P from Georgia asked the question “I am currently treating a dog with demodectic mange. The dog has not been spayed as the owners are considering breeding her despite my recommendation that she be fixed. Am I liable in any way if I continue to treat this dog (for her own well being) and she goes on to have demodex-affected puppies?

Great Question. We all have clients who do not follow our recommendations.

There is no specific additional liability to continuing to provide care at least to the level of the standard of care required by the Veterinary Practice Act. In Georgia, that means it must be above the minimum standard of acceptable and prevailing veterinary medical practice (GA 43-50-41 (6) ).  You must also continue the VCP, which means they must have agreed to follow the instruction of the licensed veterinarian. (GA 43-50-3-(15)).

Typical cases of professional liability require a duty, a breach of that duty, and damages resulting from that breach. As a professional, your duty is held to the higher standard of your profession, which I listed above. You only have that duty if you have a VCP, and it appears they did agree to follow your instructions, although you are working out portions of that. I would not interpret the VCP to mean they have to follow every recommendation or option presented, but rather generally to follow your instruction on care and not refuse all options presented. That’s just my reading, but it seems to match most Veterinary Medical Board’s interpretations of that clause.

Assuming that you had a duty, and you breached that duty by not following the professional standard of care, what are the damages of Demodex Affected Puppies? Assume you did not warn the owner of the risk. Then you may, and I do mean *may* because I am not an expert on veterinary medical standards for Demodex, have breached your duty of care. If you did, then typical damages might be veterinary expenses, the difference in value from demodex affected puppies and non-demodex affected puppies, and with a generous ruling, perhaps incidental expenses. Unless these are really rare breed puppies, it should be a relatively small liability, and it’s the type of claim that PLIT or a similar professional insurance typically covers (subject to insurance policy exclusions for things such as intentionally giving poor advice.),

But what does this all mean for us? It means you have very low risk of liability if you follow the standard of care with a properly established VCP. This ties back to the ethical requirement of “do no harm.” I’d certainly document your advice, and provide clear warnings to the owner. I’d also outline your protocol of diagnostics care for the potential litter, if they have demodex-affected puppies. Providing well documented education and advice on the consequences of refusing recommended care is important to help show how you meet the standard of care, as is providing options for care if your primary choice is rejected.

Thanks for the great question.

Now let’s get better togeterh.