The Importance of a Declaration of Refusal of Treatment: A Landmark Case for Veterinary Risk Management

Yesterday, I attended a Veterinary Surgeons Board of Hong Kong (VSBHK) hearing that highlighted a critical issue for the veterinary profession — how to manage situations where pet owners refuse to consent to recommended treatments? This case has the potential to serve as a landmark ruling, reinforcing the importance of proper documentation in safeguarding both veterinarians and their clinics.

The case involved a situation where a pet owner declined to provide consent for recommended treatments due to financial constraints. In response, the veterinarian opted for an alternative course of action, which, although deemed the next best option, unfortunately led to a significant deterioration in the animal's condition.

At the end of the hearing, the disciplinary chair asked two pivotal questions to sum up the day of cross-examinations:

1. Why did the veterinarian not ask the pet owner to sign a Declaration of Refusal of Treatment?

2. Is such a declaration now in place at the clinic?

These questions highlight the necessity of having a signed Declaration of Refusal of Treatment. While some pet owners may resist signing such declarations, the hearing showed that this documentation is essential. It serves as evidence that the veterinarian acted professionally and that the owner was fully informed of the implications of refusing treatment.

The Need for Proactive Measures

This case is expected to serve as a key reminder for all veterinary clinics to adopt and implement a Declaration of Refusal of Treatment as part of their standard procedures. Having such a declaration in place is not merely a safeguard against potential disputes — it is also a measure that ensures transparency and accountability in the patient-to-doctor relationship.

One of the common challenges faced by veterinary clinics is that some pet owners are unwilling to sign a Declaration of Refusal of Treatment when it is presented to them at the point of refusal. To address this, it is essential to communicate the obligation to sign such a declaration upfront during the patient registration process. By informing pet owners of this responsibility at the outset, clinics can set clear expectations and minimise resistance later.

It is equally important to ensure that all veterinary assistants (VAs) and staff are properly trained to explain the purpose and importance of the declaration. Clear and empathetic communication with pet owners can go a long way in fostering cooperation and trust.

Proposed Clause for Patient Registration Forms

To help clinics implement this strategy, we recommend including the following clause in patient registration forms, so that pet owners are aware of their obligation to document their refusals:

I understand that [the veterinary clinic] may recommend certain treatments, procedures, or interventions that are deemed necessary for the health and well-being of my animal. In the event that I choose to refuse or decline any recommended treatment or procedure, I acknowledge that I will be required to sign a "Declaration of Refusal of Treatment" to confirm my decision and to release [the veterinary clinic] and its staff from any liability arising from such refusal. I further understand that failure to sign the required declaration may result in [the clinic] being unable to proceed further with the care of my pet in the future.

This clause ensures that pet owners are aware of their obligation to sign a declaration in the event of a refusal and that veterinary clinics have proper documentation in place to protect themselves.

Epilogue: The Broader Implications of a Declaration of Refusal of Treatment

The Declaration of Refusal of Treatment represents more than just a formality or a safeguard against complaints. It is a critical tool that embodies the principles of transparency, accountability, and professionalism in the veterinary field.

For veterinarians, this declaration offers clarity and protection. It ensures that their recommendations are documented and that the responsibility for a decision to decline treatment lies with the pet owner. In the event of a dispute, this document becomes invaluable in demonstrating that the veterinarian acted in good faith and in accordance with professional standards.

For pet owners, the declaration serves as an opportunity for reflection and understanding. It ensures that they are fully informed of the risks and consequences of their decisions, fostering a sense of shared responsibility in the care of their animals. By signing the declaration, pet owners acknowledge their role in the decision-making process, which can lead to more constructive and open communication with the veterinarian.

On a broader scale, the implementation of such declarations elevates the standards of the veterinary profession as a whole. It underscores the importance of proper consent and documentation, ensuring that veterinarians and clinics can continue to provide the best possible care while safeguarding themselves against unnecessary risks.

Next Steps

If your clinic has not yet put in place a Declaration of Refusal of Treatment, now is the time to act. This document is increasingly recognised as an essential part of veterinary risk management, and implementing it is a critical step in protecting your practice and team.

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Disclaimer: Nothing herein shall be interpreted as legal advice to any person. Readers are encouraged to consult their legal representatives for independent advice. The information provided is based on overall observations and the experience of the practitioners of the firm at the time of writing. The content may change without prior notification depending on changes in the law. If there are two versions of the article in different languages, the English version will prevail in case of discrepancies.

About Us:

Rendy Ng Law Firm is a law firm based in Hong Kong, providing a full range of commercial legal services for all sectors, with particular focus on supporting professionals and businesses in the medical and veterinary, consumer goods and retail and entertainment industries to achieve sustainable success. By combining legal guidance with understanding of business practicalities, we ensure that our clients receive support tailored to their business goals and individual needs. Please feel free to reach out to our team should you have any questions about our services.

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