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What do European veterinary codes of conduct actually say and mean? A case
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Paper

Paper
What do European veterinary codes of conduct
actually say and mean? A case study approach
M. Magalhães-Sant’Ana, S. J. More, D. B. Morton, M. Osborne, A. Hanlon

Codes of Professional Conduct (CPCs) are pivotal instruments of self-regulation, providing the
standards to which veterinarians should, and sometimes must, comply. Despite their
importance to the training and guidance of veterinary professionals, research is lacking on
the scope and emphasis of the requirements set out in veterinary CPCs. This paper provides
the first systematic investigation of veterinary CPCs. It relies on a case study approach,
combining content and thematic analyses of five purposively selected European CPCs:
Federation of Veterinarians of Europe (FVE), Denmark, Ireland, Portugal and the UK. Eight
overarching themes were identified, including ‘definitions and framing concepts’, ‘duties to
animals’, ‘duties to clients’, ‘duties to other professionals’, ‘duties to competent authorities’,
‘duties to society’, ‘professionalism’ and ‘practice-related issues’. Some differences were
observed, which may be indicative of different approaches to the regulation of the
veterinary profession in Europe (which is reflected in having a ‘code of ethics’ or a ‘code of
conduct’), cultural differences on the status of animals in society, and regulatory bodies’
proactivity in adapting to professional needs and to societal changes regarding the status of
animals. These findings will contribute to an improved understanding of the roles of CPCs in
regulating the veterinary profession in Europe.

Introduction and reassure the public, and to provide a framework that will
Veterinarians are members of a regulated profession (European guide practitioners in their decision-making (Rumbold 1999,
Council 2005), playing vital roles in society such as safeguarding Barrett and others 2012). CPCs have been identified as chief
food safety and public health, and promoting animal health and resources in teaching ethics to veterinary students in Europe
welfare. It is usually the responsibility of national veterinary (Magalhães-Sant’Ana and others 2010, Magalhães-Sant’Ana
statutory bodies to act as the guarantors of the technical, scien- 2014). Moreover, the need for knowledge of veterinary norms,
tific and ethical competence of its members. This is achieved in particularly CPCs, has recently been identified as one of the
several ways, including registration (licence to practice), the main drivers for teaching ethics at several European veterinary
establishment of Continuing Professional Development pro- schools (Magalhães-Sant’Ana and others 2014). Despite their
grammes and ethical guidance (Hern 2000). Regarding this last importance to the training and guidance of veterinary profes-
aspect, Codes of Professional Conduct (CPCs) are pivotal instru- sionals, research is lacking on the scope and emphasis of the
ments of self-regulation, providing the standards to which veteri- requirements set out in European veterinary CPCs.
narians should, and sometimes must, comply. In the past, US veterinary CPCs have been criticised for
CPCs serve three essential functions: to regulate members of being strongly anthropocentric, focusing on standards of practice
a profession and ensure high standards of practice, to protect while ignoring, to a large extent, concerns about animals
(Shurtleff 1983, Tannenbaum 1995, Rollin 1999). Rollin (1999,
p.14), for example, recalls how the American Veterinary Medical
Veterinary Record (2015) doi: 10.1136/vr.103005
Association (AVMA) Code of Ethics, 20 years before, failed to
M. Magalhães-Sant’Ana, School of BioSciences, University of address the euthanasia of healthy animals but, in contrast,
DVM, MSc, PhD, Birmingham, Valeilles, France placed a strong emphasis on regulating advertisement. Whilst
School of Veterinary Medicine, M. Osborne, MVB, CertESM, there are studies comparing CPCs in other professions, namely
University College Dublin, MRCVS, Psychology (Sinclair 1996) and Business (Tucker and others
Dublin, Ireland Forenaghts Stud, Naas, Ireland 1999), there has been no systematic analysis of veterinary CPCs.
On secondment from: Escola A. Hanlon, BSc, MSc, PhD, Veterinarians were the first regulated professionals in Europe
Universitária Vasco da Gama, Coimbra, School of Veterinary Medicine, to have a common CPC (FVE 2009a). In May 2008, the
Portugal University College Dublin, Dublin, Federation of Veterinarians of Europe (FVE) adopted the
S. J. More, MVB, PhD, DipPM, Ireland European Veterinary Code of Conduct (EVCC), as a framework
MANZCVS, FANZCVS, DipECBHM, against which member states should develop and devise their
DipECVPH, E-mail for correspondence own national CPCs, on a voluntary basis (FVE 2009b). The
Centre for Vet. Epidemiology and Risk mdsantana@gmail.com EVCC is divided into two chapters, each considering seven stake-
Analysis, University College Dublin, holders, namely animals, clients, the veterinary profession, the
Dublin, Ireland Provenance: not commissioned; veterinary team, competent authorities, society and the environ-
D. B. Morton, BVSc, PhD, FSB, externally peer reviewed. ment. The first chapter, to be ‘implemented within national
DipECLAM(ret), DipECAWBM, MRCVS, Accepted March 9, 2015 codes of conduct’, expresses the core values and principles that
CBE, are shared by all FVE members, while chapter two contains

