Ethics in practice: Schwartz rounds and veterinary clinical ethics committees
Structured approaches to emotional and moral distress, such as Schwartz rounds and clinical ethical committees, are common in human medicine, but less so in veterinary medicine. Although different in their goals, they are both ways to provide organisational structures that support moral resilience. It is possible that, by creating a sense of moral agency and community, these interventions could also help to mitigate moral distress in staff members. Veterinary nurses have an important role to play in developing forums for ethical discussion within practice and the profession. This article discusses the structure and function of both approaches, and looks at what roles veterinary nurses can play in their development and management.
It is increasingly recognised that ethical dilemmas in the veterinary profession can be a cause of psychological harm to veterinary professionals (Williamson et al, 2022). Potential harms such as moral injury, compassion fatigue, disenfranchised grief, and post-traumatic stress disorder are commonly reported in human nursing (Giannetta et al, 2021), and studies of veterinary professionals suggest such harms may also be common in this industry (Moses et al, 2018).
There is a growing body of research into veterinary mental health and approaches to support and resilience (Royal College of Veterinary Surgeons, 2022a). This tends to focus on veterinary surgeons because of their decision-making responsibilities, but veterinary nurses are also faced with ethical challenges and the psychological issues these may raise (Quain et al, 2021).
As yet, there is little research into possible methods for mitigation of moral injury and related issues. However, it is possible to draw on research conducted in human medicine. Studies involving human nurses have evaluated a range of different approaches, including education, group discussion and reflective practice (Morley et al, 2021). These studies show that having a sense of moral community helps nurses evaluate their own decision making and supports them in giving voice to their concerns (Traudt et al, 2016).