Under the Microscope: Bioethics deals with ethical considerations arising from advances in biology and medicine.
The Irish Council for Bioethics (www.bioethics.ie) was established in 2002 as an independent body to consider such ethical issues. In September 2005 the ICB carried out a survey to examine the level of awareness, understanding and interest in bioethics among the public. The main areas covered were organ donation, stem-cell research, patenting, in-vitro fertilisation (IVF) and end of life issues. Five hundred adults of 18 years and older were interviewed.
Asked how much they knew about bioethics, 77 per cent of respondents said they knew nothing, 17 per cent know just a little and 6 per cent said they know a fair to large amount. However, things looked brighter when people were asked about specific areas. In the following areas the first figure represents the per centage of people who felt they know a fair amount to a lot about the issue and the second figure represents the per centage of people who felt they know a little: organ donation (60, 30), using DNA to solve crime (51, 31), prolonging life in very premature babies (27, 37), end of life issues (30, 31), genetic screening for disease (16, 35), stem-cell research (12, 33), gene therapy (16, 24), genetic selection (10, 26), patenting human life (4, 14).
Regarding organ donation, 69 per cent of respondents strongly felt that paying people to donate their organs is wrong. Eighty one per cent thought that organ donation by the living to their relatives should be encouraged, although 55 per cent also thought that this practice could put undue pressure on one sibling to donate an organ, eg kidney, to another sibling.
Forty-four per cent of respondents felt that the lives of severely premature babies should be preserved even with the risk that they would have very poor quality lives. Twenty one per cent strongly disagreed with this.
Eighty-seven per cent of respondents felt that DNA profiles should be taken of all those convicted of serious crimes and these profiles should be held indefinitely by the Garda. Thirty seven per cent thought that anyone questioned by the Garda should have their DNA profiles entered in a database, but 33 per cent strongly disagreed with this.
When asked, "At what point in the reproductive process do you believe human life begins?" 57 per cent said conception, 19 per cent said implantation in the womb, 13 per cent said three months into pregnancy, and 4 per cent said birth.
When asked if "surplus embryos" left over after IVF procedures should be used for medical research into disease, 44 per cent said yes, 30 per cent said no and 25 per cent didn't know. Of those who said yes, 82 per cent said embryos still should be used even though some of them would be destroyed in the process.
Fifty-four per cent of respondents felt the Government should fund embryonic stem-cell research. Thirty eight per cent felt that scientists should be allowed to create embryos specifically for use in medical research, but 25 per cent strongly disagreed with this.
Forty-three per cent felt the law should be changed to allow parents to select embryos during IVF that are free from serious disorders. Thirty one per cent disagreed. Forty-two per cent felt that unborn children should be screened for genetic disorders to help in deciding whether or not to continue a pregnancy, but 43 per cent disagreed. Eighty-one per cent were opposed to enhancing embryos during IVF to increase intelligence, athletic ability etc.
IVF allows parents of a child with a genetic disorder to choose an embryo which is free of that disorder, but whose tissue matches that of the sick child. The resulting baby could provide stem cells to help the genetically ill sister/brother. These babies are called saviour siblings. Forty-five per cent of respondents found this practice acceptable, 22 per cent did not and 33 per cent didn't know.
Twenty-two per cent felt that expensive treatments should be withdrawn from old people when the chances of success are low, but 67 per cent disagreed. Fifty per cent of respondents felt that terminally ill people are competent to decide to end their own lives, 26 per cent disagreed. Forty per cent felt that euthanasia should be legal, 46 per cent disagreed. Twenty-six per cent thought assisted suicide should be legal, 59 per cent disagreed.
This is the first comprehensive Irish survey of public attitudes to bioethical issues. I will let the results speak for themselves generally, but I will comment specifically on the stem-cell issue.
Fifty-seven per cent believe life begins at conception. I would therefore expect more than 30 per cent to say that spare embryos from IVF should not be used for research into disease. I can scarcely conceive of research that would not kill these embryos, but the manner in which the question was asked clouded this fact. However, I also note that the report of The Commission on Assisted Human Reproduction (May 2005) detailed a telephone survey in which 45 per cent agreed that medical research on embryos be allowed to advance treatment of genetic diseases.
We now live in a rapidly changing complex world. Forty-seven per cent of respondents felt that science should slow down its progress to allow ethics and law to catch up.
William Reville is associate professor of biochemistry and public awareness of science officer at UCC - http://understandingscience.ucc.ie