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The ethical debate

DVM Best Practices

Though such drug dispensing may bring significant profit to the practitioner in the short run, in the long run dispensing these dangerous drugs can erode a clinician's credibility if the drugs in question fail the tests of safety and/or efficacy and this becomes known. A clinician's reputation is too hard-won and precious a commodity to risk it for the sake of greed.

Biggest benefit: Your patients will benefit the most from owners and trainers understanding the importance of using non-pirated drugs, even though they may be cheaper.
Plain talk Dealing with the pirated drug issue and your clients may create a number of hurdles to overcome. It is important to have a candid conversation with clients about these products. They need to know pirated drugs are not approved by the FDA and are not regulated by any type of federal, state or medical organization. Although clients and trainers may see the economic value of using pirated drugs, they also need to have a clear vision of the medical ramifications of these products as well.

Let's explore a few scenarios.

  • Scenario 1: A client comes to you and says, "I want you to use that generic GastrogardTM or VentipulminTM. It's a lot cheaper."

Your response could be: "There are no approved generic formulations of these drugs. Whoever told you that (unfortunately it may have been a veterinarian) misled you. I only use quality products in my practice." Next, you can explain the issue in greater detail.

Identify that the pirated drug is substandard and that you don't practice veterinary medicine in a substandard manner - patient care is paramount. You might even have to discuss the legalities of the problem.

If the client says, "Wow, I didn't know that, thank you doctor, my horse, dog, etc. should have the best, and I would not want you to break the law," then you have won a client you should cherish. If you lose the client because they want the "cheap stuff" and care very little that you put yourself at legal and liability risk, then you have lost a client you did not need. Let them find another practitioner that will dispense a cheap, substandard, illegal drug. They could likely return to your care when they don't get the treatment results they want from someone else.

  • Scenario 2: A client comes to you and says, "Why are you using Adequan™ or Legend™ instead of the generic (i.e., Chondrodefect, or MAP5, or LoCoat or NonCell) for use in my horse or dog?" Your response could be: "Those products are topical bandages for wounds or freezer wrap for sperm, and they were never intended to go beneath the skin of any animal." It is important to explain that to use those devices as drugs would imply that you were practicing poor quality medicine and jeopardizing the health of his or her animal. It would also imply that you were more interested in money, then the animal's welfare. Again, do not be afraid to let your client walk in this situation if they disagree with your explanation.
  • Scenario 3: A client comes to you and says, "I read how evil it is to use pirated drugs in horses. You are using dipyrone to treat my horse. Is that wrong?"

Your response could be: "There is no approved dipyrone, but it is well accepted that this drug controls high fevers much better than any other drug on the market. If there were an approved form, then the use of compounded dipyrone would be defined as substandard care, but since there is no FDA-approved formulation, the compounded drug is acceptable and clinically intelligent."

These three scenarios are some of the more common situations practitioners may find themselves. It is important to remember not to become defensive and approach each situation as a discussion on the best medicine for the horse or other pet you may be treating. When talking to clients and trainers, it is also critical to reiterate the point that pirated drugs are not FDA approved and their contents and the grade of the material are unknown and treatment outcomes are unpredictable. Taking the high road to high-quality medicine will eliminate any ethical dilemma or haggling over price for a product.

Dr. Rollin is University Distinguished Professor, Professor of Philosophy, Professor of Biomedical Sciences, Professor of Animal Sciences, and University Bioethicist at Colorado State University. Rollin taught the first course ever done in veterinary medical ethics, which has been a required part of the veterinary curriculum at CSU since 1978, and was a pioneer in reforming animal use in surgery teaching and laboratory exercises in veterinary colleges. He is a principal architect of federal legislation dealing with the welfare of experimental animals, and has testified before Congress on animal experimentation. He has consulted for various agencies of the governments of the U.S., Canada, Australia, the Netherlands, New Zealand, and South Africa on many aspects of animal research, for the Office of Technology Assessment of the U.S. Congress on genetic engineering of animals, for NIH on animal pain, and for the World Health Organization on using antimicrobials in food animals. He has consulted for the USDA/CSRS on farm animal welfare research, and for APHIS on future planning.


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