Ethical conflict and moral distress in veterinary practice: A survey of North American veterinarians

Abstract

BackgroundConcerns about ethical conflicts, moral distress, and burnout in veterinary practice are steadily increasing. Root causes of these problems have not been rigorously identified. Little research has been done to evaluate the existence of moral distress in North American veterinarians or to explore its impact on career sustainability and poor well‐being.Hypothesis/ObjectivesEthical conflict and resultant moral distress are common occurrences in contemporary veterinary practice and negatively impact daily practice life, but may not be identified or labeled by veterinarians as such.AnimalsNo animals were used in this study.MethodsMixed methods sequential explanatory design; confidential and anonymous on‐line sampling of 889 veterinarians in North America.ResultsA majority of respondents reported feeling conflict over what care is appropriate to provide. Over 70% of respondents felt that the obstacles they faced that prevented them from providing appropriate care caused them or their staff moderate to severe distress. Seventy‐nine percent of participants report being asked to provide care that they consider futile. More than 70% of participants reported no training in conflict resolution or self‐care.Conclusions and Clinical ImportanceVeterinarians report widespread ethical conflict and moral distress across many practice types and demographics. Most veterinarians have little to no training on how to decrease the impact of these problems. Ethical conflict and resulting moral distress may be an important source of stress and poor well‐being that is not widely recognized or well defined. Well‐researched and effective tools used to decrease moral distress in human healthcare could be adapted to ameliorate this problem.

Veterinarians Experience Animal Welfare Control Work as Stressful

“…Official veterinarians may not have adequate professional qualifications to get through challenging client interactions when the clients also have serious personal problems (25). Versatility of work 12 (18) People (both work community and clients) met at work 10 (15) The responding official Finnish veterinarians required more training in interaction skills. This was quite opposite to the Irish governmental veterinarians who did not want to have more education in this area (25).…”

“…There are several studies on the well-being of veterinarians and it has been shown that the rates of suicidal behavior [see for review (11)], stress (12)(13)(14), and mental health problems (12,15) are elevated. Causes of veterinarian stress include long work hours, conflicting client relations (16), interference with the work-home balance (17), low income, high debt (14), ethical conflicts, and moral distress (18).…”

DVM students report higher psychological distress than the Australian public, medical students, junior medical officers and practicing veterinarians

“…Other difficult clinical decisions such as convenience euthanasia of a healthy animal and financial limitations of the client can cause great moral distress . Veterinarians reported that their training did not adequately prepare them to manage ethically challenging situations . As ethically challenging situations may lead to moral stress or moral distress, preparing veterinarians to navigate ethically challenging situations might be helpful.…”

One Health: How Interdependence Enriches Veterinary Ethics Education

“…Especially the third interpretation of interdependence-interbeing-might end up paralyzing veterinary students. Moreover, moral problems in veterinary practice already represent a great challenge, not to mention the perils of moral distress that arise when professionals are insufficiently able to live up to their own moral ideals because of the way in which their working environment and its demands structure and restrict individual agency [40].…”

“…However, letting complexity and conflicting demands narrow and blunt moral agency should be prevented if only to protect the wellbeing of veterinarians themselves. Paradoxically, numbing oneself in order to deal with moral distress can easily backfire [40], which is why becoming aware of the ways in which one's agency is shaped over time, embedded within a certain environment, and confronted with a myriad of diverging expectations, could help to bolster robust moral agency.…”