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Shaping Social Opinionsof Stem Cell Research

in Taiwan

Prof. Tsai, Duujian2007, Asian Bioethics Conference, Bangkok, Thailand

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The significance ofStem Cell Research

• Bring out new viewpoints on disease therapy, diagnosis and prevention.

• Relate to ELSI controversy, such as embryo living rights, social ethics and humanitarian values.

• Consider the perception and acceptability of the public on SCR and its applications.

• Merge the public consensus into the fundamental ethical and legal governance framework.

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The Process of Our Questionnaire Design

I) Literature Review:

• ELSI viewpoints and legislation of stem cell research in many leading countries.

• Social opinion survey in Taiwan.

II) Consensus Meeting

III) The Test of Reliability and Validity

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Taiwan Genomic Surveyby Academia Sinica

• Population ：≧ 18 y/o people in Taiwan • Sampling ： Random sampling by telephone num

ber. • Method ： based on telephone survey; interview

and focus group are in supplementary.• Survey Interval ： 1-3 times annually since 2003.• Main Topics ： Genomic Medicine and Agricultur

al Biotechnology.

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Taiwan Genomic Survey by Academia Sinica

Limitations:

• Samplings of the survey toward all population.

• Various concepts related to genome and biotechnology are covered in each single survey.

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Taiwan Genomic Survey

Have you ever heard “Stem Cell ” ?

　 Frequency 　　　　　%

Never 424 38.90%

I've　heard,　but　not　understood 409 37.50%

I've　heard,　and　somewhat　understood 232 21.30%

I've　heard,　and　highly　understood 25 2.30%

Total 1090 100.00%

Source: Academia Sinica(2004) Taiwan Genomic Survey. Available online at http://tgs.survey.sinica.edu.tw:8080/tgs/index.htm

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Taiwan Genomic SurveyHave you ever heard "Stem Cell"?

　 　 NeverI've heard,

but not understood

I've heard,

and somewhat understoo

d

I've heard,

and highly

understood

Total

Education Level Junior High School

and under

12.90% 12.80% 6.30% 0.50% 32.60%

40% 39% 19% 1% 100%

Senior High School and Junior College

1.50% 16.80% 15.30% 1.00% 34.60%

4% 49% 44% 3% 100%

Undergraduate and Above

1.10% 10.80% 18.10% 2.80% 32.80%

3% 33% 55% 8% 100%

Unanswered 0.10% 0.10%

Source: Academia Sinica(2004) Taiwan Genomic Survey. Available online at http://tgs.survey.sinica.edu.tw:8080/tgs/index.htm

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Taiwan Genomic Survey

Technically speaking, do you think scientists can make the following by using "Human Stem Cells" ?

Have you ever heard "Stem Cell"?

Heard, but not understood Heard, and understood

Cultivate Human Spinal Marrow

Yes 68.00% 87.90%

No 7.10% 4.30%

Unknown 24.90% 7.80%

Cultivate Human Livers

Yes 36.70% 49.80%

No 26.20% 27.60%

Unknown 37.20% 22.60%

Cultivate Ornamental Plants

Yes 23.70% 22.60%

No 40.60% 54.10%

Unknown 35.70% 23. 3%

Cultivate Pig's Hearts

Yes 29.30% 28.00%

No 34.00% 49.00%

Unknown 36.70% 23.00%Source: Academia Sinica(2004) Taiwan Genomic Survey. Available online at http://tgs.survey.sinica.edu.tw:8080/tgs/index.htm

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Taiwan Genomic SurveyDo you Agree or

Disagree following statement?

AgreeDisagre

e

No Comme

nt

No Respon

seTotal

It's immoral to use biotechnology in human cloning

Frequency 491 371 121 107 1090

% 45.00% 34.00% 11.10% 9.80% 100%

It's unmoral to use biotechnology in human organ cloning

Frequency 358 539 85 108 1090

% 32.80% 49.40% 7.80% 9.90% 100%

Source: Academia Sinica(2004) Taiwan Genomic Survey. Available online at http://tgs.survey.sinica.edu.tw:8080/tgs/index.htm

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Limitation inTaiwan Genomic Survey

• Samplings of the survey toward all population. Therefore,

－ The specialty of SCR itself is ignored.－ The more understanding on SCR, the bett

er public attitude is shaped.－ The public’s limited understanding on the

multiple applications of stem cell.

Selective Sampling

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The Target Populationin Our Research

• Religions: Christian, Catholic, Buddhist, Taoism and Islam.

• Academic Experience ： professionals in philosophy, medicine, psychology, public health, sociology, etc.

