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My research on ethical challenges experienced by veterinary team members during the pandemic revealed two key headaches for veterinary teams.
Analysis of responses to our survey suggests some solutions to minimize or avoid these headaches in the future.
Do you remember what you were doing when you first heard about COVID-19? I was at a dinner in a crowded restaurant when a friend mentioned a Pro-Med post about a novel coronavirus in Wuhan. “Who knows,” he shrugged. “It really could turn out to be the big one”.
Not one of the people present anticipated the declaration of a global pandemic two months later, let alone the public health measures to promote social distancing, the border closures, the panic buying, the sudden demand for and global shortage of PPE.
At the time, I was working in a companion animal practice in Sydney, and undertaking a PhD on ethical challenges faced by veterinary team members. Suddenly, colleagues began talking about ethical challenges they’d not faced before: Should I go to work and risk my safety and that of my family? (Remember, at the time there were no vaccinations in Australia, no anti-virals, and confusion about how infectious the disease was). When it comes to veterinary care, what counts as an “essential service”?
I was able to “pivot” my PhD, and develop a survey on ethical challenges faced by veterinary teams during the pandemic, which was open to veterinarians, veterinary nurses, animal health technicians and other veterinary team members around the world.
We found that since the advent of the pandemic, almost half of the respondents had experienced an increase in ethically challenging situations. (You can read about the most common and most stressful challenges here: https://www.frontiersin.org/articles/10.3389/fvets.2021.647108/full).
We undertook a risk factor analysis and found that while gender, age and experience didn’t seem to influence the likelihood of experiencing increased ethical challenges, working in companion animal practice and being a non-veterinarian team member did (read more about these and other risk factors here https://www.frontiersin.org/articles/10.3389/fvets.2021.752388/full)
The free-text responses recounted harrowing experiences – not just of veterinary team members, but also from the point of view of witnessing the distress of veterinary clients and our patients.
Why should you still care?
Unfortunately, COVID-19 has proven to be persistent, mutating and leading to subsequent waves.
COVID-absenteeism continues to impact the veterinary sector – in fact, it has impacted every sector.
Climate-related disasters and the war in Ukraine are leading to and exacerbating global supply chain issues and social disruption.
In other words, it is worth learning from past experiences and preparing for emergencies. Future emergencies, including pandemics, are likely.
Emergency planning isn’t sexy. It takes time and money and isn’t a KPI in most workplaces. But it is an investment in your team’s future and continuity. It is an investment in animal welfare. It is an opportunity to ensure that painful lessons learned throughout the COVID-19 pandemic, weren’t experienced in vain.
Veterinary team members told us that communication was harder during the pandemic. This largely boiled down to:
These challenges were made all the worse because they weren’t really expected.
Subsequent studies confirm that these challenges were a big concern for clients of veterinary services (see for example this UK study https://bvajournals.onlinelibrary.wiley.com/doi/10.1002/vetr.1681).
(You can read our full findings and recommendations here: https://onlinelibrary.wiley.com/doi/full/10.1111/avj.13125)
Low-contact euthanasia involves performing euthanasia in a way that maximises social distancing, but while the client is still present. Often it involved reducing the number of clients who could be present (e.g. just allowing one owner to be present). Some veterinary teams were able to perform euthanasia out of doors.
No-contact euthanasia involves separating the animal from the client (where the client wishes to be present) to ensure that the veterinary team have no contact with the client. This occurred more commonly earlier in the pandemic.
For a sector predicated on the promotion of the human-animal bond, separating an animal and their owners at the end of life can be experienced by some as a violation of their core values.
Unsurprisingly, we found no-contact euthanasia – where owners could not be present with their animal – to be a unique moral stressor for veterinary team members.
They also expressed the difficulty of balancing veterinary team safety with the emotional needs of clients to have close physical contact with the animal, but also with the veterinary team on occasion.
Physical distancing was more challenging in euthanasia consultations than in other consultations.
There was also the concern that low and no-contact protocols caused or worsened fear, anxiety and distress in veterinary patients.
Biosecurity measures such as mask wearing and social distancing complicated communication around euthanasia and end-of-life decision-making, and may have also impacted the timing of euthanasia and whether an animal was euthanased when indicated, or whether euthanasia was delayed.
You can read our full account here: https://www.mdpi.com/2076-2615/12/5/560
The development of vaccinations, more widespread availability of PPE and the lifting of social distancing public health orders have reduced the need for low and no-contact euthanasia for now. But in the event of future social distancing requirements, it would be ideal for minimizing risks to veterinary team members while avoiding no-contact euthanasia.
Veterinary team members need to be able to perform euthanasia safely in a variety of situations, including pandemics.
Low-contact euthanasia is not ideal but is the lesser of two evils when compared with no-contact euthanasia. Doing it well requires preparation.
More detail is provided in our paper. https://www.mdpi.com/2076-2615/12/5/560
What were your experiences during the pandemic?
What measures has your team implemented in light of these experiences? Share your experiences in the Comments section below.
Anne Quain is a companion animal veterinarian and a lecturer at the Sydney School of Veterinary Science. She is a member by examination in the animal welfare chapter of the Australian and New Zealand College of Veterinary Scientists and is a Diplomate of the European College of Animal Welfare and Behaviour Medicine in Animal Welfare Science, Ethics and Law. She co-authored the book Veterinary Ethics: Navigating Tough Cases with Dr Siobhan Mullan, and is the author of numerous academic publications including peer-reviewed journal articles and book chapters. Her research interests include animal welfare and ethics. In addition, Anne was co-editor of the Vet Cookbook, an initiative to promote mental well-being in veterinarians, nurses and others working with animals.
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