Veterinarians’ and physicians’ attitude to euthanasia

The most recent contribution from the Ordem dos Médicos, the Portuguese professional organization for physicians, to the ongoing political discussion of legalizing euthanasia was to state that they would in no way engage with the process. Of course, the discussion of euthanasia in human medicine is beyond the scope of this blog, and Animalogues is not the right place to share my personal thoughts about something that is not part of my professional consideration.

But I will take the opportunity to share a paper that I find highly relevant in the context.

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This paper, published in Journal of Medical Ethics in 2010, reports the results of a questionnaire to Swedish veterinary surgeons in 2008. It’s part of a larger body of work on attitudes to physician-assisted suicide by two of the co-authors, Lindblad and Lynöe, which also includes surveys to physicians and to the general public in Sweden.

Why would medical ethicists be interested in what veterinarians think about physician-assisted suicide in human medicine? This interest has to do with the argument sometimes presented by physicians that “less experienced physicians and the general public do not know what they are actually reasoning about when dealing with end of life issues”. But unlike medical doctors in Sweden, where euthanasia is illegal, vets regularly perform active euthanasia as part of their professional practice. Hence it can be argued that a veterinarian, at least to some extent, knows more about euthanasia than a physician.

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Perhaps unexpectedly, it turned out that veterinarians’ attitude to physician-assisted suicide is comparable to that of the general public rather than that of physicians.

The authors conclude that “Similar to the general public, most Swedish veterinary surgeons are in favour of PAS. Since veterinary surgeons have long experience of performing euthanasia in animals it seems difficult to assert that they do not understand what it means to provide PAS at the request of a terminally ill and competent patient. Accordingly, it is difficult to maintain that knowledge about PAS and euthanasia is unambiguously associated with a restrictive attitude towards these measures”.

Is a positive attitude to animal research desirable?

The question is motivated by a recently published research paper in JALAAS: Attitudes Toward Animal Research Among Medical Students in the United States by David Q Beversdorf and Nellie R Adams.

The authors recruited student members of the American Academy of Neurology to fill in a questionnaire. 168 students completed the questionnaire, expressing their agreement or disagreement with a set of 14 positively- or negatively-biased statements regarding animal research. After that, they were given the opportunity to watch a video about animal research, and asked to fill in the same questionnaire again, which 108 students did. In the text box to the right, you can see examples of the statements the students were presented with.

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After having watched the video, the students were slightly more positive towards research with animals: the score went from an average of 4.0 to an average of 4.1. (A score near 5 shows a positive attitude to animal research, a score near 1 a negative attitude).

The authors do not make much out of that change (not surprisingly, it’s so small that it doesn’t really matter) but instead discuss the observation that “a substantial number of
medical students express disagreement with statements that
describe essential components of the drug and procedure
development pipeline. As described above, 13.2% disagreed
with the statement ‘New surgical procedures should be tested
on animals before they are used on people,’ and 7.2% disagreed
with ‘New drugs should be tested on animals before
they are used on people.’” They continue to conclude that “The changes in attitudes after observing the video suggests that negative attitudes can be changed, and that medical education may have a role in this setting.” If you want to read the full paper, you can request a copy from the authors at ResearchGate.

Numerous studies with bigger samples and more comprehensive approaches have measured the attitude of different publics to animal research, but the present study is novel in the choice of a very specific public: medical students. My main issue with how the study was conducted is the quite one-sided study design. The video in question is produced by Americans for Medical Progress, an advocacy organisation for biomedical research and in particular the use of animals in such research. While I think the video is quite reasonable, it definitely represents a selective use of information. That’s not surprising, as the organisation behind it is working in favour of public support for biomedical researh with animals.

Should a goal for medical education be to make students more positive to the use of animals in research? I’m really not convinced that this should be a priority. I think it’s crucial that medical students get a reasonable understanding of the role of animals in biomedical research and drug development. But that also includes an understanding of critical challenges to how useful such research is. And an understanding of why the issue is contentious.

There is no equivalent video advocating in a comparable way for the replacement of animals in biomedical research. People such as the authors behind the book Animal Experimentation: Working Towards a Paradigm Change would probably be able to produce one, and it would be as credible (reasonably so) and balanced (not very) as the AMP video.

And sadly, both of them would miss out on the most critical issue in animal-based biomedical research today: how to design studies so that the results are reliable and translate to humans.

Should research ethics protect non-human primates as children?

I’ve played with the idea of writing about why chimpanzees are not more protected than children. But whenever I start to develop the argument it seems absurd – anyone who knows what laboratory animal research regulation looks like knows that chimpanzees are not more protected than children! Except that I regularly come across people who argue that in Europe chimpanzees are more protected than children.

