Survey of Attitudes and Ethical Concerns Related to Gene Therapy Among Medical Students and Postgraduates in China

Xiang, Liangcheng; Li-hong, Xiao; Gou, Zhongping; Li, Mei; Zhang, Wei; Wang, Haiping; Feng, Ping

doi:10.1089/hum.2015.113

Cited by 11 publications

(31 citation statements)

References 27 publications

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“…These studies suggest that-at least for a significant part of the general public-the acceptability of GGE depends on certain conditions (Delhove et al, 2020). The characteristics of GGT that affect acceptability among the general public seem similar to those identified by experts, including GGT's safety (Robillard et al, 2014;Wang et al, 2017), effectiveness (Kalfoglou et al, 2005), costs (Xiang et al, 2015;Wang et al, 2017) and whether alternative treatments are available (Hendriks et al, 2018). Furthermore, acceptability depends on whether GGE is used for disease prevention or enhancement of specific characteristics/traits (Hendriks et al, 2018) and how much GGE improves the future child's well-being (Funk et al, 2016).…”

Section: Introductionmentioning

confidence: 68%

“…Potential use of GGE by these couples could substantially expand potential users beyond the small number of couples who are unable to create disease-free embryos (Viotti et al, 2019) (which some experts proposed as a limit (Green, 2008;NASEM, 2017)). GGE costs covered by public health insurance had a surprisingly large effect on whether participants supported allowing GGE, considering that in other studies the costs of GGT had mixed importance and insurance coverage was not always specified (Xiang et al, 2015;Wang et al, 2017). The results, however, resemble those for other reproductive treatments and may be understood in the context of a finite national healthcare budget and distributive justice concerns (Wellcome Trust, 2005;Hui et al, 2009).…”

Section: Findings In the Context Of The Literaturementioning

confidence: 91%

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Should germline genome editing be allowed? The effect of treatment characteristics on public acceptability

et al. 2020

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STUDY QUESTION To what extent do characteristics of germline genome editing (GGE) determine whether the general public supports permitting the clinical use of GGE? SUMMARY ANSWER The risk that GGE would cause congenital abnormalities had the largest effect on support for allowing GGE, followed by effectiveness of GGE, while costs, the type of application (disease or enhancement) and the effect on child well-being had moderate effects. WHAT IS KNOWN ALREADY Scientific progress on GGE has increased the urgency of resolving whether and when clinical application of GGE may be ethically acceptable. Various expert bodies have suggested that the treatment characteristics will be key in determining whether GGE is acceptable. For example, GGE with substantial risks (e.g. 15% chance of a major congenital abnormality) may be acceptable to prevent a severe disease but not to enhance non-medical characteristics or traits of an otherwise healthy embryo (e.g. eye colour or perhaps in the future more complex traits, such as intelligence). While experts have called for public engagement, it is unclear whether and how much the public acceptability of GGE is affected by the treatment characteristics proposed by experts. STUDY DESIGN, SIZE, DURATION The vignette-based survey was disseminated in 2018 among 1857 members of the Dutch general public. An online research panel was used to recruit a sample representing the adult Dutch general public. PARTICIPANTS/MATERIALS, SETTING, METHODS A literature review identified the key treatment characteristics of GGE: the effect on the well-being of the future child, use for disease or enhancement, risks for the future child, effectiveness (here defined as the chance of a live birth, assuming that if the GGE was not successful, the embryo would not be transferred), cost and availability of alternative treatments/procedures to prevent the genetic disease or provide enhancement (i.e. preimplantation genetic testing (PGT)), respectively. For each treatment characteristic, 2–3 levels were defined to realistically represent GGE and its current alternatives, donor gametes and ICSI with PGT. Twelve vignettes were created by fractional factorial design. A multinominal logit model assessed how much each treatment characteristic affected participants’ choices. MAIN RESULTS AND THE ROLE OF CHANCE The 1136 respondents (response rate 61%) were representative of the Dutch adult population in several demographics. Respondents were between 18 and 89 years of age. When no alternative treatment/procedure is available, the risk that GGE would cause (other) congenital abnormalities had the largest effect on whether the Dutch public supported allowing GGE (coefficient = −3.07), followed by effectiveness (coefficient = 2.03). Costs (covered by national insurance, coefficient = −1.14), the type of application (disease or enhancement; coefficient = −1.07), and the effect on child well-being (coefficient = 0.97) had similar effects on whether GGE should be allowed. If an alternative treatment/procedure (e.g. PGT) was available, participants were not categorically opposed to GGE, however, they were strongly opposed to using GGE for enhancement (coefficient = −3.37). The general acceptability of GGE was higher than participants’ willingness to personally use it (P < 0.001). When participants considered whether they would personally use GGE, the type of application (disease or enhancement) was more important, whereas effectiveness and costs (covered by national insurance) were less important than when they considered whether GGE should be allowed. Participants who were male, younger and had lower incomes were more likely to allow GGE when no alternative treatment/procedure is available. LIMITATIONS, REASONS FOR CAUTION Some (e.g. ethnic, religious) minorities were not well represented. To limit complexity, not all characteristics of GGE could be included (e.g. out-of-pocket costs), therefore, the views gathered from the vignettes reflect only the choices presented to the respondents. The non-included characteristics could be connected to and alter the importance of the studied characteristics. This would affect how closely the reported coefficients reflect ‘real-life’ importance. WIDER IMPLICATIONS OF THE FINDINGS This study is the first to quantify the substantial impact of GGE’s effectiveness, costs (covered by national insurance), and effect on child well-being on whether the public considered GGE acceptable. In general, the participants were strikingly risk-averse, in that they weighed the risks of GGE more heavily than its benefits. Furthermore, although only a single study in one country, the results suggests that—if sufficiently safe and effective—the public may approve of using GGE (presumably combined with PGT) instead of solely PGT to prevent passing on a disease. The reported public views can serve as input for future consideration of the ethics and governance of GGE. STUDY FUNDING/COMPETING INTEREST(S) Young Academy of the Royal Dutch Academy of Sciences (UPS/RB/745), Alliance Grant of the Amsterdam Reproduction and Development Research Institute (2017–170116) and National Institutes of Health Intramural Research Programme. No competing interests. TRIAL REGISTRATION NUMBER N/A.

