Editors: Norio Fujiki, M.D. & Darryl R.J. Macer, Ph.D.
Yung Sun Kang, Dept. of Genetic Engineering, Suwon University, KOREA
Chung Choo Lee, Dept. of Biology, Seoul National University, KOREA
The subjects consisted of persons of relatively high educational background, and of mixed sex, age and religion. There were 198 males and 352 females, with 440 (80%) being in their twenties, 46 (8.4%) in their thirties, 31 (5.6%) in their forties, and 33 (6.0%) over 50 years of age. The educational background included 20 (3.6%) who had completed high school, 405 (73.6%) who were university students, and 125 (22.7%) who had a bachelor's degree or higher. The speciality of the respondents included 115 (20.9%) in cultural and social science, 327 (59.4%) in science and technology, 26 (4.7%) in art, and 82 (14.9%) in other areas. There were 137 (24.8%) who were Christian, 66 (12.0%) Buddhist, 76 (14.0%) Catholic, 8 (1.4%) other religions, and 263 (47.8%) who claimed no religion. The results from the 550 returned questionnaires which included 15 questions about bioethical topics are below.
The sample characteristics are noted above (Q1). The questions and results (N, %) follow:
Q2. Do you have interest in bioethics?
Yes, I do 407 74.4%
No, I don't 140 25.6%
Q3. What do you think about brain death?
It must be approved as death 191 34.7%
It can absolutely not be approved 36 6.5%
Must be approved case-by-case 295 53.6%
Uncertain 28 5.1%
Q4. How do you think about tissue and organ transplantation?
Agree 449 81.6%
Oppose 13 2.4%
Agree with among relatives 24 4.4%
Originally opposed, would agree in a special case 47 8.5%
Uncertain 17 3.1%
Q5. Do you think artificial fertilization is against bioethics?
Yes, I do 307 56.4%
No, I don't 148 27.2%
Uncertain 89 16.4%
Q6. What is your opinion about the following statement: "We kill harmful insects (mosquito and housefly) without any consideration, however killing a butterfly or frog indiscriminately is a cruel act".
Both cases are a cruel act 23 4.2%
Although both kinds of animals have the same life, the feeling of action
is different due to human egoism 367 66.8%
It is proper, because we have been educated and think like that 146 26.6%
Uncertain 13 2.4%
Q7. When we kill animals, we are reminded of bioethics (life consciousness), but with plants we are not. How do you feel?
That is correct, because animals express bitter behaviour but plants do not 419 76.2%
I feel bioethics in cut down trees 107 19.5%
Uncertain 24 4.4%
Q8. Women aged 35-49 years old have a 1/300 to 1/50 risk of giving birth to a child with Down's syndrome. If yourself, or spouse, or one of your family was pregnant at that age, would you advise prenatal diagnosis?
Yes, I will advise 433 78.9%
I wouldn't advise 72 13.1%
Uncertain 44 8.0%
Q9. If your fetus was diagnosed as having a genetic disorder what is the best thing to do?
I will deliver 47 8.6%
I would never deliver 380 69.2%
Uncertain 122 22.2%
Q10. Assume you already have a genetically handicapped child when there was a 25% risk of them being so. If the second fetus has the same risk do you want to have a second baby?
Surely, I do 32 5.9%
No, I don't 246 45.0%
If the fetus can be shown to be normal by prenatal diagnosis I want to have 269 49.1%
Q11. Do you agree with the development of high technology even when it can freely modify all genetic traits?
I agree 35 6.4%
Such development is only useful for humans 369 67.5%
Basic research is possible, but we don't need application because of side effects 126 23.0%
Uncertain 17 3.1%
Q12. If human cloning (duplication) is possible by genetic engineering techniques, do you approve of the application of this technique?
Yes, I do 63 11.6%
No, we must not do 312 57.2%
We must not develop the technique 140 25.7%
Uncertain 30 5.5%
Q13. Do you understand the role of genetic counseling?
Yes, I do 281 51.7%
No, I don't 263 48.3%
Q14. If you answered yes in Q13, do you think the application of genetic counseling must be activated?
Yes, I do 235 84.2%
No, I don't 44 15.8%
Q15. What is your reason for agreement or disagreement to Q14? Chose only one.
Agreement to prevent the birth of an abnormal baby 144 54.5%
Agreement for the prevention of family unhappiness by a baby with a disorder 78 29.5%
Opposition because of affects on human rights 8 3.0%
Opposition for the protection of the potential life 34 12.9%
The Korean people show interest in bioethics. About two thirds had an opinion about bioethics. Brain death was supported by about 90% (Q3), without any religious differences. There was some sex difference, (X2=9.331, df=3, P=0.025). Organ transplantation was approved by 86% (Q4), with no sex-related or religious differences. The problems of brain death and organ transplantation are closely related with human health and modern living. Actually, people suppose that these medical practices should be guarantied by laws of medical services. Recently, some specialist groups have discussed brain death in Korea. In the present situation most Korean people seem to have great hope that the government should admit brain death.
In special cases artificial fertilisation has been conducted between legally married couples in Korea. In this study however, 56% answered that it runs counter to bioethics. The responses were not significantly different dependent upon sex, however, religious men had a slightly stronger tendency to be against it. Oriental thinking has some conservative tendency. If a Korean women were to take sperm from someone other than her husband most Koreans would consider it an immoral act.
In the past we killed harmful insects, which can also be converted to various new resources, especially as gene resources. In Q6 only 4% of respondents said it was a cruel behaviour to kill harmful insects. In the future we will try to find new knowledge which can allow us to coexist without health damage. We propose that such opinion be reflected in new educational curriculum in various school.
Prenatal diagnosis has become universal in Korea. In Q14 84% showed positive attitudes to prenatal diagnosis. The authors feel confident that prenatal diagnosis itself does not raise major bioethical problems. Q9 and Q10 indicated that most respondents don't want to deliver a genetically handicapped child.
Q11 indicates there is support for the development of genetic engineering that is useful for humans. However, human cloning was not supported (Q12). Such a consciousness should be highly suitable for modern living we think.
The genetic counseling system is not yet completely established in Korea. This may explain why only half of the respondents said in Q13 that they understood it. However, there was extremely high support for the use of prenatal diagnosis as said above. In the case where a fetus has a genetic defect, the dominant response is to support abortion. There was slightly less support for abortion of a defective fetus among Buddhists or Catholics. This question shows some relationship in bioethical attitude and religion.
In summary, the overall results show that Koreans have some inconsistency between bioethical cognition and practice. The authors want to work for the development of rational bioethical reasoning through medical, social and school education in the future.