The frivolous taking of life

Johns Hopkins is among the last two U.S. medical schools using live animals to train students. Why?

You may have seen the startling bus and metro ads around town that warn, "What does JHU have that 98 percent of medical schools don't? Live animal labs."

That's right. Johns Hopkins and the University of Tennessee College of Medicine in Chattanooga are the last two holdouts that continue to use live animals to train students. They've refused to join all of the other U.S. medical schools — including the University of Mississippi School of Medicine and Rush Medical College in Chicago just this month — that have modernized medical education by ending animal labs.

At Johns Hopkins, third-year medical students take part in a surgery clerkship in which live pigs are anesthetized and cut open before being killed. While this animal lab is technically voluntary, medical students everywhere face enormous pressure to impress their professors, so nearly all students take part in this disturbing exercise. I understand the pressure that medical students face when confronted with this unpleasant experience. It was just five years ago that I was asked to do the same.

When I was a medical student at Oregon Health & Science University (OHSU) in 2010, a controversial part of the curriculum involved injecting drugs into live pigs in the hopes of learning something about human physiology. At the time, I joined the rest of my peers in taking part in the animal lab but was deeply affected by the experience. There was no reason to kill animals in the name of medical education then, and there is still no reason today. My alma mater came to /the same conclusion. In 2014, after a thorough analysis, OHSU pulled the pig lab from the curriculum.

While many schools like OHSU have undertaken thoughtful educational reviews to determine that killing shouldn't be part of teaching medicine, leaders at Johns Hopkins have defended animal use in a very confusing way. Dr. Roy Ziegelstein, vice dean of education, told a student newspaper last year that he heard from some students that the school's practice teaches them the "sanctity of life."

Yet Dr. Ziegelstein's argument raises some important questions. If the animal lab is optional, how essential can it be to the school's goal of ensuring its graduates appreciate the value of life? If a student opts not to participate in the exercise, is Dr. Ziegelstein suggesting that he or she will make a lesser physician? Further, and most importantly, how can the frivolous taking of life impart its sanctity to future healers?

There is no doubt that what is occurring at Johns Hopkins is indeed frivolous. After all, 186 other medical schools in the U.S. and Canada — including every Ivy League medical school as well as the University of Maryland here in Baltimore — see no need to kill animals in their medical student curricula. The U.S. military's own medical school in Bethesda, which is preparing physicians for deployment to combat zones, ended the use of pigs in its surgery clerkship in 2013.

All of these institutions now use training methods based on human anatomy, not the anatomy of a pig. These include virtual reality simulators that allow students to practice minimally invasive surgical skills over and over in order to improve technique — something you cannot do when using animals.

Published studies even show that trainees suspend disbelief when using these human-based methods. Medical students forget that what's on the screen or on the table in front of them is not living and they do everything they can to save the life of that "patient." But students at Johns Hopkins will never be able to save their first "patient" as long as the school continues to use and kill animals. It's long past time to change that.

Dr. Richard A. Bruno is a family and preventive medicine resident physician at MedStar Health and the Johns Hopkins Bloomberg School of Public Health. The opinions expressed herein are his own and do not necessarily reflect the views of MedStar Health or The Johns Hopkins University. His email is ridgebardo@gmail.com.

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