Change in high school student attitudes to biotechnology in response to teaching materials

- Takeishi Oka & Darryl Macer
Institute of Biological Sciences, University of Tsukuba,
Tsukuba Science City 305-8572, Japan
Email: asianbioethics@yahoo.co.nz

Eubios Journal of Asian and International Bioethics 10 (2000), 174-178.
Introduction

 Biotechnology has made remarkable progress in recent years, and caused a revolution in medical science, pharmaceuticals, agriculture, and other fields. The advance of modern biotechnology will have a great influence on the world. On the other hand, some ethical problems have emerged. Society may agree that to become happy is a common and universal good, so we can ask will using high technology really make us happy? In fact, it is very difficult to judge whether on balance unrestricted practice of high technology is really good even for individual users let alone for the whole of society.

Bioethics is the study of the ethical issues associated with life including issues raised in biology, medicine, and the environment in general. It is simply the love of life (Macer, 1998). Two of the basic principles of bioethics are doing good, and avoiding harm, and it can aid the process of decision-making to balance the benefits and risks of alternative choices in biotechnology.

Recently in the high school curriculum in many countries we have seen the inclusion of examples of modern biotechnology, for example, the use of genetic engineering in the production of disease-resistant crops, mammalian cloning, the production of pharmaceuticals in animals, and the development of humanized organs in transgenic animals. In surveys conducted in the 1990s in Australia, India, Japan, New Zealand and Singapore we can see that a majority of teachers are including some discussion of ethical and social issues associated with biotechnology (Macer, 1992; Asada et al. 1996; Macer et al. 1996; Pandian & Macer, 1998; Ong & Macer, 1999). The manner in which this material is presented will affect the way that students view the technology, and its acceptability. When it comes to the use of animals, the type of teaching materials may also alter attitudes to the use of animals (Tsuzuki et al. 1998). This paper reports the results of a trial of the impact of one type of teaching material upon the attitudes to the animal bioreactors and cloning, and found some significant changes in ethical reasoning before and after the exposure to the class material.

Design of the questionnaire

 The first issue was to chose what examples of biotechnology would be most suitable for this trial. They had to be understandable by the average high school student, of sufficient interest to make some students respond to the same questionnaire twice (pre-exposure and post-exposure), and potentially relevant to their lives so that the teaching would have some value for the students. The questions also were chosen to be relevance to our broader studies on the attitudes of students towards biotechnology in the case where the teachers only chose to conduct the survey once and did not wish to offer the associated teaching material.

The examples chosen focused on transgenic animals, in particular animal bioreactors and cloning. This survey was the second of a series of four bioethics surveys offered to the same teachers in September 1998. Each survey had a different focus and not all teachers conducted each survey, so not all students could be followed between each survey . The topics of the four surveys were: plant biotechnology, food, and information source (Komatsu & Macer, 2000); animal biotechnology; environmental attitudes (Amemiya & Macer, 1999); and the images of life (inochi) and differences in its image between different life-forms (see Oka & Macer, 2000). It has been found to be very difficult to follow the same students through the surveys because privacy was protected, and a number of students did not complete other questionnaires.

This questionnaire was titled _ganimal bioreactors_h in Japanese and consisted mainly of open questions following a fixed five point scale from agreement to disagreement (Responses given on scale (1 agree 2 3 4 5 disagree), which were given open boxes for the questions, as given below:

Researchers have injected human genes into the fertilized eggs of domestic animals, for example pigs. One reason is for making such a pig is to make drugs in the milk of the pig. Another reason is to make internal organs adapted to humans. These are called animal bioreactors.

Following the questions (Q1-7) are the results for the total of 576 responses to the total questionnaire

Q1.Hemophilia is a disease where people cannot stop bleeding. Do you accept to make a pig to make the medicine for humans? Give your reasons.

41% agree 23% disagree 35% DK

Q2.If you have hemophilia, do you accept to use this drug from pigs?

37% agree 30% disagree 32% DK

Q3. Do you accept making a pig to make a heart adapted to humans? Give your reasons.

26% agree 42% disagree 31% DK

Q4.If you have heart disease, do you accept to use heart transplantation from a pig?

