Ethical dilemmas in clinical practice: a perspective on the results of an electronic survey of veterinary anaesthetists

Lehnus, Kristina S.; Fordyce, Peter; McMillan, Matt

doi:10.1016/j.vaa.2018.11.006

Cited by 13 publications

(16 citation statements)

References 29 publications

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“…The pre-pandemic frequency of ECS reported by veterinary team members is comparable with previous surveys on the frequency of ECS experienced by veterinarians. Pre-COVID-19 surveys suggested that veterinarians experience an ECS at least weekly, with 57% of UK veterinarians reporting 1-2 ethical dilemmas per week (range 0 to more than 10 times weekly) (n = 58) (4), 52% of US veterinarians experiencing an ECS at least weekly (n = 484) (3), and veterinarians, animal health technicians and veterinary nurses globally (n = 183) reporting a median of one ethical dilemma per week (22).…”

Section: Discussionmentioning

confidence: 99%

“…Previous surveys have identified client financial limitations as common ECS encountered by veterinarians and veterinary team members. For example, veterinary anesthetists and technicians reported that animal care was impacted by financial constraints in 29% of ethically challenging cases (22). However, while identified as the most common ECS in some surveys of veterinarians, the same respondents reported client financial limitations as the least stressful ECS (2,4).…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2021

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

et al. 2021

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“…Of these, respondents never ( n = 308, 39.74%) or rarely ( n = 292, 37.68%) complied with these requests. Finally, a study of 183 veterinary anaesthetists found that 4% ( n = 9) raised euthanasia of healthy animals or animals with diseases they perceived to be readily treatable as concerns [ 15 ].…”

Section: When Is Euthanasia Ethically Indicated?mentioning

confidence: 99%

“…In a study of UK veterinarians ( n = 58), clients wishing to pursue treatment despite poor animal welfare or poor quality of life was rated as the most stressful ethical challenge, more stressful than a request to euthanase a healthy animal [ 29 ]. In a study of North American veterinarians ( n = 889), 56.95% sometimes and 21.58% often managed cases where they felt an owner requested treatment which they perceived to be futile [ 14 ], while 18% of veterinary anaesthetists felt that euthanasia was delayed beyond the point that they felt was appropriate, and 14% facilitated procedures that they felt did not improve an animal’s quality of life [ 15 ].…”

Section: What Is the Impact Of Ethically Indicated Euthanasia On Veterinary Team Members?mentioning

confidence: 99%

“…Finally, there are many who would argue that the world would be better without capital punishment. In contrast, veterinary team members report refusal of euthanasia recommendations by a client, or requests for futile care despite a poor quality of life, as among the most stressful ethical challenges encountered in companion animal practice [ 6 , 15 , 29 ].…”

Section: Is a Veterinarian Who Performs Ethically Indicated Euthanasia Really Akin To An Executioner?mentioning

confidence: 99%

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The Gift: Ethically Indicated Euthanasia in Companion Animal Practice

Quain

2021

Veterinary Sciences

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The majority of companion animals seen by veterinary practitioners will die by euthanasia. Yet euthanasia can be a source of moral stress for veterinary team members, even when ethically indicated. In this discussion, I explore when euthanasia is ethically indicated and discuss the potential impact of ethically indicated euthanasia on veterinary team members. In particular, I challenge the analogy that the veterinarian performing ethically indicated euthanasia is akin to an executioner, arguing that this analogy is both inappropriate and potentially harmful. Finally, I discuss how we can support ourselves and our colleagues in relation to euthanasia, so we can attend to and maximise the welfare of our patients at the end of their lives.

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