Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany.
Altern Lab Anim. 2018 May;46(2):65-71. doi: 10.1177/026119291804600206.
Trauma training is a crucial element of medical education in the civilian sector, as well as in the military sector. Its aim is to prepare physicians, medics and nurses for stressful and demanding emergency situations. Training methods include live-tissue training (LTT) on animal models and simulation-based trauma education. For LTT, blast, gunshot or stab wounds are inflicted on anaesthetised animals, mostly goats and pigs, but sometimes non-human primates. This training method raises ethical concerns, especially in the light of increasingly sophisticated simulation-based methods. Despite these non-animal alternatives, LTT is still widely used due to its presumed educational benefits. In this paper, the question of whether LTT can still be justified, is discussed. We developed a normative framework based on the premise that LTT can only be ethically justified when it yields indispensable benefits, and when these benefits outweigh those of alternative training methods. A close examination of the evidence base for the presumed advantages of LTT showed that it is not superior to simulation-based methods in terms of educational benefit. Since credible alternatives that do not cause harm to animals are available, we conclude that LTT on animal models is ethically unjustified.
创伤培训是民用和军事医学教育的一个重要组成部分。其目的是为医生、医护人员在面对紧张和高要求的紧急情况下做好准备。培训方法包括在动物模型上进行活体组织培训（LTT）和基于模拟的创伤教育。对于 LTT，在麻醉动物（主要是山羊和猪，但有时也包括非人类灵长类动物）上造成爆炸、枪击或刺伤。这种培训方法引发了伦理问题，尤其是在日益复杂的基于模拟的方法出现的情况下。尽管有这些非动物替代方法，但由于其假定的教育益处，LTT 仍然广泛使用。本文讨论了 LTT 是否仍然可以被证明是合理的问题。我们根据以下前提制定了一个规范框架：只有当 LTT 产生不可或缺的益处，并且这些益处超过替代培训方法的益处时，LTT 才可以在伦理上得到证明。对 LTT 假定优势的证据基础进行仔细审查表明，它在教育效益方面并不优于基于模拟的方法。由于有可信的替代方法，不会对动物造成伤害，因此我们得出结论，动物模型上的 LTT 在伦理上是不合理的。
