The silent struggle: Moral injury in the veterinary profession

Mental health in every profession is a matter of concern now, and this sent me down the rabbit hole of thinking more on the topic of persistently poor mental health in the veterinary profession.

The word moral injury perhaps seems to be a new fancy word for the general public and even for some veterinary professionals, but the concept of moral injury provides a very persuasive possible explanation for why mental health outcomes among veterinary healthcare workers are so significantly worse than the general population.

   

The prevalence of moral injury among veterinary healthcare workers potentially bridges that gap in mental health outcomes. The veterinary profession is a noble and compassionate field that is dedicated to the well-being of animals.

Veterinarians and veterinary professionals commit their lives to the care, health, and welfare of our furry and feathered friends. However, beneath the surface of this seemingly idyllic profession, there exists a hidden and profound struggle known as “moral injury”. This article delves into the concept of moral injury within the veterinary profession, exploring its causes, consequences, and potential solutions.

Defining moral injury

Moral injury is a term that has its origins in the military context but has since been applied to various professional fields, including healthcare. It refers to the psychological distress that arises when individuals find themselves in situations that violate their deeply held moral and ethical beliefs.

For veterinarians, moral injury can manifest when they are faced with situations where they are unable to provide the level of care they believe an animal deserves due to financial constraints, resource limitations, or client preferences. It can also occur when witnessing or being an indirect party to harmful practices, such as convenience euthanasia or neglect, despite the best intentions.

Causes of Moral Injury in Veterinary Medicine

Economic Constraints: One of the primary causes of moral injury in the veterinary profession is the financial reality of pet healthcare. Many pet owners may be unable to afford the necessary treatments for their animals, leaving veterinarians in a morally agonising position. They are torn between providing the best care possible and respecting the client’s financial limitations.

Euthanasia: Veterinarians are often tasked with the painful decision of euthanizing animals due to age, illness, or injury. While euthanasia is sometimes the most humane option, it can take an emotional toll on veterinarians who feel they are ending an innocent life.

Client Preferences: Veterinarians may find themselves in situations where they strongly disagree with a client’s choices regarding their pet’s care, such as not pursuing necessary treatments, neglecting proper care, or even requesting procedures that go against the veterinarian’s ethical principles.

Overwork and burnout: The demanding nature of the veterinary profession, including long hours and a heavy workload, can lead to fatigue and emotional exhaustion.

This can make it difficult for veterinarians to provide the level of care they aspire to, leading to feelings of guilt and inadequacy. What distinguishes moral injury from burnout? While moral injury shares similarities with burnout, they are not the same.

Burnout primarily stems from chronic workplace stress, resulting in emotional exhaustion, depersonalisation, and a diminished sense of personal accomplishment.

On the other hand, moral injury specifically pertains to the violation of one’s moral or ethical principles, leading to feelings of guilt and shame and a loss of personal integrity.

Burnout tends to develop gradually over time, while moral injury can result from a single traumatic event or a series of distressing experiences. Moral injury can have profound and long-lasting consequences for veterinary professionals.

The internal conflict between their commitment to animal welfare and the constraints they face can lead to feelings of helplessness, emotional pain, and a sense of betrayal. This distress may ultimately affect professional satisfaction, job performance, and overall well-being, jeopardising the mental health and career longevity of veterinary professionals.

Consequences of Moral Injury

Moral injury can have profound and lasting effects on veterinary professionals. Some of the consequences include:

Emotional Distress: Veterinarians may experience symptoms of anxiety, depression, guilt, and moral anguish due to their ethical dilemmas.

Burnout: The constant struggle between their ethical values and the practical realities of their profession can lead to burnout, contributing to a high attrition rate in the field.

Compassion Fatigue: Continuously encountering cases of animal suffering can lead to compassion fatigue, where veterinarians become emotionally detached as a coping mechanism.

Decreased Job Satisfaction: Feeling unable to fulfil their moral duty to animals can result in a decreased sense of job satisfaction and motivation.

Addressing Moral Injury in Veterinary Medicine

Ethical Training: Integrating ethics training into veterinary education can help future professionals develop the tools to navigate difficult ethical situations.

Support Systems: Veterinary organisations should establish support systems, including counselling services and peer support groups, to help veterinarians cope with moral injury.

Open Communication: Creating a culture of open communication within veterinary teams can allow professionals to discuss ethical concerns and seek guidance from colleagues.

Advocacy for Animal Welfare: Veterinarians should actively advocate for animal welfare both within their practices and in their communities, working to improve conditions for all animals.

Bottom-line

The veterinary profession is one that calls for empathy, devotion, and steadfast attention to the care of animals. However, the moral injury endured by many veterinarians cannot be ignored.

To ensure the well-being of both animals and vets, it is imperative that the veterinary community acknowledge and address the issue of moral injury.

By fostering a supportive environment, providing ethical training, and advocating for improved animal welfare, the veterinary profession can begin to heal the silent wounds of moral injury and continue to provide the best care possible for our beloved pets

Dr. Abrar Ul Haq Wani, Assistant Professor cum Junior Scientist, Dept. of Medicine, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, Punjab.

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