Reproductive Technology, Screening and Genetics in Taiwan: Centennial Profile (1902-1997)

- Yu Shi Ang, Ph.D.
Department of Health Care Management
Chang Gung University
259 Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan, Taiwan
Email: yushi@mail.cgu.edu.tw
Eubios Journal of Asian and International Bioethics 9 (1999), 99-101.


Modern medicine has been systematically introduced into Taiwan by Japan about one century ago. Medical study in Taiwan has been incessantly carried on since then, and outcomes published both domestically and abroad. The biotechnology research related to reproductive technology, screening and genetics (RTSG) has never been studied bibliographically. By taking the advantage of Taiwan's rich databases of medical study, this research attempts to not only delineate a centennial profile of RTSG in Taiwan, but also serves as the technological fundamentals for the project " A Comparative Study of the Interaction between Biomedical Law and Policy-making in Taiwan, Japan, USA, UK " [1].

RT could be classified from its technological feature into two categories: (1) contraception in a broad sense to avoid and terminate conception (including contraceptive devices, ligation, sterilization, induced abortion etc.), (2) proception to promote and facilitate conception (including assisted reproductive technology (ART), cryopreservation of gametes or zygotes, etc.). SG are technologies that have implications for betterment of conception, although its application might incur controversial ELSI like reproductive technology. RTSG could be regarded as a spectrum of cross-generation biotechnology. That's why RTSG is taken as a priority study in our project.

The papers concerning RTSG and related ELSI of Taiwan listed in the speeches, reviews, original paper, case report, brief communication, and supplements of each journal were collected from domestic medical journals from 1902 to 1997 (Table 1). Until 1960's, most of medical study including RTSG in Taiwan were published domestically. Papers from Taiwan published abroad were collected by searching Medline from 1966 to 1997. By combining these domestic and foreign databases of RTSG and related ELSI in Taiwan, a comprehensively centennial picture is obtained. The number of papers of RTSG and related ELSI were 1293 and 38, respectively. From July 1999, RTSG in Taiwan could be accessed in biormosa.cgu.edu.tw (abbreviation of "biotechnology of Formosa") homepage on-line site. Every paper of RTSG is then reviewed and classified into one of three categories according to its technological feature.

Until the first half of 1950's, the Journal of the Formosan Medical Association has been the only one medical journal in Taiwan, where almost all medical studies has been published [2]. From inception of this century until 1950's, the major part of medical study in Taiwan has been concerned with the infectious diseases, anthropometry, snake venom, and opium. There were only 12 case reports concerning genetic diseases such as alkaptonuria (1912), congenital teratoma (1922), Laurence-Moon-Biedle syndrome (1940), and albinism (1942) which were diagnosed posnatally and pathologically. The concept of SG were still in its primodial stage. There have been no RT papers in the same period.

Table 1: Major Medical Journals in Taiwan with Reproductive Technology, Screening and Genetics

Date of first issue Title of Journals

1902 Sep. Journal of the Formosan Medical Association*

1954 Jan. Chinese Medical Journal(Taipei)*(resume)

1960 Apr. Acta Paediatrica Sinica(Taipei)*

1962 Feb. Taiwanese J. Obsterics & Gynecology

1977 Apr. Chang Gung Medical Journal*

1984 Dec. Journal of Medical Ultrasound

1985 Jan. Kaoshiung Journal of Medical Science*

1992 Jul. Journal of Reproduction and Infertility

*: listed in Medline in 1997

RT emerged in Taiwan in the 1950's. Artificial induction of abortion was first reported in 1950, and AIH and AID (donor insemination) in 1954. But until the 1980's, there were no remarkable increase of papers concerning RTSG (figure 1).

Coinciding with the first to fourth family planning period (July 1964 - June 1982) in Taiwan, contraception and SG were more considered than before (Figure 1). Medical study concerning contraception seemingly meet socio-political needs in the same period. SG made use of amniocentesis, echography, cytogenetic methods started to be the object of study, leading to the exponential increase of publication in the ensuing years.

From the 1980's to 1990's, medical study of proception, screening and genetics in Taiwan experienced an exponential increase of publication, and contraception became less and less the object of study. The publication of the Journal of Reproduction and Infertility in 1992 symbolized this phenomenon, which published a major portion of proception, in Taiwan. The time lag of the first report of major ART between Taiwan and world has been shortened (figure 2). The introduction of ART into Taiwan showed that its assimilation speed became more and more faster, leading to the fact that every brand-new reproductive technology, in keeping pace with world, could be executed in Taiwan.

To sum up, there had been some knowledge of SG in Taiwan until 1950's. From 1960's to 1980's, contraception has been more concerned, and SG started to attract more attention of researchers. In 1990's, proception and SG have been the leading part of RTSG in Taiwan. SG would comprise the major part of RTSG in the future.

"A Comparative Study of the Interaction between Biomedical Law and Policy-making in Taiwan, Japan, USA, UK" about RTSG is in progress. One of point of interest is that RTSG in Taiwan has caught up with world-wide trends, so now we can compare any differences in related laws and law-making. The results of our studies would be presented.

References

1. Hung YS: Frontier program of medical gene research in Taiwan. EJAIB 9 (1999), 9.
2. Hung YS, Hung TP: [Journal of the Formosan Medical Association: publication profile from 1902 to 1997]. [Chinese] Formosan Journal of Medicine 1998;2(6):607-15.


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