January
1996
The
Big Lie: The New York State Cat Intubation Legislation
By Elizabeth Forel
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On August 7th 1995, Governor Pataki quietly signed
A8002 into law. There was no fanfare, no publicity, no photo ops — not
even an accompanying memo to support the Governor’s reasons
for approval. The next day it was formerly announced to the public.
A8002, unofficially known
as the Cat Intubation Bill, authorizes the New York State Health Commissioner
to require Emergency Medical Technicians (EMTs) to practice endotracheal
intubation on live animals for certification. In other words, in order
to become "proficient" at inserting a breathing tube into
the throat of a child, an EMT must practice on cats and small dogs.
Whose cats and dogs? Well, either yours, with your consent — as
the proponents of the bill would have us believe — or voiceless,
shelter animals.
Around in one form or another since 1991, the bill was last passed
by the legislature in 1993. Responding to an outpouring of mail and
phone
calls from caring individuals and humane organizations, former Governor
Mario Cuomo vetoed the bill that year — despite the efforts
of a powerful biomedical research lobby. In his veto message, Governor
Cuomo stated that while not perfect, life-like models had been available
for several years and were being used to train EMTs in the proper
method
of intubating children. He also noted that the bill would allow shelters
and veterinary facilities to grant permission to use the animals
in
their care, seriously compromising the trust people have in these institutions.
What is intubation?
Endotracheal intubation is the passing of a breathing tube through
the mouth or nose into the trachea and is necessary for people who
are experiencing
breathing difficulties or need respiratory support. Practice on animals,
however, is unnecessary and outdated. Animals are physiologically different
from people and skills practiced on animals are not easily transferable
to humans. Furthermore, the techniques for intubation are different:
cats are properly intubated on their stomachs; humans on their back.
Intubation has been used to provide anesthesia to animals during surgery;
but because there is such great potential to injure a cat’s trachea
during the process, many veterinarians now use nose cones to provide
anesthesia.
Anatomically correct state-of-the-art infant mannequins are being successfully
used in hundreds of hospitals around the country to train in pediatric
advanced life support — most notably at Buffalo General Hospital,
the University of North Carolina Medical Center, the Children’s
Hospital in Chicago and Elizabeth General Medical Center. Mannequins
can be used repeatedly and indefinitely — a requisite for responsible
training. Two infant mannequins that have been used with great success
are "Baby Airin" and the Laerdal Infant Intubation Model.
Why legislation?
To understand how this bill ever came into being — a bill that
would make use of companion animals as teaching tools — is to
understand the great resentment the biomedical community has experienced
since 1979, when the Metcalf-Hatch Act was repealed. The Metcalf-Hatch
Act effectively prohibited the release or sale of pound animals for
research. To researchers, the hundreds of thousands of unwanted animals
killed in New York State pounds each year is tantamount to throwing
money away.
It is also to understand that there are powerful vested interests profiting
from the horrendous overpopulation crisis of cats and dogs. They do
not want to see the overpopulation end for a number of reasons —
not least of which is that "excess pets" represent a cheap
source of research tools for the biomedical industry, although they
are a great expense to the taxpayers who are paying for animal control.
Traditionally, animals were not used to train on intubation. On April
4th 1987, then ASPCA Bergh Memorial Hospital director, Dr. Gordon Robinson,
DVM, wrote a letter addressed to Susan Weeks. She was a paramedic who
proposed using the cats who were already being intubated during surgery
in a veterinary hospital in order to train NYC paramedics in pediatric
intubation at the Bergh Memorial Hospital. Gordon Robinson offered
to
take two to three people per day and each person would perform ten
intubations. Were these cats at the Bergh Memorial Hospital ones whose "owners"
had given or not given permission for their use? Or were these shelter
cats who had no "owner"? The truth may never be known to
the public. But we do know that between 400 and 800 cats were used.
A pediatrician, Dr. Cooper of Harlem Hospital, was among those who hoped
to create a nationwide model based on using cats for pediatric intubation,
and so get federal grants and be published in the medical journals.
He did not have to try hard to convince the ASPCA head vet and former
president that this was the way to go. Of course, it may have been the
other way around.
In a letter to members of the Medical Advisory Committee dated 8th
May 1987, Susan Weeks spoke about the animals labs proposed for certification
in pediatric intubation and presented her alternative — training
at the Bergh Memorial Hospital. This was in direct contradiction to
the ASPCA’s "Fact versus Fiction" paper which made claim
to the existence of at least seven cat labs in New York State which
were used to train EMTs — where cats were intubated countless
times and killed at the end of the session. This could not be verified
and many seriously doubted the truth of these statements. They were
thought to be scare tactics intended to persuade animal rights activists
that the ASPCA program would put an end to these cat labs (thus saving
the lives of cats) while purportedly saving the lives of babies.
