**3. Hopes and fears surrounding biotechnology**

It's interesting to confirm the importance of dividing the temporal period of perception into before and after 1999. With the exception of Holland and Germany, the majority of European countries tend to maintain low levels of optimism regarding biotechnology, or show a drop in it. Nevertheless, with the exception of Austria, all European countries tend to maintain optimism about biotechnology in the second period, especially in Spain at 75 points, with Malta at the maximum with 81 and Greece at the minimum with 19. As such, the given explanations must offer an account of both movements, without having to be exclusively at the national level (European Commission, 2005a).

This inflection also marks a change in stages of development: from Science Literacy during the period of 1960 – 1980 and Public Understanding between 1985 and the 1990s, to Sciencein-Society from the 1990s to the present. The changes in these stages have come with controversies that demand a revision of agendas and discourses. Specifically, the Science-in-Society period emerges from the lack of trust following crises such as the controversy around genetically-modified food. As such, activists begin to proliferate whose analysis and investigations are their way of intervening in technological processes. The idea is to change scientific policy.


Table 1. Paradigms, Problems and Solutions (Bauer, 2009)

One of the ways to explain this change is the concern about genetically-modified food in the first period, and the explosion in biomedical investigation, with its promise to cure illnesses, like the case of investigation into stem cells, in the second period.

To a large degree, all the segments analyzed cite medicine and health as the priority sector in which to concentrate investigative efforts, although it is cited more by women (82.5%). When dealing with questions related to science and technology, the institutions that inspire the most trust (on a scale of 1 "very little" to 5 "much") are Hospitals (4.16) and Universities (4.07). Next come Public Organizations for Investigation (3.79) and Professional Colleges

It's interesting to confirm the importance of dividing the temporal period of perception into before and after 1999. With the exception of Holland and Germany, the majority of European countries tend to maintain low levels of optimism regarding biotechnology, or show a drop in it. Nevertheless, with the exception of Austria, all European countries tend to maintain optimism about biotechnology in the second period, especially in Spain at 75 points, with Malta at the maximum with 81 and Greece at the minimum with 19. As such, the given explanations must offer an account of both movements, without having to be

This inflection also marks a change in stages of development: from Science Literacy during the period of 1960 – 1980 and Public Understanding between 1985 and the 1990s, to Sciencein-Society from the 1990s to the present. The changes in these stages have come with controversies that demand a revision of agendas and discourses. Specifically, the Science-in-Society period emerges from the lack of trust following crises such as the controversy around genetically-modified food. As such, activists begin to proliferate whose analysis and investigations are their way of intervening in technological processes. The idea is to change

**Period Attribution diagnosis Strategy research** 

Trust deficit Expert deficit Notions of public Crisis of confidence

One of the ways to explain this change is the concern about genetically-modified food in the first period, and the explosion in biomedical investigation, with its promise to cure illnesses,

Public deficit knowledge Literacy education

Public deficit attitudes Know x attitude

Attitude change Education Public relations

'Angels' mediators Impact evaluation

**3. Hopes and fears surrounding biotechnology** 

exclusively at the national level (European Commission, 2005a).

(3.75).

scientific policy.

Science literacy 1960s-1980s

Public understanding 1985s-1990s

Science-in-Society 1990s-present

Table 1. Paradigms, Problems and Solutions (Bauer, 2009)

like the case of investigation into stem cells, in the second period.

Graph 2. Generalised technological optimism and pessimism. Maximum: 8 (European Commission, 2010a)

Crossings on Public Perception of Biomedicine: Spain and the European Indicators 191

pharmaceutical corporations, feigning a certain control over all of them at once. Or even Monsanto, which appears to want to encapsulate an integrated vision of chemical activities, seeds and pharmaceutical activities united with the farmer. Something which favors investors, that is, having a unified image of the technological process and its

Quantitative studies showed the ambivalence of the perception in Spain. In them it can be confirmed how Spaniards maintain a positive image of science and technology and the professionals involved in these areas (European Commission, 1993; Moreno, 1996). In the Eurobarometers, these types of perceptions are also maintained (Marlier, 1991). It is the same in comparative analyses, where scientific work is considered fundamental to improve

