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

Abstract

Background: Concerns 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/objectives: Ethical 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.

Animals: No animals were used in this study.

Methods: Mixed methods sequential explanatory design; confidential and anonymous on-line sampling of 889 veterinarians in North America.

Results: A 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 importance: Veterinarians 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.

Keywords: burnout: professional, negotiating, self-care, mental health, morals, surveys and questionnaires, medical futility, suicidal ideation, compassion fatigue, dissent and disputes; stress: psychological, morals, suicide, ethical theory, ethical dilemma, empathy.