‘I think it will eventually be done away with’: Attitudes among healthcare professionals towards the current system of animal experimentation

Introduction

Millions of animals are bred and used every year for the purpose of animal experimentation (Home Office, 2013). These include beagle dogs, mice and primates (the last of which are also captured from the wild) (The Scientific Committee on Health and Environment Risks (SCHER), 2009: 8). In Europe, roughly 40% of these animals are used to test consumer products, while the remainder are used in health research (European Union, 2010). By any standards, the tests on these animals are usually painful and almost always result in the death of the creature involved. In the United Kingdom (and elsewhere), such animals are exempt from animal welfare legislation applied to others of their species (e.g. Animal Welfare Act, 2006).

Most evidence concerning attitudes to animal research has been collected in MORI polls of the general public (Ipsos MORI, 2012). In 2012, MORI found that 37% of the public were ‘objectors’ to animal testing, and such polls suggest that in general the number of people opposed to animal experimentation is rising (Ipsos MORI, 2006, 2010). In society generally animal experimentation is a contentious topic (Haugen, 2006; Hunnicutt, 2013), but despite the fervour of the debate, medical research in peer-reviewed journals concerning attitudes of health professionals is remarkably scant. In conducting an extensive search (Appendix 1: See Supplementary Material), I could find only one such study (of medical students who reported reservations about the practice; Glick, 1995).

While few studies of health professionals exist, psychological studies (predominantly of psychology undergraduates) are much more common (e.g. Furnham et al., 2003; Hagelin et al., 2003; Ormandy and Schuppli, 2014; Serpell, 2004; Swami et al., 2008). A search of the PsycINFO database produced five such studies (Appendix 1: See Supplementary Material). One study (Ormandy and Schuppli, 2014) critiqued the ‘deficit’ model (which argues that the public may oppose animal research because they have insufficient knowledge to understand its benefits). The deficit model, however, has been discredited because as the public becomes more expert in how animal research actually works, their opposition to it grows (Ormandy and Schuppli, 2014). Opposition to animal research is also linked to the respondent’s demographic position. Younger people are more likely to oppose the practice than older people, and women oppose vivisection significantly more than men (Furnham et al., 2003; Hagelin et al., 2003; Ormandy and Schuppli, 2014; Serpell, 2004; Swami et al., 2008). This may be because men take a more ‘dominionistic’ attitude towards their environment, while women take a more ‘moralistic’ stance (Kellert, 1980, cited in Ormandy and Schuppli, 2014).

A concept known as ‘belief in animal mind’ is also an indicator of opposition to animal experimentation (Swami et al., 2008). This concept denotes a belief that animals are ‘self-aware’ and can experience emotions such as fear, sadness, happiness and pleasure (as well as physical pain). ‘Beliefs about the mental experience of animals are related to attitudes about animal testing’ (Swami et al., 2008: 269), and those who acknowledge ‘animal mind’ are much more likely to oppose animal research (Furnham et al., 2003). Images of animals which illustrate ‘animal thinking’ (e.g. where animals show love and self-sacrifice or display altruistic behaviour) abound on social media sites. Social media thus appears to have an effect on attitudes to animal testing, with pro-animal rights groups having a high Facebook membership.

Regardless of opposition to animal research, this method of testing consumer products and drugs is increasing (Home Office, 2013). Pharmaceutical companies wishing to introduce a new drug onto the market must by law test that drug on a rodent and non-rodent species (Animals (Scientific Procedures) Act, 1986). Current UK legislation permits such companies to conduct these tests in secret. Under this provision (even where the researcher consents) disclosing information concerning the experiments can lead to a lengthy prison sentence (Widdicombe, 2014). Such secrecy also makes it difficult to assess whether the Home Office is genuinely implementing alternatives to animal research (Widdicombe, 2014). The secrecy clause is currently under review (Home Office, 2014, Animals (Scientific Procedures) Act 1986, Amendment Regulations 2012) but even if repealed, current proposals appear to accommodate ‘gagging clauses’, possibly preventing violations of animal welfare coming to light (Widdicombe, 2014).

