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The Physicians Committee

Doctor Training Shouldn't Cost Animals Their Lives

By John J. Pippin, M.D., F.A.C.C.

This opinion piece was published on July 14, 2008, in The Star-Ledger.

We all want the best training for medical professionals - but is practicing emergency medical skills on live animals the best way to train our physicians and EMTs in the 21st century?

As a cardiologist and former medical educator, I know how important proper medical training is - and how crucial ethical standards are in the field of medicine. That's why so many physicians are questioning the use of live animals in the University of Medicine and Dentistry of New Jersey's advanced trauma life support training course at University Hospital in Newark.

These courses teach a handful of emergency procedures. For all of these procedures, there are validated, widely used, nonanimal teaching methods, including human patient simulators. In fact, more than 90 percent of U.S. trauma training courses now use these nonanimal methods. But several times throughout the year, University Hospital uses live, anesthetized pigs in its courses. At the end of each course, the pigs are killed.

Other medical facilities in New Jersey do things differently. Both UMDNJ medical schools stopped using live animal labs in their medical student curriculums years ago, and all four of the other New Jersey trauma training programs (including the UMDNJ programs at Robert Wood Johnson University Hospital and Cooper University Hospital) have also stopped using animals.

Trauma training courses teach procedures designed to treat acute trauma injuries, including relieving obstructed airways, removing fluid from the sac around the heart and chest tube insertion. Human patient simulators, such as Simulab's TraumaMan and Laerdal's SimMan, allow course participants to hone these skills on a humanlike - not animal - body.

TraumaMan, for example, is an anatomical human body mannequin designed for students to practice the surgical procedures taught in the trauma training course. It contains four surgical sites for skills practice: the abdomen, chest area, neck and ankle base. The sites include a simulated tissue structure that resembles all of the tissue layers of humans, including skin, fat and muscle.

Under TraumaMan's tissue structure, students will find simulated cartilage, ligaments and veins as well as abdominal organs. Inflatable lungs simulate respiration. The organs and cavities of the mannequin can be filled with fluids to lend realism to the practice procedure. When a student makes an incision on TraumaMan, it bleeds.

In a 2002 study, students found TraumaMan to be superior to animal models for many skills. As a result, more than 12,000 doctors a year now use the system to practice their trauma skills. TraumaMan can be leased for varied lengths of time, with costs as low as $100 to $150 per student. The system can also be purchased for $23,500, a reasonable price, which includes a maintenance agreement and some replacement "skins."

The American College of Surgeons, which oversees trauma training courses, approved the use of Simulab's TraumaMan simulator for teaching the courses in 2001. The college also approved the use of cadavers.

An ongoing 2007-08 survey by the Physicians Committee for Responsible Medicine showed that out of the 164 U.S. facilities offering trauma training courses that responded to the survey, 150 - more than 90 percent - exclusively use nonanimal models for instruction. The vast majority of the 150 facilities -including Cooper University Hospital in Camden and AtlantiCare Regional Medical Center in Atlantic City - exclusively use the TraumaMan system.

Is it ethical for UMDNJ's University Hospital program - or any other trauma training program - to continue using and killing animals when approved, cost-efficient training methods and teaching tools are so widely available? Every other trauma training program in New Jersey has stopped using animals to pursue better, more humane teaching methods. It's time for University Hospital's trauma training course to do the same.

John J. Pippin, a physician, is board-certified in internal medicine, cardiovascular diseases and nuclear cardiology. He has served on several medical school faculties, including Harvard Medical School and the Medical College of Virginia. Pippin is senior medical and research adviser for the Physicians Committee for Responsible Medicine.


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