By Invitation. A humane prescription for effective medicine

This year, as part of their mandatory training, medical post-graduates in India will drug patients, induce severe blood loss in them, force tubes down their throats, deprive them of oxygen, occlude their arteries, and cut their nerves. Afterwards, all of these patients will die. This sounds barbaric to any rational person. However, this archaic practice continues today because these patients who are used in classroom laboratories are animals. It’s time for this to end.

Having been on the faculty at Harvard Medical School since 1987, I know from experience that non-animal teaching methods have proven to be academically superior, widely available, and more cost-effective than dissecting or experimenting on animals. Such models include high-fidelity human patient simulators, computer-assisted learning software, and virtual reality programs.

Unlike classroom experiments on animals, these non-animal teaching methods accurately model human anatomy and physiology, create immersive scenarios that mimic real-world medical scenarios, allow students to repeat medical procedures until proficiency, improve the confidence of doctors in transferring learned skills to clinical practice, and provide educators with real-time and objective performance feedback.

Towards simulation methods

The state of medical education around the globe is moving away from using animals as living test tubes and towards more effective, ethical and economical human-simulation models.

Half a century ago in the US, undergraduate medical students frequently performed invasive and terminal procedures on animals during physiology and pharmacology courses. I helped end Harvard’s controversial physiology lab that involved terminal experiments on dogs, and the university ended its use of animals for the undergraduate medical curricula in the mid-1990s.

Today, in the US and Canada, no medical schools use any animals in laboratory practicals as part of the undergraduate MD degree.

Similarly, until recently, Bachelor of Medicine and Bachelor of Surgery (MBBS) programmes at medical colleges in India required students to perform pharmacology and physiology experiments on approximately 1.5 to 2 million live animals each year. These experiments involved administering drugs to rabbits’ eyes and measuring the effects of stimulants and depressants on mice, dissecting live frogs and exposing their hearts to various drugs, and isolating guinea pigs’ small intestines to observe their response to administered drugs.

In January 2012, I flew to India to conduct lectures and simulation demonstrations, with medical education experts and scientists from People for the Ethical Treatment of Animals (PETA) India. We reached nearly 500 medical teachers from 120 medical schools across the country, many of whom showed a desire to change to non-animal methods of MBBS instruction.

That same month, the Indian Ministry of Environment and Forests issued a directive to the Medical Council of India, the Pharmacy Council of India and the University Grants Commission, requiring them to stop dissection and experimentation on animals for training both undergraduate and post-graduate students and to use non-animal methods of teaching, instead.

These agencies amended their biomedical training regulations to replace the use of animals in the undergraduate curricula. However, post-graduate training has continued to use animals despite their being poor surrogates for human medicine. Indeed, more than 90 per cent of drugs that are shown to be effective and safe in animals end up failing during human clinical trials, which is largely due to the significant differences in physiology between species. This high failure rate should alarm anyone who relies on life-saving therapies, since the use of animals is a negative weight on the advancement of human medicine.

The future of biomedical research will not be based on four-legged or tail-wagging models, but rather on more sophisticated non-animal methods such as computer software, cell cultures, non-invasive imaging, micro-fluidic chips, micro-dosing studies, Quantitative Structure–Activity Relationship (QSAR) models, mass spectrometry and genome mapping. For the sake of doctors who treat sick patients and researchers who spend years in school to learn the tools necessary for discovering new treatments for human diseases, it is vital to teach the research methods of the future by fully removing the use of animals from post-graduate training.

The writer is Assistant Professor, Harvard Medical School; and Director, Division of Thoracic Anesthesia, and Co-Director, Shapiro Simulation & Skills Center, Beth Israel Deaconess Medical Center.

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