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Paper
those values that should be ‘taken into account in all revisions of
national codes of conduct’ (FVE 2009b, p.7). The code was
revised in November 2012, introducing responsibilities associated
with the use of medicines (FVE 2012).
The aims of this paper are: (a) to systematically explore the
structure and content of European veterinary CPCs, based on
five study cases (namely Denmark, Ireland, UK, Portugal and the
FVE), and (b) drawing on these results, to make a critical
appraisal of the self-regulatory requirements of the veterinary
profession in Europe. It is intended that these findings will con-
tribute to an improved understanding of the role of CPCs in
regulating the veterinary profession in Europe.
Methods
Selection of study cases
The FVE European Code of Conduct (FVE-EVCC) and national vet-
erinary CPCs of four western European countries were used in
this study, specifically Denmark (Danish Veterinary Association
Code of Ethics—DDD-EKi), Ireland (Veterinary Council of Ireland
Code of Professional Conduct—VCI-CPC), Portugal (Portuguese
Veterinary Order Deontological Code—OMV-CDii) and the UK
(Royal College of Veterinary Surgeons Code of Professional Conduct—
RCVS-CPC).
The case studies were purposively selected, to represent geo-
graphical and organisational diversity in terms of guidance and
regulation of the veterinary profession. In Ireland and the UK, all
veterinarians must be registered with the VCI and the RCVS,
respectively. Additionally, in the UK, the RCVS-CPC has
recently replaced the former Guide to Professional Conduct by
taking the FVE-EVCC as a starting point and has been designed
as a short document with 27 chapters of supporting guidance
(Millington 2012). In Portugal, veterinarians are required to be
registered in the Portuguese Veterinary Order (OMV) but in
effect professional licences are only demanded for those veteri-
narians involved in clinical practice. In Denmark, veterinary pro-
fessional licences are issued directly by the Ministry of
Agriculture, Food and Fisheries and not by the Danish Veterinary
Association (DDD Secretariat, personal communication, October
6, 2014). Furthermore, in Denmark there is no statutory require-
ment to be registered with the DDD, which operates both as a
trade union and as a regulatory body. According to their website
(accessed 4 March 2014), the DDD estimates that 90 per cent of
all veterinarians in Denmark are registered members.
Content and thematic analyses
The CPCs were retrieved in January 2014 from the FVE and the
national veterinary regulatory bodies’ websitesiii. Portuguese and
Danish languages were translated to English by individuals
experienced in the teaching of ethics to veterinary students in
both countries. Content and thematic analyses were conducted
using NVIVO 10 (QSR International 2013) and representatives
of regulatory bodies were contacted by email, where further clar-
ifications were needed.
The analysis involved both quantitative and qualitative
approaches (Forman and Damschroder 2008). For the content
analysis, documents were categorised according to their general
purposes, overall structure, length and phrase formulation. For
the thematic analysis resources were deconstructed and their
contents coded independently from their original chapter
i
DDD-EK – Danish acronym, Den Danske Dyrlægeforening – Etisk Kodeks
ii
OMV-CD – Portuguese acronym, Ordem dos Médicos Veterinários – Código
Deontológico
iii
Codes of Professional Conduct were assessed in January 2014 using the
following web links:
RCVS-CPC: www.rcvs.org.uk/advice-and-guidance/code-of-professional-
conduct-for-veterinary-surgeons/
OMV-CD: www.omv.pt/estatutos/codigo-deontologico/
DDD-EK: www.ddd.dk/omddd/etisk/Sider/default.aspx
FVE-EVCC: www.fve.org/news/publications.php?item=71
VCI-CPC: www.vci.ie/Disciplinary/Documents/
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structure. Several themes—including subthemes—emerged,
representing the range of concepts covered by the documents. As
the documents were being coded, emergent themes were
re-examined iteratively while looking for meaningful patterns. In
order to ensure reliability, two of the authors (MMS and AH)
independently coded one of the documents (VCI-CPC). The
average Cohen’s κ coefficient was k=0.83, indicating excellent
intercoder agreement (Altman 1991). This also allowed for a con-
structivist revision of the themes, by incorporating the coding
consensus process into the thematic analysis (Forman and
Damschroder 2008).
Results
Content analysis
Chapters describing veterinarians’ responsibilities to at least
three stakeholders (clients, the veterinary profession and society)
are present in all CPCs. Separate sections on the use of medicines
and the environment are only found in the FVE-EVCC. The
order in which the stakeholders are considered varies and the fol-
lowing table compares how the information is organised within
the documents (Table 1). In the case of the DDD-EK, the topics
are organised alphabetically and—similarly to the OMV-CD—
do not include topics or chapters specifically devoted to animals.
In terms of formulation, the FVE-EVCC uses the modal verb
‘shall’ throughout the document; other verbs (used once each)
include ‘owe’, ‘may’ and ‘must’. In the case of the RCVS-CPC,
the modal verb ‘must’ is used throughout the main text, while
‘should’ is mostly used in the Supporting Guidance. With few
exceptions, sentences are used in a positive orientation (‘veterin-
ary surgeons must…’). The VCI-CPC uses a more varied formu-
lation, and the verbs ‘should’, ‘must’ and ‘shall’ are frequently
used and often in the same section. Other verbal forms used
include: ‘obliged to’, ‘required to’, ‘responsibility for’, ‘advisable
for’. Both positive (eg must) and negative (eg must not) sen-
tences are used. All the recommendations in the DDD-EK are
expressed using the same positive semantic orientation: ‘It is
considered good ethics to…’ The OMV-CD, on the other hand,
relies frequently on negative orientations. These include terms
such as ‘not allowed’ (art.8), ‘absolutely prohibited’ (art.9;
art.50), ‘forbidden’ (eg art.11; art.12; art.16), ‘reprehensible atti-
tudes’ (art.28). Positive orientations include the use of ‘the duty
for’ and ‘should’.
Thematic analysis
Eight overarching themes were identified during the thematic
analysis: Definitions and Framing Concepts; Duties towards
Animals; Duties towards Clients; Duties towards Other
Professionals; Duties towards Competent Authorities; Duties
towards Society; Professionalism; and Practice-related Issues.
Each theme comprises a number of topics and subtopics
(Table 2). Fig 1 illustrates the extent to which the themes are
covered by each CPC. Almost one-third of OMV-CD and
DDD-EK is devoted to regulating the relations of the veterinar-
ian with other professionals, whereas only a small fraction of
those documents (over one per cent) is devoted to duties
towards animals. Over one-third of the FVE-EVCC is used to
define and frame the concepts being used whereas in the case of
VCI-CPC and RCVS-CPC there is a more uniform coverage of
themes. The following sections describe the range of topics
covered by the five CPCs as well as the most prominent differ-
ences found between them. A more detailed description of the
analysis is available upon request.
Definitions and framing concepts
Table 3 summarises the general ethical principles set out by the
five CPCs. In their practice, veterinarians are expected to accord
with the following general principles.
Duties to animals
In two of the codes, animal welfare is considered to be the
primary concern of the veterinary profession (VCI-CPC;
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TABLE 1: Organisation of chapters in the five Codes of Professional Conduct and approximate overall length
Animals Clients/costumers Veterinary profession Society/public Medicines Environment Length in words

