In the literature of bioethics there are milestones worth periodic rereading. Mary Midgley's “Must Good Causes Compete?” (CQ, Vol. 2, No. 2) is surely one such marker. Her piece is especially appropriate to revisit in light of this issue's Special Section, “On Animal Experimentation: Seeking Common Ground.”

For a very long time, the scientific and animal welfare communities have faced each other across a seemingly unbridgeable divide. Each side tends to view the other in simplistic and distorted terms. Animal welfare advocates see scientists as, at worst, sadists who enjoy torturing animals, and at best, as self-interested careerists intent on building careers out of publishing more papers and getting more grants, irrespective of the cost to animals. Scientists committed to research see the animal movement as consisting of, at best, ignorant, simple-minded people awash in emotion and sensationalism, and at worst, violent and dangerous fanatics who claim to care for animals but are indifferent to human suffering.

Since the 1940s the Draize test had been the standard test applied to any substance that might conceivably get into a human eye. The Draize test involved immobilizing fully conscious rabbits in stocks so that they could not scratch their eyes, and then applying the substance to one eyeball of each rabbit. The eyeballs were examined at intervals of, for example, 24, 48, and 72 hours, and graded for damage such as blindness or blistering. In 1980 Henry Spira launched a campaign against the Draize test. By taking out full-page ads asking Revlon why it was blinding rabbits for the sake of beauty, he persuaded that company to donate $750,000, over 3 years, to a search for alternatives to the Draize test. Other leading cosmetics corporations soon followed suit. By 1982 there were signs that progress was being made. In July of that year Revlon reported that it had established a panel to ensure that unnecessary Draize tests are not performed, and as a result it had cut back the number of rabbits it used annually in the Draize test from 2,210 in 1979 to 1,431 in 1981. Avon adopted a policy of always using local anaesthetics if there was any anticipated discomfort for the animals. Bristol-Myers said that it was using fewer animals than had been used in the classical Draize test. All three of the companies were continuing to contribute substantial sums to research programs designed to find alternatives to the Draize test.

Few human uses of nonhuman animals (hereafter simply “animals”) have incited as much controversy as the use of animals in biomedical research. The political exchanges over this issue tend to produce much more heat than light, as representatives of both biomedicine and the animal protection community accuse opponents of being “Nazis,” “terrorists,” and the like. However, a healthy number of individuals within these two communities offer the possibility of a more illuminating discussion of the ethics of animal research.

One of the barriers between ordinarily compassionate animal researchers and pro-animal ethicists is that the ethicists are usually seen as asking for far too much. They are perceived as demanding the complete abandonment of careers. In consequence, the ethicist is often ignored. Ethicists rarely give clear-cut rules to animal researchers as to how they can continue in animal research while at the same time adopting an increasingly moral approach. The purpose of this paper is to provide some rules to help the animals by aiding conscientious researchers who are not (yet) in a position to give up their careers entirely. These are ethical rules and not, therefore, in quite the same category as Russell and Burch's “three Rs” (replacement, refinement, and reduction) or the proposal that experimenters should seek proper training and retraining in animal care, and in the skills of euthanasia, anaesthesia, and analgesia. Nor are ethical rules quite the same as the requirement that all experimenters should acquaint themselves with the latest techniques for improving the animals' quality of life (such as the techniques of environmental enrichment, for example) or the need to keep themselves up to date in alternative research techniques that do not use animals. All these steps are of great importance and should be taken in addition to the ethical rules I propose.

It began in 1992, with two men walking out of a television studio. Colin Blakemore, Oxford Professor of Physiology, is a quiet-spoken, eloquent defender of the use of animals in medical research. Les Ward, Director of the Edinburgh-based Advocates for Animals, is a passionate opponent of animal use. Bringing them together in front of an invited audience with strong opinions on both sides would make the sparks fly and be good viewing. But Blakemore and Ward, retiring after yet another bout that neither side won, were dissatisfied. Both knew that media debates gave them a chance to highlight the flaws and evasions in the other side's arguments, and perhaps to recruit some new supporters to their own. But Ward realized that this was not enough to achieve the radical change he wanted: replacement of animals by other methods. And Blakemore disliked defending animal experiments against all comers. He too wanted to replace animals, albeit only when this could be done without forgoing the real benefits of research.

