Public, Experts, and Acceptance of Advanced Medical Technologies: The Case of Organ Transplant and Gene Therapy in Japan

What do people think about genetic engineering? A systematic review of questionnaire surveys before and after the introduction of CRISPR

The advent of CRISPR-Cas9 in 2012 started revolutionizing the field of genetics by broadening the access to a method for precise modification of the human genome. It also brought renewed attention to the ethical issues of genetic modification and the societal acceptance of technology for this purpose. So far, many surveys assessing public attitudes toward genetic modification have been conducted worldwide. Here, we present the results of a systematic review of primary publications of surveys addressing public attitudes toward genetic modification as well as the awareness and knowledge about the technology required for genetic modification. A total of 53 primary publications (1987-2020) focusing on applications in humans and non-human animals were identified, covering countries in four continents. Of the 53 studies, 30 studies from until and including 2012 (pre-CRISPR) address gene therapy in humans and genetic modification of animals for food production and biomedical research. The remaining 23 studies from after 2013 (CRISPR) address gene editing in humans and animals. Across countries, respondents see gene therapy for disease treatment or prevention in humans as desirable and highly acceptable, whereas enhancement is generally met with opposition. When the study distinguishes between somatic and germline applications, somatic gene editing is generally accepted, whereas germline applications are met with ambivalence. The purpose of the application is also important for assessing attitudes toward genetically modified animals: modification in food production is much less accepted than for biomedical application in pre-CRISPR studies. A relationship between knowledge/awareness and attitude toward genetic modification is often present. A critical appraisal of methodology quality in the primary publications with regards to sampling and questionnaire design, development, and administration shows that there is considerable scope for improvement in the reporting of methodological detail. Lack of information is more common in earlier studies, which probably reflects the changing practice in the field.

User Diversity as a Challenge for the Integration of Medical Technology into Future Smart Home Environments

Facing the growing aging population in many countries of the world, healthcare-related technologies become increasingly important, representing a possible solution to the soaring overstrained health care systems and dwindling number of caregivers. Though a user-centred and sensible integration of medical technology in home environments is highly challenging, especially when focusing on the group of old and frail users. Their specific needs and wants, their (dis)abilities and limitations have to be carefully considered, in order to reach full acceptance and a successful rollout of e-health applications in home environments. As the knowledge about acceptance in the medical sector is still limited, an elaborate research is needed in order to understand and respect aged persons’ specific demands. In an empirical approach, the role of age, technology generation, technical expertise, and gender are determining for the acceptance of medical technologies. As the acceptance of medical technologies might be also biased by social norms and the way aging and age-related consequences are evaluated within a society, individual ageing concepts as well as economic and educational levels were considered for the evaluation of the perceived benefits and drawbacks of medical technologies. Outcomes show the importance of understanding users’ needs and wants in order to develop user-centred medical technology concepts and to allow a successful rollout.