When is the last time you had a really good secret? A secret so good it hurt not to tell it?
What if that same secret REALLY did hurt if you didn't tell it?
We have all been there at some point; it is when we find ourselves in that position in the hospital setting that it can become a problem, "When confidentiality hurts." So what is our position? Have you checked the laws in your state? What is our moral duty? What does our veterinary oath say? These are all good questions.
So, what, you may ask yourself has brought this up. Well, let me give you something to ponder. You have a client, with snakes. Very large, very dangerous snakes, some are even poisonous. Yes, he is licensed to have these snakes ($67 in Texas for what it’s worth) and you are caring for one that is sick. Actually, that is part of the problem, it is at your clinic for a very long time and you don't know why he isn't calling you back. Then one day he does call, and informs you he is in the process of adopting a very young child. So, is he using you to hide the snake? Does the adoption agency know about the license or the snakes? And what is your duty to notify someone?
Situation number two, you have a client that brings in their pet for a biting issue, perhaps even an attack? Maybe of a person, maybe another pet, you fill in the blanks. You and they follow all the required guidelines, report the bite, etc. After the required time legal quarantine times (if any), you assume all is fine. Several months pass, until; you have a new client, they come in with their newly adopted pet. It is the same pet. You are positive, not a doubt. The previous client has it plainly marked in their record, NO, you are not allowed to give out information (we have that option in our software, do you)? So, do you tell the new owner of the pet's history? Can you tell them?
The point being, there are times when we are required by law to report, or do something about a situation, animal abuse, drug abuse, theft. And there are some grey areas we all struggle with, the client we suspect is being abused by a spouse, the drunk client, the drug abusing client. We would all like to "change the world" or make a difference but what about the time when we don't and it causes real damage?
The client that has obviously been drinking, "just a little," we don't prevent them from leaving the clinic and we find out later they were involved in a car accident. Are we liable?
The client we are starting to "suspect" may be abusing their pets Tramadol, we fill one more prescription and find out later they overdosed. Are we guilty of "loading the gun?”
So what do we do when we are presented with a case in which we are unsure what our actions should be?
1. Familiarize yourself with the particular laws of your state relating to the situation. It may be clearer than you think. Be sure to reach out to your network of colleagues, it is likely that someone else has had a similar case that can give you some input.
2. Sit down with your practice owner and review your policies and procedures to determine the appropriate course of action. It is possible that your policies don’t cover the situation and you may need to develop one. It may be wise to consult your local attorney to ensure that you are complying with the law and that your policies are reasonable.
3. Review your policies and procedures with your staff; make sure everyone in the practice understands how the case will be handled.