But one of the principal points of ambivalence detected in this first period refers to the consumption of genetically-modified food. Despite the optimism shown toward science and technology, more than 76% of Spaniards reject genetic engineering, and 72.1% are against its application for human consumption. One of the reasons can be found in the gastronomic culture, which doesn't much accept industrially treated foodstuffs. Also influential were the controversies over poisoning from the ingestion of colza oil not suitable for human consumption. On the other hand, in this period of analysis, the Eurobarometer never asked about the evaluation of the application on different organisms, nor about obtaining different products. Rather, it described a generic type of investigation by way of some examples and questions about the level of agreement or disagreement with affirmations like "investigation (on plants, microorganisms and farm animals) should be supported." That is, they asked about the processes and not about the products of investigation. Moreover, when the question was about support for applications of biotechnology and genetic engineering on different types of organisms, a moral evaluation was made; and when the question was about a specific application, its utility was evaluated. Hence, the ambivalence is the result of the conflict between evaluation of the process and evaluation of the product. So, while the application of genetic engineering on plants and foods received a positive moral evaluation,

the usefulness of the products obtained from these processes lacked support.

 *"Question (Q): Do you agree that genetic manipulation should be used for. . . ?"*  "Yes" "No" Diagnoses for hereditary diseases 96.2 3.8 Herbicide resistant plants 69.5 30.5 New gene therapies 66.6 33.4 Bigger fish for consumption 27.8 72.2 Faster growing livestock 23.8 76.2

Table 2. Attitudes towards applications of genetic engineering (IESA, 1990 in Luján and

products (Bauer, 2002).

Unit: percentages.

Todt, 2000)

the conditions of life (Bauer & Schoon, 1995).

#### **3.1 The genetically-modified food controversy**

During the decade of the 90s, the image of biotechnology was changing. On one side, the controversy on the distribution of genetically-modified food began. One of the milestones in the debate was importations of genetically modified soy, such as Roundup Ready soy from Monsanto in 1996. The analysis and contrast of different studies made at the European and national level on public perception of biotechnology has been an object of study of previous researches. The ambivalence reflected in the work of Luján & Todt (2000) lies in the difference in the response to moral evaluations of a general type and the attitudes maintained towards specific products. This responds in part to the fact that at the center of the controversy on the regulation of genetic engineering are questions such as if the processes or products are the same or not, if they are substantially or functionally equivalents, and if the techniques are old or new.

The first results of the Eurobarometers in the 1990s celebrated the idea that the public perceived distinctions between diverse biotechnologies. At the same time, regulations throughout Europe were distinguishing between agri-foodstuff technologies and biomedical applications. The regulation of foodstuffs and pharmaceutical products has led to the establishment of procedures which are institutionalized in diverse organizations, unlike the process in the United States with its Food and Drug Administration. Thus, the European Food Safety Authority (EFSA) was set up in January 2002, following a series of food crises in the late 1990s, as an independent source of scientific advice and communication on risks associated with the food chain. For its part, the European Medicines Agency is responsible for the scientific evaluation of medicines developed by pharmaceutical companies for use in the European Union. In Spain, the Spanish Food Safety and Nutrition Agency (AESAN in Spanish) was created in 2001 with the mission to "guarantee the highest level of food safety as a basic aspect of public health and to promote the health of citizens so that they have full confidence in the food they eat and adequate information available to be able to choose2. Whereas the Spanish Agency for Medicines and Health Products (AEMPS in Spanish) is "responsible for guaranteeing for society, from a public service perspective, the quality, safety, efficiency and correct information of medicines and health products, from their investigation to their utilization, in the interest of protecting and promoting the health of people, animals and the environment.3"

On the other hand, the allocation of funds for investigation is delegated to different organisms that project diverse images of biotechnology. This recognition of the distinct attitudes of the public and of the diverse institutions involved in these technologies contrasts with any type of unifying discourse that can be found in other fields. Or, for example, the declared support of the majority of governments for biotechnology as a "strategic technology for the 21st century." Or when they speak from a sociological standpoint of a "genetic revolution"or of "bioeconomics." That is, phases where it is biotechnologies that would define the future of our societies. One of the umbrella concepts under which diverse interests await is that of "life sciences." It's a concept promoted to cover the university scientific community as well as small companies and

<sup>2</sup> http://www.aesan.msc.es/AESAN/web/sobre\_aesan/sobre\_aesan.shtml. Last consulted in September 2011.