FVE-EVCC 1 2 3 4 5 6 4000
RCVS-CPC (UK) 1 2 3 4 – – 1272 (53000)
VCI-CPC (IE) 1 2 4 3 – – 10000
DDD-EK (DK) – No order—topics are arranged alphabetically – – 1521
OMV-CD (PT) – 3 2 1 – – 7800

The numbers indicate the order by which the chapters are considered within each document. Length of OMV-CD and DDD-EK refers to the original (non-translated)
documents; length of RCVS-CPC is measured without (and with) Supporting Guidance
DDD-EK, Danish Veterinary Association Code of Ethics; EVCC, European Veterinary Code of Conduct; FVE, Federation of Veterinarians of Europe; OMV-CD, Portuguese Veterinary
Order Deontological Code; RCVS-CPC, Royal College of Veterinary Surgeons Code of Professional Conduct; VCI-CPC, Veterinary Council of Ireland Code of Professional Conduct.

RCVS-CPC) and, in the case of the VCI-CPC, a definition is pro-
vided. Concerns with animal welfare include the duty of con-
tinuity of care (VCI-CPC; RCVS-CPC), showing respect for
animals (OMV-CD) and avoiding harm in handling, diagnosis,
treatment and transport (FVE-EVCC; OMV-CD). It also
involves knowledge of animal health and welfare legislation
(FVE-EVCC, DDD-EK), and the duty to report animal welfare
violations to legal authorities (FVE-EVCC).
Concerns with animal enhancement include the use of
performance-altering drugs (VCI-CPC) and surgeries or medical
treatments performed to conceal genetic defects (VCI-CPC),
namely the insertion of prosthetic testicles (RCVS-CPC). It also
includes illegal interventions in order to obtain biological yields
that are beyond the animals’ natural abilities (OMV-CD;
RCVS-CPC). This topic is also related to non-therapeutic surgical
procedures in companion animals, such as tail docking and
removal of dew claws (RCVS-CPC), and to advanced veterinary
interventions, such as canine surgical artificial insemination and
feline renal transplantation (RCVS-CPC).
Animal euthanasia emerged as a topic in three codes
(VCI-CPC; RCVS-CPC; FVE-EVCC). General guidelines for
euthanasia are provided (eg humane, compassionate, out of
public sight, not delegated to others) together with issues of
communication, decision-making and owner’s consent. Other

TABLE 2: Coverage of the eight key themes (and corresponding topics) for each of the five Codes of Professional Conduct
THEMES TOPICS (and Subtopics) FVE-EVCC RCVS-CPC VCI-CPC DDD-EK OMV-CD

Definitions and framing concepts Purposes of the Code (including to whom provisions apply) ✓ ✓* ✓ ✓
General ethical principles ✓ ✓ ✓ ✓† ✓
Definitions (stakeholders) ✓
Provisions for revision ✓
Duties to animals Animal welfare ✓ ✓* ✓ ✓ ✓
Continuity of care * ✓
Five freedoms ✓ ✓
Animal enhancement * ✓ ✓
Research and teaching * ✓ ✓
Euthanasia ✓ * ✓
Surgery * ✓
Duties to clients Respectful communication ✓ ✓* ✓ ✓ ✓
Responsible ownership ✓ * ✓
Respect for autonomy ✓ * ✓ ✓
Informed consent ✓ ✓* ✓ ✓
Confidentiality ✓ ✓* ✓ ✓ ✓
Duties to other professionals Vet and veterinary colleagues ✓ ✓* ✓ ✓ ✓
Vet and the veterinary team ✓ ✓* ✓ ✓ ✓
Vet and non-vet professionals * ✓ ✓
Duties to competent authorities Regulatory body ✓ ✓* ✓ ✓ ✓
Other authorities ✓ * ✓
Duties to society Certification ✓ ✓* ✓ ✓ ✓
Use of medicines ✓ ✓* ✓ ✓
Public health ✓ ✓* ✓ ✓
Environment ✓ ✓* ✓ ✓
Professionalism Acknowledgement of limitations ✓ ✓* ✓ ✓ ✓
Veterinary declaration (oath) ✓
Conflicts of interests ✓ ✓* ✓ ✓ ✓
Continuing Professional development ✓ ✓* ✓ ✓ ✓
Veterinarian wellbeing (including autonomy and physical/mental health) ✓* ✓ ✓
Fraud—misconduct—negligence ✓* ✓ ✓
Publications—press * ✓ ✓ ✓
Titles and qualifications ✓* ✓ ✓ ✓
Personal and professional qualities ✓ * ✓ ✓ ✓
Practice-related issues Advertising—marketing ✓* ✓ ✓ ✓
Ancillary techniques ✓ * ✓ ✓
Clinical records ✓* ✓ ✓
Distance and answering services * ✓ ✓
Emergency 24 hours care ✓ ✓* ✓
Financial issues ✓ ✓* ✓ ✓ ✓
Professional and practice insurances ✓ ✓* ✓
Premises standards and rules ✓* ✓ ✓ ✓

