Professor Jeffrey Kahn visited UW Madison to discuss the use of monkeys in medical research.
He is the Robert Henry Levi and Ryda Hecht Levi Professor of Bioethics and Public Policy and the Deputy Director for Policy and Administration at the Johns Hopkins Berman Institute of Bioethics.
Professor Kahn has participated in numerous federal panels and chaired the influential Institute of Medicine (IoM) committee on the Use of Chimpanzees in Biomedical and Behavioral Research, which recommended that the NIH phase out most biomedical research on chimpanzees.
Because he is respected and listened to by those in charge of making policy decisions on matters of important medical research and public health issues, his talk at UW Madison drew much attention.
During his comments Prof. Kahn raised several objections about how animal research is regulated in the United States that deserve closer scrutiny.
Unfair application of the principles of utilitarian philosophy
Professor Kahn objected to justifying research based on utilitarianism on the grounds that it is unfair to consistently harm one group (non-human animals) for the benefit of another (humans).
However, the notion that pure utilitarianism forms the basis for an ethical defense of biomedical research is incorrect.
For example, a pure utilitarian view would also call for doing invasive experiments in mentally disabled human beings whose cognitive capabilities are comparable to those of animals used in research, or demand we forcefully harvest the organs of a potential human donor to save the lives of several others.
Of course, we don’t do any of these things. So it was perplexing to hear him state that utilitarianism is “how the system is set up.”
No, it is definitely not.
Medical research with human and non-human animals is not based on a pure, utilitarian view. Instead, it is partly based on a graded moral status perspective that posits we owe moral consideration to all living beings, but not to the same degree that we owe consideration to the lives of fellow humans. It is also partly based in our mutual recognition of equal, basic rights for all members of the human family.
These ethical considerations are embedded in federal regulations and NIH guidelines that call for minimizing the number of animal subjects used in any one study, the amount of suffering involved, and require the use the “lowest” species that can be expected to yield meaningful scientific answers. It is also reflected in specific federal programs aimed at developing alternatives to animal use and, of course, in protections for human subjects.
It is true that NIH has never made explicit the ethical and philosophical principles underlying its research. Nevertheless, the ethical principles etched in these regulations should be clear to anyone who spend the time to become familiar with them.
A misguided notion of scientific necessity
Professor Kahn views the “scientific necessity” of the work as inextricably linked to the ethics. His views are aligned with the conclusions of the panel that he chaired on chimpanzee research. Within this framework a project would be morally justified only if all the following three conditions were met:
- No suitable alternative is available
- The work cannot be performed ethically on human subjects
- The work is required in order to accelerate the prevention, control and treatment of life-threatening or debilitating diseases
A large class of studies readily meet the first two requirements. When we seek information about the cellular and molecular mechanisms in a living organism, the technologies available to us at the present are invasive, and the work cannot be performed ethically in human subjects. If we could observe and manipulate molecular pathways and cells in living humans without jeopardizing their well being, then the work would be done in humans. But we don’t yet have such tools. No computer simulation, no in-vitro system, no MRI, no organs-on-a-chip currently available, provide an adequate alternative to animal studies.
The crux of the matter then boils down to the third condition, and therein lies the rub. When you are talking about the process of scientific discovery, this third condition is meaningless when applied to individual scientific projects. Science, as Professor Kahn himself points out, is not necessarily a predictable linear path from point A to point B, because it involves the exploration of the unknown. Science cannot promise that any one experiment can lead to a cure, nor can researchers know ahead of time which specific experiment or line of research will lead to a breakthrough. In Professor Kahn’s own words, “we call it research because we don’t know what the answer is.” Why does he not realize that demanding a specific outcome in advance is out of the question? One can only evaluate outcomes in retrospect, as Peter Singer has done offering in his approval for monkey studies in Parkinson’s research. Unfortunately, scientists on NIH study sections do not have the luxury of an oracle that can guide their decisions.
Instead, researchers understand that without animal studies we will not be able to develop new therapies and cures. Our expert scientific opinion is that were we to suspend animal research, most fields of biomedical research would come to a full stop. Meanwhile, patients and their families would pay the price of more human suffering.
