Thursday, September 18, 2008

Veterinary Ethical Standards Support; Not Oppose, Treatment

I decided to look up the ethical standards for vets and see what they said, since it seemed that was what some of these people were so afraid of, and I was pleasantly surprised that they are overall in our favor!

I think these excerpts support our advocacy for this treatment!


Veterinarians should first consider the needs of the patient: to relieve disease, suffering, or disability while minimizing pain or fear.

It is clearly in Carmella's best interest to do this procedure (injecting Newcastle Disease Virus Vaccine into the spinal canal to kill the Distemper virus so it will not continue to damage her brain, spinal cord, and myelin). The sentence referring to minimizing pain or fear is meant to allay the dog's fear (not making the vet's fear first priority by not doing what's necessary). This treatment would certainly "relieve disease, suffering, and disability."


Attending veterinarians are responsible for choosing the treatment regimens for their patients. It is the attending veterinarians responsibility to inform the client of the expected results and costs, and the related risks of each treatment regimen.

*It is unethical for veterinarians to prescribe or dispense prescription products in the absence of a VCPR. (VCPR is an acronym for veterinarian-client-patient relationship)

*It is unethical for veterinarians to promote, sell, prescribe, dispense, or use secret remedies or any other product for which they do not know the ingredient formula.

*It is unethical for veterinarians to use or permit the use of their names, signatures, or professional status in connection with the resale of ethical products in a manner which violates those directions or conditions specified by the manufacturer to ensure the safe and efficacious use of the product.

Since NDV is neither secret nor the ingedients unknown, and full disclosure has been provided as to what it and the dog-based serum is made of, these vets have absolutely nothing to worry about in terms of ethical violations.

The NDV packaging insert also does not say it is unsafe to use this in a smaller dose in dogs than is generally used for chickens (which is actually safer), so that clause is satisfied.

The dog-based serum formula devised by Dr. Sears himself has instructions to it as to exactly how it should be used, yet there are some vets who deviate from it anyway, (so they couldn't be too afraid of that clause).

Furthermore, there is no treatment proven to kill the Distemper virus that a vet has to offer as a qualitatively equivalent alternative.

Here is the oath veterinarians take:

Being admitted to the profession of veterinary medicine, I solemnly swear to use my scientific knowledge and skills for the benefit of society through the protection of animal health, the relief of animal suffering, the conservation of animal resources, the promotion of public health, and the advancement of medical knowledge. I will practice my profession conscientiously, with dignity, and in keeping with the principles of veterinary medical ethics. I accept as a lifelong obligation the continual improvement of my professional knowledge and competence.

This implies pretty strongly that a vet is expected to do whatever he can to protect animal health, and not to merely rest on tradition, but to learn new things, be open to new discoveries, and to advance.

I noticed that noplace in the ethical standards did it ever say that using "experimental" or new treatments was in any way unethical. I'm sure the board realized that to impose a rule like that would cut off people's noses despite their faces when not all disease can be cured with conventional methods and new discoveries are made all the time and take time to become accepted. I'm sure they had a legal expert go over it with a fine-toothed comb and that there was a good reason in their not making a rule against it.

As Dr. Sears says; "There's a good reason why it's called private "practice". Granted he said that a little bit tongue in cheek, but nevertheless it just goes to show that not everything in science or medicine fits into a perfectly neat little box and you've got to be willing to go out on a limb sometimes even if it is scary and somewhat uncharted territory. Look at firefighters. They do that all the time and consider it all in a day's work. There are times when you just have to throw the book out the window and get in there and make an executive decision to put that client first. This is one of those instances.

I printed out another Atlanta vet listing today; eight full pages of names! There's a clinic on there I used to take my animals to for many years, although they've changed vets many times. I don't know if the management is still the same but they used to be very willing to work with various situations and were even good about not charging alot. I'll call and see if they might be a possibility.

It also occurred to me that it would be a good idea for Carmella to have an MRI to see exactly how bad and where the damage is in her brain. If nothing else, Dr. Johnson, the local neuro vet at Georgia Veterinary Specialists should be able to do that. Maybe that will tell us how much time we have to get her help before the damage is too severe and how fast the virus is moving.

Today I sent off something to the Regional office of the Humane Society to see whether they'd post about Carmella on their website and/or any newsletters that go out to readers.

Then I called Dr. Norwood's office and asked whether we needed a new referral for that or not. He'd already left for the day, but should be back tomorrow. Between the most recent appointment and now, in the interrim Felicia has warmed up to Carmella and I. I think we've grown on her, and the whole staff having seen us through the ups and downs sees where I'm coming from more so than ever. I may be wrong, but what I heard on the other end was not a kiss-off at all. Dr. Norwood was back from a week in Aruba and things seemed as though they were the same as they'd always been, only maybe now we were considered long-time clients of theirs. There is an invisible line one crosses over between being "just another client", to the kind that seems patinaed with age in the most fond of senses, and it felt as though we'd crossed over into that realm, and not only on their end. Why otherwise would it matter to me?

