Arbe Montoya Alejandra I, Matthew Susan M, Jarden Aaron, Hazel Susan J, McArthur Michelle L
School of Animal and Veterinary Science, University of Adelaide, Roseworthy, South Australia, Australia.
College of Veterinary Medicine, Washington State University, Pullman, Washington, USA.
Vet Rec. 2023 Oct 21;193(8):e3173. doi: 10.1002/vetr.3173. Epub 2023 Jul 16.
Veterinarians may face various ethical decisions and potential moral conflicts in clinical practice. The ethical decision-making process often leads to a satisfying resolution. However, when such a process is accompanied by a perceived inability to act according to a person's values, it can lead to psychological distress that characterises moral distress. Theoretical models in professions such as nursing attempt to explain the evolution of moral conflict into moral distress. In veterinary professionals, a model has been proposed to explain this pathway (the moral deliberation pathway). However, empirical data are still lacking on whether veterinary clinicians experience a moral deliberation pathway as hypothesised.
Using thematic analysis, this qualitative study investigates veterinary clinicians' experiences with moral distress and aims to explain the moral deliberation pathway in these veterinarians.
The results suggest that veterinarians' experiences with moral distress follow a deliberation process that can be explained by the proposed moral deliberation pathway. Experiencing a moral conflict leads to moral stress, then either to moral distress or resolution into moral comfort.
Self-selection of participants and possible recollection bias may have biased the findings.
The empirical data provided by this study can inform future research and intervention strategies to identify, measure and manage moral distress in the veterinary context.
兽医在临床实践中可能面临各种伦理决策和潜在的道德冲突。伦理决策过程通常会带来令人满意的解决方案。然而，当这样的过程伴随着一种无法按照个人价值观行事的感觉时，就可能导致以道德困扰为特征的心理痛苦。护理等专业领域的理论模型试图解释道德冲突如何演变为道德困扰。在兽医专业人员中，已经提出了一个模型来解释这一途径（道德审议途径）。然而，关于兽医临床医生是否如假设那样经历道德审议途径，仍然缺乏实证数据。
本定性研究采用主题分析法，调查兽医临床医生的道德困扰经历，并旨在解释这些兽医的道德审议途径。
结果表明，兽医的道德困扰经历遵循一个审议过程，这可以通过所提出的道德审议途径来解释。经历道德冲突会导致道德压力，然后要么导致道德困扰，要么解决为道德舒适。
参与者的自我选择和可能的回忆偏差可能使研究结果产生偏差。
本研究提供的实证数据可为未来的研究和干预策略提供参考，以识别、测量和管理兽医领域的道德困扰。