Tick indicates inclusiveness; for RCVS-CPC, tick indicates inclusion within main text and *denotes coverage within Supporting Guidance.
†The General Ethical Principles of DDD are provided separately from the Code of Ethics
DDD-EK, Danish Veterinary Association Code of Ethics; FVE-EVCC, Federation of Veterinarians of Europe European Veterinary Code of Conduct; OMV-CD, Portuguese Veterinary
Order Deontological Code; RCVS-CPC, Royal College of Veterinary Surgeons Code of Professional Conduct; VCI-CPC, Veterinary Council of Ireland Code of Professional Conduct

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1.3
OMV-CD 7.7% 5.5% 34.9 % 6.1 % 23.5 % 15.1 % 17.2 % 111.3 %
%

1.5 3.4 2.5

DDD-EK 15.9 % 10.3 % 36.1 % 18.5 % 21.8 % 110.0 %
% % %

3.2
VCI-CPC 19.8 % 7.9 % 18.4 % 9.8 % 22.6 % 9.0 % 26.3 % 117.0 %
%

3.3
RCVS-CPC 23.7 % 8.6 % 8.1 % 25.0 % 15.7 % 17.2 % 11.8 % 113.4 %
%

FVE-EVCC 40.5 % 9.2 % 9.2 % 15.7 % 13.9 % 12.8 % 6.7 % 2.2 110.2 %
%

0 20 40 60 80 100 120
Definitions Animals Clients Other Professionals Competent Authorities Society Professionalism Practice-related issues

FIG 1: Theme coverage in the five Codes of Professional Conduct. Overall percentages are greater than 100 per cent due to coding overlap.
DDD-EK, Danish Veterinary Association Code of Ethics; FVE-EVCC, Federation of Veterinarians of Europe European Veterinary Code of
Conduct; OMV-CD, Portuguese Veterinary Order Deontological Code; RCVS-CPC, Royal College of Veterinary Surgeons Code of Professional
Conduct; VCI-CPC, Veterinary Council of Ireland Code of Professional Conduct.

related issues include humane culling, mortality insurance productive capacity or appearance of an animal, or might result
(VCI-CPC), the destruction of animals in sporting events, and of in unexpected expenses during the recovery period”. The General
‘dangerous’ dogs, as well as the fate of animals at the end of Ethical Principles (see Table 3) provide the only reference to
regulated scientific procedures (RCVS-CPC). informed consent in the DDD-EK.

Duties to clients Duties to other professionals

Veterinarians and lay staff should treat clients in a courteous
manner (VCI-CPC, RCVS-CPC, OMV-CD) and without dis-
crimination (FVE-EVCC). Communication skills are emphasised
and include explaining treatment options, prognosis, aftercare,
possible side effects, fees and out-of hours service (DDD-EK,
FVE-EVCC). As a subtheme of respectful communication, veteri-
narians have a duty to advise on responsible animal ownership in a
number of situations such as: animal handling and prolonged
care (VCI-CPC); minimising human-related health hazards
(FVE-EVCC); animal identification (ie microchip); and mediating
ownership disputes (RCVS-CPC).
Veterinarians are also required to respect clients’ autonomy.
Owners have the right to choose their veterinarian (VCI-CPC,
OMV-CD) and to seek a second opinion (RCVS-CPC).
Veterinarians should respect ‘owner’s wishes and circumstances’
and not override them, except in cases of owner’s mental incap-
acity or on welfare grounds, such as in some cases of euthanasia
(RCVS-CPC).
The contexts within which veterinarians should ensure
client’s informed consent are seen to vary amongst some of the
codes. Two of the codes state that veterinarians “shall/must
ensure that informed consent (…) is obtained before treatments
or procedures are carried out” (FVE-EVCC/RCVS-CPC).
According to the VCI-CPC, veterinarians have the duty to
inform the owner when heritable defects or diseases are
involved, when carrying out postmortem examinations, and
when obtaining samples from ‘normal animals’. In addition, a
veterinarian should obtain the client’s approval before seeking a
second opinion (VCI-CPC). The OMV-CD specify that owner’s
consent must be obtained, preferably in writing, “before any pro-
longed or onerous treatment or before any surgery that might be
life threatening, or else might put at risk the economic value,
When dealing with their colleagues, veterinarians should have
good relationships of ‘fraternity and solidarity’ (OMV-CD), and
cooperate in a ‘constructive and informative’ manner with each
other (VCI-CPC). This includes seeking a second opinion when
needed, covering for a colleague in an emergency, supersession
and referrals (OMV-CD, VCI-CPC, DDD-EK). Veterinarians
shall not speak or write disparagingly of a veterinary colleague
to the public (VCI-CPC, RCVS-CPC) or in any way offend their
reputation (OMV-CD). Any complaints against a fellow profes-
sional should be addressed in confidence to the regulatory body
(Ethics Committee) (OMV-CD). Disagreements regarding diag-
nosis or treatment should be resolved in private (VCI-CPC).
In their relationship with members of the veterinary team,
employer veterinarians have the duty to provide a fair salary
(FVE-EVCC), plan shifts and holidays (DDD-EK) and ensure
that the employees are given the opportunity for development
of professional and personal knowledge and skills through par-
ticipation in relevant courses (RCVS-CPC, FVE-EVCC). As
employers, veterinarians are liable for the actions of lay staff
(VCI-CPC) and shall ensure that conduct of their personnel—
including students—conforms to the CPC (FVE-EVCC,
VCI-CPC). As employees, veterinarians have a duty to be loyal
and committed, and to carry out the assigned tasks by following
the designated guidelines (DDD-EK). Veterinarians must ensure
that tasks are delegated only to those who have the appropriate
competence and with appropriate supervision (RCVS-CPC,
FVE-EVCC). Veterinarians shall not permit any act of veterinary
medicine to be performed by non-registered persons (VCI-CPC).
Regarding their relationships with non-veterinary professionals,
veterinarians must comply with their CPC when working for or
advising lay bodies or societies or when working as public ser-
vants (VCI-CPC, OMV-CD). They should not take part in

