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.
Highlights
IntroductionEthically challenging situations (ECS) are commonly encountered in veterinary settings and can lead to moral stress
Under normal circumstances, ethically challenging situations (ECS) are commonly encountered in veterinary settings and can lead to moral stress
The median frequency of ECS encountered by veterinary team members increased from several times per month to several times per week with the advent of the COVID-19 global pandemic
Summary
Ethically challenging situations (ECS) are commonly encountered in veterinary settings and can lead to moral stress. Previous surveys have identified the most common ECS as client financial limitations restricting treatment options [1,2,3], and euthanasia in general [2]. Due to restrictions on movement and closures of non-essential services, veterinarians may have been required to cull animals, for example surplus livestock [9] or animals in research settings [10]. Veterinary team members were forced to limit the range and volume of services provided, due to lack of staff, limited access to PPE, or restrictions impacting ancillary services such as diagnostic laboratories and suppliers of goods and services [11, 12]. One study documented a reduction in mental well-being of equine veterinarians and veterinary nurses since the advent of the COVID-19 pandemic [13]
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