Like many professional regulators, such as those for doctors or teachers or lawyers, the College of Veterinarians of Ontario does not wish to attract public attention only, or frequently, for its discipline cases.
But now that Ontario’s drastically outdated veterinary oversight laws are being updated and new legislation brought into effect, with sharper disciplinary teeth to bring veterinary professionals into line when they stray, a few recent prosecutions give a sense of just what a professional regulator sometimes has to deal with at the extremes.
There is, for example, Matthew Allossery of Mount Albert, Ont., who according to a disciplinary decision, punched a horse called Sapphire in the face and kicked it in the abdomen during a dentistry procedure. Then, when Sapphire’s owner posted security camera video of this misconduct online, Allossery posted a detailed justification of it (“This horse was a complicated case,” he began), which violated his duty of client-patient confidentiality.
There is also Ashok Dua of Burlington, Ont., who botched the tail amputation on a Great Dane called Titan so badly the dog died in untreated pain. And there is Vipulkumar Patel of London, Ont., who according to a discipline decision told a woman her cat Sammy had leukaemia, offered to hug her, resisted her efforts to pull away, asked to kiss her, then rubbed her back as she left, all of which amounted to professional misconduct and sexual abuse.
Hardly representative of the profession, they are nevertheless problem cases that need to be addressed.
But the old ways were sluggish, weak, and ran the risk of being ineffectual or at least inefficient, according to Jan Robinson, registrar and chief executive of the College of Veterinarians of Ontario.
The same went for ensuring even good veterinarians maintain their competence under required orders outside of the discipline process, as other professional regulators use. If a vet declined to participate, there was precious little the College could do about it.
Likewise, there was no way, for example, to do an interim suspension of a veterinarian’s licence in egregious cases. Most of the rules about how to deal with complaints were in legislation, not the regulations made under it, so the system was sluggish and clumsy, stuck in its ways, unable to adapt by using the same strategies as other regulators, such as mandatory quality assurance programs.
When complaints about veterinarians spiked during the pandemic, they followed the familiar spectrum. Typically, three quarters are eventually dismissed; some are seen to be valid complaints but ultimately just errors or misunderstandings; and a very few are serious discipline cases. But the system was overwhelmed. What once took about a year now takes three. There is a major discipline “bottleneck,” Robinson said.
The legislation that passed last year, and which is now being brought into force, is a once-a-lifetime legal overhaul of the veterinary profession. It aims to ease this “bottleneck” even as it expands its disciplinary role to include other members of the veterinary clinical team, said Jan Robinson, registrar of the College of Veterinarians of Ontario.
The College is reinventing itself under the new governing legislation passed last year, vastly expanding the scope of practice and bringing a whole professional sector, veterinary technicians, under its authority.
“It’s like a capstone project,” Robinson said. “This doesn’t come around very often. It’s usually several decades between opportunities for change.”
It will streamline the discipline system to allow easier triage at the intake stage, with fewer committees, and more efficient investigations. There will be a new larger college, the College of Veterinary Professionals of Ontario, which already has a transition council.
The Ontario Association of Veterinary Technicians, whose members will now be regulated in a new legal framework by the same college as veterinary doctors, rather than regarded as self-regulated “auxiliaries,” called it “a significant, positive development in the regulation and modernization of veterinary care for the benefit of animals, veterinary teams, and the public.”
Lisa Thompson, Ontario’s minister of rural affairs, said in the legislature last year that since the law was last updated in 1989, the practice of veterinary medicine has “evolved significantly, transforming the way animals are cared for in Ontario. Veterinary care is increasingly being provided by a team of qualified professionals, including both veterinarians and veterinary technicians.”
She described meeting a veterinarian and team of vet techs in Thunder Bay and saw “they could do so much more if their complete scope of practice and training was officially recognized.”
So the changes, widely supported in legislature and long overdue, reflect a more current view of the place of animals in society, from the tiniest pet dog to the largest dairy cow, and how to best care professionally for their health.
They aim to strike a balance among the rights of animals, the rights of the people who own them, the professional duties of veterinarians or technicians, and the commercial liberties of livestock farmers.
“Therein forever lies the challenge of a regulator,” Robinson said.
But the new legislation has also drawn criticism that it could unfairly hobble livestock farmers by banning anyone but a veterinarian from performing procedures such as dehorning, ultrasound to monitor pregnancy, and artificial insemination.