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Section: Introductionmentioning

confidence: 68%

Section: Findings In the Context Of The Literaturementioning

confidence: 91%

Should germline genome editing be allowed? The effect of treatment characteristics on public acceptability

et al. 2020

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“…As noted earlier, attitudes toward gene editing reflected two broadly distinct-albeit moderately correlatedlatent factors concerning treatment and enhancement. This finding had been hinted at in recent work (Gaskell et al, 2017;Robillard et al, 2014;Xiang et al, 2015), but prior to the current study had not been formally established. As such, these results indicate that future research into gene editing attitudes should consider using distinct scales with regard to these issues as well as seeking to further understand and establish the latent architecture of attitudes in this domain.…”

Section: Discussionmentioning

confidence: 53%

“…Perhaps unsurprisingly, surveys have shown that people differ quite notably in their perceptions of and attitudes toward gene editing (Calnan et al, 2005;Hendriks et al, 2018;McCaughey et al, 2019;Xiang et al, 2015). For example, recent work found that 59% of respondents agreed with "genetic editing of cells in children or adults to cure a life threatening disease," with 31% responding with "neutral" or "don't know" and 10% reporting that they disagreed with its use.…”

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confidence: 99%

Understanding opposition to human gene editing

Halstead

Lewis

2020

Polit. life sci.

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Recent advances in gene editing technology promise much for medical advances and human well-being. However, in parallel domains, there have been objections to the use of such biotechnologies. Moreover, the psychological factors that govern the willingness to use gene editing technology have been underexplored to date. In this registered report, we sought to test whether pathogen disgust sensitivity is linked with opposition to gene editing. U.K.-based adult participants (N = 347) were recruited to this study. Gene editing attitudes reflected two largely distinct latent factors concerning enhancing human traits and treating medical disorders. In contrast to prediction, pathogen disgust sensitivity was related to greater support for gene editing in both of these domains. This result suggests that gene editing, at least in the current study, is not viewed as pathogenic, or that the perceived benefits of gene editing outweigh any perceived pathogen risk.

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“…32 However, a study in the general public, university students and high school teachers from various countries in Asia, Australia, New Zealand, Russia and China found no significant effect of religion on the application of gene therapy that included gene correction. 38,39 Education was one of the influencing factors on the attitudes of the respondents to this rising technology. Our study found that respondents with higher education had more favorable attitude toward genome editing as treatment for fatal and debilitating diseases on somatic cells, but they were more likely to oppose its application for increasing human ability.…”

Section: Discussionmentioning

confidence: 99%

Attitudes of Indonesian Medical Doctors and Medical Students Toward Genome Editing

Izzah¹,

Setyanto²,

Hasanatuludhhiyah³

et al. 2021

JMDH

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Purpose This study aimed to measure the attitudes of Indonesian medical doctors and students toward new technology in genome editing. Materials and Methods Online questionnaires regarding attitudes toward genome editing on health and non-health conditions, both in somatic cells and embryo, were distributed through researcher networks, email and social media specific to medical doctors and students. The data of 1055 valid questionnaires were processed; descriptive and association analyses between sociodemographic factors and attitudes toward genome editing were performed. Email in-depth interview was performed to explore the respondents’ answers. Results The results showed that Indonesian medical doctors’ and students’ knowledge of genome editing was limited and correlated with gender, place of residence, religion, education, marital status, childbearing and experience abroad. More than half of respondents supported genome editing for the treatment of fatal and debilitating diseases both in somatic cells and embryos, implying their consent to edited gene inheritance. However, this approval decreased when applied to non-health-related aspects, such as physical appearance, intelligence and strength. Factors affecting their attitudes toward genome editing included their status as medical doctors or students, gender, age, education, religion, economic status and place of residence. Conclusion Increasing knowledge and awareness of Indonesian medical doctors and students regarding genome editing is important. Even though its application in health-related matter was supported by a majority of the respondents, discussion from ethical and religious perspectives is necessary to ensure the acceptance.

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Survey of Attitudes and Ethical Concerns Related to Gene Therapy Among Medical Students and Postgraduates in China

Cited by 11 publications

References 27 publications

Should germline genome editing be allowed? The effect of treatment characteristics on public acceptability

Should germline genome editing be allowed? The effect of treatment characteristics on public acceptability

Understanding opposition to human gene editing

Attitudes of Indonesian Medical Doctors and Medical Students Toward Genome Editing

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