

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• Selling: Offering for sale a veterinary medicine, including gifting or offering samples.
  
  Offering for sale a veterinary medicine, including gifting or offering samples.
   
  

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• Using: A veterinarian administering a veterinary medicine to an animal(s) in their care. This includes staff administering in accordance with the veterinarians instructions.
  
  A veterinarian administering a veterinary medicine to an animal(s)
  in their care. This includes staff administering in accordance
  with the veterinarians instructions.
   
  

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• Veterinary medicine: Any substance, mixture of substances or biological compound used or intended for use in the direct management of an animal.
  
  Any substance, mixture of substances or biological compound used
  or intended for use in the direct management of an animal.
   
  
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Certification is the action of providing a written assurance or notification to any person about any animal or animal product. (In this context 'written' includes using electronic means).

Certification is the action of providing a written assurance or
notification to any person about any animal or animal product.
(In this context 'written' includes using electronic means).
 

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A client of a veterinarian is a person (or organisation) that uses or has used the professional services of that veterinarian.

A client of a veterinarian is a person (or organisation)
that uses or has used the professional services of that veterinarian.
 

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Clinical practice means the professional examination, diagnosis, prophylactic, medical and/or surgical services veterinarians provide.

Clinical practice means the professional examination, diagnosis,
prophylactic, medical and/or surgical services veterinarians provide.
 

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Competency is the application of knowledge, skills, attitudes, communication and judgement to the delivery of appropriate veterinary services in any particular field of veterinary practice. Competence is demonstrated through performing the tasks required to an acceptable standard and doing this on a consistent basis.

Competency is the application of knowledge, skills, attitudes,
communication and judgement to the delivery of appropriate
veterinary services in any particular field of veterinary
practice. Competence is demonstrated through performing the tasks
required to an acceptable standard and doing this on a consistent basis.
 

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Compounded preparation: A preparation prepared by a veterinarian or by a person on behalf of a veterinarian for use or sale as a veterinary medicine without regulatory assessment or approval.

A preparation prepared by a veterinarian or by a person on behalf
of a veterinarian for use or sale as a veterinary medicine without
regulatory assessment or approval.
 

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Compounding: Combining ingredients (some of which may be generic chemicals or biological compounds and others may be trade name products) to prepare a medication to be supplied to a person to treat an animal. To prepare means not only the process of combining ingredients in an appropriate manner for the intended purpose, but also placing the medication into appropriate packaging with appropriate labelling to allow it to be supplied to and used by a person other than the veterinarian who compounded it.

Combining ingredients (some of which may be generic chemicals
or biological compounds and others may be trade name products) to
prepare a medication to be supplied to a person to treat an animal.
To prepare means not only the process of combining ingredients in an
appropriate manner for the intended purpose but also placing the
medication into appropriate packaging with appropriate labelling to
allow it to be supplied to and used by a person other than the
veterinarian who compounded it.
 

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Controlled drug means any substance, preparation, mixture, or article specified or described in Schedule 1, Schedule 2, or Schedule 3 of the Misuse of Drugs Act 1975. (http://www.legislation.govt.nz/act/public/1975/0116/latest/DLM436101.html?search=ts_act_misuse+of+drugs_resel&p=1&sr=1)

Controlled drug means any substance, preparation, mixture, or
article specified or described in Schedule 1, Schedule 2, or
Schedule 3 of the Misuse of Drugs Act 1975.
 

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General Veterinary Practitioner is the predominant veterinarian who a client chooses to provide the continuing and comprehensive primary veterinary care requirements for an animal or group of animals.

General Veterinary Practitioner is the predominant veterinarian
who a client chooses to provide the continuing and comprehensive
primary veterinary care requirements for an animal or group of animals.
 

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Generic Chemical
A substance that is offered for sale without any veterinary medicine claims being made by the manufacturer, proprietor or seller.

A substance that is offered for sale without any veterinary medicine
claims being made by the manufacturer, proprietor or seller.
 

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Human medicine refers to any medicine, prescription medicine or pharmacy-only medicine as defined in the Medicines Act 1981.

Human medicine refers to any medicine, prescription medicine or
pharmacy-only medicine as defined in the Medicines Act 1981.
 

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Ill treatment of an animal means causing an animal to suffer pain or distress which is unreasonable or unnecessary.

Ill treatment of an animal means causing an animal to suffer
pain or distress which is unreasonable or unnecessary.
 

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Immediate means taking place without delay.

Immediate means taking place without delay.
 

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Inducements are gifts or rewards offered to individual veterinarians or their staff which provide a significant personal benefit and therefore have the potential to influence treatment decisions (including the choice of restricted veterinary medicine) or incentivise sales. Examples might include but are not limited to cash, attendance at entertainment or sporting events, travel, hospitality, loans, personal items and consumables.

Inducements are gifts or rewards offered to individual
veterinarians or their staff which provide a significant personal
benefit and therefore have the potential to influence treatment
decisions (including the choice of restricted veterinary medicine)
or incentivise sales.
Examples might include but are not limited to cash, attendance at
entertainment or sporting events, travel, hospitality, loans,
personal items and consumables.
 

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MAF: Ministry of Agrictulture and Forestry.

MAF: Ministry of Agriculture and Forestry.
 

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NZVA: New Zealand Veterinary Association.

NZVA: New Zealand Veterinary Association.
 

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Off Label Use: Using a registered veterinary medicine (over the counter or restricted) product for a purpose not assessed by MAF ACVM Group.

Off label use: Using a registered veterinary medicine
(over the counter or restricted) product for a purpose not
assessed by MAF ACVM Group.
 

