Euthanasia Consent Forms

Re: Euthanasia Consent Forms

Simon Neuhoff — Thu, 07 Oct 2010 13:40:09 GMT

Shrug - as I said - and others have echoed - there is no impact on the relationship between the client and the vet. We have consent forms signed for every admission/procedure/euthanasia and our clients expect this. In my locumming days I worked at lots of the neighbouring practices and the system is very much the same there. So maybe its area dependent but I don't think the consent form in any way traumatises our clients.

Re: Euthanasia Consent Forms

Bob Russell — Thu, 07 Oct 2010 12:50:43 GMT

We do not always get a client to sign a consent form if they are well known to us and where a bond of trust has been established. I feel it is an unacceptable intrusion at a difficult time and appears uncaring on occasions.

Clients and patients that are not well known to the practice or those pets euthanased for behavioural or legal reasons obviously will require a signature.

A signed consent form may give some 'peace of mind' to the vet but sometimes the relationship between vet and client is more important.

Re: Euthanasia Consent Forms

Rob Davis — Thu, 07 Oct 2010 12:28:01 GMT

[quote user="Louise Alexander"]If the animal is registered under 'Mr Smith' can Mrs Smith sign the consent form? I remember hearing a story about this kind of query a few years ago, but can't remember the outcome![/quote]

On our consent forms there is an option to tick "I am the owner / registered carer" or "I have been authorised by the owner / registered carer" to cover this situation. We also ask whoever is signing to print their name below the signature.

Re: Euthanasia Consent Forms

Simon Neuhoff — Thu, 07 Oct 2010 12:08:20 GMT

[quote user="jamie winstone"]

one thing it doesn`t do is stop an `innocent` animal being put to sleep where perhaps on occasions close questioning may raise suspicions that something is not quite right and cause a delay in this irreversible procedure.

[/quote]

Not sure I understand what you're getting at here Jamie. A consent form does not replace the examination/discussion procedure or hasten this process in anyway - it is simply the last step. I find it tends to be a symbolic, commiting moment for the client. I actually only produce the paperwork once the discussion is largely over and the decision is reached.

If I feel "somthing is not right" then I am under no obligation to do the prceudre and I have, over the years and in very specific situations, refused to do a number of euthanasias. I AM careful about this though because I fear that some owners may then take matters into their own hands - and the animal may suffer more as a result.

Re: Euthanasia Consent Forms

jamie winstone — Wed, 06 Oct 2010 22:45:36 GMT

Why does anyone get consent forms signed?

Is it to ensure that the owner truly wishes the animal to be euthanased?

The rightful owner is actually signing the consent form?

A piece of paper to show that the vet in charge took all steps required if there is a future dispute, therefore is the innocent party?

Perhaps it`s a bit of all three, one thing it doesn`t do is stop an `innocent` animal being put to sleep where perhaps on occasions close questioning may raise suspicions that something is not quite right and cause a delay in this irreversible procedure.

Re: Euthanasia Consent Forms

Louise6732 — Wed, 06 Oct 2010 22:07:27 GMT

[quote user="Simon Neuhoff"]

I find the process does not cause distress to the client - it is done gently and tactfully and our clients expect it and understand it.

[/quote]

I agree. When the client has come to the decision for PTS, I explain what happens (from brief to in depth, depending on how upset they are/how much they want to know) and included in this explaination is the consent form. I have not had one person complain, at the time or afterwards, that I was not tactful or that it was upsetting to discuss consent. I think everyone is very aware of signed consent these days, it is expected by the majority of clients.

I feel it is very important to have the consent form. You never know who will come back at you. the ex-partner, neighbour etc.

One thing this topic has flagged up:

If the animal is registered under 'Mr Smith' can Mrs Smith sign the consent form? I remember hearing a story about this kind of query a few years ago, but can't remember the outcome!