Thus, the ethical question should be reframed as not whether one individual study is required but, in the case at the heart of this debate, whether the use of animal models is required to understand the molecular pathways underlying mental disorders so that we can develop new treatments and cures for them. Or more generally, if animals are required at all to advance medical knowledge and human health. The scientific consensus in this matter, as indicated by a recent Nature magazine poll, is overwhelming:
Bonus points should go to UW Professor Eric Sandgren who was nevertheless able to use Professor Kahn’s framework to explain, point by point, why he feels the studies under discussion can be justified. You may agree or disagree with his justification, but you cannot say he did not offer one. In contrast, Professor Kahn simply stated that he was “deeply skeptical” of the necessity of the work, despite acknowledging a lack of familiarity with the details of the study, nor bothering to explain the rationale for this view.
Given that the research at the center of this debate is aimed directly at anxiety disorders, a specific neurological condition that affects millions of humans, one might safely assume that Professor Kahn would express even graver doubts about basic research in animal subjects. He would have likely have rejected outright the research on olfactory cells that eventually allowed paralyzed people (and dogs) to walk again, among numerous advances in knowledge that have led to medical breakthroughs.
Professor Kahn ought to be reminded that the mission of the NIH is “to seek fundamental knowledge about the nature and behavior of living systems and the application of that knowledge to enhance health, lengthen life, and reduce illness and disability,” and try to understand better the inherent uncertainty and necessity of scientific research.
Do IACUCs and NIH study sections fail to evaluate scientific necessity?
Given his misguided view of necessity, it should not be surprising Professor Kahn believes that neither IACUCs nor NIH study sections are able to assess the scientific need for specific studies. He harshly criticized such committees for taking the claims of any one proposal at “face value.”
That is a very strong statement… and a decidedly incorrect one, too.
First, the overall scientific direction of medical research in the country is established by our medical and scientific leadership. In the neurosciences, scientists are guided in their research by NIH’s Neuroscience Blueprint. Among the important scientific directions relevant to this particular discussion—ones that Professor Kahn should have known about—were the Blueprint Neurotherapeutics Network (to advance the development of new drugs for nervous system disorders) and the Blueprint Non-Human Primate Brain Atlas (to provide comprehensive data on gene expression in the rhesus macaque brain , from birth to four years old). Such work is expected to aid research on human brain development and its disorders.
Second, NIH study sections diligently assess proposals with an eye to which studies stand a better chance of advancing our knowledge of function and disease and therefore may have the greatest potential to lead to new cures or fundamentally advancing a field of study. In making their assessments, scientists who participate in study sections use their expertise to assess which research directions and pilot data look most promising. There is never a guarantee that any one study will produce a breakthrough. If there is any one premise it is that animal research has led to numerous advancements in knowledge and medicine that has benefited human and non-human animals alike. This is not taken at face value, rather, it is an indisputable fact of medical history.
Third, once the scientific merit of a proposal has been established, IACUCs provide an additional layer of local scrutiny and compliance oversight. It is perfectly reasonable for IACUCs to ensure the work at the institution maximizes the welfare of the animal subjects in each study, and NIH requires such an assurance for institutions that receive federal funding. (For the small minority of projects that have not yet received NIH review, the IACUCs seek local expertise to evaluate the scientific merit of the study.)
Is funding “unnecessary” research a waste of resources?
Another miscalculation derived from Professor Kahn’s flawed view of “necessity” is the claim that if research is “unnecessary” according to his definition, then it is also unethical, especially considering the limited funding resources we have available at the moment.
It is perfectly legitimate for a society to assess how it distributes its resources, but in doing so the entire budget ought to be considered.
One may ask, for example, how Professor Kahn feels about resources spent on drones for the military, the Hubble telescope, unmanned trips to Mars, funding for theoretical physics, game theory, or the Arts.
Or, more to the point, one could ask for a more detailed justification of why society should spend its resources on philosophers and bioethicists?
Should society prioritize the support of bioethics over the development of a vaccine for Ebola or a cure for cancer, Alzheimer’s or Parkinson’s?
Which is one more crucial to our social welfare and which is more “unnecessary”?
Who will direct medical research?
