Can vets legally treat people?

Re: Can vets legally treat people?

warwickshire vet — Sun, 14 Apr 2013 20:52:19 GMT

I seem to recall that the famous Maurice Kirk used a testimonial from Oliver Reed, who was very complimentary about the care he recieved from Mr Kirk, at an RCVS disciplinary hearing.... http://news.google.com/newspapers?nid=2507&dat=19880106&id=UTpAAAAAIBAJ&sjid=UlkMAAAAIBAJ&pg=2737,492070 so presumably it was OK then if you had consent.

Re: Can vets legally treat people?

Mark Hedberg — Wed, 10 Apr 2013 14:02:50 GMT

Be careful about embassies, they often know absolutely nothing about veterinary matters so you're best off contacting (if possible) the relevant agriculture or health ministry.

Re: Can vets legally treat people?

james herriot lied — Wed, 10 Apr 2013 12:32:15 GMT

Would echo comments about diamox: it's wholly inappropriate to look at it as a routine trekking drug - there are virtually no places you'd find yourself where dropping a couple of hundred metres would be difficult and/or particularly inconvenient.

In terms of taking drugs abroad, I'm taking some supplies out for the Himalayan Animal Rescue Trust (HART), which will include some POM-Vs, mainly slightly OOD. It doesn't seem to be a problem, provided you're not exporting for commercial purposes; I even emailed the Nepalese embassy in London to check, and they weren't remotely bothered.

Whilst out there, though, there ARE rules. The Nepalese veterinary authorities don't allow unregistered vets to practice, and it seems to be a right PITA to get registered as a foreign vet. People, nobody seems to be bothered: in fact, locals often ask for drugs, mainly OTC pain relief. Other travellers can give informed consent in any case.

I would tend to source most of my human POMs like antibs from a decent pharmacy over there in any case - cheaper, and no hassle with customs at this end.

Re: Can vets legally treat people?

Clive Ansell — Tue, 09 Apr 2013 12:52:10 GMT

[quote user="Neil Wheadon"]

I can't find anything that confirms or denies. I seem to recall that doctors can't treat animals but we can treat people.

An example is Acetazolamide (Diamox) for altitude sickness I do know that some people carry it, so if it was given in good faith, am I liable?

Neil

[/quote]

I carry Diamox on high altitude mountaineering trips, and have on occasions given it out to others although I have never needed to take it myself.

I am always extremely cautious, given the potential seriousness of AMS, and it is always on the basis that I am not a doctor and I am not qualified to give comprehensive medical advice and it is up to you whether you take it or not.

I feel it is vastly overused, it is often taken prophylactically and is encouraged by some travel companies to get clients up routes in a shorter time. It should not be needed if one is following a well planned itinerary that allows adequate acclimatisation and rest time, and is drinking plenty of fluid.

Re: Can vets legally treat people?

Clive Ansell — Tue, 09 Apr 2013 12:38:22 GMT

[quote user="martin whiting"]

However, the drugs issue is separate. They are governed tightly. You as a vet can prescribe POM-V and anything less to animals, and under the cascade you can prescribe most other things to animals. You are not permitted to prescribe them to a human. Nothing in law permits you as a vet to make available a POM to a person. Not even with their permission as you cannot consent to something illegal.

POM are the realm of doctors and SQP/pharmacists etc only. There is one minor exception in the Medicines Act 1968, where you may inport any medicine (so long as it is not listed under the Misuse of Drugs Act 1971) for your own use or the use of a member of your household. But you may not give that medication to anyone else.

[/quote]

Does anyone know what the legal position is with taking human POM's (initially intended for own use) and then giving them out in a case of need once in another country. In many countries the drugs which are POM here can be bought over the counter with ease.

Was there not a vet in front of the RCVS DC a few years ago for prescribing nsaid's to his wife?

Re: Can vets legally treat people?

Martin Whiting — Tue, 09 Apr 2013 09:31:05 GMT

Michael

You could do a tracheotomy or suture wounds if there was consent - without the consent it would be surgical trespass and leads to consideration of battery. So there is no statute law saying you can't, just civil law about the consent between two competent adults. (if incompetent then a different set of legislation kicks in regarding the mental incapacity act too).

However, the drugs issue is separate. They are governed tightly. You as a vet can prescrive POM-V and anything less to animals, and under the cascade you can prescribe most other things to animals. You are not permitted to prescribe them to a human. Nothing in law permits you as a vet to make available a POM to a person. Not even with their permission as you cannot consent to something illegal.

POM are the realm of doctors and SQP/pharmicists etc only. There is one minor exception in the Medicines Act 1968, where you may inport any medicine (so long as it is not listed under the Misuse of Drugs Act 1971) for your own use or the use of a member of your household. But you may not give that medication to anyone else.

Re: Can vets legally treat people?

Michael Woodhouse — Mon, 08 Apr 2013 18:29:22 GMT

[quote user="james herriot lied"]doing an elective appendectomy brings on a whole other set of issues.[/quote]

[Hypothetically] assuming that a doctor provided you with the required medicines is there anything in law stopping you performing that operation?

Appreciate that if you messed things up your arse would be on the line.

I'd do an emergency tracheotomy. I'd suture wounds.

I suspect that if society broke down a vet might be a damn sight more use that doctors who are increasingly specialised. There is not a doctor that covers as much surgery, medicine and obstetrics that we do daily.

