I love my dog. On my days off I usually plan my activities around dog-friendly destinations. Tolerance for dogs in public places such as hotels, stores, and taxicabs is quite variable, while tolerance for dogs in restaurants, theatres, and on public transit is practically nonexistent. My dog likes to accompany me on pleasant chores like visiting the hardware store. So imagine my anger when we were asked to leave a big-box hardware store because they’d changed their dog-friendly policy, when at the same moment a small Boston terrier, wearing a service-dog jacket, accompanied by his seemingly nondisabled owner, marched into the store unencumbered.
So what are the rules for having a service dog? Service dogs encompass a broad range of animals that have been trained to assist their handlers with physical or psychiatric disabilities. According to a for-profit organization named Service Dogs Canada, in order to qualify as a service dog the dog has to be safe in public and able to obey a number of commands such as “sit,” “stop,” “heel,” and “down.” Owners are allowed to home-train their dogs. Service Dogs Canada charges a $199 fee to obtain a personalized service dog certificate, a wallet card, and a dog vest with service dog patches.
What does this have to do with the practice of medicine? The dog handler must have a disability. Service Dogs Canada allows for a self-declaration, recognizing that “every person in America may have some form of disability.” This might be great for traveling in the United States, where the Disabilities Act requires public access for service dogs and the definition of disability is broad. In Canada we are somewhat more suspect of individuals with disabilities without some form of legitimate confirmation. Recent cases of patients with invisible disabilities such as PTSD being denied canine access to restaurants are a good example of this.
Until recently the only regulation in BC pertaining to service dogs was the Guide Animal Act (RSBC 1996 Chapter 177). This Act defines a person with a disability as “a person who is apparently blind or otherwise disabled and is dependent on a guide animal or white cane.” Moreover, the animal has to be used by disabled persons “to avoid hazards or to otherwise compensate for disability.” This Act is more in keeping for Seeing Eye dogs but does not legitimize or define canine assistance for many other reasonable circumstances. In response to a number of organizations representing guide and service dog users, government has introduced Bill 17, the Guide Dog or Service Dog Act.
The new Act is more prescriptive of certification of dog training, access to public places, and tenancy, and it proposes the appointment of a registrar of guide dogs and service dogs who will grant certification. This Act allows for yet-to-be-created regulations about the conditions, qualifications, and requirements that must be met by individuals and dogs. The comprehensiveness of these regulations has the potential to be of concern to physicians in that approving a disability that merits the use of a guide or service dog undoubtedly will become our task.
As practising physicians we are challenged enough adjudicating on work limitations imposed by various disabilities while trying to be responsible patient advocates. Will regulations for Bill 17 set out clear criteria about the types and severity of disabilities that will qualify an individual for a guide or service dog?
Bill 17 is a good step toward curbing the current self-certification of service dogs. However, unless physicians have objective information on applicable disabilities to enable us to make a judgment, patients will soon discover which of us like dogs and which of us do not.
Above is the information needed to cite this article in your paper or presentation. The International Committee
of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally
accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.
About the ICMJE and citation styles
The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.
An alternate version of ICMJE style is to additionally list the month an issue number, but since most journals use continuous pagination, the shorter form provides sufficient information to locate the reference. The NLM now lists all authors.
BCMJ standard citation style is a slight modification of the ICMJE/NLM style, as follows:
- Only the first three authors are listed, followed by "et al."
- There is no period after the journal name.
- Page numbers are not abbreviated.
For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit www.icmje.org