{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T11:06:09Z","timestamp":1789988769973,"version":"4.0.1"},"reference-count":47,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Vet. Sci."],"abstract":"<jats:p>The spiritual health of veterinarians is challenged by moral distress that expresses a conflict between personal core values and clinical practice. The morally resilient veterinarian experiences and addresses moral distress in constructive ways that express care for patients, owners, colleagues and society. As such, moral resilience is a positive aspect of spiritual health that can be built through reflections and dialogue on the ethical, existential, spiritual and religious questions raised by veterinary practice. Veterinarians often face complex moral dilemmas when attempting to balance the interests of animal patients, their owners, the veterinary business, surrounding society, and themselves. When it is not possible to accommodate all these responsibilities, moral distress may occur, a state associated with compassion fatigue, burnout and depression. Human spirituality concerns a person\u2019s central relationships with the self, others, nature, animals and \u201cthe sacred\u201d giving meaning, purpose and values to life. Consequently, moral distress affects not only physical, social and mental health, but also spiritual-existential health and well-being, as it disrupts these core relationships in a way that defies simple technical and practical solutions. We argue that strategies to increase moral resilience (and thus spiritual health) should include conversations with peers and mentors aiming to articulate experiences of moral distress and reinterpret their meaning. Since moral distress in a veterinary clinic involves emotions, values and ideas about the human-animal relationship, resilience-building reflections and conversations must address existential themes like personal responsibility, guilt, acceptance, forgiveness and moral agency. These questions cannot be answered by scientific knowledge alone, but involve personal faith perspectives (secular-existential, spiritual or religious). Consequently, veterinarians, both individually and collectively, should increase attention to the broader existential context of clinical work in order to cultivate moral resilience and enhance spiritual health.<\/jats:p>","DOI":"10.3389\/fvets.2026.1922787","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T10:49:17Z","timestamp":1789987757000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Moral distress, resilience and human spirituality in the veterinary clinic"],"prefix":"10.3389","volume":"13","author":[{"given":"Emil B\u00f8rty","family":"Nielsen","sequence":"first","affiliation":[{"name":"Centre for Science and Faith, Faculty of Theology, University of Copenhagen","place":["Copenhagen, Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva Maria Meier","family":"Carlsen","sequence":"additional","affiliation":[{"name":"Centre for Science and Faith, Faculty of Theology, University of Copenhagen","place":["Copenhagen, Denmark"]},{"name":"Department of Veterinary and Animal Sciences, Biomedicine, Faculty of Health Sciences, University of Copenhagen","place":["Copenhagen, Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maja Louise","family":"Arendt","sequence":"additional","affiliation":[{"name":"Department of Clinical Veterinary Sciences, Faculty of Health and Medical Sciences, University of Copenhagen","place":["Copenhagen, Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Per Torp","family":"Sangild","sequence":"additional","affiliation":[{"name":"Centre for Science and Faith, Faculty of Theology, University of Copenhagen","place":["Copenhagen, Denmark"]},{"name":"Department of Veterinary and Animal Sciences, Biomedicine, Faculty of Health Sciences, University of Copenhagen","place":["Copenhagen, Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"618","DOI":"10.3138\/jvme-2022-0118","article-title":"Life, death, and humanity in veterinary medicine: is it time to embrace the humanities in veterinary education?","volume":"50","author":"Brosnahan","year":"2023","journal-title":"J Vet Med Educ"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"617","DOI":"10.1001\/journalofethics.2017.19.6.mhst1-1706","article-title":"What moral distress in nursing history could suggest about the future of health care","volume":"19","author":"Jameton","year":"2017","journal-title":"AMA J Ethics"},{"key":"ref3","volume-title":"Animal Liberation","author":"Singer","year":"1995"},{"key":"ref4","first-page":"224","volume-title":"Animal Theology","author":"Linzey","year":"1995"},{"key":"ref5","volume-title":"The case for animal rights","author":"Regan","year":"2004"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"371","DOI":"10.4278\/0890-1171-9.5.371","article-title":"Review of spiritual health: definition, role, and intervention strategies in health promotion","volume":"9","author":"Hawks","year":"1995","journal-title":"Am J Health Promot"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1537","DOI":"10.1007\/s10943-017-0379-z","article-title":"Spiritual health: a concept analysis","volume":"58","author":"Jaberi","year":"2019","journal-title":"J Relig Health"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"642","DOI":"10.1089\/jpm.2014.9427","article-title":"Improving the spiritual dimension of whole person care: reaching national and international consensus","volume":"17","author":"Puchalski","year":"2014","journal-title":"J Palliat Med"},{"key":"ref9","doi-asserted-by":"crossref","DOI":"10.4324\/9781003502364","volume-title":"Introducing Existential Health: The Four-Dimensional Model","author":"Cour","year":"2025"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1111\/dial.70004","article-title":"Playing god with animals? 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