Re: Euthanasia Consent Forms

Simon Neuhoff — Wed, 06 Oct 2010 21:21:39 GMT

[quote user="Julian Earl"]

I was about to disagree but then realised that if it is someone who I know very well, I do tend to give it a miss. The only other situations of note are if an animal is in such a terrible state that it has to be put to sleep, I am not sure a form matters - it might be illegal NOT to euthanase it.

Anyway, re. the original comments about it being intrusive etc., I don't think that that is a problem if handled correctly, "I'm ever so sorry, but I have to ask you..." etc. People understand.

[/quote]

I always get a consent form signed - the only exception is the PTS "on the table" where verbal consent is given over the phone - but in 95% ofthese cases a prior discussion will have taken place with the client warning them of the possibility of a pts and this will be in the notes.

I find the process does not cause distress to the client - it is done gently and tactfully and our clients expect it and understand it.

Re: Euthanasia Consent Forms

Julian Earl — Wed, 06 Oct 2010 19:13:48 GMT

[quote user="Niall Taylor"]

[quote user="jamie winstone"]

I am of the opinion that to insist on a consent form when people are, in many instances, so upset that they can hardly speak let alone give informed consent is an unnecessary and distressing procedure so we tend not to worry. Clearly there are instances where one does get written confirmation but these are the minority not the routine and are always obtained just to add weight to an unambiguous verbal request.

I realise this is a minority view point but I see the paperwork as an excessive intrusion which may cause offence.[/quote]

Couldn't agree more - to insist on a paper filling exercise at a time of extreme emotional distress in a case that is familiar to the practice with a well known, trustworthy client is offensive and cruel. If the client is new or the circumstances uncertain we will always get a consent form signed, otherwise we have a positive poilicy of NOT getting them completed.

Stick to your guns Jamie, it's possible to obtain and record consent without subjecting a grieving owner to further distress.

Niall

[/quote]

Also when on visits, I invariably forget to have a form with me.

Anyway, re. the original comments about it being intrusive etc., I don't think that that is a problem if handled correctly, "I'm ever so sorry, but I have to ask you..." etc. People understand.

Re: Euthanasia Consent Forms

Niall Taylor — Wed, 06 Oct 2010 18:09:50 GMT

[quote user="Vikki Halliday"]the weeping and wailing client you cannot bring yourself to ask to sign a bit of paper, could well turn out to be the one that lands you infront of the DC[/quote]

How many times have you had a run in with the DC which has been resolved in your favour by virtue of a signed euthanasia consent form?

Bear in mind that the Guide to Prof Con states that 'consent' is a process, the signature on the form being the very last step in that process - ie a signed consent form is NOT evidence of consent.

I am perfectly capable of judging for myself which clients I know well enough to decide they have genuinely given consent and which ones I am concerned enough about to ask for a signature. Why should PSS believe that I am incapable of making this judgement, how does it imporve practice standards?

Niall

Re: Euthanasia Consent Forms

Niall Taylor — Wed, 06 Oct 2010 18:02:56 GMT

[quote user="plantagenet"]I have never had any problems asking for signed consent, even with very stressful circumstances and owners who are more friends than clients[/quote]

Well obviously I have done this too and, I flatter myself, have done it well and compassionately but that's not the point. The point is should I have to do it when it is clearly unnecessary and further, should I be forced to do it, against my better judgement, by PSS.

Niall

Re: Euthanasia Consent Forms

Niall Taylor — Wed, 06 Oct 2010 17:59:35 GMT

[quote user="plantagenet"]Two days later her son phoned, claimed ownership of the dog and threatened to come and deal with both us and mother with a shotgun.[/quote]

Certainly that is a good argument for the importance of good communication but it is not a terribly convincing argument in favour of written consent forms (unless they're bullet proof ). With someone like that they're unlikely to be swayed by a piece of paper.

