To Report or Not to Report: Is That the Question?
The relationship between veterinarian and 'patient' is unique in more ways than one might think. Recognizing that we are looking at this relationship as it pertains to the reporting and/or investigation of alleged neglect and abuse, there are some key elements to consider.
When we look at human victims of rape, assault, neglect or other forms of abuse there are, more often than not, first- or second-hand accounts – by the victims or others - of the events leading up to or surrounding the act. Whereas in the case of animal abuse or neglect, unless someone has witnessed the act and reports it to the authorities, the victim can never verbalize what actually transpired. More often than not this means that unless the owner of the animal or a witness reports the crime, it will never be discovered. No starving horse, no abused dog, no tortured cat has ever picked up the phone and asked for help. There must be, in each and every case, a person who steps forward to advocate for the animal. And since owners are often the ones inflicting the neglect or abuse and witnesses only observe a fraction of the actual cases, this places the veterinarian in a very unique posture. The veterinarian might well be the only hope, the last line of defense for a creature that cannot speak for itself.
Law enforcement agencies and physicians have struggled with the issue of doctor-patient confidentiality on such issues as rape, incest, child neglect and family matters for decades. Only during recent times have roles and responsibilities become more clearly defined. Still, there remains broad latitude and interpretation of reporting laws from state to state and between the US and Canada.
ER Physicians Initially Concerned
One obvious concern among emergency room physicians was the potential to discourage people from seeking treatment if the patient, patient-guardian or spouse knew beforehand that law enforcement or social services would become involved post treatment. Indeed, there exists still today, a reluctance among some patients, guardians, spouses, etc. to bring a patient in for an injury or illness if they perceive that officials may scrutinize them. Horror stories of accidents being interpreted as intentional abuse are still recounted in modern society. Recently, a Michigan father delayed seeking treatment for his son who had suffered a broken arm. In a subsequent interview with the child’s father, he related that his estranged wife had often threatened to accuse him of abuse as a leverage mechanism in their ongoing court battle over custody for the child. Ironically, the father realized a self-fulfilling prophecy as his delay in seeking treatment for his son saw him charged with neglect.
Mandatory Reporting by Veterinarians
During recent years, several state, provincial and regional governments have grappled with the concept of requiring mandatory reporting of veterinary concerns. The American Veterinary Medical Association Model Veterinary Practice Act includes the reporting of known or suspected cruelty to animals, animal abuse, or animal neglect as defined by law. But there is a vast difference between mandatory reporting and suggested reporting. As of 1997, mandated reporting of animal abuse was required in Minnesota, West Virginia and Quebec, Canada. A call to the Alberta SPCA Enforcement Division suggests that veterinary professionals are “expected to report” but not mandated by law.
Liability and Client Privacy Concerns
Like their human physician counterparts, veterinarians are concerned about a host of issues pertaining to mandatory reporting. Perhaps the biggest legal obstacle is the threat of civil action by the owner of the animal. Loss of business or a “bad rep” in the community were also cited as concerns. In California, Arizona, Idaho and West Virginia veterinarians are protected from civil litigation under state law. These laws indemnify the veterinary professional for “good faith reporting”. Indeed, many more veterinarians surveyed have indicated they would report abuse more often if they felt protected by law.
In an interesting twist, veterinarians in Colorado and California are mandated reporters of child abuse but not animal abuse. But why would a veterinary clinic be a mandated reporter of child abuse? Simply put, there is an undeniable link in the pattern of violence against people and animals. It is a proven fact that persons who commit acts of abuse against animals are much more likely to do the same to people and while it may be ironic or even confusing to require a veterinarian to report child abuse and not animal abuse, these laws, policies and suggestions all point toward a society that is becoming increasingly aware and proactive about the humane treatment of animals.
Is there a pat answer?
If common sense could be legislated, all of society's ills would be resolved with the stroke of a pen. We could eliminate unnecessary, cumbersome laws with the signing of one simple law mandating common sense. Unfortunately, we have swung the pendulum far beyond the point of recall and common sense will never be enacted as a law. Nonetheless, veterinarians are, for the most part, still free to exercise common sense when attending to their daily practice. In effect, veterinarians should resolve to “do the right thing” within reason and common sense.
It is speculated that during the next decade, most states and provinces will enact some form of mandatory reporting. This makes reporting compulsory and may take any latitude of discretion away from the doctor. In this scenario, there is a potential for innocent lives to be ruined on both sides of the fence. It is important that we understand the mechanics of abuse and neglect to better understand reporting.
Mechanics of Abuse and Neglect.
The difference between abuse and neglect is more than semantics. Recognizing these differences is as important as understanding the mechanics between the two.