25% agree 41% disagree 34% DK

Q5.If your family or friend has heart disease, do you accept to use heart transplantation to your family or friend from pigs?

30% agree 24% disagree 46% DK

Q6.If someone who is not very closely connected with you has heart disease, do you accept them to use heart transplantation from pigs?

34% agree 19% disagree 46% DK

Q7. Do you accept to continue this research?

49% agree 20% disagree 31% DK

Q8. What is different between animal bioreactors from domestic animals for eating?

Q9. What is cloning?

Q10. What is the purpose of cloning?

Q11. If you know a good or bad point of cloning, please write below:

Design of Teaching Materials

 To examine how students might form their ideas now, the examples and manner used to discuss animal bioreactors and cloning, and associated issues, were examined in standard school textbook for senior high school biology. To give an illustration of the scientific concepts found:

- The concepts predominant in a biology IA textbook

germ cell, stem cell, fertilized egg, genetic engineering

- The concepts predominant in a biology IB textbook

germ cell, stem cell, fertilized egg, reproduction, development, embryo, gene, chromosome

- The concepts found in a biology I textbook

immunity, gene, chromosome, enzyme, DNA, gene expression, virus, genetic engineering

- The concepts predominant in a biology textbook

transgenic animal technology, cloning, rejection

As found in the earlier study of bioethics education in Japan, over 80% of teachers used supplementary teaching materials to cover bioethical issues because they felt the textbook coverage was not sufficient (Macer et al., 1996). These materials included printed materials, copies from newspapers and magazines and other books, and videos. With this in mind, and after seeking advice from teachers active in the Bioethics Education Network in Japan (Asada & Macer, 1998), suitable teaching materials were developed. The teaching materials were developed beyond those previously offered to all high schools in Japan (Asada & Macer, 1997), so that students could better understand them.

The following scientific concepts are used, and the main purposes of the materials were:

- Students will be able to understand and explain the fundamental concepts of genetics and molecular biology relevant to the case.

- Students will be able to think about a variety of ethical issues, and express their ideas based on scientific concepts and knowledge.

- Students will be able to explain the basic content of animal bioreactors and cloning.

The materials are in Japanese, and those interested in obtaining a copy of them should write to the authors.

Results of the Teaching Material Study

 The teaching materials were tested in a class with the generous cooperation of Mrs. Junko Sawada among year students at Hitachi-kita High School in October, 1998. The results of the study on teaching materials are analyzed from two points of view. Firstly, the trends in level of agreement with each application; and secondly, qualitative analysis of the reasoning expressed in the open comments. The student numbers allow comparisons between the different questions, and the results are seen in Table 1-3. After the teaching materials more students mentioned the animal's point of view, from 4 to 7 persons in Q1 and from 2to 7 persons in Q3. A similar number of students would still support the use of the techniques to alleviate human suffering. In Q7 there is a shift from Yes to No (Table 3), but in question 2, 4 and 6 after the materials there is a trend to be more decided with less don't knows.

The teaching materials had a positive impact on the ability of students to describe the techniques of cloning and bioreactors, as seen in the results to the open questions Q9-11. The types of comments written in response to _gQ8. What is different between animal bioreactors from domestic animals for eating?_h were categorized into several categories and the results before and after exposure were: Describing purpose (N=3, N=4); Unnatural (N=3, N=4); Animal concerns (N=3, N=4); To eat or not (N=3, N=4); Genes (N=3, N=4); Use (N=3, N=4); Don_ft know (N=3, N=4); Same (N=3, N=4).

Before the exposure 54% could not describe cloning (Q9), but after exposure 92% gave a correct answer describing cloning (Chi squared=11.733, p<.01, N=24). Before the exposure 67% could not describe the purpose of cloning (Q10), but after exposure 79% gave a correct answer (Chi squared=10.243, p<.01, N=24). In response to Q11 on the positive and negative aspects of cloning, before the exposure to the teaching materials, 50% could not answer, and 4% (1 student) expressed both positive and negative points. After exposure, only 8% could not answer, and 75% (18 student) gave both good and bad points. This ability to consider both sides suggests that the materials were balanced.

