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Physicians' Forum
Welcome to the Physicians' Forum of doctorsagainstdoglabs.com
Nancy L. Harrison, M.D.
Scripps Memorial Hospital Chula Vista
Scripps Mercy Hospital
Doctorsagainstdoglabs.com invites physicians and students who oppose
dog vivisection for pedagogical purposes to share their views with us.
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Thoughts, reports, and insights that we believe will be of interest to our web-site
visitors will be posted in the Physicians' Forum.
To read the contributions these physicians have made to the forum, click on their names:
| Why Not Kill Dogs?
Lawrence A. Hansen, M.D. |
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As a physician, neuroscientist, and associate professor at UCSD School of Medicine, my opposition to dog vivisection is perceived by some of my colleagues as eccentric. Why oppose killing dogs for education? Well ... dogs are special animals.
When I compare dog and human brains the similarities far outnumber the differences. It's true dogs have smaller frontal lobes, which explains their lack of inhibition (e.g., butt sniffing) and unfortunately also accounts for their poor judgment in relying on the kindness of humans. But the very similarities that make dogs "good models" for human physiology and pharmacology labs are good reasons why we shouldn't be killing creatures so like ourselves.
Because dogs and humans are more alike than different we should treat dogs more like we would want to be treated ourselves. During a particularly awful moment in his tragedy, King Lear despairs, "As flies to wanton boys are we to the gods! They kill us for their sport!" Well, that may or may not be true of the gods or of God, but to dogs we humans are gods. We made them what they are through millennia of selective breeding until they became the perfect companion animal -- loyal, loving, devoted. They only want to please us. It is a betrayal of trust and of the bond between men and dogs to so casually kill them for minuscule educational benefit. We can and should choose to be merciful gods, unlike those tormenting Lear for sport, or boys pulling the wings off flies.
Some argue that no one wants to kill dogs, but it is a necessary evil for medical education. But since graduates of Harvard, Yale, Stanford, and the Mayo Clinic medical schools (and most others in the U.S.) have become pretty good physicians without killing dogs, it's hard to avoid concluding that dog vivisection is not necessary. Once you remove the "necessary" from necessary evil, only the evil remains. An ancient Greek playwright observed that when little boys throw rocks at frogs, it's a game to the boys but it's life and death to the frogs. Once we have grown beyond boyhood we realize the damage our actions cause, and most of us try to refrain from gratuitous cruelty. Once we realize that dog vivisection is unnecessary (see Stanford, Yale, Harvard, etc.) we should stop doing it simply because, if we listen to what Lincoln called "the better angels of our natures," we know that killing faithful friends is wrong.
Correspondence with Richard W. Samsel, M.D.
(Reproduced with the permission of the authors)
24 Jun 1999
Dear Dr. Harrison:
I am pleased to see your summary of our work on your web site. I
am writing this to clarify some of the questions you raised in your
summary of our article.
The work reported in the American Journal of Physiology/Advances
in Physiology Education article was the first trial of the predecessor
of SimBioSys -- effectively version 0.5 of the program. At that time,
we weren't really sure how to get financial support for the research
work. At that point I was based at a university, and we hadn't settled
between an educational/nonprofit model for our efforts and a
corporate/for profit model. Although we had started a company and
started to make the software available, the company was largely on
paper until about the time the article appeared in print. Since that
time we have fully embraced a commercial approach: the private
sector is really the better choice if widespread deployment is
desired.
The authors on the paper were primarily involved in the simulation
effort. In particular, I am now primarily involved in development of
SimBioSys on a full time basis. The other authors are still at the
university where the work was performed. It is perhaps paradoxical
that as the primary developer of the computer simulations, I taught
the animal laboratory rather than the computer laboratory.
There is a possibility of conflict of interest in the paper. We pointed
this out to the editor, who was satisfied that we had written the paper
in a suitably objective fashion. In addition we believe we made this
clear in the manuscript.
The article was written with an effort to illuminate some points and to
give a fair discussion of different issues. The moral and ethical
appropriateness of vivisection is a highly charged subject; strong
feelings exist on both sides. In a forum aimed at physiology
educators, we intentionally focussed on pure educational and
resource issues, leaving ethical debates to other forums. In your
forum, you focus primarily upon these ethical issues, and I heartily
endorse open discussion and debate.
In your summary of our article, you suggest that there is no
information about how the dogs were killed. As always in our
laboratory, the dogs were fully anesthetized once prior to the
laboratory demonstration, and they were frequently reassessed to
verify that they remained deeply anesthetized, using standard
approaches. At the conclusion of the experiment, while they were
still deeply anesthetized, the dogs were given doses of potassium
chloride. The hearts promptly stopped. They were monitored to
verify persistence of cardiac standstill. I believe that we treated the
dogs humanely. I never would have been involved had I believed
otherwise.