• Medical Personnel ： physicians, nurses, social workers.• Medical Resource Users ： organ donators/recipients, in

fertility patients, and rare disease patients.• Legal & Professional ： lawyers, staff at legal films.• Civil Service ： governmental officers.• Student ： college and university students• General Public ： persons who have been interested and

involved in biotechnology.

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Limitation inTaiwan Genomic Survey

• Various concepts related to genome and biotechnology are covered in single survey.

－ Topics: Human Cloning, Stem Cell Research, Gene Testing, Biobank, Geneticly Modification Food.

－ Do the interviewees really understand the difference??

－ It may confuse or mislead respondents because of its intricate concepts.

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Taiwan Genomic Survey

Should the survey be more specific on Stem Cell solitarily ?

Biobank Stem Cell

Focus on Public Health Focus on Medicine

Long-term following in Epidemiology

The application to Medical Technology

Population’s health and well being

Individual’s dignity, rights and interests

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The Process of Our Questionnaire Design

II) Consensus Meeting:1. To collect and present the views concerning

ELSI among communities, and the points they are concern about.

2. To discuss the proper ethical and legal governance framework in stem cell research.

3. To promote the communication and cooperation among communities through “empowerment” strategy.

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Dimensions of Our Questionnaire

• The knowledge and perception of stem cell research and embryo identity.

• The definition and attitude of stem cell research under the ethical and legal governance framework.

• The acceptability of stem cell research and it’s applications within Taiwan culture and environment.

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Dimensions of Our Questionnaire

• The diverse opinions on the conflict between purpose of medical treatment and values of living will.

• The applications, goals and values in stem cell research and embryo identities, according to the ethical and legal framework.

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Questionnaire

Part 1. Embryo Stem Cell Research• What does embryo present in the stem cell research?• How do you consider the values of embryo?

• what kind of development stem cell can function? （ m

ultiple choice ）• Do you know what achievement the stem cell research

will conduct? (multiple)• Do you agree with the sources as following for stem ce

ll research? (multiple)• Do you agree to destroy the embryo in which has been

selected to produce embryo stem cell?

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QuestionnairePart 2. Human Cell Nucleus Transplant Technology• Do you support research based on human cell nucleus tran

splant technology? (multiple)• Do you agree to use donated cells for the human cell nucle

us transplant technology?• Do you support the experiments on human cell nucleus tran

splant technology?• Will you donate your own cells for experiments on human c

ell nucleus transplant technology?• Will you donate your own ova for experiments on human cel

l nucleus transplant technology?• Why are you willing to donate your own cells or ova for the

experiment on human cell nucleus transplant technology?（ multiple ）

• Why are you not willing to donate your own cells or ova for the experiment on human cell nucleus transplant technology?（ multiple ）

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QuestionnairePart 2. Human Cell Nucleus Transplant Technology

• Would you agree to have research personnel keep in touch with you after your cell or ovum donation?

• Would you like to receive research information or results after your cell or ovum donation?

• How do you consider the donation of cells or ova for cell nucleus transplant technology? (multiple)

• Do you agree that human cell nucleus transplant technology should go through the academic ethics examination?

• Which authority should survey over the human cell nucleus transplant research? (multiple)

• Which authority should take part in the human cell nucleus transplant research? (multiple)

• What should be the reward for your cell or ova donation?（ multiple ）

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Questionnaire

Part 3. Ethics Committee• Do you think that it is necessary to establish an ethics co

mmittee to supervise the national stem cell research?• What is the basic reason for you to approve an ethics co

mmittee? （ multiple ）• What is the basic reason for you to against an ethics co

mmittee? （ multiple ）• What is the obligation and responsibility for an ethics co

mmittee to conduct? (multiple)• What qualification should be included for the personnel o

f an ethics committee? (multiple)

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Conclusion/Principle of Questionnaire

• It’s meaningless to ask for public opinions on an issue required conception and understanding.

• It’s a way to comprehend the opinions of leaders and stakeholders from selective sampling, instead of general public, initially.

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Conclusion/Principle of Questionnaire

• To incorporate correct and neutral scientific knowledge into a survey form concerning of Knowledge, Attitude and Practice (KAP), this social opinion survey will not only be a questionnaire but also an educative knowledge medium.

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What we want to try in the future

• Survey on public opinions remains significant.

• The prerequisite on the role of the ethical governance guidance on stem cell research.

• Provide further public opinion surveys with information, such as the outcome of research and previous surveys concerning the opinions of community leaders.

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Thank you for your attention

Any further questions, please feel free to contact professor Tsai via e-mail:

dj.tsai@msa.hinet.net