The Business of Practice: How to Evaluate and Resolve Ethical Dilemmas

In this episode of The Business of Practice podcast, we talked with Barb Crabbe, DVM, MA, about how equine veterinarians can use a basic ethical construct to evaluate and resolve ethical dilemmas and minimize moral distress.

Ethical frameworks are useful for deciding what course of action will provide the most moral outcome. Crabbe began by defining ethical decisions versus ethical dilemmas. She explained that the field of Human Bioethics was developed in the 1970s. Since then, much work has been done to upgrade the ethics of veterinary medicine with the principles of stewardship, integrity, and respect.

Crabbe noted the emotional toll that can occur when a veterinarian gets a call from a nonclient about a severe colic, especially if that veterinarian simply can’t get there to treat the horse. She said it is important to remember that your veterinary services won’t be available to anyone if you leave the profession due to burnout.

Crabbe also talked about the moral distress that can arise when another person makes a decision that goes against your best judgment. She suggested using a system to think through difficult situations. An ethical framework for sorting out ethical dilemmas could include asking the questions, “What are the choices?”, “Who are the stakeholders?”, “Who has agency?”, and “What would a compassionate person do?”

In closing, Crabbe reminded listeners that “Ethical dilemmas don’t always have a right or wrong answer,” and “what’s ethical is not always fair.”

About Dr. Barb Crabbe

Barb Crabbe, DVM, MA, is a graduate of the UC Davis School of Veterinary Medicine. She also completed an internship in large animal medicine and surgery at Washington State University. While at UC Davis she did graduate work in biomechanics, studying patterns of locomotion in exercising horses. Crabbe spent 30 years as a private practitioner and the owner of Pacific Crest Sporthorse, a three-doctor general equine practice in Oregon, where she had a special interest in performance horse medicine. She is an FEI official veterinarian in dressage and jumping. In early 2023, Crabbe transitioned her practice to her two long-term associates to pursue her passion for ethics in veterinary medicine. She completed a master’s degree in bioethics from the Neiswanger Institute of Bioethics at the Stritch School of Medicine at Loyola University, Chicago, where she is on the home stretch of a doctoral program. She currently serves as the chairman of the AVMA’s Council on Veterinary Services where she led the committee responsible for a recent overhaul of the AVMA’s Principles of Veterinary Medical Ethics. She is also a member of AAEP’s Ethics and Professional Conduct Committee.

Crabbe is a frequent contributor to a wide variety of horse publications, and her articles have won numerous American Horse Publications awards. Her book Comprehensive Guide to Equine Veterinary Medicine was published in 2007 by Sterling Publishing in New York. She is currently contracted with Wiley to write a Veterinary Bioethics textbook that will introduce basic ethical theory in the first sections and then draw from cases collected from veterinarians in a “narrative ethics” approach. She has developed a 10-step template to help veterinarians evaluate and resolve ethical dilemmas.

Crabbe is an avid dressage rider and USDF silver medalist. She lives on a farm outside Portland, Oregon, with her husband, Bob, a veterinary internal medicine specialist. They have two girls who are almost fully launched and currently focus their attention on four dogs, a cat, and two horses.

Related Reading

• The Business of Practice: How Equine Veterinarians Can Build Confidence
• The Business of Practice: Silencing Your Inner Critic
• The Business of Practice: Veterinary Well-Being Study Results

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