This is what I never had the chance to say to my best friend as we were doing our usual brainstorming before things turned suddenly and unexpectedly dark and perilous like a hurricane coming out of nowhere. It was like a scene right out of a Lifetime television movie (if you've seen many of those true stories then you know the pattern). She referred to me as her "very good friend" so maybe the "best friend" thing isn't as mutual as I thought. Well I am trying like hell to be philosophical about this right now but still I'm crying my eyes out at midnight, and I'm just so tired. I don't mean sleepy, just tired of feeling like I have to go it alone, and then what hit me tonight was just too much. Talk about "in your face!" Sheesh!

When I brainstorm I just try to think of every angle (and with something as serious as what's happening to Carmella you have to). Short of doing something illegal I consider no ideas off-limits. It's a creative process I've learned and I use it in my art as well. One cannot be creative if you're always censoring the free flow of though as it comes in and through you. Some ideas are viable and should be used and some, maybe not, but if you cannot allow yourself to explore all the possibilities then you get bogged down and you may miss alot of good strategies, designs, or what have you. I thought I could do that with my friend without being judged. It's not like I have a team of people working on this. I don't know for sure what it's going to require to bring this into being, but at least I'm thinking and throwing out ideas. They can't all be in final draft form right out of my head. I guess what hurt most was that my thought/sentence that had somehow set off this explosion of protestation came about after ideas she had posed. We were both going along that train of thought as a team and suddenly she diverged, like a wishbone, one half cracking suddenly and severely away from the other. That's the best way I can describe it. It wasn't like she said, "Well let's not do that because ---this would be a better strategy." Somehow instead it got all personal and negatively charged emotionally. I didn't see it coming and in my overtired state it was just one more big log on the pile of obstacles I did not need.

When I think about it objectively it sounded really like it may have had nothing at all to do with this situation about me and Carmella but something she was going through, that instead of just telling me about it so that I could empathize, got all melded into what we were talking about in this.

Making me the target of the angst over any number of stresses she had going on in her own life really didn't help either one of us or Carmella. The particular trigger had something to do with the concept of obligation/trickery, and now with some distance from having been blind-sided I think I know where that's coming from and it's not about me. I know that the situation she's dealing with was thrust upon her just as this one was thrust upon me so that should make us allies, but who knows maybe sometimes feelings just get misapplied in the wrong places mismatched to the wrong people. I do realize that she's got alot on her plate too and Carmella's situation being so catastrophic requires me to spend just about every waking moment on this as a matter of sheer survival. There's just no way around it.

Any of you who have watched the Lifetime television movies knows that these kinds of "orphaned" situations require that the one person centrally responsible for fixing it have almost tunnel vision until a solution is found. That is the nature of the beast and it's what it takes to get it done.

My friend paints me as this extraordinarily strong person, but then the same could be said about her with her situation because she hasn't dropped it no matter how hard things have gotten. I'm not sure that I'm any stronger than she is. It may be more the fact that when you are chosen for one of these marathon catastrophic events you can't get out of it so you adapt and do what you have to do to get through it. The faces and the names may be different, but the principles are the same.

I do have an obligation to Carmella, and I don't resent it, I don't have time. All emotional resources are needed to deal with whatever comes, but just as I told Felicia at Dr. Norwood's office on the phone today, carrying this on my shoulders is hard. It's really hard. She told me that I was brave to be sending out all these press releases to news agencies to get Carmella the help she needs, but I just feel like I'm doing what I have to do to get the job done, putting one foot in front of the other. That's what you do when you care. It's not even a conscious decision. It's this un-namable thing propelling me into action. I know I've heard others who've said the same thing. I'm not that unique.

Maybe nature or God gives you the inner strength to do what needs to be done when those resources are required.

This can take a toll on other relationships in the meantime, but those of you who have seen those real-life movies know that there are two types of archetypes in those movies; those who don't go the distance, and those who are true friends or family, and their love is the real deal. They may not fully "get it" for awhile and be off on their own stint for a moment, convinced that you're way off-base, but those come back with an even stronger understanding of your passion for the issue, and a renewed faith in you and in the relationship.

Sometimes people don't wait to hear the other stuff that's in your head or they have to let it germinate for awhile before they understand what you're really trying to say. It's kind of like those news stories where the papparazzi takes a celebrity's statements out of context, little snippets here and there, and formulates an opinion based on those, like text cut from random magazines, then pieced together. It has the illusion of the whole picture but isn't really.

I went in and hugged Carmella and she greeted me with her loving eyes and in her usual coy way, curled up in my lap. I met her approval.

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