Niall

Re: Euthanasia Consent Forms

Vikki Halliday LLB — Wed, 06 Oct 2010 17:26:24 GMT

[quote user="plantagenet"]

I have never had any problems asking for signed consent, even with very stressful circumstances and owners who are more friends than clients - I never make an exception and have never felt it caused any offense or further upset to owners.

[/quote]

I agree, I have never found it an issue, and for the "in surgery" scenario, we do get the listened to by two people consent and they both sign the consent form.

It may seem harsh, but the weeping and wailing client you cannot bring yourself to ask to sign a bit of paper, could well turn out to be the one that lands you infront of the DC.

Re: Euthanasia Consent Forms

plantagenet — Wed, 06 Oct 2010 15:52:04 GMT

I always get a consent form (or verbal + witness if owner not present) after a very nasty experience a few months after graduation. Consent forms were not particularly widespread then but thankfully I had one. The person we had always treated as the client requested euthanasia on very reasonable ground, which I performed. She was in such a state when I left her house, I went through her address book (with permission) to get a friend or relative to sit with her. Two days later her son phoned, claimed ownership of the dog and threatened to come and deal with both us and mother with a shotgun. Nothing came of it and we had done everything by the book, but I learnt a lesson.

Re: Euthanasia Consent Forms

toby travis — Wed, 06 Oct 2010 15:34:12 GMT

[quote user="robloxley"]

[quote user="toby travis"]

if you read the link it says at the very bottom of the page....

*[The RCVS Practice Standards Scheme Manual provides that for ‘General Practice’ (Tier 2 practices), signed consent forms are required for all procedures including diagnostics, medical treatments, surgery, euthanasia and when a patient is admitted to the care of a veterinary surgeon.]

[/quote]

Are you admitting the animal for Euthanasia, or performing it with the owner present?

[/quote]

I usually euthanase with the owner present - ie not admitted. Either way, the advice from the RCVS appears to be that a signed consent form is required (in PSS general/tier 2 practices) for any procedure (incl euthanasia) , any diagnostics and any other situation when an animal is admitted into the care of a veterinary surgeon - I would have preferred something more vague from them!

Re: Euthanasia Consent Forms

Rob Loxley — Wed, 06 Oct 2010 13:51:56 GMT

[quote user="toby travis"]

if you read the link it says at the very bottom of the page....

[/quote]

Are you admitting the animal for Euthanasia, or performing it with the owner present?

Re: Euthanasia Consent Forms

Hannah Wynne Richards — Wed, 06 Oct 2010 11:05:12 GMT

I'm Tier 2 , and I have euthanasia consent forms. Whether or not I use them depends on client. Always with casual off street, or very occasional client-not with bonded client, often old pet I've been proping up for the last couple of years, and we have mutually, after long discussions decided it is the end of the road-hope I won't lose Tier 2 status now !!!!!!!!!!!!!!

Wynne

Re: Euthanasia Consent Forms

toby travis — Wed, 06 Oct 2010 11:03:27 GMT

[quote user="robloxley"]

Does the PSS rules say that? From a quick scan of the online manual: 'all practices must show informed consent is obtained'. OK, this is usually through a consent form but could be an entry on the notes e.g. following a phone call. As far as I can see the Tier 2 requirement for a signed consent form is for animals 'admitted', where:

'“Admitted” means where an animal is in the care of the veterinary surgeon and is outwith the presence of the owner."

[/quote]

Thanks Rob, I wasn't sure either but on seeking clarification.......

"I have spoken to my colleague in the Professional Conduct Department
with regards to your query about consent forms for euthanasia. She
confirmed they would be needed in all cases and suggested you at Annexe
E of the Guide to Professional Conduct which can be found online for
further information"

http://www.rcvs.org.uk/Templates/PreviousNext.asp?NodeID=89767&int2ndPar
entNodeID=89738&int1stParentNodeID=89642

if you read the link it says at the very bottom of the page....