I understand where the argument comes from: there is a single regulatory framework for research with animals in Europe (Directive 2010/63/EU) but not for research involving children. Now, this doesn’t mean that there are no rules for children’s participation in research, it only means that the rules differ between countries. And as far as I know, none of these rules allows any researcher to involve a child in invasive and risky research under any condition – except perhaps if that research is likely to help the child. In contrast, a so called safeguard clause allows EU Member States to lift the general ban on the use of great apes (chimpanzees, bonobos, orangutans and gorillas) in invasive research “in relation to an unexpected outbreak of a lifethreatening or debilitating clinical condition in human beings” (Directive 2010/63/EU Article 55:2). Or in other words, facing an outbreak of Ebola in Europe, vaccine trials in chimpanzees would be permissible. (Whether this research could actually be done in practice is a different question. For a long time, the only industrialized country to keep chimpanzees for invasive research was the USA, but in 2015 the NIH announced it would no longer fund such research and lab chimps are now being retired into sanctuaries).

Interestingly, before I got around to writing any of this, I came across this paper which proposes that research regulation should protect chimpanzees and in fact all non-human primates (NHPs) in much the same way as it protects human research subjects. The authors argue that with so many important similarities in cognitive, emotional and social capacities, it doesn’t make sense to have different ethical frameworks depending on whether a primate is human or non-human. Therefore, they argue, we should move non-human primates out of the utilitarian framework that is generally applied to animal research ethics and into the deontological framework that applies to human research subjects. In practice, this means that research with non-human primates should respect the principles of beneficence and non-malevolence, or in other words, research should preferably benefit and definitely not harm the research subjects.

The paper is an interesting contribution to the debate and well worth reading, for the ideas and the examples of research that would be acceptable under a deontological framework. The idea that some animals should be given a rights-based protection is not new (it underlies the entire animal rights movement), but the paper contributes a unique discussion of the potential to do biomedical research with NHPs in a way that is compatible with the principles of benevolence, non-maleficience and even autonomy and justice. Unfortunately, I don’t think that the picture they paint is realistic. What can be achieved by studying naturally occurring situations is strongly limited, and I would have appreciated if the authors had been more thorough in their analysis of  what research would be made impossible if changing the ethical framework. On the other hand, if this were a paper about how to protect children in research, nobody would dream of arguing about the important research benefits to be lost if children couldn’t be harmed in research! This observation in itself clearly marks the difference in thinking about research in utilitarian and consequentialist terms versus in deontological terms.

From a pragmatic perspective, taking into account the diversity of opinion on the matter, I don’t foresee a change of framework any time soon for non-human primates in research at large. A change for the great apes is way more likely to happen in the near future. With the phasing out of invasive research in chimpanzees, the only great ape species which really played a role in biomedical research, a full ban may be accepted without much protest. By then, it may be reasonable to ask if chimpanzees enjoy greater protection than children in biomedical research. .

 

 

 

Time to think about your contribution to EurSAFE2019!

The conferences of the European Society for Food and Agricultural Ethics (EurSAFE) are among the most important arenas for the academic discussion of animal ethics. The next conference will be held in Tampere, Finland 19-21 September 2019.

These conferences have a two-stage submission procedure: first you submit a short abstract and on basis of that you are (hopefully!) invited to submit a short paper. This paper is then published in a proceedings book, which is available at the conference. As a long-time conference participant and a previous congress organizer, I have lots to say about this concept… On a positive note, it’s always an interesting book. And being responsible for editing one really made me a much more efficient editor!

In any case, this two-step procedure takes time, and therefore the deadline for submitting abstracts is well ahead of the conference. You still have a month and a half, though, this year the deadline is 2 December. More information about how to submit here.

Conference topics on animals are Animal politics, Fisheries and aquaculture ethics and Animal and veterinary ethics. Those of you who are interested in animal politics and animal law may like to know that Gary Francione and Alasdair Cochrane are confirmed as plenary speakers.

Open Science in October

Do you think about Open Science? Do you practice Open Science? Do you think Open Science matters? My research group is working on the topic during the month of October, with the aim of formulating an Open Science strategy for the group. We’re doing this because we think it makes sense for us to put Open Science into practice, but we need to work out the best way for us and our research.

We identified the following burning issues:

  • Study preregistration
  • Protocol and methods sharing
  • Data sharing
  • Preprint publication

These are the ones we are interested in but need to know more about in order to be able to practice (or make an informed decision not to practice) them. In addition, we prioritize  open access publishing and social media communication – but we’re already working on this. Although with a permanent backlog, we are uploading papers to the university open repository and we try to keep the group’s Facebook page up to date.

In a month, I hope to be able to report back on this. In the meantime, if you want to learn more about Open Science you may want to look at the FOSTER project.