Report of the Mini-Workshop in Beijing
On December 1 2012, the Centre for Bionetworking (Xinqing Zhang, Margaret
Sleeboom-Faulkner, Suli Sui) held a Mini-Workshop on International life Science
Collaboration at Peking Union Medical College in Beijing. The aim of the
Mini-Workshop was to gain a better understanding of how different stakeholders are
perceived to indentify and understand ethical and regulatory issues related to stem cell
research and therapy in China and other countries, and to obtain experience in
preparation for a second workshop to be held later on in the project.
Pre-task preparation: participants selecting and grouping
The prospective participants were postgraduates from seven hospitals and research
institutes of PUMC. We selected 30 students with a background in basic medicine,
stem cell research, clinical medicine, and drug research. The reading materials of the
cases we prepared and sent to the participants two weeks before the workshop. The
participants were divided into five teams. Each team was to perform a role of a
particular stakeholder, including ‘doctors’, ‘ ‘patients’, ‘regulators from the Ministry
of Health’, ‘the ethics committee’ and ‘the public’. The ‘stakeholders’ were to discuss
and address ethical and regulatory issues from the perspective of the stakeholders they
represented.
Case Selected
At the beginning of November 2012, we selected two target cases for discussion, one
located in China and one in Nigeria.
Case one:
The first case study concerned an actual case of innovative stem cell therapy using
mesenchymal stem cells (MSCs) Guest-versus-Host Disease (GvHD) under
discussion in a hospital outside Beijing. The patient had received allogenetic
hematopoieticstem cell therapy (alloHSCT), afte which GvHD developed. Therapies
using MSCs are regarded as experimental and are currently prohibited by the MoH in
a notification. The students had to take on different roles in discussing the difficulties
around this case.
Case two:
The second case concerned a case from Nigeria, chosen for the difficulties related to a
foreign company conducting experimental research in ‘one’s own’ country. Pfizer in
1996 had conducted a drug experiment on 200 children during a meningitis epidemic
in the state's main city called Kano, resulting in 11 deaths, brain damage, paralysis
and slurred speech in many of the children. Pfizer treated 100 meningitis-infected
children with an experimental antibiotic, Trovan. Another 100 children, control
patients in the study, received an approved antibiotic, ceftriaxone -- but the families’
lawyers claimed that the dose was lower than recommended. Although Pfizer was
sued, in the end the company and the Nigerian government came to a settlement.
Case discussion in the workshop:
Team presentation and debate
Every team first discussed and then presented their views in a team statement. The
other ‘stakeholder groups’ could ask questions after the statement. The students could
very easily relate to the first case, and debate was serious, animated and sometimes
humorous. The second case was harder for the students. This was partly due to the
fact that most of the materials provided to them was in English, and many students
had only read the Chinese summary, not realizing that this left them with a knowledge
gap. The discussion, nevertheless, was fascinating, as the case allowed the student to
be both critical of Pfizer AND of the Nigerian government, which may not have been
the case if we had chose a similar case located in China.
Personal opinion expression
The ‘performative part’ of the mini-workshop was followed by free debate, where the
students expressed their ‘own’ views. This mode of debate provided us with an idea
of how medical professionals experience research regulation and ethical issues and
how they perceive the roles of those involved. It provided us with insight into
unresolved problems and ideas of where some of the difficulties lie in the
communication between stakeholders in relation to experimental stem cell therapies.
Evaluation
All the participants responded the form. One teacher sitting on also filled the form,
and so totally we got 31 filled evaluation forms. The evaluation form includes the
overall evaluation and comments for this workshop, and their personal views,
suggestion and expectation based on this workshop.
The data from these 31 evaluation forms shows: among the overall evaluation items,
for ‘clarity of the meeting’: Excellent 19, Good 11, Satisfactory1, and Poor 0. For
‘rate the workshop overall on: 1) importance of topic: Excellent19, Good 10,
Satisfactory1 and Poor0; 2) Relevance and usefulness to you: Excellent 13, Good 15,
Satisfactory 2, and Poor0; 3) Format of the workshop: Excellent 20, Good 9,
Satisfactory 2, and Poor 0. The average rate for the overall evaluation is: Excellent
58% Good 40% Satisfactory 2% Poor 0%. Generally, the result of participant
evaluation shows that the mini-workshop was highly praised.
From the comments and suggestions, it can be seen that most of the participants
regarded that the discussion expand their horizon and offer them a way to think and
understand life science from different perspectives. Many of them think they may
benefit from experience of taking part in this workshop. 18 participants affirmative
expressed that they would participate again in a similar event in the future on the basis
of your experience of this workshop. Meanwhile, in the participants’ comments there
are some useful suggestions, such as more pre-task preparation is needed; case
choosing is crucially important; more time for discussion and debate, etc.
As organizers of the mini-workshop we were satisfied with this positive start. It
reached our expectations and offered valuable experience for our next workshop
organization.