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TABLE 3: Summary of the General Principles set out by the
five Codes of Professional Conduct (CPCs)
CPC General principles
FVE-EVCC ▸ Independence and impartiality
▸ Honesty and integrity
▸ Confidentiality and professional secrecy
▸ Competence and professionalism
▸ Accountability and insurance
VCI-CPC ▸ The primary concern of the profession is for the welfare of
animals;
▸ Perform to a standard of competence acceptable to peers;
▸ Act to promote cohesion within the profession and the trust
of the profession by the general public.
RCVS-CPC ▸ Professional competence
▸ Honesty and integrity
▸ Independence and impartiality
▸ Client confidentiality and trust
▸ Professional accountability
DDD ▸ Animals: promote animal health and welfare; know his/her
capacities and only offer services and use methods he/she is
qualified to; duty to stay professionally updated.
▸ Client: show respect for the client (provide information and
guidance, seek client’s consent, and provide confidentiality);
and be aware of his/her own integrity (including their
obligations as public authorities and their professional status)
▸ Public: responsibility for food safety, public health and to
provide information.
▸ Colleagues: demonstrate collegial behaviour and refrain from
unworthy actions; abide by the authority’s provisions, orders
and regulations.
OMV-CD ▸ honesty, dignity and professional awareness;
▸ appropriate scientific and technical knowledge;
▸ respect for animal life and welfare;
▸ to safeguard the health, conservation, breeding and
management of animal resources (including wildlife), to
safeguard public health and environmental protection.
The information is condensed but the original numbering and order were
maintained. The DDD ethical principles are not included within the Code of Ethics
but instead are presented separately on the DDD’s website
DDD-EK, Danish Veterinary Association Code of Ethics; FVE-EVCC, Federation of
Veterinarians of Europe European Veterinary Code of Conduct; OMV-CD,
Portuguese Veterinary Order Deontological Code; RCVS-CPC, Royal College of
Veterinary Surgeons Code of Professional Conduct; VCI-CPC, Veterinary Council of
Ireland Code of Professional Conduct
commercial initiatives, except those which are part of their job
requirement (OMV-CD). Veterinarians should also redirect
clients in need of financial assistance to charities (RCVS-CPC).
Duties to competent authorityv
Duties of veterinarians to regulatory bodies and legal authorities are
varied, with particular emphasis on their legal obligations.
Veterinarians must adhere to (and should be familiar with) rele-
vant regulatory provisions, such as the Veterinary Practice Act
2005 and the Veterinary Practice (Amendment) Act 2012
(VCI-CPC), the Statutes of the Portuguese Veterinary Order
(OMV-CD), the Veterinary Surgeons Act 1966 and the Animal
Welfare Act 2006 (RCVS-CPC). Veterinarians who are members
of the Danish Veterinary Association are requested to encourage
non-members to join the Association (DDD-EK). The
FVE-EVCC stresses that the public must be confident that
contravention of regulatory provisions will result in
v
‘Competent authority’ means any body or authority which has a
supervisory or regulatory role in a Member State in relation to service
activities, including, in particular administrative authorities, professional
bodies, and those professional associations or other professional
organisations which, in the exercise of their legal autonomy, regulate in a
collective manner access to service activities or the exercise thereof.
(Directive 2006/123/EC)
Paper
proportionate actions by the competent authority. Duties to
legal authorities are especially emphasised in cases of suspected
animal cruelty since veterinarians have an obligation to report
these cases to the authorities, such as District Veterinary Office,
Local Authority Veterinary Service or An Garda Síochána (the
Irish police) (VCI-CPC).
Duties to society
Duties to society emerged within four main topics. Veterinarians
have a duty to “uphold the integrity of veterinary certification”
(VCI-CPC), including an awareness of the 12 Principles of
Certification approved by the FVE (VCI-CPC, RCVS-CPC,
OMV-CD). The responsible use of medicines involves following
best practices “in relation to the recording, prescription, safekeep-
ing, use, supply and disposal of medicinal products”
(FVE-EVCC). The RCVS-CPC describes the responsible use of
veterinary medicines as “one of the major skills of a veterinary
surgeon (…)”. CPCs express particular concern regarding anti-
microbial and anthelmintic resistance (FVE-EVCC, RCVS-CPC),
dangerous and possibly addictive drugs (OMV-CD),
performance-altering drugs and their residues in animals
(VCI-CPC). This topic also deals with safety intervals, making
medicines available to third parties (OMV-CD), the security of
records (VCI-CPC), the prescribing cascade and suspected
adverse reactions (RCVS-CPC). Use of medicines is not men-
tioned by the DDD-EK.
Defending public health involves the promotion of biosecurity
and hygiene standards (VCI-CPC) as well as observing ‘legal
obligations in the food chain’ (FVE-EVCC). It also includes
recommendations about veterinary inspection (OMV-CD),
carcase disposal in practice (VCI-CPC) and drug residues in the
food chain (RCVS-CPC). The RCVS-CPC also includes a refer-
ence to child abuse and domestic violence, and provides contact
details of competent authorities. Concerns with the environment
are only tangentially referred to by VCI-CPC and RCVS-CPC.
According to the FVE-EVCC, veterinarians should attempt to
reduce pollution, promote recycling and the responsible usage of
