Ethically challenging situations encountered by veterinary team members

Veterinary team members (VTMs) commonly encounter ethically challenging situations (ECS). ECS can lead to moral distress & impact the safety & welfare of patients. Literature searches (1990−2020) & a focused review on advanced veterinary care (AVC) identified key ECS. A global survey of VTMs during the early COVID-19 pandemic explored frequency, stressfulness & types of ECS encountered by VTMs. Frequency increased for almost half of VTMs during the pandemic. ECS encountered by VTMs, resources used to resolve ECS, & barriers to resolution are discussed. Risk factors for experiencing increased ECS during the pandemic included being a veterinary nurse or animal health technician, working with companion animals, working in USA/Canada & having low confidence dealing with ECS in the workplace. Qualitative analysis identified key factors that may lead to or exacerbate ECS during the pandemic: communication challenges & low or no-contact euthanasia. Strategies to prevent or mitigate ECS are recommended. Access to resources (e.g. technology to facilitate telemedicine, protocols to facilitate low-contact euthanasia) are needed to prevent/mitigate ECS impacts. Ethics rounds (ER), used in medical settings, was trialed with VTMs, who completed the Euro-MCD 2.0 pre & post. The Euro-MCD evaluates outcomes of ethics rounds across domains of moral competence, moral teamwork & moral action. VTMs improved in the domains of moral competence & moral teamwork after 1 session of ER. ER has potential to improve the ability of VTMs to identify & navigate ECS & to mitigate moral distress. Recommendations: veterinary empirical ethics research to include perspectives of non-veterinarian VTMs & clients, develop a validated measurement of veterinary team member moral distress, challenge the triad of veterinary stakeholders, further evaluate & develop CESS, conduct regular surveillance of ECS & to prepare VTMs, clients, animals & other stakeholders for ECS occurring in emergencies