12. Use and re-use of samples, images, post mortems and disposal

Informed consent

12.1  There may be occasions when veterinary surgeons have to consider taking samples for diagnostic or treatment purposes, or post-mortem. These ‘samples’ may include blood, tissue, body parts or whole cadavers. After samples have been taken, it may be that the re-use of the sample for other proper purposes is considered.

12.2  The starting point for the use of samples is informed consent. A client should consent to a sample for initial diagnostic or treatment purposes, whatever the size or species of the animal, whether it is a farm animal or domestic pet and whether the animal is living or dead. Generally, a client should also consent to any re-use of the sample for other purposes.

12.3  The RCVS has produced detailed guidance on informed consent. This includes guidance on written/oral consent; contractual relationships; establishing who the client is; confirming the client has understood what has been said; mental incapacity; dealing with young persons and children; and, consent forms.

(Communication and consent)

12.4  In situations where another veterinary surgeon becomes involved in the treatment of an animal, for instance, with a referral or transfer to a dedicated out-of-hours provider, the referring veterinary surgeon should ensure that consent is obtained from the client for the referral. View further information about referrals and the transfer of personal data. Once the animal has been transferred to the second practice, consent for procedures subsequently carried out is a matter for the second practice.

Disease surveillance schemes and the re-use of samples

12.5  Veterinary surgeons may take samples from animals for testing for treatment purposes, academic research or statutory purposes. Generally, samples will be taken with the consent of the client for a specific purpose.

12.6  Under current legislation in England and Wales, samples can be taken under the Animal Health Act 1981 as amended for the control of specified diseases, but this legislation arguably provides insufficient powers for general and pre-emptive surveillance testing. Scottish legislation does allow the use of samples for more than one purpose. There are additional provisions set out in European legislation with regard the taking of samples.

12.7  The legal obstacles to the re-use of samples for general disease surveillance can be overcome with the specific consent of the client. This could be set out in a suitably worded consent form, making the client aware of the re-use of the samples from their animal.

12.8  If the client’s personal data will be collected with or connected to the samples from their animal, the consent form should provide clear information about how that data will be used, by whom and for what purpose(s). The form can ask for consent to the collection and processing of the data, or it may be more appropriate to rely on another legal basis, for example if it is necessary to process the data for compliance with a statutory obligation, to perform the contract with the client, to perform a task in the public interest, or possibly for the purposes of the veterinary surgeon’s legitimate purposes. The form should make clear which basis is being relied on.

12.9  The re-use of samples without the consent of the client may be reasonable for animal welfare or public interest reasons, for example, disease surveillance by the State, or where obtaining the consent of the relevant animal owners is impracticable and the samples are re-used anonymously. Nevertheless, consent should be obtained wherever possible.

Images

12.10  Generally, a veterinary surgeon should seek client consent before taking images of animals, especially where it would be possible to recognise the animal and therefore possibly the client. Clients should also be informed about the ways in which the images will be used. Where possible, further consent should be obtained if the images are used in a way that is not covered by the original consent (for example, if images of an animal are taken for use in a casebook, they should not subsequently be used on a practice website without further consent from the client).

Pathology

12.11  Diagnostic veterinary pathology is covered by the definition of veterinary surgery and is legally undertaken only by veterinary qualified pathologists. The generation of objective numerical clinical pathology data (for example, blood biochemistry and haematology) is acceptable only if it excludes diagnostic interpretation. Surgical and post-mortem pathology is inherently diagnostic and is fully within the legal definition of veterinary surgery.

Post-mortem examinations

12.12  The veterinary surgeon should ensure that the client has been fully advised of the scope of the post-mortem examination and/or any limitations to manage client expectations, and understands not only the financial implications of that request, but also that the findings may prove inconclusive. The veterinary surgeon should give the client the option of an examination by an independent veterinary surgeon.

12.13  In cases in which the owner has retained the cadaver of an animal following treatment by a veterinary surgeon prior to its death, and subsequently requests another veterinary surgeon to carry out an independent post-mortem examination, the normal ethical rules regarding supersession and second opinions do not apply. Nevertheless, generally the original veterinary surgeon should be advised by their colleague that the post-mortem examination is to be carried out and should be invited to provide information regarding previous treatment as an aid to the preparation of an accurate report. The results of the examination must, however, be communicated only to the client and not to the original veterinary surgeon without the client's consent.

12.14  Veterinary surgeons wishing to carry out a post-mortem examination upon the cadaver of an animal which they have previously treated, in order to satisfy themselves as to the cause of death (rather than at the request of the client), must seek the permission of the client to carry out such an examination. Consent may be provided verbally, for example, by telephone, although it is best practice to obtain the consent in writing, for example, on a specific consent form which may provide for the use and re-use of samples.

12.15  Veterinary surgeons should be mindful that owners may be in an emotional or distressed state at this time.

Disposal

12.16  Generally, a veterinary surgeon should seek informed consent from the owner to disposal options for the cadaver and should ensure that any third party involved in the disposal is appropriately licensed, for example, if the animal is to be cremated.