energy and water. The OMV-CD includes a section on protec-
tion of wild species and the environment.
Professionalism
Veterinarians are reminded that with their privileged position in
society “comes certain rights, but also responsibilities”
(VCI-CPC) and that through their daily professional work, per-
formance and conduct, practicing veterinarians are models of the
veterinary profession at large (DDD-EK). Desirable personal and
professional qualities include independence, impartiality and
integrity, being faithful and conscientious to their clients
(FVE-EVCC), as well as being dedicated, competent and honest
(OMV-CD, RCVS-CPC). Veterinarians are also expected to
“respond promptly, fully and courteously to complaints and criti-
cism” (FVE-EVCC, RCVS-CPC). Only the RCVS-CPC provides
instructions for whistle-blowing, reporting inappropriate
conduct and poor standards of performance of another veterin-
ary surgeon or nurse to the regulatory body.
Veterinarians must be aware of their own limitations in terms of
“knowledge, competence or resources” (VCI-CPC) and “should
deliver only those services for which they are competent”
(FVE-EVCC), except for emergency first aid (RCVS-CPC). They
should refrain from performing veterinary acts or issue state-
ments for which they do not have sufficient knowledge or
experience (OMV-CD, DDD-EK, RCVS-CPC). Faced with diffi-
cult situations such as these, a veterinarian should seek profes-
sional help or refer cases responsibly (DDD-EK, RCVS-CPC).
The wellbeing of veterinarians is also acknowledged; in this
regard, veterinarians have the right to refuse clients’ wishes, pro-
vided that other relevant requirements have been met
(VCI-CPC; OMV-CD), and also to take steps to protect their
own physical and mental health (RCVS-CPC).
All the documents address the issue of conflicting interests.
Conflicts of interest may arise when performing: certification
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Paper
(VCI-CPC, DDD-EK); tasks on behalf of the Competent
Authorities (FVE-EVCC); equine prepurchase examinations; and
independent veterinary advice regarding the health and welfare
of the animals used in experiments (RCVS-CPC). Veterinarians
are required to help police authorities to investigate animal
welfare cases, “regardless of any conflict of interest” (VCI-CPC).
According to the DDD-EK, conflicting situations in which a vet-
erinarian should decline to participate include: being involved in
the case; having an interest in its outcome; being closely related
or related by marriage to one of the parties; or having previously
commented on the case.
Practice-related issues
The CPCs also include recommendations regarding the running
of a veterinary practice. Provisions should be made to provide
24-hour emergency services, and veterinarians should cooperate in
this regard (VCI-CPC, FVE-EVCC, RCVS-CPC). When attending
to services outside the practice premises, veterinarians have the
right not to expose themselves to unnecessary risks (VCI-CPC,
OMV, CD, RCVS-CPC). Veterinarians shall not offer consulta-
tions or prescribe drugs or treatments to animals they have not
observed (OMV-CD).
Marketing and advertising of services and qualifications are
subject to a number of restrictions. According to the DDD-EK, it
is considered good ethics to provide information on practice
accreditation, specialist training and other documented qualifica-
tions. In Portugal, veterinarians are forbidden to be involved in
marketing campaigns, except for the advertising of services and
qualifications (OMV-CD). On the other hand, in Ireland veteri-
narians “have the right to inform the public of services offered”
and are advised to “develop a marketing strategy”. When provid-
ing information, veterinarians must comply with provisions
from the Premises Accreditation Scheme (VCI-CPC).
Veterinarians have a duty to keep clear and detailed written
clinical records, in order to ensure the quality and continuity of
care (DDD-EK, RCVS-CPC, VCI-CPC). This also includes
consent forms (RCVS-CPC) and the labelling of radiographs
(DDD-EK). The ownership of clinical records and diagnostic
tests is also addressed (DDD-EK, RCVS-CPC).
Regarding financial issues, veterinarians should adhere to
appropriate rules for pricing (OMV-CD, FVE-EVCC, DDD-EK,
RCVS-CPC), and guidelines regarding fees and costs of services
such as unpaid bills and unfair competition (OMV-CD) are pro-
vided. The provision of professional indemnity and practice
insurance schemes is recommended (VCI-CPC, FVE-EVCC,
RCVS-CPC). Finally, several topics regulate the ownership, loca-
tion and quality of veterinary premises (VCI-CPC, OMV-CD,
DDD-EK, RCVS-CPC).
Discussion
This study provided an in-depth view of a purposive sample of
European veterinary CPC. It relied on a case study approach,
combining content as well as thematic analyses. This is the first
known empirical study dedicated to evaluating veterinary CPCs.
Previously published literature on the topic was mostly based on
expert opinion (Tannenbaum 1995, Rollin 1999, McCulloch and
others 2014).
The thematic analysis revealed eight key themes covered by
the five CPCs (Table 2). The range of themes identified demon-
strate commonality within the profession. The attention given
to each of the themes, however, varied greatly (Fig 1), which
may be indicative of: (i) different cultures within the regulation
of the veterinary profession in Europe (which is reflected in
having a ‘code of ethics’ or a ‘code of conduct’); (ii) cultural dif-
ferences on the status of animals in society; and (iii) regulatory
bodies’ proactivity in adapting to professional needs and to soci-
etal changes regarding the status of animals.