A key tenet of existing animal research welfare legislation is the ‘3Rs’ (Animals (Scientific Procedures) Act, 1986). This stands for ‘replacement’ (with alternatives where possible), ‘refinement’ (to minimise suffering and improve welfare) and ‘reduction’ (of the number of animals used). Animal rights groups, however (BUAV, 2011), suggest that the 3Rs remain unenforced (Taylor, 2010), inspection of facilities is pre-arranged and Home Office licences are granted on the basis of the experimenter’s own evaluation of suffering to benefits (Animal Aid, 2006).

Animal rights groups have adopted a variety of methods by which to oppose animal experimentation (Animal Aid, 2006), most of which constitute legal and peaceful protest (The Economist, 2011). However, at the far end of the antivivisectionist spectrum, some activists have adopted more extreme measures. For example, in December 2012, a permanent injunction was granted at the UK high court (Peachey, 2014) against extreme animal rights activists campaigning to shut down Huntington Life Sciences (a facility in Cambridge alleged to conduct particularly cruel experiments; Broughton, 2001). In January 2014, these activists received prison sentences (Press Association, 2014). Such events are part of the recent context in which current attitudes to animal experimentation (in the United Kingdom) can be placed. However, given the extreme activities of the animal rights groups concerned, these events may have been expected to reduce public sympathy for antivivisection. Current evidence nevertheless suggests that public opposition to animal experimentation in the UK is rising (Ipsos MORI, 2006, 2010).

This article assesses nurses’ attitudes to the current system of animal testing. These professionals spend the most ‘hands-on’ time with patients (DOH, 2012), so it is important to assess such attitudes among this group. Such professionals might be expected to hold ‘information-rich’ opinions concerning how medications are developed. In addition, nurse prescribing has expanded in recent years (Royal College of Nursing, 2012), and nurses might thus be expected to take a keen professional interest in the development of the drugs they prescribe.

A total of 52 healthcare professionals (HCPs) gave their opinions in three separate focus groups (with 18 HCPs in the first group and 17 in the remaining two). The study concentrated on animal research for health interventions only. Experimentation to produce consumer goods was not investigated (although some brief discussion of this practice emerged and was strongly condemned by all HCPs present).

Methods

The 52 health professionals enrolled in the study were Level 3 students on the ‘top-up’ BSc Professional Practice and BSc Public Health Studies degrees at Coventry University. Each HCP was completing a 2-year part-time degree programme which offered professionals with a diploma, an opportunity to complete honours degree level. No doctors were enrolled on the programme (but past alumni had ‘fast-tracked’ onto medical degrees). Ethical approval for the study was granted by the university research ethics committee.

All HCPs were completing an advanced module in research methods as part of their degree. This study was conducted after the last but one session of this module. Information was gathered from three recent module cohorts containing 52 health professionals in total. The cohort date was recorded but is withheld to conceal participants’ identities (and pseudonyms were assigned for the same reason). All cohorts were roughly the same size and undertook the research module at some point between 2011 and 2014.

Qualitative data were gathered through focus groups (together with quantitative data described elsewhere; Dignon, 2014). In addition, the study recorded the age, sex, years of work experience, grade and employer of each HCP. The focus groups occurred after the scheduled 3-hour seminar on ethics (presented as a normal part of the research module curriculum). This session included a discussion of animal testing (with a 40-minute lecture giving an ‘unbiased’ overview). Two weeks earlier, the students had been directed to ‘read up’ on animal experimentation and were referred to a list of resources presenting both sides of the argument (Appendix 2: See Supplementary Material). At this point, the study was described and verbal consent elicited. The lecturer (a non-clinical research scientist) identified her own standpoint (one of opposition to the current system) which was presented as an example of ‘reflexivity’ (whereby researchers are honest about their bias and invite their work to be critiqued in this light; Gerrish and Lacey, 2013: 425). The lecturer strongly emphasised, however, that views that were different to hers would be actively sought in the study for reasons of balance.

