Moral conflict and moral distress in veterinarians: a mixed-methods approach.

Veterinary professionals are often confronted with moral conflicts from which moral distress can develop. Moral distress can lead to a cascade of deleterious processes and outcomes including emotional anguish, distress, reduced patient care, and attrition from both the workplace and workforce. The current study established a pilot measure for moral distress in Australian veterinary clinicians, as well as reporting additional sources of moral and ethical conflicts in veterinary practice. The pilot scale was based on adapting the Measure of Moral Distress for Healthcare Professionals (MMD-HP) to the veterinary context and analysing responses from 643 veterinarians in Australia to create the Measure of Moral Distress for Veterinary Clinicians (MMD-VC). The MMD-VC comprised three sub-scales: (1) team communications that compromise patient care, (2) conflicting client interactions and (3) situations perceived as a personal threat. The additional sources of moral and ethical conflict that were reported by respondents to an open-ended survey question reflected two themes: (1) Animal Health, where the conflict arises from the effect of a situation on the animal patient and (2) Human Interactions, where the conflict relates to interpersonal relationships rather than to the animal patient. The results contribute towards developing comprehensive measures of moral and ethical conflict in clinical practice, and these measures can inform and evaluate intervention strategies designed to mitigate the harmful effects of moral distress in veterinarians.