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Practice:
Any aspect of veterinary endeavour. The practice of veterinary science includes:
1. signing any certificate e.g. clinical and export certificates;
2. prescribing;
3. treating;
4. reporting or giving advice in a veterinary capacity using the knowledge, skills, attitudes and competence initially attained for the BVSc degree (or equivalent) and built upon through experience and/or post-graduate and continuing professional development. "Practice" goes wider in this context than clinical veterinary science to include regulatory and compliance functions, teaching, consultancy, advice and health and welfare management.
Any aspect of veterinary endeavour.
The practice of veterinary science includes:
1. signing any certificate e.g. clinical and export certificates;
2. prescribing;
3. treating;
4. reporting or giving advice in a veterinary capacity using
   the knowledge, skills, attitudes and competence initially attained
   for the BVSc degree (or equivalent) and built upon through experience
   and/or post-graduate and continuing professional development. "Practice"
   goes wider in this context than clinical veterinary science to include
   regulatory and compliance functions, teaching, consultancy, advice
   and health and welfare management.
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Referral: The act of handing over a matter/clinical case to a person, who has particular skills, or who is a registered specialist in the appropriate discipline.

The act of handing over a matter/clinical case to a person, who has
particular skills, or who is a registered specialist in the
appropriate discipline.
 

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RVM: Restricted veterinary medicine.

Retricted veterinary medicine.
 

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Veterinarian means a person who is registered with the Veterinary Council of New Zealand and who holds a current practising certificate.

Veterinarian means a person who is registered with the
Veterinary Council of New Zealand and who holds a current
practising certificate.
 

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Veterinary authorisation: An instruction, in an appropriate documented form, from a veterinarian authorising:
1. the use of a restricted veterinary medicine by the specified person in accordance with the authorising veterinarian's instructions;
2. the holding of a relevant restricted veterinary medicine by a person who is neither a recognised trader nor a veterinarian;
3. the sale from a person recognised to sell restricted veterinary medicines to a person specified in the authorisation.
The terms veterinary authorisation and veterinary prescription have the same meaning and may be used interchangeably.

An instruction, in an appropriate documented form, from a
veterinarian authorising:
1. the use of a restricted veterinary medicine by the specified
   person in accordance with the authorising veterinarian's instructions;
2. the holding of a relevant restricted veterinary medicine by a
   person who is neither a recognised trader nor a veterinarian;
3. the sale from a person recognised to sell restricted veterinary
   medicines to a person specified in the authorisation.
The terms veterinary authorisation and veterinary prescription have the
same meaning and may be used interchangeably.
 

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Veterinary consultation
A veterinary consultation must include the veterinarian:
1. interviewing the client (or a legitimate and authorised representative of the client);
2. collecting and recording sufficient information relevant to the individual circumstances to ensure the proposed course of action (including treatment) is appropriate and meets the needs and best interests of the animal(s) and the client;
3. obtaining appropriate consent to the proposed course of action;
4. being given and accepting responsibility for the ongoing health and welfare of the animal(s) concerned in relation to the consultation. This includes arranging emergency care taking into consideration the circumstances and the potential for adverse effects from, or failure of the agreed course of action;
5. determining and providing the appropriate level of advice and training in order to be satisfied that the agreed course of action can occur as planned
Consultation will usually involve the animal(s) having been seen by the veterinarian at the time of the consultation. If not, they will have been seen recently or often enough for the veterinarian to have sufficient personal knowledge of the condition/health status of the animal(s). This consultation is required in order for the veterinarian to be able to propose the particular course of action/treatment.

A veterinary consultation must include the veterinarian:
1. interviewing the client (or a legitimate and authorised representative of the client);
2. collecting and recording sufficient information relevant to
   the individual circumstances to ensure the proposed course of action
   (including treatment) is appropriate and meets the needs and best
   interests of the animal(s) and the client;
3. obtaining appropriate consent to the proposed course of action;
4. being given and accepting responsibility for the ongoing health
   and welfare of the animal(s) concerned in relation to the consultation.
   This includes arranging emergency care taking into consideration the
   circumstances and the potential for adverse effects from, or failure
   of the agreed course of action;
5. determining and providing the appropriate level of advice and training
   in order to be satisfied that the agreed course of action can
   occur as planned; and
Consultation will usually involve the animal(s) having been seen by the
veterinarian at the time of the consultation. If not, they will have been seen
recently or often enough for the veterinarian to have sufficient personal knowledge
of the condition/health status of the animal(s). This consultation is required in
order for the veterinarian to be able to propose the particular course of action/treatment.
 

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VCNZ: Veterinary Council of New Zealand

Veterinary Council of New Zealand
 

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Veterinary emergency: Any sudden, unforeseen injury, illness or complication in an animal demanding immediate or early veterinary treatment to save life or to provide timely relief from unreasonable or unnecessary pain or distress.

Any sudden, unforeseen injury, illness or complication in an
animal demanding immediate or early veterinary treatment to save
life or to provide timely relief from unreasonable or unnecessary
pain or distress.
 

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Veterinary Operating Instruction (VOI): A set of instructions from an authorising veterinarian (AV) to a non-veterinarian to hold restricted veterinary medicines (RVM) in anticipation of their use, and to use RVMs only in accordance with the AV's instructions in circumstances in which the AV will not be carrying out a case-specific consultation.

A set of instructions from an authorising veterinarian (AV) to a
non-veterinarian to hold restricted veterinary medicines (RVM) in
anticipation of their use, and to use RVMs only in accordance
with the AV's instructions in circumstances in which the AV will
not be carrying out a case-specific consultation.