Table 1: Reasoning about pigs to produce blood clotting factors

Q1.Hemophilia is a disease where people cannot stop bleeding. Do you accept to make a pig to make the medicine for humans? Give your reasons.

# answer pretest comment posttest comment
3503 DK to 2 I think humans can effectively use an organ from pig. If that is OK, it is good. But what do pigs become? I do not know detail, so I cannot say it is good or bad. If my family or friends are hemophiliac and they get well by using this drug, I want this drug. But I do not know if it is good or bad ethically.
3510 2 to 4 I think sorry for the pig, but we must protect human beings because we are the same species. We don_ft have a right to use pigs for humans.
3511 1 to 4 It is sorry that people die by losing much blood. The pig thinks why we must make the human organ. I disagree that just humans feels good by making another animal produce drugs. I feel that animals are tools of humans.
3517 DK to DK Many patients may be saved by using this drug, but because some problems will cause. Many patients may be saved by using this drug, but because some problems will cause.
3522 2 to 2 If the drugs are good drugs, it is acceptable. If the drugs are good drugs, it is acceptable.
3523 1 to 1 I hate this logic very much, but humans value life over ethics, so these things are acceptable. These things are acceptable, because many people have suffered from hemophilia. I think that people who say they are sorry for pigs are hypocrites. Human beings have lived by killing other creatures.
3524 2 to 2 There is nothing for it but to do it for saving many patients. If many patients will be saved, There is nothing we can do but to use drugs from pigs.
3525 1 to 1 I think it is good, if this drug is useful. I don_ft like these things, but I think it is good, if this drug is useful.
3526 DK to DK I don_ft know whether there are some harms. Many patients may be saved by using these drugs, but I don_ft know to what extend we can modify animals. And I think that if we say we are sorry for the pigs, we cannot eat meat.
3530 DK to 2 I don_ft know how to use drugs and to make drugs in pigs. There is no choice but to use drugs from pigs for treating hemophilia
3531 DK to 3 I don_ft know whether it influences the pigs badly or not. I think humans ignore the ecosystem of pigs.
3532 2 to DK If we can treat by the drugs, I think it is OK even if from pigs. It may be OK that curative medicine are made. But I don_ft know whether it is good or not to make pigs producing human drugs, because even pigs are living.
3537 2 to 3 If there is no problem, it is OK to make drugs from pigs or another animal. I oppose this project, because pigs are no longer pigs by injecting another species gene.
3540 2 to 2 I think it_fs OK whether the drug is from humans or pigs, because of the drug is to treat disease. I dislike to say that we should make pigs producing the drug, but I think it_fs good because it is not killing pigs and it is saving human life.
3541 DK to 3 I don_ft know whether it is safe or not. We don_ft know what happen after we use the drug.
3543 DK to 1 Why do they use pigs? I cannot say I agree or not because I don_ft have special knowledge. If the drug is safe, I think it_fs OK.
3545 1 to 1 If humans are saved, there is nothing for it but to use the drug. If humans are saved, I think that we must do more and more.
3602 1 to 2 I think that we should thank pigs for making the drug. I feel a little reluctant that just human are saved, so I think that it_fs not so acceptable.
3606 DK to 4 Because we cannot know the result of using the drug. Because I feel it_fs not OK.
3607 2 to 2 If the drug is useful, to suit the human body, and there is not a side effect, I think it is better than using a drug given the fear of infection of HIV from human. I think it_fs OK, if there is no problem of discrimination and the drug is safe. But if pigs are killed, I think it_fs not OK.
3623 2 to 1 Because there is no choice but to use the drug, if there is no other way of treatment. I think the drug from pigs is OK, if there are no problems.
3630 DK to 4 Because I don_ft know how to make in pigs. Because humans are selfish.
3632 DK to 4 Because I don_ft know what is the drug from pigs. Because I don_ft know what the bad effects of the drug are, and whether there is something to worry about.
3718 1 to 1 If I become hemophiliac, I want drugs even from pigs. Because it_fs better to use than to die.
_@

Table 2: Reasoning about pigs as human heart donors

Q3. Do you accept making a pig to make a heart adapted to humans? (Q3) Give your reasons.

