Public Awareness Research 2005: Human Health
Biotechnology Australia
October, 2005
Contents
1. Research context 1
Background 1
The nature of public attitudes 1
Research design 2
2. Research findings 3
2.1 Gene technology in health and medicine 3
2.2 Views on use of gene technology in human health 4
2.3 Using gene technology to produce medicine 8
2.4 Using gene technology in human transplants 13
2.5 Attitudes towards gene therapy 18
List of Figures
Figure 1. Methodology 2
Figure 2. Support for fields of gene technology application 3
Figure 3. Awareness of applications 5
Figure 4. Perceived usefulness of applications 6
Figure 5. Perceived risk associated with applications 7
Figure 6. Acceptability of applications 8
Figure 7. Awareness of using gene technology to produce medicine 9
Figure 8. Perceived usefulness of using gene technology to produce medicines 10
Figure 9. Perceived risk associated with using gene technology to produce medicines 11
Figure 10. Acceptability of using gene technology to produce medicines 12
Figure 11. Awareness of using gene technology in human transplants 13
Figure 12. Perceived usefulness of using gene technology in human transplants 14
Figure 13. Perceived risk associated with using gene technology in human transplants 15
Figure 14. Acceptability of using gene technology in human transplants 16
Figure 15. Awareness and knowledge of technologies 18
Figure 16. Perceived impact of technologies 19
Figure 17. Time frame for impact of technologies 20
Public Awareness Research 2005: Human Health
1 . Research context
Backgro u nd
Biotechnology Australia's Public Awareness Program aims to provide members of the community with the information they need to make more informed choices regarding the adoption of biotechnologies.
Public attitudes are a crucial issue in the development of the Australian biotechnology sector, and public understanding of the science involved is important. However, there is as great a need for scientists (and policymakers) to understand the public's needs and concerns. Therefore, a need to understand the underlying drivers of community attitudes relating to biotechnology is crucial.
The nature of public attitudes
There has been a trend towards increasingly complex analysis of applications of technology from a simple risk-benefit analysis with some consideration of its ethical underpinnings, to a more considered analysis in terms of both the process of development and the outcomes (for individuals, industry and society) of the application.
Five key factors have been identified that underlie the public's acceptance of applications of biotechnologies[1]. These are:
· Information — Information on what biotechnologies are and are not capable of, provided by a credible source.
· Regulation — Confidence that regulatory safeguards are in place to ensure the safety of the public and the environment.
· Consultation — A belief that the public has been appropriately consulted and given the opportunity for input into the development of biotechnology.
· Consumer choice — The ability of the consumer to either accept or reject each particular application of biotechnology.
· Consumer benefit — A perceived societal and individual benefit for each application.
Finally, the rapid developments and advances in biotechnology mean that attitudes and acceptance relating to biotechnology, as well as the associations between them, are likely to change over time. It is important that these changes and explored and understood. To track these changes, research on behalf of Biotechnology Australia has been conducted every two years since 1999. This report provides details on the 2005 research conducted by Eureka Strategic Research.
Research design
A three-phase research program was employed, as illustrated in the following diagram.
Figure 1. Methodology
The CATI (Computer Assisted Telephone Interviewing) survey involved 1,067 respondents, between 18 and 75 years of age, which provided a 95% confidence interval of no more than ±3.0%. Survey respondents were selected from the electronic White Pages and were stratified by location (by state and territory, and then into capital and non-capital) to ensure that the sample was in proportion to the population. Broad age and gender quotas were also applied, within each location, once again to ensure the sample was proportionally representative. (More details on the research design are in the document Public Awareness Research 2005 Overview.)
2 . Research findings
2.1 Gene technology in health and medicine
Respondents were asked to rate their level of support for the use of gene technology in human health and medical applications, as well as in food and agricultural applications, using a scale from 0 to 10, where 10 represents full support for the technology. The results are displayed in Figure 2.