On the day of the study, HCPs were invited to remain for 60 minutes at the end of the scheduled session to participate in the investigation. Health professionals who did not wish to participate were allowed to leave – however, all but two health professionals (in all groups) chose to participate. Participant information and consent leaflets were distributed. The study was again described, right to withdraw emphasised and written informed consent obtained. Quantitative data (Dignon, 2014) including age, sex, years of work experience, grade and employer were collected from each HCP, and for the remaining 45 minutes, a focus group (facilitated by an independent researcher not otherwise involved with the HCPs) was held. Focus groups are considered to be a highly useful method of eliciting health-related information (Crossley, 2003), as they allow health professionals to ‘spark off’ each other, prompting information and generating ideas (Wilkinson, 1998). In these focus groups, the health professionals were invited to offer their opinions on animal experimentation, in answer to the prompt ‘what is your opinion about the current system of animal testing?’ The study purposely avoided asking whether participants were opposed to all forms of animal testing, concentrating instead on the workings of the current system.

The focus groups were recorded using a digital voice recorder. Transcripts were made of these recordings, and thematic analysis (Gooden and Winefield, 2007; Jowett et al., 2012; Sullivan, 2003) was performed. Transcripts were read and re-read to extract important themes. This was a time of reflection for the researcher where text was sifted and appraised until eventually the key issues emerged (labelled using the words of the HCPs themselves). These themes are presented below and included concerns regarding welfare, secrecy and regulation.

Results

The healthcare professionals had an average age of 38 years (range: 25–59 years; standard deviation (SD) 8.7) years and an average length of healthcare experience of 12 years (range: 2–35 years; SD 8.73; see Table 1: See Supplementary Material). In all, 10 were male and 42 were female. All were comparatively senior nurses from various branches and specialisms including cardiovascular, acute and critical care, long-term conditions, palliative care, paramedic nursing, midwifery and mental health. All had educational qualifications to at least higher education diploma level.

Discussion

Several HCPs appeared to have strong views on the need for much better regulation of laboratories and breeding facilities. Where surplus animals were bred, the breeding facility should underwrite the care and rehoming of such animals, and legal statutes should be in place to require this. In the view of these HCPs, facilities which euthanised large numbers should be subjected to criminal proceedings (leading to meaningful financial (and other) penalties). The breeders and testers should also ensure that their facilities could house the animals in exemplary accommodation, given the contribution these creatures would later make to human health.

Several HCPs queried animal research on the basis of ‘conflicts of interest’, given that the pharmaceutical companies commissioning the research were profit-making concerns (needing to get their products to market before their competitors). One HCP suggested that such facilities might benefit financially from cutting corners both in research procedure and in animal welfare. Animal welfare issues were clearly of central concern to the HCPs. Basic welfare needs, they suggested, seemed to be disregarded. They could not understand how the provision of comfortable accommodation and exercise, within and before the experiment, could confound the results. Regardless of potential external ‘contaminants’, it seemed nonsensical that regular outdoor exercise for dogs, for example, would introduce sufficient variation to invalidate the research.

The HCPs were senior nurses (most at Band 6 or above) and had been sponsored by their trusts to ‘top up’ their professional qualifications. As part of their degree, all had been given extensive tuition in research methods in health. Their understanding of research (and of health care) was significantly higher than that of a ‘normal’ layperson (Brody et al., 2012). Even so, they reported a lack of awareness about the way in which pharmaceuticals were tested on animals. This was coupled with a belief that if their fellow professionals were to become more aware, then opposition to the system would be greater.

HCPs seemed to be aware, however, that some testing facilities would have worse standards than others. The most enlightened would have the best facilities and would rehome (rather than euthanise) dogs that were no longer useful to the laboratory. HCPs were nevertheless concerned that such best practice was rare. In this context, they were alarmed that animal experimentation was conducted in secret and such secrecy was sanctioned by law (Animals (Scientific Procedures) Act, 1986). The HCPs questioned how the research could be subjected to external scrutiny when it was conducted ‘behind closed doors’.

The involvement of animals in research may have led to the discovery of important therapies, some HCPs suggested, but this made them all the more shocked at the manner in which the animals were treated. They wondered why dogs who were contributing so much to the welfare of humankind were given only sawdust for bedding, refused exercise and confined to cages. These animals should be given the best life possible outside of the experiment and rehomed where feasible at the end of the research.

