As a Hopkins student who has done my surgical rotation and someone who has actually personally raised pigs and seen them slaughtered for food (while I was living abroad), here's my perspective on the use of pigs in the surgical rotation.
I wouldn't contest maowl's assertion that pigs are intelligent, social animals; I think it would be hard to have worked with pigs and not believe that. At the beginning of the surgical curriculum, each student is given the choice to participate or not to participate in the pig lab - a decision that can be reversed at any time, and truly without penalty. The surgical rotation administration has faced a lot of criticism for the use of pigs in the lab, especially through groups like PCRM, and they took great pains to emphasize that participation was entirely voluntary.
When it came time for me to choose, I weighed a couple of things in my mind in order to discern whether I believed that the practice was, as maowl writes, "cruel and unnecessary".
First, are there differences between animal testing and the use of animals in the surgical lab? I believe that there are. In what one would commonly consider animal testing, animals are subjected to an intervention, and then followed to see the effects of that intervention. In the pig surgery lab at Hopkins, the pigs are placed under general anesthesia by veterinary assistants, remain anesthetized for the duration of the procedure, and then euthanized at the end of the procedure without having been awakened. In animal testing, the animals live for some period of time after the intervention, subject to any pain or distress that that intervention may provoke. For me, this was a significant difference in determining whether or not the practice is "cruel".
What, then, would be the basis for believing that using pigs in surgery lab is "cruel?" Would it be the actual surgery that we as students performed? The surgeries are performed under general anesthesia. In my view, I couldn't ethically maintain that cutting a living being open under general anesthesia, performing a surgical procedure, and then closing the wound is, in and of itself, "cruel" - since that's what we do every day on the surgical rotation. Granted, the surgical procedures are medically indicated while I suppose that there's no "medical indication" for surgery from the pig's point of view, but I will return to that point below in the discussion of whether or not the lab is "unnecessary."
From my point of view, then, the actual operation was not "cruel," in the sense that it didn't produce undue distress for the pig while the operation was going on. The pigs are closely monitored to ensure that they are continually sedated. The next question then became: is the "cruelness" of the procedure inherent in the fact that the pigs die at the end of the procedure?
Here, my personal values came into play. I am not a vegetarian, although I certainly recognize that there are a host of personal, ethical, and environmental reasons for one to be so. I believe, however, that it would have been logically inconsistent for me to eat meat and refuse to participate in the pig lab on the basis that the death of the pigs was unethical. Take the eating of pork for food: in the United States alone, 1200-1300 pigs per
hour are slaughtered for human consumption
[1]. The slaughter process for food is certainly equally or less humane than the Hopkins lab: pigs are stunned (with electric shocks or carbon dioxide), then bled out before being processed. Any Google search will bring up a host of sites describing the problems with the process on factory farms. It's always a little curious to me that those advocating for pigs' rights would spend so much time focusing on a lab like Hopkins - where there are 3 labs per surgery rotation, each involving ~6-8 pigs, five times per year - as compared to the much larger volume of pigs slaughtered for food in much less humane conditions.
Yet, clearly, establishing that a process is more humane than the slaughter of pigs on factory farms is not a great argument for its ethical appeal. At this point, however, I had established for myself that the use of pigs at Hopkins was not any more cruel than the
ideal procedure that I could imagine for food production, and I therefore wouldn't reject the process while still eating meat. This calculus clearly changes if one is a vegetarian, which I wholly respect.
Second, is the process "unnecessary?" Clearly, if your criterion is "can we do without it?" the answer must be "yes" - many other schools do not have pig labs for their surgery rotation. Yet perhaps a more relevant question would be "what is to be gained from the sacrifice of these pigs?" Again, I believe that food consumption is a relevant comparison: those of us who eat meat condone the death of animals on a massive scale for our personal consumption, clearly at no benefit for the animal. By analogy, my personal ethical framework allows for the death of an animal if a substantial benefit is produced for humans. Again, this is a different framework than that of a vegetarian.
So, what is there to be gained? On your surgical rotation, you're by and large a passive observer. Sure, you're allowed to close the surgical wound, retract, and even assist with various procedures when you're farther along in your training. Yet as those of you who want to be surgeons well know, that's not what keeps people in surgery. As medical students, we get no taste of the decision-making, planning, and leadership that runs through the lead surgeon's mind during a procedure.
As others have mentioned above, the pig lab is the best technical training that one could receive as a medical student during the curriculum. There is no substitute for the feel of the tension of thread between your fingers as you tie off a blood vessel, balancing the need to tie a solid knot against the risk of tearing the vein. There are simply things that we do in the pig lab that you as a medical student don't get to do - and for good reason - on your surgery rotation: from start to finish, you and your team members do a nephrectomy, a splenectomy, a bowel anastamosis, and a partial pneumonectomy (among other procedures). Once you've been in anatomy lab and in surgery, you recognize that there is no comparison between the two from a technical standpoint. While simulation has come a long way - and Hopkins certainly has its share of laparoscopic training opportunities (even a Da Vinci robot for training), open surgery has its own needs.
Yet the biggest impact on your training is mental & psychological. There are few other times in medical school where you and your classmates assume the primary role. Here, you take your turn as the lead surgeon or first assist, and it is a
totally different experience from watching or assisting on the rest of the rotation. It is an entirely different sensation to plan the incision, decide whether it should be extended or not, and then enter the abdomen, your mind racing to integrate all of the anatomy you learned two years earlier as you decide which vessels to tie off first. You have to anticipate which instruments you'll need, coordinate with the others around the table to optimize your exposure, position the lights correctly. I am certainly not a surgeon; I'm going into a more medically-related specialty. Yet the pig lab was the best glimpse into what it's like
intellectually to be a surgeon, and for that I felt that the lab was invaluable.
So for all that, I believe it's not an ethically clear-cut situation, although after careful consideration I feel that it was a real asset to my education here. I do get somewhat frustrated when organizations like PCRM assert that such a lab is categorically wrong, although I appreciate their objections. It's a difficult question that really gets to the heart of the difficulty of medical education: to what lengths are we willing to go to better the training of the next generation of physicians? I think that it's a more important question when applied to the ways that we as students interact with
humans, but that's my point of view. In any case, it's a question that deserves thoughtful discussion.
Finally, I would point out that - for those of you for whom animal rights in medical research are an important issue - Hopkins is a leader in this field as well. The Center for Alternatives to Animal Testing (
CAAT) at the School of Public Health is dedicated to the "3 Rs" of developing alternatives: replacement, reduction, and refinement of current methods. So if you're interested in actually solving the problem of furthering medical knowledge while reducing the impact on animals, rather than simply protesting, there's a place for you here as well.
So come to Hopkins - where we think deeply about important things and consider them with the carefulness that they deserve! It doesn't go on bumper stickers as well as "stop the pig lab," but I believe that the
discussion makes me a better medical student and future physician.