Cultural differences within the veterinary profession in
Europe are evident in the role of the veterinary bodies in each
jurisdiction. For example, the DDD’s main role is as a trade
union and thus the DDD-EK is a short document, mainly
6 of 8 | Veterinary Record | 10.1136/vr.103005
devoted to regulating the relationships between veterinary pro-
fessionals (see Fig 1). The FVE is an umbrella organisation, with
representatives from 38 European countries of both national vet-
erinary associations and national statutory bodies, and the detail
with which terms and concepts are defined in the FVE-EVCC
(see Fig 1) probably reflects the requirements in terms of trans-
parency and inclusiveness that a pan-European document
entails. In addition, both DDD-EK and FVE-EVCC, are volun-
tary documents while the remaining three are statutory and
required by law.
CPCs are, in essence, anthropocentric because they serve to
protect the public against malpractice. But veterinary CPCs are
probably unique in the fact that they are also zoocentric, by safe-
guarding the interests of animals, alongside those of human
beings (cf. Hanlon and Magalhães-Sant’Ana 2014). In this
regard, both the VCI-CPC and the RCVS-CPC emphasise veteri-
narians’ primary responsibility in defending animal welfare,
while the DDD-EK and the OMV-CD place a greater emphasis
on professional relationships (Fig 1). Moreover, the DDD-EK and
OMV-CD do not reflect direct responsibilities towards animals.
In effect, the term ‘animal welfare’ is only referred to in both
documents as part of the definitions and framing concepts
(Table 3). Probably more significant is the absence of any refer-
ence to euthanasia/humane killing in both codes (Table 2). This
may signify different priorities in terms of the responsibilities of
the veterinary profession towards stakeholders, but could also
reflect cultural differences on the status of animals in society. For
example, the Special Eurobarometers on Animal Welfare
(European Commission 2007) illustrates the diversity of atti-
tudes across European Member States. In effect, the zoocentric
components of the RCVS-CPC may reflect the strong political
tradition of animal protection in the UK (FAWC 2009).
Differences in CPCs may also be related to how proactive
regulatory bodies have been in accommodating the evolving
needs of the veterinary profession and in adapting to societal
changes regarding the moral (and often legal) status of animal.
By way of example, the Portuguese Deontological Code was
approved in 1994 and, despite including provisions for future
revision (see Table 2), in the last 20 years only once have amend-
ments been made. This was to amend the code on the pricing of
veterinary services, which had been subject to a legal action by
the Portuguese Competition Authority (Autoridade da
Concorrência 2005). On the other hand, the VCI-CPC has had
six versions since the Guide of Professional Behaviour was first
issued in 1998 (VCI Administration Office, personal communica-
tion, 16 Jan 2014), and a seventh has since been approved
(November 09, 2014). However, the significance of these changes
has not been investigated. Proactivity can also be illustrated by
the 2012 edition of the FVE-EVCC as well as the recent recom-
mendations provided by the RCVS regarding 24/7 Emergency
Care (Anonymous 2014), already included in the latest version of
the RCVS-CPC.
The content analysis revealed that the RCVS-CPC (excluding
Supporting Guidance) and the DDD-EK (excluding Ethical
Principles) are formulaic and use the same word structure
throughout the document. In addition, they are both short docu-
ments with less than 1500 words. The VCI-CPC and the
OMV-CD, on the other hand, are considerably longer and more
complex documents, both in terms of formulation and overall
structure. This is particularly evident in the VCI-CPC where, the
verbs ‘should/shall’ and ‘must’ are frequently used within the
same section, which could give the impression that these verbs
have interchangeable meanings. The difference between using
‘must’ and ‘should/shall’ is more than semantic as both entail an
obligation: ‘must’ prescribes a correct behaviour, whereas
‘should/shall’ allows for personal discretion and professional
autonomy (McCulloch and others 2014). In fact, a recent quali-
tative study of veterinary educators’ perspectives of their teach-
ing of ethics has identified two visions for the role of veterinary
CPCs: one that sees them as regulations which provide rules of
practice (rooted in the tradition of obeying professional
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obligations), and another that sees them as guidelines which
provide working references and hence enabling for some autono-
mous judgements (Magalhães-Sant’Ana and others 2014). These
results are even more significant bearing in mind that the above
mentioned study was conducted in several of the same jurisdic-
tions used in the present study.
Phrase formulation can have a significant effect on how regu-
latory frameworks are perceived. In this regard, the five CPCs
adopt different framing approaches between promoting good
(“It is considered good ethics to…” —DDD-EK) from preventing
harm (“it is forbidden to…” —OMV-CD). A recent study in
applied psychology has shown that, although people anticipate
that they will be more motivated to perform a task when faced
with positive rather than negative incentives, the opposite
occurs and they end up performing better when avoiding a loss
than when pursuing a gain (Goldsmith and Dhar 2013). These
results seem to confirm the adaptative role of recollecting bad
experiences over good ones (Baumeister and others 2001). Some,
however, reject the idea that ethics is about negative codes of
