Banning Animal Use in Medical Training: The Military’s LTTT

Banning Animal Use in Medical Training: The Military’s LTTT

TMC, LTTT are the acronyms of training exercises in which, over the last decades, pigs, mice, goats, dogs and other animals whose anatomy resemble human parameters have involuntarily participated as subjects in medical training in the military in the United States of America and Canada. Their sacrifices allow medical trainers to reinforce their medical and scientific abilities.

Live Tissue Trauma Training & Tactical Medicine Course

Most of the mentioned animals tend to be used through the Live Tissue Trauma Training (LTTT) and its specialty course, the Tactical Medicine Course (TMC). Tactical medicine is emergency lifesaving on the battlefield or in other high-threat conditions, and TMC has saturated it. In this training, swine models are used for the management of combat injuries. Trainees are endeavoring to save the model-animal in a stressful and real situation. Then, either the animal will not be rescued by the trainee and as a result will die, or the medical practitioner will save it, and the surviving swine model will be euthanatized after that. Thus, from the beginning, the animal is doomed to die.

In 2013, Eastridge et al. noticed 4596 combat deaths during Operation Iraqi Freedom and Operation Enduring Freedom, and 87.3% of deaths were in a non-hospital area. From those deaths, only 24.3% of soldiers could be saved, if they had received tactical medicine. For the above reason, tactical medicine is vital during battle, for the survival of injured soldiers. Veteran healers are key to this process, and with suitable training, the potential deaths army personnel will decrease. However, it is questionable in our days if the LTTT can prepare the clinicians for tactical medicine.

Live Tissue Trauma Training, LTTT, Military; A group of US Marines take care of a soldier wounded in action outside Baghdad, April 2003. [2015-12-08. Major Omar Abdel Aziz, MD. Offiziere.ch]A group of US Marines take care of a soldier wounded in action outside Baghdad, April 2003. (Credit: Offiziere.ch)

Department of Defense’s Point of View

“The answer to your question, ‘[does] the U.S. DoD uses [sic] animals in its military and/or special operations forces (SOF) medical training exercises,’ is yes.” (U.S. DoD, 2011)

The U.S. DoD is among the prevailing 21.4% of the North Atlantic Treaty Organization (NATO) countries which use animals in their military medical training. Among them, Canada also participates in those practices. Other European countries like Denmark, Norway, Poland, and the United Kingdom have supported this animal testing in medical and military training. To illustrate the use of animals from their sides, the U.S. DoD tends to use rats for microsurgery and rabbits for eye surgery or chest tube insertion. Further, the Canadian Department of National Defense exposes pigs to chemical accidents for the management of injuries.

However, these practices have been criticized by the Physicians Committee for Responsible Medicine (PCRM) and People for the Ethical Treatment of Animals (PETA). They disagree with the LTTT, supporting the idea that it could use simulators and training aids. Despite that, bill H.R. 4269 or Battlefield Excellence Through Superior Training ‘BEST’ Practices Act proposed that LTTT should be replaced by human-based training methods, and animals should not be used as mirrored models of human body function.

Against this bill, a former member of a US Special Forces unit, Jim Hanson, stated “Banning medic training using live animals could kill US troops.” Also, Jim Hanson added that the medical trainees will face combat situations, and live beings are the only ones which could prepare the trainees to treat real and live injuries, and the simulations could not do that. Furthermore, Garry Martinic in his article highlighted that exposing the trainees to animal injuries (e.g. by gun shooting) reduces the emotional shock of medical students when they face the horror of war. In this way, the medical trainees reinforce the psychological resilience towards war conditions. Although killing animals in a lab or in a safe environment cannot replace the high threats of the battlefield or injured soldiers.

The Solutions for Better Military Medical Training

The PCRM corroborates that high-tech simulators are more important in training than animal testing. In addition to this, many trauma centers have adopted the non-animal methods training. More specifically, 98% of civilian trauma training programs use only medical simulators. Reducing the animals in medical training endows in trainees more accurate anatomical skills (e.g., for surgery), because there are differences of human anatomy compared with animals, and the medical practitioners repeatedly exercise their skills on human anatomy, and there is a familiarization in muscle memory.

Live Tissue Trauma Training, LTTT, Military; Intubation Gas Mask at Tactical EMS School Essentials for Tactical Medic Certification Paramedic Emergency Medical by Tactical Specialties and Todd Burke in Columbia MO. [2017-07. Tactical EMS School. Tactical Specialties]Intubation Gas Mask at Tactical EMS School Essentials for Tactical Medic Certification Paramedic Emergency Medical by Tactical Specialties and Todd Burke in Columbia MO. (Credit: Tactical Specialties)

Studies have shown that medical students who have received such training have superior surgical traumatic skills than the students who have been educated by animal testing. Moreover, virtual reality techniques and other studies have shown no statistical differences in training between animal testing and human simulator. Nevertheless, the statistical differences provide a favor towards human simulators than animal usedness. Thus, the simulators tend to supply the medical students with better surgical skills than animal testing; there is a burgeoning need for more in-depth research towards the effectiveness of simulators versus animal testing for better military and medical training.