The history of the vivisection debate is a case study in the use of vilification not unlike its rhetorical use by adversaries in the pro-life/pro-choice controversy. According to Vanderford, vilification in that debate serves a number of functions: to identify adversaries as “them and us”; to cast opponents in an exclusively negative light; to attribute diabolical motives to one's adversaries; and to magnify the opposition's power as an enemy capable of doing great evil. In the vivisection debate, both sides have attempted to delegitimize each other by one or more of these means. On the antivivisection side, Samuel Johnson in 1758 produced the fiercest attack up to that time on “the inferior Professors of medical knowledge” and “race of wretches whose lives are only varied by varieties of cruelty.” When the antivivisectionist movement peaked in England in the 1870s, the animal experimentalists began to organize in earnest to fend off the charge that vivisection was both cruel and useless. By the turn of the century an American neurologist, Charles Loomis Dana, identified a way to discredit the mainly female antiscience “cranks” in the antivivisection movement by inventing the disease “zoophil-psychosis” to describe one of the diseases affecting mainly women who, having no children or a useful occupation, joined animal protection societies and campaigned against vivisection. Zoophil-psychosis, it was claimed, was a form of mental illness, an incurable insanity that afflicted the hysterical opponents of vivisection.

The publication in 1959 of Russell and Burch's The Principles of Humane Experimental Technique initiated a new era in the history of the debate between science and animal protection, the era of alternatives. Although Russell and Burch never used the word “alternatives” (speaking instead of the “three Rs”: replacement, reduction, and refinement), and although the animal protection movement was somewhat moribund at the time in both England and the United States, within a decade of the book's publication a number of signs indicating a resurgence of public interest in the issue began to appear. At the same time, increased knowledge and understanding of neurophysiology and ethology heightened scientific awareness of the significance of humane treatment in the laboratory and professionalized laboratory animal science.

In the late 1970s, while working in my laboratory at the American Health Foundation, I received a phone call from Henry Spira. Not one for small talk, he did not even bother introducing himself beyond his name. He immediately began questioning me about my studies using the protozoan Tetrahymena thermophila, which I hoped would serve as an alternative to the Draize ocular irritation test. While flattered that someone cared about my work, I was soon lost in confusion and skepticism about the true purpose of his call. Who was Henry Spira? Why did he want to visit my animal facility and why did he want to bring a physician colleague with him? Not only was I naive about the budding opposition to the Draize test, I was equally naive that it was Spira, an ardent animal protectionist, who was leading the fight. This seminal interaction began a friendship that spanned nearly twenty years; a friendship that indelibly changed my perception of nonhuman animals and how I relate to them.

For years there was no focus within the U.S. federal government for alternatives to animal toxicity testing. Questions coming to regulatory agencies fell upon individuals to address in the best way they could. Given this void, the ad hoc Interagency Regulatory Alternatives Group was founded by staff in a number of federal agencies in the late 1980s to coalesce efforts in the field. The group sponsored two international workshops on eye irritation, the first making proposals for change in the current test method in rabbits, the second reviewing available data on in vitro alternatives. The result has been that the Organization for Economic Cooperation and Development (OECD) is considering revision of the in vivo eye irritation test guideline to incorporate a number of the workshop deliberations. However, movement of the in vitro eye irritation alternatives has been disappointing; attempts to determine their practical testing significance have thus far been unrewarding.

Twenty years ago, Australian biomedical researchers took the first steps along a pathway toward common ground with opponents of the use of animals in science. Leaders of Australian medical research at that time saw the necessity of established science facing the ethical and political challenges that a revived antivivisectionist movement was mounting in the late 1970s and the 1980s.