It has also inspired worries among animals rights activists that, from the patients’ perspective, this overhaul of veterinary medicine fails to solve some of the most pressing concerns about animals whose health and welfare is at risk.
In the new scheme, there is just one overarching definition of veterinary medicine, and two parallel professions, veterinarians and technicians.
Similar to human health care, there are now authorized activities spelled out in the new law that only a veterinarian can perform. These include diagnosing, medically assessing, ordering lab tests, prescribing drugs, performing procedures that pierce the skin or mucous membrane or teeth or cornea, invasive use of an instrument, including artificial insemination.
Some of these cannot be delegated to veterinary technicians, but some can, either directly or under a standing medical order, or in some cases a tech can initiate a procedure such as an intravenous line. It also allows veterinarians to delegate some procedures to people who are not licensed by the College, as in the livestock industry.
A key element of how these laws integrate with farming is called the “Risk of Harm” clause, and basically says no one other than a vet or vet tech can treat an animal or advise its owner to do anything about its health in circumstances where serious bodily harm is reasonably foreseeable.
This puts the duty on the veterinary professionals in the livestock industry to ensure their own training is up to standards, and it empowers the new College to level fines against companies whose employees or contractors flout this rule.
Camille Labchuck, lawyer and executive director of Animal Justice, a national animal law advocacy group, is not reassured. She points to broad exceptions for owners of animals or the staff they employ.
“We have seen lots of unqualified people performing veterinary procedures on animals on farms, doing it lawfully,” she said.
Just because animals are legally regarded as property, it does not follow that they cannot have “small R” rights, an enforceable legal status, like the right not to be poisoned or treated cruelly, Labchuk said. Her team’s undercover investigation of an Ontario pig farm in 2020, for example, revealed grotesque scenes of poorly performed castrations on piglets, and of a C-section performed on a conscious mother pig to obtain the piglets before she died in pain.
“Allowing that mass exemption to perpetuate to me is troubling,” Labchuk said. “There will always be people who are willing to accept money to perform unconscionable interventions on animals.”
In the household pet context, Labchuk mentioned cosmetic ear cropping and tail docking on dogs, widely banned across Canada, and said Ontario is the only Canadian province that still allows cat declawing.
Robinson said the College does not support medically unnecessary interventions, but said its policies are premised on trusting a veterinarian’s best judgment.
Listing prohibited procedures constrains and “erases” the expertise of the veterinary professional who is trusted to make the best decision for the animal, Robinson said. “That is not where you want to see professional regulators start to fetter, because that list is endless.”
“Because animals are property, whether we like it or not, there are scenarios where people can do things to animals,” Robinson said. If there are practices that society regards as unacceptable, that should be an animal welfare law, not a matter of veterinary regulation, Robinson said.
Labchuk said it is “disturbing” to hear that position, and that declining to ban procedures is out of step with wider societal attitudes. She said there are signs the societal concept of animals as property is slowly eroding.
“Sure, legally, they’re considered property, but that’s not how anyone in society thinks about animals, unless you’re a farmer raising them for profit,” Labchuk said. “They’re family members. People respect the existence of animals. They’re not like a chair or a toaster.”
“We’re talking about entities that have moral value,” Labchuk said. “I think over time their status will inevitably change.”
In the meantime, legislative rebirth has inspired a boldness of vision, as the College tells it.
There is a new scheme, for example, developed along with agricultural industry groups in the College’s “sandbox” program of pilot projects, to resolve a problem in emergency veterinary care for livestock in rural Ontario, where it can be hundreds of kilometres between clinic and farm.
Under this new plan, three veterinary practices can share a hub staffed by veterinary technicians, who could be dispatched in emergencies and report back remotely to a veterinarian who can make the decision about what is wrong and what to do, whether further tests or treatment or stabilizing the animal for transport.
There is also the wide open blue sky of artificial intelligence, with all its promise and peril.
“We are the first regulator internationally to publicly speak about this,” Robinson says about the concept of “software as a medical device,” the emerging area of health care that uses artificial intelligence and other computerized tools to improve veterinary medicine, especially in diagnostic procedures.
The challenge is there is no oversight or regulation by authorities like Health Canada or the Standards Council of Canada as there is in technology like X-rays or CT scanners. It is hard, therefore, to know what new technology is useful, or indeed dangerous.
“It lands on the veterinarian, trying to decide what’s good, bad or ugly,” Robinson said. “This is walking the imperfect road.”
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