While some HCPs believed that animal experimentation had contributed to human health, others were not so sure. As one of them said, ‘It’s very hit and miss, isn’t it?’ It seemed equally likely to this HCP that using animals may have delayed or even prevented the introduction of life-saving drugs (Greek and Greek, 2000). In her view, little evidence was available to establish exactly which tests were effective and which were not (Heywood, 1990). Another HCP queried the extremity of the tests believing that equally valid results could be obtained by halting the tests at an earlier stage when the animal was starting to struggle.

In this context, the protocol used in animal research was questioned. Specifically, the HCPs queried the evidence base on which much animal research was conducted. Nowadays, all health professionals are required to engage in evidence-based practice, where care must be underpinned by findings generated by the most rigorous research (Sackett et al., 2000; Straus et al., 2011). To these HCPs, it was remarkable that in such an era, the initial stages of drug development (using animals) centred on procedures and findings where the evidence base was so weak (Hackam and Redelmeier, 2006; Perel et al., 2007). HCPs referred to the ‘tick-box’ nature of animal experimentation. It occurred for procedural rather than scientific reasons. This was viewed as conducting research as a ritual, ‘because we have always done it like that’ rather than because such research genuinely contributed to human health.

Given that the participants were all nurses, it is not surprising that such a group of professionals would display high levels of compassion (both towards patients and animals). Some studies have stressed the link between empathy and unfavourable attitudes to animal experimentation (Furnham et al., 2003; Serpell, 2004), and such findings have a resonance in this study. It is also noteworthy that 81% of the sample were women, and (as was mentioned previously) almost every study in this area (Furnham et al., 2003; Hagelin et al., 2003; Swami et al., 2008) has emphasised that women are far more likely than men to oppose animal testing.

It is, however, important to address the limitations of this study. Researchers have indicated that it may be difficult to draw definitive conclusions from studies of attitudes to animal research because ‘some survey questions require experience that many people do not possess’ (Hagelin et al., 2003: 76). This study, however, was an investigation among health professionals who had been educated in research methods and had gained significant knowledge concerning how the system of animal experimentation operates. As such, lack of knowledge about animal experimentation caused few limitations in this study. A more serious limitation was that the HCPs were enrolled on a research methods module and were being taught and assessed by the principal investigator (and may have preferred to give the answers they believed she wanted to hear). Such bias, however, is present (although possibly to a lesser degree) in all research (where the ‘authority’ status of the investigator can influence responses; Bowling, 2014). In addition, this source of error cannot fully explain the overwhelming opposition to animal experimentation observed in the study. The author would contend that the opposition observed is a genuine reflection of the real views of participants.

A further limitation was that participants were enrolled between 2011 and 2014, a period during which important events related to animal research in the United Kingdom were unfolding. For example, extreme animal rights activists in 2012 (Press Association, 2014) were sentenced and imprisoned during this period. Media coverage of these events, however, was generally unsympathetic (to the activists concerned), and it might be argued that such coverage may have reduced opposition to vivisection rather than enhancing it. The HCPs in this study, nevertheless, were clearly opposed to the current system. Their enrolment in the study during a period of adverse publicity for antivivisectionism therefore presents only a minor limitation. A more significant limitation was that the principal investigator clearly stated her own opposition to the functioning of the current system. This may have influenced responses, and results from the study should be read in this light. It is unlikely, however, that such error can fully explain the overwhelming opposition to the current system of animal testing that was recorded.

Conclusion

HCPs (particularly nurses) are a section of the public who are one of the greatest stakeholders in the development of new life-saving drugs and therapies. Such professionals might have been expected to have had a heightened commitment to the use of any type of research method which would lead to new therapies and advances in care. Nurses, who make up most HCPs in the National Health Service (NHS; DOH, 2012) (and comprised all HCPs in this study), are the professional group that spend the most ‘hands-on’ time with patients (including patients in the final stages of their lives). It is highly noteworthy that these professionals should have expressed such concern about the failures of animal testing. The compassion that such professionals displayed towards their patients appeared to extend to compassion for animals also. In this study, HCPs were opposed to the current system of animal experimentation.