The Internal Morality of the Veterinary Profession

Due to an increasing number of diagnostic and therapeutic options, practical veterinarians are more often challenged to reflect on whether all available therapeutic possibilities should be exhausted. Artificial hip joints, dialysis, cardiac pacemaker, state-of-the-art imaging techniques and the flourishing branch of oncology are standards in todays veterinary medicine. Veterinarians and owners responsibilities extend to new and far reaching issues that cannot be answered by referring to medical reasons alone: is there a moral responsibility to use high-tech devices to diagnose a disease as early, as comprehensively and as profoundly as possible? Is there a moral obligation to use high tech in veterinary practice even when owners financial possibilities are exhausted? In brief, high tech has changed and will continue change the scope of clinical and ethical decision-making processes in veterinary practice. Against this background the project starts from the assumption that technological innovations influence veterinarians professional responsibilities and have normative implications on crucial medical concepts such as diagnosis, therapy and prognosis. This will be examined in the field of oncology. Uncertainties and insecurities, which are triggered by high tech in oncology, will allow for the explication of crucial moral dimensions of the veterinary profession. Therewith, this interdisciplinary project will investigate the moral cornerstones of veterinary medicine and explicate its moral infrastructure, what has been coined the Internal Morality of Veterinary Medicine (IMVM). The focus of the project lies on a systematic approach that comprises a theoretical and an empirical part. We aim at gaining empirical data regarding veterinarians uncertainties and strategies when using high tech in clinical practice. The first step (theoretical part) of the project will be to elaborate key aspects of veterinary practice in order to formulate case vignettes (real life scenarios) for a subsequent focus group study. Second, the focus group study will be carried out in order to develop hypotheses for a questionnaire-based survey (empirical part). Consequently, a survey will be conducted among Austrian practicing veterinarians. The gained empirical data will provide insights into major aspects in the veterinary profession and extend our knowledge of the IMVM. Therefore, this interdisciplinary research project, which comprises veterinary medical aspects, veterinary medical ethics and empirical social science, will contribute to the emerging field of veterinary ethics and its institutionalisation. In terms of potential consequences, this project will contribute to a better and empirically informed understanding of the present conflicts and ethical dilemmas veterinarians are faced with. Further, there is a high probability that the results will not only be of interest for the research community but also for teaching programs in veterinary medicine.

Although the project has officially ended, the work on the project is still ongoing and will likely be finished by end of August 2021. The following summary refers to the results obtained so far. Veterinary medicine is experiencing a steady increase in the use of innovative technologies and methods that are nearly as advanced as in human medicine. Artificial hip joints, dialysis, pacemakers, imaging techniques and flourishing branches of oncology are now integral parts of today's small animal medicine. The project started from the assumption that technological innovations influence veterinarians' professional responsibilities and have normative implications at the same time, since new uncertainties and moral challenges might arise due to the implementation of innovative technologies and methods. Therewith, this interdisciplinary project aimed to investigate the moral cornerstones of small animal veterinary medicine and explicate its moral infrastructure, what has been coined the Internal Morality of Veterinary Medicine (IMVM). Based on data from an Austrian focus group study, the project gained in-depth insights into challenging factors and moral dilemmas that arise in the context of the constantly developing small animal medicine. The results showed that although advanced diagnostics and therapies lead to real benefits in patient care, they also add complexities to the decision-making processes, bringing new factors relating to the client (e.g. financial limitations or strong emotional relationships between the client and the animal) and the veterinarians themselves (e.g. profit, amortization of technical devices) that create moral challenges. Consequently, challenges arise particularly from veterinarians' dual awareness that they know about their advocate position towards their patients, and that their decisions are highly dependent on factors relating to clients or veterinarians themselves. In a second step, the leading hypothesis of the project was that veterinarians refer on established strategies that facilitate the handling of challenging situations as well as influence clinical decision-making processes. By means of a transnational questionnaire study with small animal veterinarians from Austria, Denmark and UK, four strategies were identified that can be described as decision ethics orientations (DEO): (I) Client-empathetic DEO, (II) Development-oriented DEO, (III) Patient-focused DEO and (IV) Client-devolved DEO. Based on results of this project, important insights into moral challenges in modern small animal medicine could be gained. The identification of the four DEOs contribute to a better and empirically informed understanding of the Internal Morality of the veterinary profession since they provide not only an approach to deal with moral challenges, but also highlight how complex decision-making processes are shaped in the clinic. Therefore, the results are not only of interest for the research community but also for teachers in the field of veterinary ethics as well as practising veterinarians.