Frequency, Stressfulness and Type of Ethically Challenging Situations Encountered by Veterinary Team Members During the COVID-19 Pandemic

Abstract

Ethically challenging situations (ECS) are common in veterinary settings and can lead to moral stress. However, there is no published information about how a global pandemic affects the frequency and types of ECS encountered by veterinary team members. An online mixed methods survey was developed to determine the frequency, stressfulness and types of ECS experienced by veterinarians, animal health technicians and veterinary nurses since the advent of the global COVID-19 pandemic in March 2020. Responses from 540 veterinary team members from 22 countries were analyzed. With the advent of the COVID-19 pandemic, the median frequency of ECS encountered by respondents increased from several times per month to several times per week (Spearman Rank Correlation 0.619, P < 0.0001). The most common ECS (encountered at least several times per week) were: challenging decisions about how to proceed when clients have limited finances (64.4%), conflict between personal well-being and professional role (64.3%), conflict between the interests of clients and the interests of their animals (59.6%). These were followed by challenging decisions about what counts as an essential veterinary service (48.1%); conflict between well-being of family/household members and professional role (46.3%); and challenging decisions about whether to perform non-contact veterinary visits (46.3%). The most stressful ECS (reported to be very or maximally stressful) were: conflicts between the interests of clients and the interests of their animals (50.2%), other (42.9%), conflicts between the interests of my employer and my own interests (42.5%), challenging decisions about how to proceed when clients have limited finances (39.4%), conflict between personal well-being and professional role (38.0%), and conflict between well-being of family/household members and professional role (33.6%). Thematic analysis of free-text responses revealed biosecurity, client financial limitations, animal welfare, working conditions, and client relations as prominent themes. This is, to the best of our knowledge, the first study to describe the impacts of the pandemic on ECS experienced by veterinary teams globally. It identifies an increase in the frequency of ECS associated with the COVID-19 pandemic, and a number of stressors unique to the pandemic. We identified a number of resources and strategies that may help veterinary team members navigate ethical challenges that may emerge in their daily work, as well as in the context of global crises.

The Human Aspect of Horse Care: How the COVID-19 Pandemic Impacted the Wellbeing of Equestrian Industry Stakeholders

“…Decision making regarding the provision of appropriate care for animals has been, and continues to be, a potential source of stress for veterinarians [17]. During and after the pandemic, veterinarians had additional considerations to take into account when assessing cases, and a recent survey of 540 veterinarians revealed that 46% found decision making around service provision and visits "ethically challenging" during the COVID-19 pandemic [18]. It is possible that pre-existing stressors for veterinarians may have been exacerbated by the accumulation of challenges that presented in day-to-day practice as well as those associated with the pandemic, including teleconsultation.…”

Ethical Challenges Posed by Advanced Veterinary Care in Companion Animal Veterinary Practice

“…[16]. Conflicts between the interests of the owner and the interests of the animal are one of the most common ethical challenges faced by veterinarians and veterinary team members [37,38,[59][60][61][62]]. Yet, it is possible for veterinarians, like other healthcare professionals, to be influenced by considerations other than the needs of the client and the patient.…”

Risk Factors Associated With Increased Ethically Challenging Situations Encountered by Veterinary Team Members During the COVID-19 Pandemic

“…During the COVID-19 pandemic, declared by the World Health Organization on 11 March 2020 ( 7 ), veterinarians, animal health technicians, veterinary nurses, and other health professionals (“veterinary team members”) encountered ECS not documented in previous surveys. A global survey of 540 veterinary team members, found that such ECS included conflict between personal well-being and professional role, and deciding what constitutes an essential veterinary service ( 8 ). They also encountered well-documented ECS, such as dealing with clients with financial limitations, and conflicts between the interests of the animal and those of the client.…”

“…They also encountered well-documented ECS, such as dealing with clients with financial limitations, and conflicts between the interests of the animal and those of the client. Of those experiencing an increase in ECS since the beginning of the COVID-19 pandemic, the median frequency of ECS encountered by respondents increased from several times per month to several times per week (Spearman rank correlation 0.619, p < 0.0001) ( 8 ).…”

“…They must therefore balance the needs of themselves and their loved ones with those of their patients and clients ( 9 ). During the early months of the pandemic in particular, risk management was complicated by uncertainty around the nature and transmissibility of SARS-CoV-2, as well as uncertainty around what veterinary services were “essential,” and which could be delayed ( 8 , 10 ).…”