Scientists must participate more in public life because social policies need to be decided on the basis of rational grounds and facts. These include important issues ranging from climate change, to the goals of the space program, to the protection of endangered species, to the use of embryonic stem cells or animals in biomedical research.
When scientifically inaccurate statements emanate from someone who has demonstrable influence on public policy decisions, scientists have a duty to speak up and correct the mistakes.
Animal research poses a legitimate moral dilemma. Decisions to pursue different lines of research that are perceived as controversial — be it research involving animals subjects or embryonic stem cells — cannot be assessed fairly without the active participation of scientists, physicians, patients and their families, because all are stakeholders in the work.
Unless these stakeholders get involved in such debates, we may find that their interests are not taken into account when the future direction of medical research is determined.
17 thoughts on “Jeffrey Kahn’s Odd Views on Animal Research”
Dario Ringach – [XXXXXXX]
Michèle, you are welcome to try again without the insults. Here are the guidelines — https://speakingofresearch.com/about/comments-policy/
Reblogged this on Be Veg Make Peace and commented:
Being old enough to remember the days of polio victims with terrible physical problems, I also remember how happy people were when the vaccine was provided, first to all the children in the US, then to all adults. This was a miracle for us who knew polio victims. This would not have been possible without research using animals. In this day and age when we have made so much progress on so many fronts against terrible diseases, and that progress was dependent on animal research, I cannot imagine anyone with ethical concerns for both animals and humans who would be against research using animals. Because research on animal diseases is also occurring, and in order to occur, animals must be used or answers will not be found. This seems to me like simple common sense.
Laurella, this article is not about being for or against animal research – it is about how to decide which studies should be approved and which not.
From your comment it sounds like your opinion is that of all animal research should be approved because some time ago people used animals to find a cure for polio.
Perhaps if you have a look at some of the studies being done (specifically this I find particularly unethical: http://www.cbsnews.com/news/mental-health-experiments-on-baby-monkeys-at-federal-nih-labs/ and http://wisconsinwatch.org/2014/07/university-of-wisconsin-to-reprise-controversial-monkey-studies/) you might change your mind.
Furthermore, there is a lot of evidence that shows that the polio vaccine may actually be doing more harm than good in some areas of the world.
It is relevant because one could ask if, under Kahn’s framework, we would have ever approved of the research that led to the polio vaccine.
Would he have approved the work of Salk and Sabin or would he declare himself “deeply skeptical”?
So again it would seem you are falling back to saying that, since the Polio vaccine might not have been discovered if some animal tests that later proved helpful were deemed unethical today we must approve any and all research that have an off chance of resulting in a similar cure in the future.
Using this reasoning there is no test that can be deemed unethical, because since human life has a higher value than animal life we can do anything we want as long as there is a probably greater than zero for contributing to a cure that might save a human life in the future.
This is in effect what Laurella is saying and I am disagreeing with – just because polio was cured using animal research does not make it compulsory for everybody to support all animal research.
Furthermore, just because polio was cured many years ago thanks to the use of animal research does not mean that animal research is (or even was) the best way to find a cure. At that time it was the only known way, but with advances in other technology perhaps in the future we find better ways – in that case you should choose that new method and not continue to support animal research just because it helped cure a disease a long time ago.
People blindly supporting all animal research because of past positive results is something I find ridiculous. In everybody had that mindset there would be no progress in the world.
You are not answering the question — would Kahn have approved of the polio vaccine work? Would you?
You seem to be mixing, what I see as, a valid and invalid point. It is fair to point out that a system that could justify all research (even if it only took the top ranked projects) is flawed. I do not believe our system does this. We do not just rank projects according to “which studies stand a better chance of advancing our knowledge” but also by the a harm-benefit analysis – is the potential suffering of the animal justified by the potential outcome. So we get a calculation a bit like:
If “potential benefits x likelihood of informative outcome” is greater than animal suffering AND is greater than financial cost (or opportunity cost), then project should be approved.
Would you agree, in principle, with this idea?