Unknown to most of their members, the ASPCA continued with the Bergh
Memorial Hospital Program for at least two years until the fear of exposure
about violating a NYS education law caused them to seek an amendment
to the law. The existing law allowed only licensed animal-health technicians
to perform intubations in a clinical setting. The amendment would allow
emergency medical technicians to perform intubations on animals in a
clinical setting. (It is not necessary to be licensed to perform intubations
or other research experiments on animals in a non-clinical setting).
With the "protocol" — the name for the Program — now
in writing, the ASPCA was out of the closet. The first bill was introduced
in 1991. The animal rights community mobilized. International
Society for Animal Rights, PETA, Friends of Animals to name a few,
joined forces with Physicians Committee for Responsible Medicine, Medical
Research
Modernization Committee and thousands of concerned citizens to defeat
this bill.
The ground swell was enough until this year when Governor Pataki, who
had voted against the bill when he was a state senator, gave in to
partisan
pressure and the demands of his new position, and signed the bill into
law. A partner to this betrayal was Senate Majority leader Joseph Bruno,
long a supporter of humane animal causes. As recently as 1992, in a
letter to the writer concerning his requested opposition to the Intubation
Bill, he stated "I agree with you that this legislation is ill-advised.
I can assure you that I will do all that is possible to assure that
this legislation is not enacted during the 1992 legislative session
of the NYS senate." So what happened? With new found pressure and
power for both, they buckled under. Unsubstantiated but probable rumors
had both Pataki and Bruno trading votes to get the NYS gambling resolution
passed — one in which their political strength was in question.
An article in an upstate paper discussed a new biomedical facility being
constructed in Senator Bruno’s district.
A New York Times article of 8/9/95 characterized the debate
surrounding Governor Pataki’s signing of this legislation as one
between the medical community and animal rights activists — an
uncreative, but expected journalistic approach. However, in a letter
to the Times of 8/17/95, the Physicians Committee for Responsible Medicine
stated that widespread opposition to the use of live cats for endotracheal
intubation training also exists in the medical community. The reasons
cited were the anatomical differences between animals and humans and
the possibility of not mastering a necessary skill because of the disturbing
nature of the training.
A8002 ... What It’s Really About
The bill is deceptive and pointless on many levels. First of all, it
states that only certified EMTs may perform endotracheal intubation
on animals under the immediate supervision of a licensed veterinarian
or vet tech. But then it goes on to say that the Commissioner of Health
shall have the right to decide whether endotracheal intubation training
on animals shall be required for certification of EMTs. The bill allows
for "instruction in animal anatomy and [in] the proper method of
animal intubation" to have been received prior to the "practice"
session being performed. This could only mean that EMTs will now be
required to dissect animals and actually intubate animals before they
allegedly perform intubation once on someone’s cat. It also lays
the groundwork for setting up standard animal labs where EMTs would
be required to practice endotracheal intubation on animals for certification
— something they could have done without the sham of this legislation
— since animal labs are legal. New York may become the only state
to require emergency medical technicians to practice on animals for
certification, if the Commissioner decides to exercise the authority
given him in this bill.
The Public Relations Fantasy
The bill’s supporters want the public to believe that individual
animal caretakers would willingly consent to their animal being used
as a practice tool — that it would be perfectly acceptable to
have an EMT stick tubes down their beloved companion’s throat.
The proponents obviously have no understanding of the deep bond that
exists between caring and compassionate people and animals.
The real source of animals could only come from the abandoned, homeless
and betrayed animals in shelters. That is the only way there would
ever
be enough animals to satisfy the purpose of the bill. As "custodians," animal
shelters or veterinary facilities would be allowed to grant permission
with respect to the animals in their care. Unscrupulous shelters could
set up in-house laboratories, or cooperate with outside veterinarians,
abusing animals in their custody for profit. The confidence people
have
in shelters as an animal control tool (adoption or humane euthanasia)
would be seriously undermined if it was suspected that the animals
were
being used as practice tools by EMTs.
When the ASPCA first joined forces with the biomedical community in
1987 to develop this protocol, they held the animal control contract
in NYC. The possibility of access to the thousands of homeless cats
at the shelter did not go unnoticed by the bill’s proponents.
The Center for Animal Care and Control now has the contract and they
have promised a written resolution to The Coalition for New York City
Animals stating that no shelter animals will be used for this or any
other similar program. The Coalition has received a written statement
from the ASPCA stating that they will not participate in any program
created by this legislation.
Where Do We Go From Here?
Because this bill is now law, there is not much we can do. Repeal of
the legislation is not probable because the same players are in the
state legislature. However, each of us can make it difficult to enact
the provisions of the bill. When you admit your animal to a veterinary
clinic, read the fine print on the admittance form and know that you
have the right not to consent to such a procedure. Ask your veterinarian
if he or she is participating in this program and let them know you
will take your business elsewhere if it continues. Depending on how
A8002 is interpreted, the NYC Dog Law prohibits shelter animals from
being used for teaching purposes. Resolution in court may ultimately
be the only answer. And lastly — do not vote for anyone who voted
for this bill.
© 1995 Elizabeth Forel
Elizabeth Forel is an animal advocate who lives
in Manhattan.
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