Intentional abuse is just that. The word “intent” denotes that the act was done in a purposeful manner and was no act of omission nor was it born out of ignorance or neglect. Neglect cases outnumber abuse cases by a ratio of 10-1. Still, any investigator will tell you that they can recall, in great detail, nearly every abuse case they have handled while neglect cases are a blend of owner ignorance and financially motivated woes. Stabbing, hanging, lighting on fire and other unimaginable forms of torment are commonplace in abuse investigations. Virtually every serial killer apprehended during the past century had some history of animal abuse in his or her criminal history.
Animal abuse and domestic violence as well as collateral family violence go hand in hand. This is exactly the reason why Colorado authorities mandate that both animal control officers and veterinarians report child abuse. Authorities recognize that these two groups of professionals are often exposed to episodes of animal abuse and therefore, are likely to witness some other evidence of family violence such as child abuse. There should be no question in anyone’s mind as to the importance of reporting intentional abuse.
Animal neglect is not as neatly packaged as abuse. Neglect can mean a variety of things. Most obvious are:
1. Failure to provide adequate shelter
2. Failure to provide necessary sustenance, which might include food or water.
3. Failure to provide veterinary care for an existing illness or injury.
The reasons for animal neglect are even more open to interpretation. During the course of my career as a state investigator, special agent and director of two of the largest animal enforcement agencies in the US it is estimated that I processed, investigated or otherwise supervised more than 10,000 neglect and abuse investigations. My first- and second-hand knowledge of these cases makes me absolutely qualified to offer the following patterns in a factual rather than simply anecdotal fashion. Causes for animal neglect in order of occurrence are:
1. Owner ignorance - basic lack of understanding
of the needs of that particular animal
2. Financial - bankruptcy, loss of work, divorce, overspending and general lack of resources
3. Plain apathy - laziness, lack of moral discipline. Instant gratification society means instant divestiture society. Easy come, easy go etc. These are the kind of people that would rather sit on the couch with a six-pack than show up at an absolutely free spay and neuter clinic. Too lazy to drive to the vet, pick up hay, clean stalls etc.
4. Narcotics abuse - substance addiction, alcoholism
5. Domestic violence - husband cuts off pets to punish spouse, father won’t feed dog to punish child, etc.
Because of the diverse scenarios behind neglect, reporting by the veterinary community requires equally diverse discretion and therefore would be dangerous to legislate. More often than not, neglect can be resolved by education, assistance and support. Understanding and programs aimed at helping those in need are the absolute best recourse for these situations. Reporting should be reserved for those given the opportunity to correct or amend a neglect situation that have chosen to consciously ignore these efforts.
Too many humane organizations and animal rights groups place their emphasis strictly toward saving or helping pets when it is the animal steward or owner that programs should be aimed at helping. In effect, help the owner and you help the pet.
One exception to this, however, might be exigent circumstances cases. In 1999 I received a call from a well-known and respected equine veterinarian. He had been called to a barn for the first time to treat a horse that was down. Upon his arrival he observed a 7-year-old gelding, which was subsequently scored at a 1.5 on the Henneke scale. The horse was in an advanced state of wasting and needed to be euthanized. A field necropsy and subsequent laboratory tests confirmed starvation as the primary factor for the horse's condition. Other horses at the barn were also scored at between 2 and 3.0. Several horses were seized and the owner, a drug addict, subsequently convicted.
The dilemma that arose was this:
Should the veterinarian, when summoned to the barn to help horses, and upon his observation of these horses observe an advanced state of neglect, notify authorities? And what is his liability? After all, he was summoned there by the same people he subsequently reported.
It is reasonable and prudent for a veterinary professional to step forward and advocate for animals in dire need and it is necessary for veterinarians to report any and every case of intentional abuse. Veterinarians should be allowed some latitude when reporting neglect, but horses found in an advanced state of neglect, when the neglect is clearly severe or intentional, even when it is the owner/caretaker who summons the veterinarian, should be reported.
In cases of owner ignorance, reporting should be a last-resort option for the veterinarian. Everyone wins when people and communities come together to educate and assist those who have allowed neglect to occur through misunderstanding or lack of proper skills. However, when it is obvious that any reasonable or prudent owner could be taking remedial steps and they choose not to, the veterinary professional should elect to summon a responsible agency to investigate, whether it is the owner/caretaker or someone else who summoned the veterinarian.
Any animal owner, caretaker or admirer can help stop abuse and neglect by recognizing and reporting it. To help recognize equine abuse and neglect, one can become familiar with the Henneke Body Scoring guidelines, and contact the local animal protection organizations or humane societies for information. Suspected abuse and neglect cases can be reported to these organizations, to the state Department of Agriculture Equine Services Division, or to the local sheriff or police.
© Kimball Lewis
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About the author:
Kimball Lewis is recognized as one of North America’s leading experts on neglect and abuse issues. After a lengthy career as an abuse and neglect investigator, Lewis now travels and lectures throughout the United States, Canada, Great Britain and Australia on a variety of topics including the link between violence against people and animals and abuse and neglect. You can email the author at email@example.com.