What concerns me is your additional line of argument suggesting we may have cured it anyway – that is a dangerous ivory tower to build and watch whose lives were destroyed by diseases like polio (while you note there may be some issues with the polio vaccine, the overall outcome of the treatment has been MASSIVELY beneficial). I think you need to stop thinking of the development of medicine as being done by animal or non-animal techniques. Developing a medicine requires a whole plethora of biological understanding which is gained through BOTH animal and non-animal methods – you use the method which is most appropriate to answer the question you have.
Tom, I agree with that idea (I might disagree with how the potential benefits and animal suffering is quantified, but that is a different discussion). Also, from what I understand of the opinions of Prof. Kahn he also agrees to this idea.
What I commented on was the statement from Laurella that [due to the success of the polio vaccine] “I cannot imagine anyone with ethical concerns for both animals and humans who would be against research using animals.”
I strongly disagree with making a blanket statement condoning all animal research because of a singular positive result in the past (for various reasons including the fact that technology and techniques change and the fact that each experiment must be judged on its specific merits and not just be supported because of the success of a previous experiment).
Furthermore, I never argued that we might have cured it anyway, I stated that for the historic circumstances and technologies available when the polio vaccine was discovered animal research was (probably) the only option and thus justifiable – but that this does not mean that in the future it will continue to be the only option and thus must continue to be justifiable in the future. If in the future a cure for a disease similar to polio had to be found, perhaps there may be different options available that would not require animal research and in that case it would be unethical to approve animal research just “because it worked in the past”.
I also agree that today we are still reliant on animal research. My opinion is that, unfortunately, we have not yet advanced enough technologically to completely get rid of the distasteful practice of animal research. There are people that would say we have the technology and that if animal research was to be banned these technologies would advance much more rapidly and will fill the gap that exists – I don’t know about that.
So I agree with your statement that today, “you use the method which is most appropriate to answer the question you have”, but I would add “you use the method which is most appropriate to answer the question you have” weighing the importance of the question you have and the potential for achieving significant results to the harm done to the animals used.
Furthermore, this balance should constantly be re-evaluated.
Dario, my comment was not related in any way to the Polio vaccine – I am saying that the Polio vaccine work should not determine whether or not animal research projects should be supported today or in the future.
But to answer your question – I doubt that I would have approved ALL the work that played some part in the development of the polio vaccine, but that does not mean that the vaccine would not have been discovered or even that it would have taken longer to discover. I suspect the same applies to Prof. Kahn – he might not have approved all of the animal research projects that contributed in some way to the end result, but again, that does not mean the vaccine would not have been discovered or even that it would have taken longer to discover.
But to answer your question – I doubt that I would have approved ALL the work that played some part in the development of the polio vaccine, but that does not mean that the vaccine would not have been discovered or even that it would have taken longer to discover.
Does this mean you would have approved SOME of the work? If so, please explain how would you decide.
Lsadehaan – I think I broadly agree with your last comment (to me). I believe that if animal research was unnecessary, it would be unethical to do it.Obviously we may disagree with the balance of potential suffering to potential benefit, but we come to it with the same idea.
First, although I stated that I am in support of animal research, I do not think that statement included an implication that I would be in favor of any and all research projects using animals. That would make no sense scientifically or ethically. It would seem obvious to me that a responsible animal research project should be undertaken if the need is great and the research is well designed. Otherwise, what would be the point of conducting the project?
Furthermore, I do not see how even tremendous improvements in technology will eliminate the need for all animal research. Living beings are so complex that proving a product or procedure is safe and effective for humans, will likely require animals must be used at some point during this research.
It seems like you are saying that any animal experiment that has not been done before can be justified because “you never know”.
Perhaps if I poke a cancer infected rat with a hot poker for 10 hours and measure his levels of adrenaline it will contribute in some way to somebody someday finding a cure to cancer, you can’t say for sure that it won’t so that experiment should be morally acceptable, since it’s only a few rats that are humanely being tortured to potentially save the life of a human.
If you don’t consider point 3. you can justify anything.
I did not mean to imply you should get rid of point 3 but replace it. One idea is that at any point in time we should give priority to studies that maximize the likelihood of substantially advancing knowledge in a field or leading to a medical breakthrough while minimizing the amount of suffering. This is pretty much what study sections do. Your proposed study will rank very low in any list.
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