<sup>3</sup> http://www.aemps.gob.es. Last consulted in September 2011.

During the decade of the 90s, the image of biotechnology was changing. On one side, the controversy on the distribution of genetically-modified food began. One of the milestones in the debate was importations of genetically modified soy, such as Roundup Ready soy from Monsanto in 1996. The analysis and contrast of different studies made at the European and national level on public perception of biotechnology has been an object of study of previous researches. The ambivalence reflected in the work of Luján & Todt (2000) lies in the difference in the response to moral evaluations of a general type and the attitudes maintained towards specific products. This responds in part to the fact that at the center of the controversy on the regulation of genetic engineering are questions such as if the processes or products are the same or not, if they are substantially or functionally

The first results of the Eurobarometers in the 1990s celebrated the idea that the public perceived distinctions between diverse biotechnologies. At the same time, regulations throughout Europe were distinguishing between agri-foodstuff technologies and biomedical applications. The regulation of foodstuffs and pharmaceutical products has led to the establishment of procedures which are institutionalized in diverse organizations, unlike the process in the United States with its Food and Drug Administration. Thus, the European Food Safety Authority (EFSA) was set up in January 2002, following a series of food crises in the late 1990s, as an independent source of scientific advice and communication on risks associated with the food chain. For its part, the European Medicines Agency is responsible for the scientific evaluation of medicines developed by pharmaceutical companies for use in the European Union. In Spain, the Spanish Food Safety and Nutrition Agency (AESAN in Spanish) was created in 2001 with the mission to "guarantee the highest level of food safety as a basic aspect of public health and to promote the health of citizens so that they have full confidence in the food they eat and adequate information available to be able to choose2. Whereas the Spanish Agency for Medicines and Health Products (AEMPS in Spanish) is "responsible for guaranteeing for society, from a public service perspective, the quality, safety, efficiency and correct information of medicines and health products, from their investigation to their utilization, in the interest of protecting and promoting the health of

On the other hand, the allocation of funds for investigation is delegated to different organisms that project diverse images of biotechnology. This recognition of the distinct attitudes of the public and of the diverse institutions involved in these technologies contrasts with any type of unifying discourse that can be found in other fields. Or, for example, the declared support of the majority of governments for biotechnology as a "strategic technology for the 21st century." Or when they speak from a sociological standpoint of a "genetic revolution"or of "bioeconomics." That is, phases where it is biotechnologies that would define the future of our societies. One of the umbrella concepts under which diverse interests await is that of "life sciences." It's a concept promoted to cover the university scientific community as well as small companies and

2 http://www.aesan.msc.es/AESAN/web/sobre\_aesan/sobre\_aesan.shtml. Last consulted in

3 http://www.aemps.gob.es. Last consulted in September 2011.

**3.1 The genetically-modified food controversy** 

equivalents, and if the techniques are old or new.

people, animals and the environment.3"

September 2011.

pharmaceutical corporations, feigning a certain control over all of them at once. Or even Monsanto, which appears to want to encapsulate an integrated vision of chemical activities, seeds and pharmaceutical activities united with the farmer. Something which favors investors, that is, having a unified image of the technological process and its products (Bauer, 2002).

Quantitative studies showed the ambivalence of the perception in Spain. In them it can be confirmed how Spaniards maintain a positive image of science and technology and the professionals involved in these areas (European Commission, 1993; Moreno, 1996). In the Eurobarometers, these types of perceptions are also maintained (Marlier, 1991). It is the same in comparative analyses, where scientific work is considered fundamental to improve the conditions of life (Bauer & Schoon, 1995).