Re: Can vets legally treat people?

karen jones — Mon, 08 Apr 2013 18:22:13 GMT

My husband is a paramedic but the station still needs someone to attend a FirstAid at Work course

Re: Can vets legally treat people?

Richard Carter — Mon, 08 Apr 2013 17:58:55 GMT

I know that when we did the first aid review for the practice, the fact there were 2 qualified vets with > 30 years between them counted for nothing unless you had been on one of these magic day courses that then allows you to perform CPR and other potentially life threatening practices.

Lots of vets have been first on the scene at RTAs and have used their skills to keep body and soul together until the ambulances arrived - don't think there have been too many complaints.

Re being on a mountain and being the most experienced person regarding dehydration, electrolyte imbalance, hypoxia, exhaustion - would you treat yourself? of course you would - so give the option to your mate.

Re: Can vets legally treat people?

james herriot lied — Mon, 08 Apr 2013 14:04:32 GMT

Excellent answer above - really comprehensive; this was something I looked into previously, and it turned out that the restrictions are largely on our side: because the VSA says that ONLY vets can do, erm, vet work, then that excludes doctors. But on the human side, only doctors can call themselves thus, but for first aid at least it's a moot point practically. Note, though, that it only really applies to first aid: doing an elective appendectomy brings on a whole other set of issues.

I'm off to the Himalayas shortly. And I tend to take a pretty comprehensive medical kit. Certainly, in the past I have doled out some antibiotics and painkillers, mainly the latter, to fellow travellers. Only ever enough to get them back to the nearest town, and I always make sure they understand this. But certainly, by the time the world's been falling out of them for a few days, they'd take pretty much ANYTHING.

Re: Can vets legally treat people?

Alastair Franklin — Mon, 08 Apr 2013 02:52:59 GMT

From my understanding, in the UK at least, vets have just the same 'rights' (and fortunately liabilities too) as any other (non-GMC registered) person to treat a human, provided there is consent from the patient.

Due to this aspect of autonomy/self determination and consent, there is nothing in law that I'm aware of that prevents lay people (including vets) treating humans (in comparison to the good old VSA (1966) which governs who can (legally) treat an animal). Failure to obtain consent could (in theory) end up in assault charges, however there is also implied consent - eg if the patient is unconscious and in need of aid.

However, there is the Medical Act (1853) which allowed the formation of the GMC, which does grant specific right and powers to registered people (ie human doctors) and prevents non-registered people charging for services, writing certificates (including sick-notes) and makes it a criminal offence to present oneself as a registered (human) medical practitioner.

In terms of liability if you treat a human, that is somewhat variable by country. The 'Good Samaritan' laws vary significantly by geographical location and are intended to avoid the situation where people don't help for fear of being held liable if things go wrong. In fact, some countries (eg France and Germany, I think) go a step further and can prosecute for not helping when able to. Canada rules vary by province (most follow English style non-liability ruling, whereas Quebec follows a Napoleonic based code, which does require assistance. in Australia, there is no specific statute, however most states and territories have applied "Good Samaritan' rules as a point of public policy. More recently, it has been codified into (I think) all state and territory laws (interestingly, the NT has a policy of requirement to aid where possible, possibly in relation to the remoteness).

As far as I know, there is no specific Good Samaritan law in England (and neither is there a legal duty to rescue someone). In Scotland I believe there is a special defence of 'self defence' which can protect the person from liability. However, my understanding (with no good source to back it up) for English law, is that a vet treating a person would not be held to have any higher medical training than the average lay person and so is not at any greater risk of liability, provided there is the consent (implied or actual). Interestingly, there may not be any higher responsibility of a (human) doctor if they are not paid for the action (though again, no source at the moment to back this up).

Giving veterinary medications to a human (since it is less likely you would have many human specific medications on the shelf) would, in my opinion, be risky, particularly in absence of explicit consent, unless in dire emergency. And even then, with few exceptions (such as anaphylaxis) not knowing specific human doses, one could argue that you are better off doing CPR etc until the appropriate authorities arrive rather than risk an OD and kill your patient (primum non nocere).

Re: Can vets legally treat people?

David Mills — Mon, 08 Apr 2013 00:14:41 GMT

Legally, vets can treat people if the patient has given consent. That goes for anyone, not just vets. Unless you were doing it whilst pretending to be a doctor I don't see how you could be liable given the consent.

I remember hearing from somewhere that vets 'take priority' over others in the treatment of people if no doctor of HCP around but I think this is say-so rather than law.

Re: Can vets legally treat people?

Neil Wheadon — Mon, 08 Apr 2013 00:03:55 GMT

Thanks for replying Michael.

I can't find anything that confirms or denies. I seem to recall that doctors can't treat animals but we can treat people.

An example is Acetazolamide (Diamox) for altitude sickness I do know that some people carry it, so if it was given in good faith, am I liable?

Neil

Re: Can vets legally treat people?

Michael Woodhouse — Sun, 07 Apr 2013 18:56:37 GMT

I tried looking and can find nothing that specifically prohibits this.So long as we don't represent ourselves as doctors. There would be issues using medicines.I was told on here that we are breaking the law buying 100 packs of ibuprofen from the wholesaler for staff use as they are a pharmacy medicine.

If I was somewhere remote from help I'd do what I could. In a dire emergency I would break the law and use vet medicines in people (severe anaphyaxis springs to mind).