conduct or moral prohibitions and that, instead, it should be
“about the commitment to positive values to ensure the well-
being and flourishing of individuals and society” (Thompson
and others 2000, p.5). Moreover, negative codes of conduct could
conflict with the fact that people are more inclined in engaging
in morally objectable actions by omission (ie harming by doing
nothing) than commission (ie harming by doing something)
(Anderson, 2003, DeScioli and others 2011).
Furthermore, differences in phrase formulation can reflect
the distinction between the voluntary nature of a code of ethics
(as found in the case of DDD-EK), and the statutory nature of a
code of conduct (as in the case of OMV-CD). Rumbold (1999,
p.258) considers a ‘code of ethics’ as an aspirational “statement
about what the profession believes itself and its purpose to be”,
whereas a ‘code of conduct’ provides a “statement about how
the profession considers its members should behave toward
clients, society as a whole and each other”. Aspirational codes of
ethics, however, are more difficult to enforce than mandatory or
coercive codes of conduct (Sinclair 1996).
The way the information is organised is also relevant. For
example, in their revision of the EVCC, the FVE has differen-
tiated duties to society from those to medicines (FVE 2012). It
seems strange, however, that veterinarians should have direct
moral duties to medicines, since medicines are only instrumental
and do not have intrinsic worth. A different structure would
probably be preferable. The duty to use medicines responsibly is,
in fact, a duty to others, namely society, and in this analysis,
responsible use of medicines has been considered as being part of
veterinarians’ societal duties. The VCI-CPC presents the relief of
animal pain and suffering as both a responsibility to animals
(chapter 2) and to clients (chapter 3). The structure used in the
RCVS-CPC helps to avoid these overlaps because the background
information is annexed as Supporting Guidance, irrespectively of
what stakeholder is being considered. However, the RCVS-CPC
describes the Supporting Guidance as ‘essential’ ( p.11) for the
regulation of the profession despite being presented as supple-
mentary information, which might be somewhat confusing. In
addition, the RCVS-CPC is condensed to such an extent that
important ethical issues are only mentioned as supporting guid-
ance and with little linkage to the main text. The supporting
guidance on euthanasia, for example, is only referred to in the
main text within the context of effective communication and
informed consent (responsibility 2.4), which can be insufficient
to instruct a busy veterinary practitioner into the ethical com-
plexities of euthanasia and end-of-life issues (Yeates and Main
2011, Dickinson and others 2014). These results mirror the con-
cerns expressed by others (McCulloch and others 2014).
This study used a relatively small number of CPCs. Although
the jurisdictions were intentionally selected to represent western
European diversity in terms of veterinary regulation, it is reason-
able to suggest that additional approaches may exist and future
studies on the current subject are therefore recommended.
Paper
Furthermore, this is a cross-sectional study rather than longitu-
dinal and therefore it does not take a retrospective look at the
foundation and development of regulatory documents over time.
Also, the fact that the study relied on the translation of
Portuguese and Danish to English may have distorted some sen-
tences from their original meaning, although precautions were
taken to prevent this.
Conclusion
CPCs play a pivotal role in the regulation of a profession but it is
not always clear what they should include and how they should
best be framed, bearing in mind the different roles played by
veterinarians in society and the diversity of contexts in which
veterinarians operate. Some have even questioned if it is possible
to conceive a CPC that is common to every field of veterinary
activity (McCulloch and others 2014). The national codes con-
sidered in this paper vary from prescriptive rule-books dictating
right actions, to descriptive guidelines upholding autonomous
judgements, possibly reflecting differing cultural biases between
countries. On the other hand the FVE code attempts to accom-
modate this diversity of contexts in one overarching document
and the question remains of whether this is possible, or even
desirable. Interdisciplinary research strategies are required to
further elucidate these issues. These findings will contribute to
an improved understanding of the roles of CPCs in regulating
the veterinary profession in Europe.
Acknowledgements
The authors thank Trine Dich and Stine B Christiansen,
University of Copenhagen, for their help in translating the
Danish Code of Ethics and for additional comments. The
authors also thank representatives of national regulatory bodies
and Nancy De Briyne, from FVE, for their valuable clarifications.
MMS thanks the Veterinary Council Educational Trust Newman
Fellowship in Veterinary Ethics for financial support.
Funding The research project was funded through the Veterinary Council of Ireland
Educational Trust and the Newman Foundation. However, these organisations did not
influence the study design, data collection and analysis, and manuscript preparation.
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What do European veterinary codes of

conduct actually say and mean? A case
study approach
M. Magalhães-Sant'Ana, S. J. More, D. B. Morton, M. Osborne and A.
Hanlon

Veterinary Record published online April 10, 2015

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