Figure 2. Support for fields of gene technology application
As can be seen from the chart, there is no one "public view". Instead, members of the public hold diverse opinions in relation to the use of gene technology in both health/medical and food/agricultural applications. On the whole, health/medical applications received a greater number of higher scores, and food/agriculture received a greater number of lower scores. Accordingly, the mean level of support for health/medical (6.2) was higher than that for food/agriculture (4.9).
Group discussions shed some light on why, in general, the use of gene technology in health/medical applications received more support than its use in food/agriculture. Most participants felt the use of gene technology in a medical context was acceptable and considered using it to treat disease and injury a 'noble' pursuit. For example, in relation to modifying human genetic material, one participant said:
"For any legitimate medical purpose I think it's okay."
With only a few exceptions, a technology's potential to save lives or significantly improve the quality of lives was valued highly. Participants acknowledged they were likely to find almost any given technology acceptable if it were going to benefit one's self or loved ones. In relation to the transplant of pigs' heart valves, a participant noted:
"It would have been acceptable to me at the outset because it saved my friend's life."
The use of gene technology in medical applications was also considered by some, for a variety of reasons, to pose fewer risks. It was seen to be something that would be used infrequently, as opposed to on an everyday basis, and usually as a last resort. Furthermore, often such applications would be a patient's last hope for survival, at which point they would have little to lose and be willing to try anything.
"By the time it gets to the stage it's so critical that anything would be acceptable."
In addition, in terms of the process itself, participants mentioned that as it would be contained in scientific laboratories and hospitals, it posed somewhat less risk. Nevertheless, participants were wary of the risks involved and cautious of the way in which the technology could progress. Acceptance of any medical application was balanced by a need to be informed, and for strict regulation.
2.2 Views on use of gene technology in human health
Respondents in the survey were asked a series of questions relating to different applications of biotechnology. For each set of applications, questions were asked regarding respondents' awareness, perceived usefulness, perceived risks and acceptability of the technology. Each question was first asked in relation to a general area (e.g. use of gene technology to produce medicines and in human transplants) and then more specifically in relation to the techniques used in that area. Here, results are presented for the general areas (Figures 3 to 6). This allows for comparison of the perceptions of the use of gene technology in producing medicines and in human transplants with those of other applications of gene technology. More detailed findings for the use of gene technology in these two areas provided in the following sections.
Figure 3. Awareness of applications
The majority of respondents had heard of the use of stem cells in medical research (93.4%) and treating disease (85.5%), and using gene technology to modify food plants (75.8%). In contrast, the majority was not aware of the use of gene technology in producing medicines (60.5%) or in transplants (52.4%).
Figure 4. Perceived usefulness of applications
Stem cell research and treatment were perceived as useful by the highest proportion of respondents (89.7% and 87.6% respectively). Genetically modified food was perceived as useful by the lowest proportion, but still a majority of respondents (63.7%). About three-quarters felt that the use of gene technology in human transplants (76.8%) and to produce medicines (72.5%) would be useful.
Figure 5. Perceived risk associated with applications
Using gene technology to modify food plants was perceived to be risky by the highest proportion of respondents (71.3%). The majority did not perceive the use of stem cells in medical research (52.4%) or to treat disease (51.7%) as risky. The majority of respondents considered the use of gene technology to produce medicines (52.9%) and in human transplants (56.3%) to be risky, but just over a third disagreed in relation to each of these applications (34.9% and 37.5% respectively).
Figure 6. Acceptability of applications
The majority of respondents found each of the applications of biotechnology to be acceptable, with the possible exception of genetically modified foods crops. The greatest proportion of respondents found the use of stem cells to treat disease (79.8%) and conduct medical research (80.0%) acceptable. Approximately as many respondents considered the use of gene technology to modify food plants acceptable (47.8%) as found it unacceptable (46.8%).
2.3 Using gene technology to produce medicine
Respondents were asked their opinions about the use of gene technology to produce medicine. They were asked about their awareness, perceived usefulness, perceived risk and acceptability of using gene technology in this context. They were then asked their views on producing medicine by introducing human genes into animals and by introducing human genes into bacteria. The results are displayed in Figures 7 to 10.
