In the dilemma discussed in the September issue of In Practice, a practice has introduced average amount billed per consultation as a key performance indicator for vets and, since then, a vet has been prescribing antimicrobials in situations in which he would not have done so previously or in cases which do not warrant it (IP, September 2017, vol 39, pp 382-383). Anne Fawcett and Thomas Gottlieb discuss virtue ethics and say that there is an expectation that vets do not pursue personal gain at the expense of their clients. They discuss the Tragedy of the Commons, which hinges on the belief that personal gain should not be sought at the expense of others, pointing out that imprudent use of antimicrobials contributes to antibiotic resistance. Fawcett and Gottlieb conclude that antimicrobials should be excluded from practice profitability calculations.
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