CQ Sources is compiled and edited by David A. Buehler, 50 Elliot Street, Dartmouth, MA 02720 USA. Please send any additions, corrections or suggestions directly to him at this address or online to 〈[email protected].〉

Germ-line therapy has long been regarded with great caution both by scientists and by ethicists. Even those who do not reject germ-line therapy in principle have tended to reject it in practice as carrying unacceptable risks in our current state of knowledge. For this reason, a recent paper by Rubenstein, Thomasma, Shon, and Zinaman is unusual in putting forward a serious proposal for the use of germ-line therapy in the foreseeable future.

The article by Jessica Pierce and Christina Kerby, “The Global Ethics of Latex Gloves: Reflections on Natural Resource Use in Healthcare,” raises some important but seldom asked questions about the use of natural resources in healthcare. They take for their example latex gloves, which are in wide everyday use, especially since the establishment of principles of universal precautions in infection control as a reaction to the spread of HIV. They trace the production of latex gloves back through rubber processing to their origins in Malaysian rubber plantations and elsewhere. They then ask, but do not answer, some hard questions about the ethics of our relationship as patients to the impact of the materials we use on communities and the environment. To draw out their theme more starkly, consider the rumor widespread in South America that some babies purportedly adopted by Northerners are sold and cut up for their organs. Suppose this story were true; suppose your donated organ were obtained in this way. You would probably be so revolted by the immorality of its acquisition that you would refuse to accept it. But now take a morally more ambiguous case, as Pierce and Kerby intend. Suppose that the process of obtaining latex gloves is part of the gradual erosion of the Malaysian environment, and that workers in latex factories are poorly paid. Now, should or would you refuse to use latex gloves? Should or would you even be more selective in their use? The practice of universal precautions presumes a virtually unlimited supply of gloves; yet to react to resource scarcity with selective precautions hazards discrimination. Is there any way philosophically to balance the local justice issue of discrimination in comparison to injustice on a global scale and to future generations?

A quick tour through an average U.S. hospital gives pause to anyone with even a rudimentary concern for environmental issues. To a careful observer, the typical U.S. hospital presents an array of challenges to the health of ecosystems. For example, hospitals consume vast quantities of natural resources. The most obvious of these are fossil fuels, which form the basic building blocks of the industrialized medical care industry. Aside from the worry that our healthcare systems are technologically and functionally dependent upon nonrenewable, relatively scarce, and politically volatile resources, our heavy reliance on fossil fuels has important ill effects, including unfavorable health outcomes for humans. For example, the combustion of fossil fuels is the driving force behind global warming, which will likely result in increasing heat-related mortality and morbidity and may contribute to the spread and resurgence of infectious diseases around the world. Also, the combustion of coal and oil releases pollutants such as sulfur oxides, nitrogen oxides, and ground-level ozone that contribute to various respiratory ailments. In addition to being energy intensive, the modern hospital uses a great deal of water, wood, paper, metals, minerals, plastics, chemicals, food, and land.

Physicians and nurses caring for terminally ill patients are expected to center their moral concerns almost exclusively on the needs and welfare of the dying patient and the patient's family. But what about the relationship of traditional medical ethics to the emerging new theories of environmental ethics, like deep ecology? As we glide into the twenty-first century, can anyone seriously doubt that the mounting global concerns of environmental ethics will eventually influence the ethics of medicine too?

It was a hot summer night, the kind where the air is so thick it seems to ooze into your lungs. I heard a knock on the door. “Come in,” I complained.

This section is meant to be a mutual effort. If you find an article you think should be abstracted in this section, do not be bashful—submit it for consideration to Kenneth V. Iserson care of CQ. If you do not like the editorial comments, this will give you an opportunity to respond in the letters section. Your input is desired and anticipated.