# answer pretest comment posttest comment
3503 DK to 2 I think humans can effectively use an organ from pig. If that is OK, it is good. But what do pigs become? I do not know detail, so I cannot say it is good or bad. I think it's good if the heart from pigs is useful, but I think we treat pigs as things not creatures. But I agree because I want to cure a disease.
3510 2 to 4 Because I need a heart from pigs if my family has heart disease. I think we cannot kill pigs for human needs.
3511 1 to 4 Because pigs are useful for humans. Pigs are pigs, humans are humans. So I think making human hearts in pigs is a mistake. Because the species themselves have the best adapted organs for the species. So we like to break the rule of the world, I think.
3517 DK to DK Many patients may be saved by using this heart, but bI don't know because some problems will be caused. Because while many patients may be saved by using this heart, we don't know whether it is safe or not.
3522 2 to 2 If the heart is useful, and there is no harm, it is acceptable. Because there are patients who need the heart.
3523 1 to 1 If patient actions are restricted by heart disease all their life, I think its acceptable to use the pigs heart. These things are acceptable, because many people have suffered. I think that people who say they are sorry for pigs are hypocrites. Human beings have lived by killing other creatures.
3524 2 to 2 I have doubts about whether we should use hearts from pigs, I think it is good to study about making human hearts in pigs. If many patients will be saved, it's OK.
3525 1 to 1 Sorry for pigs, but I think it is good, because humans are saved. Sorry for the pigs, but I think it is good, because humans are saved. Mo matter how we oppose this project, I think the heart from pigs will be made.
3526 DK to DK Because I don_ft know all the details. I know about the shortage of organs, but I don't know whether we can use pigs for human benefit or not.
3530 DK to 2 Because I don_ft know whether it is safe or not. If there is no choice but to use hearts from pigs I agree.
3531 DK to 3 Because I don_ft know some details. Because I think it is terrible that humans use pigs for survival.
3532 2 to DK If we can treat by the drugs, I think it is OK even if from pigs. Many patients may be saved, but I wonder whether humans should do such things if I think of the pigs.
3537 2 to 4 If there are no problems, it is OK to have a heart from pigs. We must get organs from humans. I oppose this project changing the genes of pigs.
3540 DK to 3 Because I worry whether the heart that continues to move in my body works correctly. When I saw the video about a man whose life was saved by using heart from pigs temporarily, I feel it's very good. But I cannot agree because I am sorry for the pigs.
3541 DK to 4 Because I don_ft know whether it is safe or not. Because I am worry about rejection reaction.
3543 DK to 2 Because I don_ft know whether it is safe or not. We cannot help making organs from pigs, because there is a shortage of organs. So it's OK.
3545 1 to 1 If humans are saved, there is nothing for it but to use the heart. If humans are saved, I think it's very much acceptable.
3602 DK to 2 I think that skins or something else is OK, but the heart is a main body part. So it's dangerous to use the heart from pigs, isn't it? I feel a little reluctant that human change another animals' genes.
3606 4 to 2 Because I feel it is unpleasant. Because I think it's good to study about these things for our future.
3607 DK to 4 If humans use the heart from pigs, I think that humans kill pigs only in order to get the heart. If pigs have their heart removed, the pigs die. I think humans must not kill another animals only for reasons of egoism, it is hypocrisy.
3623 3 to 1 Because I somehow worry. If there are no problems, it's acceptable even from pigs.
3630 DK to 4 Because I don_ft know how to make in pigs. Because pigs should live a pigs life.
3632 DK to 3 Because I don_ft know how to make heart in pigs. Because I think there are some differences between a pig's heart and human one.
3718 2 to 1 If there is no problem, it's OK. Because it_fs better to use it than to die.
_@

Table 3: Trends in acceptance before and after teaching materials

Q2.If you have hemophilia, do you accept to use this drug from pigs?

Q4.If you have heart disease, do you accept to use heart transplantation from a pig?

Q6.If someone who is not very closely connected with you has heart disease, do you accept them to use heart transplantation from pigs?

Q7. Do you accept to continue this research?

