In health and disease
How can we apply these principles to the conscientious practice of veterinary medicine?
Consider the following illustration of three states of normal function and dysfunction of a conscience applied to establishing
fees for various diagnostic tests and treatments.
»THE HEALTHY CONSCIENCE: If our conscience is well-trained and if we allow it to guide our actions, it will prevent us from performing diagnostic
tests and treatments for the primary purpose of monetary gain. It will help us avoid unethical practices, even when our actions
will not be found out. Our conduct will attest (i.e., bear witness) to the fact that we are practicing our profession conscientiously.
» THE GUILTY CONSCIENCE: If our conscience is properly trained, yet we do not let it guide our actions, it will often make us feel guilty after we
have willfully recommended and performed needless or risky diagnostic and therapeutic procedures. If we listen to our conscience
and take action to correct our errant choices, our conscience can be restored as a reliable guide for ethical conduct. However,
if we repeatedly ignore our feelings of guilt, we may move to a state of "un-conscience-ness."
» THE SCARRED CONSCIENCE: If our conscience is properly trained, but we abuse it by repeated acts of wrong conduct, it may no longer be able to sound
warnings and give us ethical guidance. The conscience then may become figuratively scarred. Like literal scar tissue that
no longer has a functional sensory nerve supply, the conscience becomes progressively insensitive to various stimuli. In fact,
if others discover that we care more about our profits than our patients, they may say that we "lack feelings" about the
welfare of others.
A scarred conscience fed by misinformation that tickles our ears by arousing a highly competitive spirit may allow us to rationalize
that to sustain and/or improve the financial health of our veterinary practice, it is acceptable (and in fact at times necessary),
to defraud our clients by charging them excessive fees for services or by performing unnecessary diagnostic tests and treatments.
Today's consumer-oriented culture kindles the fires of greed. Influenced by subtle but powerful ways, many believe that whatever
they have is not enough. In my opinion, if this philosophy underlies our intent, we have deviated from conscientiously practicing
the art and science of veterinary medicine. Our conduct may then become influenced by fear of exposure.
A reliable guide
Can you trust your conscience as your ethical guide in the practice of veterinary medicine? The answer largely depends on
how your conscience has been trained, and whether you allow it to guide you.
To help guide us, broad-based and general principles of veterinary medical ethics have been adopted by the American Veterinary
Medical Association. However, they do not cover all facets of our profession. Thus we must rely on our conscience to guide
our course of conduct when existing rules and guidelines do not apply.
If we, as veterinarians, accept the Golden Rule as a guide for our conscience, and take the lead in applying it, we likely
will be able to fulfill our promise to practice our profession conscientiously. In context of ethical interactions with our
patients, clients and associates, the ultimate test of our conscience is the conduct that it dictates or inspires.
Our conscience will then be a source of protection for all.
Adapted from an article in JAVMA Volume 215: pages 1238 – 1239, 1999.
Dr. Osborne, a diplomate of the American College of Veterinary Internal Medicine, is professor of medicine in the Department
of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Minnesota.