The dogs were purchased from USDA licenced, out-of-state
vendors, who typically kept the dogs about a month between
acquisition and delivery. The dogs were not specifically raised for
the research (such dogs are much more expensive). I am told that
farmers keeping dogs in some rural settings simply don't bother
controlling their dogs' reproduction, and sell surplus dogs to
vendors. However, I acknowledge that I did not have firsthand
knowledge of the vendors' operations.
The animal laboratories reported in this article were among the last
animal laboratories I ever performed, and since that time have come
to believe that the simulation approach is better for many purposes.
I do not share the view that vivisection is necessarily wrong or even
inappropriate in specific educational settings. Still, on balance I
myself would omit it from most medical curricula.
Best Regards,
Richard W. Samsel, MD
Scientific Director
Critical Concepts, Inc
http://www.critcon.com
Dr. Nancy L. Harrison's Reply
24 Jun 1999Dear Dr. Samsel,
Thank you very much for your detailed and thoughtful message. The points
you answered as well as the ones you raised are well made. Background on
the commercial vs. academic decision is interesting. In regard to the
potential conflict of interest, I commented on that in my summary only
as a "reactive pre-emptive strike." (Remember the Gulf War?) In my
opinion you succeeded in presenting a fair discussion of the educational
and resource issues. Do you not agree, however, that to leave the moral
issue untouched, without explanation as to why, could and probably will
be misinterpreted as dismissive of the moral issue? Anyway I suspect
that overall you and I agree more than we disagree. I hope that the lack
of serious criticism in your letter means I haven't distorted your good
work too badly. {.....}
Sincerely,
Nancy L. Harrison, M.D.
Dr. Samsel's Reply
25 Jun 1999
Dr. Harrison:
I think you interpreted and summarized our work perfectly well,
although there is another minor misinterpretation (see below). You
may use my prior letter or portions of it provided you do so fairly
(i.e. in context). Insofar as you have already summarized our work
fairly, I have no doubt you would do so again. I suspect your
readers will, by self-selection, be biased against dog use.
{.....} Many of your readers will disagree with me
wherever I say anything permissive of vivisection, and perhaps this
is an area where we will not expect to come to an agreement. I
doubt Dr. Hansen will ever be convinced of the merits of dog labs,
and I doubt that the American Physiology Society will ever be
convinced that they are morally wrong. I myself am somewhere in
between: I believe that vivisection is morally correct if (1) it is done
without cruelty (defined as imposition of significant suffering) and
(2) it is justified by suitable benefit. Both of these conditions must
be subjectively interpreted, but they serve as a framework for my
own determinations.
Our published work is supportive of elimination of dog labs, for
reasons retain their validity regardless of where one stands on the
moral suitability of vivisection. We intentionally omitted discussion of
whether dog use is morally appropriate. Keep in mind that the
American Journal of Physiology and all of its sub-journals cater
explicitly to the physiology teaching community. That community
has largely concluded that dog use is morally appropriate. In my
view, then and now, arguments about dog labs being necessarily
inappropriate would have have undermined the basic thrust of our
experience. We thought it would be better to dispassionately report
an experience. This will certainly have a greater effect on
physiology educators, our target audience.
The minor misinterpretation of our article: as I recall, we used a
total of six dogs per year (before we quit doing the lab). It took
place on two afternoons. There were three rooms, each one an
active research laboratory with full instrumentation. The sessions
took place concurrently. Each dog was used in two separate
sessions: 1PM-3PM, and 3PM to 5PM. This meant a total of 12 total
sessions, of which I taught 4 personally. I had been teaching this
for several years, and I thought it was an outstanding learning
experience. Still, we thought it worthwhile to do the side by side
comparison of the two approaches. Before we did the comparison I
was not expecting to favor elimination of the dog lab. {.....}
Best Regards,
Richard W. Samsel, MD
Message from Dr. Leslie A. Mark
29 Sep 1999
As an alumna of UCSD School of Medicine, class of 1976, I agree that doglabs for the physiology/pharmacology course should be modified , so as not to utilize live dogs. I remember my doglab of 25 years ago very clearly: Everything could have been taught in the absence of the dog, much as we learned the other aspects of the course material. The thought of those large, healthy dogs, one for each four students, being sacrificed without apparent justification still haunts me. I wish the alternative ways of teaching the course had been employed then.
---Leslie A Mark, M.D., Associate Clinical Professor of Medicine, Division of Dermatology
Message from Dr. Robert Hasson
It's ironic that we expend gigawatts of energy and tons of money seeking signs of intelligence in the universe, and yet we are oblivious to the sentience and feelings of our fellow creatures.Of all the primates we are the criminally ridiculous ones.
