Disclaimers and informed consent
The Code of Professional Conduct requires veterinarians to obtain a client’s informed consent before proceeding with a treatment or course of action. Essentially, informed consent means that the client has enough information about a treatment to make a decision about whether to proceed.
Veterinarians must obtain a client’s informed consent before proceeding with a proposed treatment or course of action, including a post-mortem. This includes:
- making sure clients have enough information to make an informed choice about treatment options.
- giving clients the information they need in a way they can understand.
- checking clients understanding of the information and ensuring they have the ability and authority to give informed consent.
- ensuring the informed consent process is adequately documented.
The Code includes expectations about providing information.
The following information must be provided:
- the likely diagnosis, where appropriate, and the reason for the proposed course of action.
- treatment options including expected outcomes, risks, side effects, benefits and costs (this can be a range of likely costs).
- the veterinarian’s experience and skills to undertake the treatment, if relevant.
- referral options, where appropriate.
- post treatment requirements and likely costs.
While including verbal consent in a clinical record would meet these expectations, VCNZ prefers written documentation.
A disclaimer relates to the acceptance of risk and can be defined as:
Generally any statement intended to specify or limit the scope of rights and obligations (legal liability) that may be exercised and enforced by parties in a legally recognised relationship. In contrast to other legal terms, a disclaimer usually implies situations that involve some level of uncertainty, waiver, or risk.
Disclaimers fit in commercial relationships where two parties, such as a veterinarian and a farmer, agree on who is going to accept the risks of particular events.
Where a veterinarian cannot prevent an outcome (e.g. known side effects) then they are likely to not be liable for a loss. However, there may be a level of responsibility that lies with the veterinarian if they can influence the outcome (e.g. where there is a question of competence), which may result in some liability.
To protect a veterinarian from:
- a complaint to VCNZ – A professional indemnity insurer is likely to encourage the veterinarian to have documented informed consent (preferably in writing).
- a claim for loss – A professional indemnity insurer would likely encourage the vet to have a disclaimer document signed with the client.
Informed consent and a disclaimer may be contained in a single document.
In VCNZ’s experience, veterinarians can protect themselves in circumstances where staff or clients are undertaking certain procedures or administering restricted veterinary medicines (RVMs) that carry some level of risk.
This can be done by considering the qualifications, level of training, and the advice provided to them. The Code provides a good framework for this, and veterinarians can also document the steps they have taken to mitigate the risks (see Veterinary medicines Section 1: Product Stewardship for example).