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
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1. Methodology ............................................................................................ 2
2. Support for fields of gene technology application.......................................... 3
3. Awareness of applications ......................................................................... 5
4. Perceived usefulness of applications ........................................................... 6
5. Perceived risk associated with applications .................................................. 7
6. Acceptability of applications ....................................................................... 8
7. Awareness of using gene technology to produce medicine ............................. 9
8. Perceived usefulness of using gene technology to produce medicines ............10
9. Perceived risk associated with using gene technology to produce medicines ...11
10. Acceptability of using gene technology to produce medicines ......................12
11. Awareness of using gene technology in human transplants .........................13
12. Perceived usefulness of using gene technology in human transplants ...........14
13. Perceived risk associated with using gene technology in human transplants ..15
14. Acceptability of using gene technology in human transplants ......................16
15. Awareness and knowledge of technologies ................................................18
16. Perceived impact of technologies .............................................................19
17. Time frame for impact of technologies .....................................................20
Public Awareness Research 2005: Human Health
1. Research context
Background
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 biotechnologies1. 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.
Social causes of public concerns about developments in biotechnology in Australia:
Comparisons with other countries and lessons for Asia. By Craig Cormick. Accessed on
the Biotechnology Australia website.
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Public Awareness Research 2005: Human Health
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.)
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Public Awareness Research 2005: Human Health
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
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Public Awareness Research 2005: Human Health
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.
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Public Awareness Research 2005: Human Health
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%).
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Public Awareness Research 2005: Human Health
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.
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Public Awareness Research 2005: Human Health
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).
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Public Awareness Research 2005: Human Health
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.
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Public Awareness Research 2005: Human Health
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.
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Public Awareness Research 2005: Human Health
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 threequarters (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.
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Public Awareness Research 2005: Human Health
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.
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Public Awareness Research 2005: Human Health
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.
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Public Awareness Research 2005: Human Health
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%).
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Public Awareness Research 2005: Human Health
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%).
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Public Awareness Research 2005: Human Health
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.
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Public Awareness Research 2005: Human Health
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.
There was concern about this application among some participants. Some expressed
concern about an 'industry' of body parts developing. In part, this concern was based on
examples from overseas where body parts were stolen from individuals and sold on the
black market.
"If it were a whole industry of creating body parts, I might be a bit squeamish
about it."
As the details of specific techniques were discussed, additional concerns arose among
participants. Some suggested that certain groups would be opposed to this application on
religious grounds, for example, it was anticipated that there would be concerns about
transplants similar to those regarding halal or kosher foods, or those by groups that
disapprove of blood transfusions.
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Public Awareness Research 2005: Human Health
Another concern that participants expressed was that this application had the potential to
cause suffering to the animals involved. Some were concerned that animals would have
to be sacrificed in order for this technology to be employed. Others noted that animals
were slaughtered everyday for their meat and that it was much more acceptable to
sacrifice an animal to save the life of a human, than simply as a source of food. For
many, the image of the mouse growing the human ear on its back was brought to mind
and they were concerned at the animal's likely discomfort.
Another source of anxiety for participants was crossing the species barrier between
animals and humans. Some participants felt uneasy mixing body parts (and genes) from
different species.
"I don't know, it just makes me cringe."
"It's just a bit off-putting."
Body parts of animals into humans
Several participants believed that transplants involving body parts of animals being
transplanted into humans were already taking place. These people drew on the example
of pigs' heart valves (although some thought it involved the entire heart) being
transplanted into humans. The view that this application (or at least similar applications)
of gene technology was already the status quo made it more acceptable to many.
"What about the heart valve operations with the heart valve from a pig? That's
been going on for years and years. My friend had it done 20 years ago."
"That's already being done . . . the ape hearts etcetera . . . that's been going on for
a long time."
Human body parts grown in animals into humans
In contrast, participants generally agreed that human body parts grown in animals were
not yet being transplanted back into humans. Some felt that this may be why they found
the technique somewhat less acceptable, but that this may change in time. They
acknowledged that new technology always takes time to become familiar and acceptable
to the public, citing heart bypass surgery as an example.
"In 20 years' time it may be commonplace and people won't give it a second
thought."
Despite these expressed concerns relating to the use of specific techniques, most
participants acknowledged that their views about the acceptability would be balanced by
the potential to save a person's life. For example, many stated that if it could save their
life, or the life of someone they loved, then they would want it to be available.
"If you're dying or in that situation, it's very different."
"The bottom line is, I would like to think it were there if I needed it."
"If it was a choice between having a pig's heart or dying, I'd be choosing the pig's
heart — no question."
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Public Awareness Research 2005: Human Health
2.5 Attitudes towards gene therapy
Respondents in the survey were asked to indicate their self-assessed level of awareness
and knowledge of gene therapy, as well as five other technologies — biotechnology,
cloning, use of stem cells, genetic engineering and fibre optics. Results are shown in
Figure 15.
Figure 15. Awareness and knowledge of technologies
Compared to other technologies, far more respondents (31.5%), reported not having
heard of gene therapy, while just over a half (52.6%) claimed to have heard of it. The
smallest proportion of respondents (15.9%) felt they knew enough about gene therapy
that they could explain it to a friend.
Respondents in the survey were then asked whether they believed each of the
technologies was likely to improve our way of life in the future, have no effect or make
things worse. The results are illustrated in Figure 16.
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Public Awareness Research 2005: Human Health
Figure 16. Perceived impact of technologies
Placing it midway in relation to the other technologies, two thirds of respondents
(66.9%) felt that gene therapy was likely to improve our way of life in the future. In
addition, almost a fifth (18.9%) was not sure what impact it was likely to have.
Last in this series of questions, for each of the technologies, respondents who indicated
that they believed it would have some effect on our way of life (either positive or
negative) were asked when they thought this would happen. The findings are shown in
Figure 17.
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Public Awareness Research 2005: Human Health
Figure 17. Time frame for impact of technologies
Compared to all other technologies, fewer respondents (43.0%) felt that gene therapy
was already having an effect, with the majority considering that this technology was yet
to have an effect. However, of these respondents, the greatest proportion (18.9%)
indicated that they believed the effects were likely to be felt in the next five years.
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