Robert Hasson, M.D.General Practice and Emergency Medicine, retired
Letter from Manoj V. Waikar, MD
My first year at UCSD School of Medicine was 1993. Dog lab was approaching and nobody was really talking about right or wrong, necessary or unnecessary. A classmate and friend, Bill (not his real name) decided that it was an act he would not take part in. Bill related to me what was a very humiliating and possibly discriminatory process he had to endure to ‘prove’ that he could learn the material he would miss.
What exactly did Bill miss that day in the bowels of the BSB? From an educational perspective, confusion: few of these unwilling canine patients had cardiovascular responses that followed the principles we were learning. That a living organism does not conform to textbook standards is indeed an important clinical concept but one that is easily learned later in the clinical settings. Early in the pre-clinical years, when the goal is to learn fundamentals, such inconsistency is merely confusing. And from a personal perspective Bill missed a very disturbing and maybe even traumatic scene. Beautiful, healthy animals all around, some were dying well before the experiment was to conclude others were ‘stubbornly’ clinging to life and required large doses before they would die. Some of my classmates were visibly disturbed. One of my friends, a rather tough, athletic man who likes dogs actually passed out at the sight. Incidentally he is now an excellent physician and never had trouble with procedures or trauma. Most, like myself, just went ahead with it as though it was any other assignment. Afterwards I didn’t feel right about it and when I talked to classmates most were surprised by how little they felt they got out of it. Today most of my friends from medical school remember just two things about that dog-lab: how little we learned from it and what Bill had to suffer for not doing it.
Perhaps it is not surprising then that Bill—who ‘missed’ the ‘learning’ from dog lab—ended up displaying a superior level of knowledge on the subjects allegedly taught by dog lab. After several ‘meetings’ with course officials, where according to Bill, he was almost ridiculed outright for his beliefs, he finally secured permission to opt out of dog lab. The ‘deal’ however included assignments far more involved, in-depth and time consuming than what the rest of us were doing. He was also forced to show his learning of the same material in settings far more stressful than the multiple-choice exams the rest of us took.
While Bill’s greater knowledge of an important subject may have been an acceptable result his arguably punitive treatment for acting in accord with his beliefs was not acceptable and it raises some important questions. For whom is dog-lab a necessity? Dr. Hansen explains clearly and succinctly (see ‘forum’) that the absence of dog labs at other top-notch medical schools renders the argument about their ‘necessity’ moot. So who, if not the student, does gain from the continuation of dog labs? Not the dogs who are killed; not the school administrators—they have to budget for a hefty expense that many other medical schools do not. Perhaps the answer is self-evident. Who are the individuals arguing to keep the dog lab open and what is the nature of their argument since it cannot be about educational necessity?
Often, in the context of debate an anti-vivisectionist encounters the terms ‘reason’ and ‘emotion.’ The former is deceptively linked with science, righteousness and all that is rational while the latter is denigrated as something base, suspect and reactionary. But in dog lab debates, where we have yet to come up with a reason why it is necessary, ‘reason’ is merely the rhetoric of resistance, a homeostatic force, a voice for the status quo. In these same debates ‘emotion,’ contrary to its portrayal as something base, is the engine of change that might lead us to a higher place. Historically, emotion leads to and follows from inspiration; emotion is at the heart of discovery and therefore at the heart of science. Our emotional reaction to killing a dog causes us to question ourselves at a very rational level: "what is the reason for my killing this being?" Emotion not ‘reason’ brings us to a more rational place. Emotion compels us to consider the risks, benefits and alternatives to killing a dog—a process we call informed consent, which is the standard by which we measure rational decision making capacity in a medical setting. In this case, the attempt to shame those who give voice to their emotions is itself shameful; and to perpetrate this intellectual subterfuge under the guise of ‘reason’ is base, suspect and reactionary.
I am heartened to know that in recent years up to a third of the class has opted out of dog lab with relative ease and anonymity. But the dog labs are still operating and my understanding is that no alternative teaching module exists for those who choose not to do it.
In the year prior to his death, Jonas Salk spoke to a small roomful of medical students at UCSD. I was fortunate enough to be among the lucky few. The most important thing that he said that night was: "Where there’s a will there’s always a way; but where there’s a way there’s not always a will." Emotion provides the will when ‘reason’ says there’s no way. It is emotion that allows us as physicians to deliver compassionate and competent care in settings where reason has left the building such as the 35th consecutive hour of work or the 45th consecutive minute on the phone with an HMO representative who wants to deny your patient’s hospital stay. At a time when external pressures on physicians are at peak levels, it is perhaps becoming increasingly difficult to care about patients. Stripped of its human or emotional element medicine may have a lot less to offer as a profession. Let’s not add to that growing disconnect by having a medical student’s first patient encounter be one with no room for compassion and patient advocacy. Dog lab is contrary to the true spirit of medicine and has no place in medical education.
Manoj V. Waikar, MD
UCSD SOM Class of 1998
Waikarm@stanford.edu
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