Re: Euthanasia Consent Forms

toby travis — Wed, 06 Oct 2010 10:58:30 GMT

[quote user="Niall Taylor"]

[quote user="toby travis"]On seeking clarification from the RCVS...[/quote]

Well there's your problem right there - never, ever seek 'clarification' from the RCVS on anything if it can be avoided. Vague is good.

[/quote]

Thanks Niall, I certainly agree with you in principle but this year I was given a pay rise with the option of a little more if I took on the PSS, conditional on us getting through the inspection, so while i have always been keen on vague when I might not be right, I do want to be right on this one!

Also, I am lucky in that in many instances of euthanasia myself and the practice do have a close relationship with the client and I do feel slightly uncomfortable at the idea of having to go and get a form from the printer (which is in reception) and then get a signature etc. I suspect that there are plenty of vets in Tier 2 / General PRactice accredited practices who aren't doing that but I gues that is probably the case right across the PSS.

Re: Euthanasia Consent Forms

bob lehner — Wed, 06 Oct 2010 10:12:19 GMT

Currently sitting here in v swish private hospital, waiting to have nasal polyps removed under GA. Surgeon wandered in and after brief chat shoved consent form at me to sign. Just had a peep at it at end of the bed. most details blank - surgeon's scrawl illegible.....! Anaesthetist wandered in also for brief chat - didn't listen to heart. No mention of pre-op bloods (I'm equivalent to a 9 yo dog). Makes what we do routinely seem quite thorough. Oh well, expect I'll survive.

Re: Euthanasia Consent Forms

Niall Taylor — Wed, 06 Oct 2010 07:14:53 GMT

[quote user="toby travis"]On seeking clarification from the RCVS...[/quote]

Well there's your problem right there - never, ever seek 'clarification' from the RCVS on anything if it can be avoided. Vague is good.

When asked they will always make up a ruling that covers themselves without a thought for the practicalities or ethics of the subject. We made the mistake of doing the same when there was a rash of local practices getting carrier bags printed with practice names on and we were told by RCVS that to do so would be unacceptible. Were any of the other practices reprimanded for doing so? No. Did we go ahead and get the bags printed? Yes. Never again.

Niall

Re: Euthanasia Consent Forms

Niall Taylor — Wed, 06 Oct 2010 07:09:00 GMT

[quote user="jamie winstone"]

I realise this is a minority view point but I see the paperwork as an excessive intrusion which may cause offence.[/quote]

Stick to your guns Jamie, it's possible to obtain and record consent without subjecting a grieving owner to further distress.

Niall

Re: Euthanasia Consent Forms

Michael Woodhouse — Wed, 06 Oct 2010 00:21:10 GMT

Almost always get pet owners to sign a consent form. Never with farmers dogs. Don't usually if we go out for euthanasia, depends on the client. Don't always bother if owner very upset, sometimes I feel a bit of paper is an unnecessary intrusion at an emotional time.

Re: Euthanasia Consent Forms

nikki — Tue, 05 Oct 2010 22:40:54 GMT

always a signed consent form for any euthanasia and anything coming out the back for any procedure. also get 2 people to witness verbal consent over the phone for euthanasia.

Re: Euthanasia Consent Forms

svn — Tue, 05 Oct 2010 22:23:33 GMT

In cases where the owner is unable to sign a form, we have 2 members of staff 'hear' verbal consent - usually just by pressing speakerphone for a few seconds, rather than making the client repeat it twice!

Re: Euthanasia Consent Forms

Rob Loxley — Tue, 05 Oct 2010 22:19:36 GMT

[quote user="toby travis"]On seeking clarification from the RCVS, they say that to become a general small animal accredited practice, in every case of euthanasia a signed consent form is required. [/quote]

'“Admitted” means where an animal is in the care of the veterinary surgeon and is outwith the presence of the owner."

Maybe the person at the RCVS you spoke to might explain what to do when I phone Mrs Smith to say that sadly at ex-lap mets through the liver and spleen have been found and she requests that her dog be euthanased while under GA? Wait for her to come and sign a form??