BACKGROUND The provision of veterinary clinical services is known to elicit a range of challenges which require an ethical appraisal. In a recent Policy Delphi study, referrals/second opinions and 24 h emergency care were identified as matters of key concern by veterinary professionals in Ireland. In this case study (the first in a series of three resulting from a research workshop exploring challenges facing the veterinary profession in Ireland; the other two case studies investigate the on-farm use of veterinary antimicrobials and emergency/casualty slaughter certification) we aim to provide a value-based reflection on the constraints and possible opportunities for two prominent veterinary clinical services in Ireland: referrals/second opinions and 24 h emergency care. RESULTS Using a qualitative focus group approach, this study gathered evidence from relevant stakeholders, namely referral and referring veterinarians, clients, animal charities, and the regulatory body. Six overarching, interrelated constraints emerged from the thematic analysis: the need to improve current guidance, managing clients' expectations, concerns with veterinarian well-being, financial issues, timeliness of referral, and conflicts between veterinary practices. CONCLUSIONS Possible solutions to improve veterinary referral and out-of-hours clinical services included clarifying the terms used in current norms and regulations (namely 'referral', 'second opinion', '24 h emergency care' and '24 h cover'), improved communication (making the client aware of the different levels of veterinary care that are being offered, and transparent and full disclosure of clinical records), and the promotion of Continuing Veterinary Education in communication, business management and ethical decision-making. These findings may help inform the Veterinary Council of Ireland about future recommendations and regulatory measures.

中文翻译：

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爱尔兰兽医业面临的挑战：1.临床兽医服务。

背景技术众所周知，提供兽医临床服务会引发一系列挑战，需要进行伦理评估。在最近的德尔菲政策研究中，转介/第二意见和24小时紧急护理被爱尔兰的兽医专业人士认为是关键问题。在本案例研究中（三分之三中的第一部分来自研究研讨会，该研讨会探讨了爱尔兰兽医行业面临的挑战；其他两个案例研究了农场中使用兽用抗菌素和紧急/伤亡屠宰认证）提供基于价值的思考，以说明爱尔兰两项出色的兽医临床服务的局限性和可能的​​机会：转诊/第二意见和24小时紧急护理。结果使用定性焦点小组方法，这项研究从相关利益相关者那里收集了证据，这些利益相关者包括推荐和推荐的兽医，客户，动物慈善机构以及监管机构。专题分析中出现了六个相互联系的总体制约因素：需要改进当前的指导，管理客户的期望，对兽医福利，财务问题，转诊及时性以及兽医实践之间的冲突的关注。结论改善兽医转诊和非工作时间临床服务的可能解决方案包括澄清当前规范和法规中使用的术语（即“转诊”，“第二意见”，“ 24小时急诊”和“ 24小时覆盖”），改善沟通（使客户知道所提供的兽医护理水平不同，透明和充分披露临床记录），并促进在交流，业务管理和道德决策方面的继续兽医教育。这些发现可能有助于告知爱尔兰兽医理事会未来的建议和监管措施。