This is the html version of the file http://www.nmsu.edu/Research/docs/iacuc.doc. Use word version for submittal
Investigator/Instructor: Dept.: Tel.:
FACULTY/PROFESSIONAL STAFF (Only if Investigator/Instructor
is a student):
Title of Research Project/Course:
Animal Use is for: Research Teaching
Agriculture Other (Specify) ______________
Application is: New Renewal Continuation Supplement Revision
Pilot Project
Funding Source:
Duration of Project/Course: to
Research/Course involves vertebrate animals
(yes, no)
Species: ______________________
Name, position, education, and years
experience with this species of each person who will perform the experimental/instructional
manipulations on the animal(s) and(or) be involved in the care, use
and treatment of the animal(s) (includes teaching assistants, graduate
students, etc.).
Does this person have a certificate in Animal Welfare Training?
If no, please explain
This project will involve Category (A,B,C,D,E
see attached page):
Rationale for using animals and the appropriateness
of this SPECIFIC SPECIES and NUMBER in this project:
Drugs will be used in this Research Project/Course
(yes, no). If yes, provide names, dosages, and routes of administration
Provide a brief Description of the Purpose
and Experimental Procedures used in this Project/Course:
Provide the name and telephone number
of the veterinary consultant utilized for this program.
Describe actions taken, including literature
search to seek valid alternatives and avoid unnecessary duplication
for the proposed research. Include names of databases searched
and key words utilized.
Information on Animals used in THIS Research/Course:
Total Number of Animals to be used:
Animal Supplier:
Animal housing location:
Method of Euthanasia:
Disposition of Dead/Live Animal
FACULTY/PROFESSIONAL STAFF ASSURANCE
STATEMENT
I accept and will conform to all Federal
and State Laws and guidelines and all institutional policies and procedures
concerning the care and use of vertebrate animals. I understand that
I have a responsibility to notify in writing the Institutional Animal
Care and Use Committee of any substantive changes in the proposed project
or personnel, relative to this application, PRIOR to proceeding with
any animal use.
Faculty/Professional Staff __________________________________________ Date
Dept. Head
___________________________________________
Date _____________________
Dean, Director, or Research Leader
___________________________________
Date
_____________________
INSTITUTIONAL ANIMAL CARE AND USE COMMITTEE
APPROVED/DISAPPROVED
IACUC Chair ____________________________________
Date ____________________________________
Send the original signed form to: Dr. Dennis Hallford, IACUC Chair, Box 3I.
Also email the form as a word or word perfect attachment to dhallfor@nmsu.edu
Form Revised January 26, 2003
| TABLE 1 CATEGORIES OF BIOMEDICAL EXPERIMENTS BASED ON INCREASING ETHICAL CONCERNS FOR NON-HUMAN SPECIES |
| CATEGORY A |
| Experiments
involving either no living materials or use of plants, bacteria, protozoa,
or invertebrate animal species. Biochemical, botanical, bacteriological, microbiological, or invertebrate animal studies, tissue cultures, studies on tissues obtained from autopsy or from slaughterhouses, or studies on embryonated eggs. Invertebrate animals have nervous systems and respond to noxious stimuli, and therefore must also be treated humanely. |
CATEGCATEGORY B
Experiments on vertebrate animal
species that are expected to produce little or no discomfort.
Mere holding of animals captive
for experimental purposes; simple procedures such as injections of relatively
harmless substances and blood sampling; physical examinations; experiments
on completely anesthetized animals which do not regain consciousness;
food/water deprivation for short periods (a few hours); standard methods
of euthanasia that induce rapid unconsciousness, such as anesthetic
overdose or decapitation preceded by sedation or light anesthesia.
CATEGCATEGORY C
Experiments that involve some
minor stress or pain (short-duration pain) to vertebrate animal species.
With anesthesia, exposure of
blood vessels or implantation of chronic catheters; behavioral experiments
on awake animals that involve short-term stressful restrain; immunization
employing Freunds Adjuvant; noxious stimuli from which escape is possible
surgical procedures under anesthesia that may result in some minor post-surgical
discomfort. Category C procedures incur additional concern in
proportion to the degree and duration of unavoidable stress or discomfort.
CATEGCATEGORY D
Experiments that involve significant
but unavoidable stress or pain to vertebrate animal species.
Deliberate induction of behavioral
stress in order to test its effect; major surgical procedures under
anesthesia that result in significant post-operative discomfort; induction
of an anatomical or physiological deficit that will result in pain or
distress; application of noxious stimuli from which escape is impossible;
prolonged periods (up to several hours or more) or physical restraint;
maternal deprivation with substitution of punitive surrogates; induction
of aggressive behavior leading to self-mutilation or intra-species aggression;
procedures that produce pain in which anesthetics are not used, such
as toxicity testing with death as an end point, production of radiation
sickness, certain injections, and stress and shock research that would
result in pain approaching the pain tolerance threshold, i.e. the point
at which intense emotional reactions occur. Category D experiments
present an explicit responsibility on the investigator to explore alternative
designs to ensure that animal distress is minimized or eliminated.
Procedures that involve inflicting
severe pain near, at, or above the pain tolerance threshold of unanesthetized,
conscious animals.
Use of muscle relaxants or
paralytic drugs such as succinyl choline or other curariform drugs used
alone for surgical restrain without the use of anesthetics; severe burn
or trauma infliction on unanesthetized animals; attempts to induce psychotic-like
behavior; killing by use of microwave ovens designed for domestic kitchens
or by strychnine; inescapably severe stress or terminal stress.
Category E experiments are considered highly questionable or unacceptable
irrespective of the significance of anticipated results. Many
of these procedures are specifically prohibited in national policies
and therefore may result in withdrawal of federal funds and/or institutional
USDA registration.