Figure 7. Awareness of using gene technology to produce medicine
While almost half (47.3%) was aware of producing medicines by introducing human genes, only a quarter (25.2%) claimed awareness of doing so by introducing human genes into bacteria.
Figure 8. Perceived usefulness of using gene technology to produce medicines
Producing medicines was considered useful by fewer respondents once they had been prompted with the specific methods that could be utilised — dropping from almost three-quarters (72.5%) indicating they thought it would be useful for producing medicines, to almost half (49.4%) if it involved introducing human genes into bacteria, to just less than two-fifths (38.4%) where introducing human genes into animals was involved.
Figure 9. Perceived risk associated with using gene technology to produce medicines
Producing medicines was considered risky by a greater proportion of respondents once they had been prompted with specific methods; just over half (52.9%) perceived producing medicines as risky, increasing to almost two-thirds (64.5%) where it involved introducing human genes into bacteria and almost three quarters (73.8%) where it involved introducing human genes into animals.
Figure 10. Acceptability of using gene technology to produce medicines
The acceptability of using gene technology to produce medicines was almost two-thirds (65.5%), but dropped to two-fifths (41.6%) for introducing human genes into bacteria and around a third (33.4%) for introducing human genes into animals.
In general, participants in the qualitative research supported the use of gene technology in producing medicines, as this application offered the potential to reduce disease, helping individuals and society.
Introducing human genes into bacteria and animals
Once specific methods were raised in group discussions, participants' concerns increased. In particular, many participants had concerns bacteria and regarding the use of gene transfers across kingdoms.
Participants also had fears relating to each of the specific methods. In terms of introducing human genes into bacteria, some participants raised concerns such as the potential to create a dangerous hybrid bacterium. There was also a fear that the bacteria could mutate the human genes. In terms of introducing human genes into animals, participants' comments were often reminiscent of science fiction.
"It just sounds creepy — human genes and animals sounds like the island of Dr Moreau — sounds like a horror story."
Some participants were also concerned that the introduction of human genes into animals may cause those animals pain and suffering.
2.4 Using gene technology in human transplants
After first gauging respondents' reactions to using gene technology in human transplants, their reactions to the use of specific techniques (transplanting animal parts into humans and transplanting human parts grown in animals back into humans) were determined. Results are displayed in Figures 11 to 14.
Figure 11. Awareness of using gene technology in human transplants
Awareness of using gene technology in human transplants was reasonably low (44.7%). However, this increased once people were prompted with the specific methods used, with the majority of respondents claiming they had heard of transplanting the body parts of animals into humans (83.0%) and transplanting human body parts grown in animals back into humans (70.6%).
Figure 12. Perceived usefulness of using gene technology in human transplants
A large proportion (76.8%) felt that using gene technology in human transplants would be useful. However, this proportion decreased somewhat in relation to the specific techniques, with around two-thirds seeing the value in transplanting the body parts of animals into humans (64.4%) and transplanting human body parts grown in animals back into humans (63.5%).
Figure 13. Perceived risk associated with using gene technology in human transplants
Over half (56.3%) the respondents felt that the use of gene technology in human transplants would be risky. This increased for each of the specific techniques used, with the majority believing transplanting the body parts of animals into humans (70.6%) and transplanting human body parts grown in animals back into humans (68.7%) would be risky.
Figure 14. Acceptability of using gene technology in human transplants
About two-thirds of respondents (64.8%) thought it would be acceptable to use gene technology in human transplants. However, only around half felt that transplanting human body parts grown in animals back into humans (50.4%) and transplanting the body parts of animals into humans (49.3%) was acceptable.
In the qualitative research, many participants were supportive of using gene technology in human transplants. They generally considered that in this context, the technology offered the potential to save human lives. Some also acknowledged the role that gene technology (as opposed to using human organ donors) could play in reducing the risk of organ rejection, particularly if the organs were able to be 'custom-made' for recipients. However, a small minority of participants felt this application of gene technology was unnecessary, as they perceived there to be sufficient, and probably increasing (due to government campaigns), availability of organs for transplant from human organ donors.