Abbreviations and coding: Pre=before teaching materials; Post=after teaching material
# Pre2 Post2 Pre4 Post4 Pre6 Post6 Pre7 Post7
3503 DK 2 DK 2 DK 2 2 1
3510 2 4 2 3 1 3 3 4
3511 1 4 DK DK DK DK 1 4
3517 4 4 DK DK DK DK 4 4
3522 2 DK 2 DK 2 2 2 2
3523 1 1 1 2 4 DK 1 1
3524 DK 2 DK 2 DK 2 2 2
3525 1 1 1 1 1 1 1 1
3526 DK DK DK DK DK DK DK DK
3530 DK 2 DK 2 DK 1 1 1
3531 DK 4 DK DK DK DK DK 3
3532 2 DK 1 DK 1 DK 1 DK
3537 2 DK DK 4 DK 3 1 3
3540 2 2 DK 3 DK 3 1 3
3541 DK 4 1 2 1 2 1 1
3543 DK 2 DK 2 DK 2 1 1
3545 1 1 1 1 1 1 1 1
3602 1 1 2 2 2 2 1 DK
3606 4 4 DK DK DK 1 1 1
3607 2 2 DK DK DK 3 2 DK
3623 2 2 DK 1 DK 1 1 1
3630 DK 4 DK DK DK DK DK DK
3632 DK 4 DK 3 DK 3 DK 4
3718 1 1 1 1 1 1 1 1
Total (%)
Approve 54 50 38 46 33 50 75 50
Disapprove 9 33 0 16 4 21 9 29
Don_ft know 37 16 62 38 43 29 16 21
Discussion

 From the range of comments given we can see that the ethical problems, or dilemmas, biotechnology poses do generate interest in students. However, limited class teaching time meant that only one of the total of twelve teachers who completed this survey was able to administer the questionnaire a second time. The results of the survey on 576 persons show 41% agree with production of clotting factors in pigs but only 26% agreed with use of pig hearts, but half thought the research should continue.

High school students will become future citizens. The techniques of animal bioreactors and cloning are expanding, and we can expect much wider use in the future. The citizens will have to make decisions about these problems from a broad view point and we can see from these results that some students developed new ideas in response to the materials, and in this case the materials appear to have made more students consider the question from the point of view of the animals. When people make a decision, they always need ethical assessment based on sound science. This study provides some baseline for comparison and testing of alternative teaching materials.

There are two groups of people seen in the "Don't know" responses as revealed from the reasoning they gave. Some people lack information, but others are unsure because of the nature of the moral dilemma. In Q1 after the teaching material there were 9 moves to the negative and 4 to the positive. Some people shifted from their earlier "Don't know" response to positive or negative; while a few others perhaps started to think more deeply so they shifted in the reverse direction.

When compared to the results of the Biocult survey (Macer et al. 1997; Komatsu & Macer, 2000) we can see young people have ability to reason about these developments. These also suggests they can make decisions about moral dilemmas they face in their life, and we have to consider how early they can be asked to make moral decisions about medical treatment.

References

 Amemiya, K. & Macer, D. Environmental education and environmental behaviour in Japanese students, EJAIB 9 (1999), 109-115.

Barman C. R. (1980), Four values education approaches for science teaching, The American Biology Teacher, 42, 152-156.

I. Wilmut, A. E. Schnieke, J. McWhir, A. J. Kind & K. H. S. Campbell (1997), Viable offspring derived from fetal and adult mammalian cells., Nature 385, 810-813.

Komatsu, H. & Macer, D. Expectations of biotech of Japanese high school students in 1998, EJAIB 10 (2000), 142-56.

Darryl Macer, Bioethics for the People by the People (Eubios Ethics Institute 1994).

Darryl Macer et al. Bioethics in High Schools in Australia, Japan and New Zealand (Eubios Ethics Institute 1996).

Macer, D. , Obata, H., Levitt, M., Bezar, H. & Daniels, K. Biotechnology and young citizens: Biocult in New Zealand and Japan EJAIB 7 (1997), 111-114.

Oka, T. & Macer, D."Change in high school student attitudes to biotechnology in response to teaching materials", pp. 92-97 in Bioethics Education in Japanese High Schools (in Japanese) (Eubios Ethics Institute, 2000).

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