Ethical dilemmas encountered by small animal veterinarians: characterisation, responses, consequences and beliefs regarding euthanasia.

Small animal veterinarians' opinions were investigated regarding the frequency and nature of ethical dilemmas encountered, beliefs regarding euthanasia and balancing client and animal interests, prevalence and value of ethics training and proposals to mitigate the stressful effects of ethical dilemmas. The majority (52 per cent) of 484 respondents in the USA indicated via an online survey experiencing an ethical dilemma regarding the interests of clients and those of their patients at least weekly. Scenarios involving client financial concerns were commonly reported causes of ethical conflicts. While only 20 per cent of respondents indicated that other practitioners prioritise patient interests, 50 per cent of respondents characterised their own behaviour as prioritising patients. Most respondents (52 per cent) reported that ethical dilemmas are the leading cause, or are one of many equal causes, of work-related stress. Less experienced practitioners, general practitioners and associate veterinarians were more likely to encounter situations they defined as ethical dilemmas, and female respondents were more likely to find ethical dilemmas stressful. Most small animal veterinarians experience ethical dilemmas regularly, which contribute to moral stress. Results suggested that most small animal practitioners believe that greater awareness of moral stress and providing training in ethical theories and tools for coping with ethical dilemmas can ameliorate moral stress.