A systematic approach for establishing humane endpoints

Abstract

David B. Morton, Ph.D., B.V.Sc, M.R.C.V.S., F.I.Biol., is Head of the Centre for Biomedical Ethics, Division of Primary Care, Public and Occupational Health, School of Medicine, University of Birmingham, Edgbaston, Birmingham, United Kingdom. Assessing pain in animals, which is similar to assessing pain in human babies, relies on the observations of care staff and owners. However, one of the notable drawbacks in both humans and animals is observer variability (in animal studies, e.g., Beynen et al. 1987 ; Holton et al. 1998 ) as well as the interpretation of observations in terms of whether an animal is distressed. Clinical signs (by definition, those observable and not reported by a patient) potentially provide an objective, rather than a subjective, judgment of animal pain and distress. However, for such signs to be effective, observers must have good powers of observation, knowledge of what is normal for that individual animal and strain and species, and good clinical skills. Ideally, they should also have an empathetic attitude. (“There is none so blind as those who will not see.”) The best strategy for assessment is to involve all those in animal research work because each will bring a different focus to bear: caretakers “know” their animals, veterinarians possess clinical skills, and researchers know the potential side effects of their scientific procedures. Several systems have been used for assessing pain in humans, but they all rely on some form of “patient reporting…