LTTT Falling Out of Favor

Live Tissue Trauma Training (LTTT) has been involved dynamically in tactical medicine, and still in our days, medical trainees are educated via animal testing. But 98% of civilian trauma training programs support the idea that simulators are crucial. For instance, the Coast Guard has changed animal testing to simulators in trauma training. Commandant Adm. Paul Zukunft suspended animal use, saying that “[The simulation] may be more expensive, but for us it will be the right thing to do to prepare our Coast Guard members who may be deployed to theaters where they may encounter traumatic injuries.”

Most NATO countries and civilian trauma training programs prepare their medical trainees via non-animal methods. In research, it seems that simulators are superior educational techniques compared to animal testing, meaning that perhaps non-animal methods are essential for tactical medicine. Other countries of NATO have maintained that.

References

  1. THE FUTURE OF TRAINING WITH LIVE ANIMAL TISSUE ON THE TACTICAL MEDICINE COURSE [2015-2016. LCdr W.F.A. Brockway. Collège des Forces Canadiennes]
  2. Death on the battlefield (2001-2011): implications for the future of combat casualty care. [2012-12. Eastridge BJ, Mabry RL, Seguin P, Cantrell J, Tops T, Uribe P, Mallett O, Zubko T, Oetjen-Gerdes L, Rasmussen TE, Butler FK, Kotwal RS, Holcomb JB, Wade C, Champion H, Lawnick M, Moores L, Blackbourne LH. J Trauma Acute Care Surg. 2012 Dec;73(6 Suppl 5):S431-7. doi:10.1097/TA.0b013e3182755dcc.]
  3. Use of animals by NATO countries in military medical training exercises: an international survey. [2012-08. Gala SG, Goodman JR, Murphy MP, Balsam MJ. Mil Med. 2012 Aug;177(8):907-10.]
  4. H.R. 4269 (111th): Battlefield Excellence through Superior Training Practices Act [2019-12-10. Govtrack.us]
  5. Save people, not pets [2010-05-25. Jim Hanson. The Washington Times]
  6. The use of animals in live-tissue trauma training and military medical research. [2011-09-21. Martinic G. Lab Anim (NY). 2011 Sep 21;40(10):319-22. doi: 10.1038/laban1011-319.]
  7. The Battlefield Excellence through Superior Training (BEST) Practices Act (S. 498/H.R. 1243) [PCRM]
  8. Live tissue versus simulation training for emergency procedures: Is simulation ready to replace live tissue? [October 2016. Stephen L. Barnes, MD, Alex Bukoski, DVM, PhD, Jeffrey D. Kerby, MD, PhD, Luis Llerena, MD, John H. Armstrong, MD, and Catherine Strayhorn, BS, the University of Missouri Combat Casualty Training Consortium. Journal of Surgery Volume 160, Issue 4, Pages 997–1007]
  9. Use of a human patient simulator for the advanced trauma life support course. [2002-07. Block EF, Lottenberg L, Flint L, Jakobsen J, Liebnitzky D. Am Surg. 2002 Jul;68(7):648-51.]
  10. Validation of SimPL — a simulator for diagnostic peritoneal lavage training. [Colonel Mark W. Bowyer, Alan V. Liu, James P. Bonar. Studies in Health Technology and Informatics. Volume 111: Medicine Meets Virtual Reality 13. 2005;111:64-7.]
  11. Accuracy of cricothyroidotomy performed in canine and human cadaver models during surgical skills training. [2002-11. McCarthy MC, Ranzinger MR, Nolan DJ, Lambert CS, Castillo MH. J Am Coll Surg. 2002 Nov;195(5):627-9.]
  12. Use of animals by NATO countries in military medical training exercises: an international survey. [2012-08. Gala SG, Goodman JR, Murphy MP, Balsam MJ. Mil Med. 2012 Aug;177(8):907-10.]
  13. Ending ‘Abhorrent’ Live Tissue Training Was Right: Coast Guard [2017-05-18. Hope Hodge Seck. Military.com

Constantine Papoutsis has received a BSc (Hons) degree in Psychology from Canterbury Christ Church University in England. He is working as a research and neurology assistant in the area of sleep-wake disorders and epilepsy. Furthermore, in the past, Constantine has taken part in a lab where he investigated the effect of dissociation on eyewitness testimony. Constantine has more than two years’ research and writing experience in the neurological and psychological area.

Constantine Papoutsis has received a BSc (Hons) degree in Psychology from Canterbury Christ Church University in England. He is working as a research and neurology assistant in the area of sleep-wake disorders and epilepsy. Furthermore, in the past, Constantine has taken part in a lab where he investigated the effect of dissociation on eyewitness testimony. Constantine has more than two years’ research and writing experience in the neurological and psychological area.

Constantine Papoutsis has received a BSc (Hons) degree in Psychology from Canterbury Christ Church University in England. He is working as a research and neurology assistant in the area of sleep-wake disorders and epilepsy. Furthermore, in the past, Constantine has taken part in a lab where he investigated the effect of dissociation on eyewitness testimony. Constantine has more than two years’ research and writing experience in the neurological and psychological area.

Constantine Papoutsis has received a BSc (Hons) degree in Psychology from Canterbury Christ Church University in England. He is working as a research and neurology assistant in the area of sleep-wake disorders and epilepsy. Furthermore, in the past, Constantine has taken part in a lab where he investigated the effect of dissociation on eyewitness testimony. Constantine has more than two years’ research and writing experience in the neurological and psychological area.