But one of the principal points of ambivalence detected in this first period refers to the consumption of genetically-modified food. Despite the optimism shown toward science and technology, more than 76% of Spaniards reject genetic engineering, and 72.1% are against its application for human consumption. One of the reasons can be found in the gastronomic culture, which doesn't much accept industrially treated foodstuffs. Also influential were the controversies over poisoning from the ingestion of colza oil not suitable for human consumption. On the other hand, in this period of analysis, the Eurobarometer never asked about the evaluation of the application on different organisms, nor about obtaining different products. Rather, it described a generic type of investigation by way of some examples and questions about the level of agreement or disagreement with affirmations like "investigation (on plants, microorganisms and farm animals) should be supported." That is, they asked about the processes and not about the products of investigation. Moreover, when the question was about support for applications of biotechnology and genetic engineering on different types of organisms, a moral evaluation was made; and when the question was about a specific application, its utility was evaluated. Hence, the ambivalence is the result of the conflict between evaluation of the process and evaluation of the product. So, while the application of genetic engineering on plants and foods received a positive moral evaluation, the usefulness of the products obtained from these processes lacked support.



Table 2. Attitudes towards applications of genetic engineering (IESA, 1990 in Luján and Todt, 2000)

Crossings on Public Perception of Biomedicine: Spain and the European Indicators 193

debates on the use of human embryos for investigation, therapeutic cloning and the

3

Synthetic biology

Human enhancement

Xenotransplantation

Gene therapy

11

36

Fully approve Approve if strict laws to regulate Do not approve unless special circumstances Do not approve under any circumstances

Graph 3. Levels of approval of biomedical research and synthetic biology, EU 27 (European

In fact, although research with stem cells (embryonic or adult) appears to be an important source of knowledge to improve therapies and fight against illnesses, moral aspects exist that determine the support of some citizens for embryonic stem cell research. The policies of scientific popularization assume that a higher level of scientific knowledge among citizens can help in having greater support for investigation. In fact, some studies have shown that the opinion that citizens have about certain controversial investigative subjects, as is the case with stem cells (SC), isn't influenced by the information they receive but rather by moral or religious aspects (Nisbet, 2005). Nor does it seem correct to assume that a higher level of scientific knowledge is associated with more support for SC research. It's possible that individuals who are more informed have a firmer position, whether in favor or against SCs

In Spain, there is an average understanding of the properties of embryonic stem cells. According to the BBVA study, 2009, 41.9% of those surveyed knew that stem cells can be transformed into various types of different cells and change into specialized tissue like muscles or nerves, but didn't know that the extraction implies the destruction of embryos. Spain (along with the Czech Republic) is the country that most supports research with embryonic stem cells that are only a few days old, in hopes of finding effective treatments as soon as possible for illnesses such as Parkinson's, Alzheimer's or diabetes, at 6.8 (on a scale of 0 – 10 where 0 means complete disagreement and 10 means complete agreement). This can be interpreted to mean that acceptance increases when medical benefits are specified in possible treatments for illnesses that citizens consider important. And this is consistent with Spain being one of the countries that least considers research on days-old

44

46

52

51

54

21

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

20

17

18

18

17

15

17

22

7

7

8

7

7

17

11

13

9

11

11

12

15

generation of hybridoma cells.

Non embryonic stem cell research

Don't know

(Bauer, Allum y Miller, 2007).

Commission, 2010b)

Embryonic stem cell research

*"Q: Nowadays it is possible, for example, to introduce genes of corn in potatoes to increase their nutritional value. Would you be willing to consume this type of potatoes?"* 


Table 3. Attitude towards the consumption of transgenic products (Atienza & Luján, 1997)

*"Q: Please tell me whether you tend to agree or tend to disagree with the following statement: I would buy genetically modified fruit if it tasted better."* 


Unit: percentages.

Table 4. Attitude towards the consumption of transgenic products II (European Commission, 1996)

#### **3.2 The promise of stem cell research**

Biomedical investigation has had more support than agricultural applications of biotechnology, and has a huge social and economic impact. Its hopeful aspect as a cure for illnesses and improving people's quality of life has been influential in this. However, it appears that regenerative medicine, specifically, also arouses controversies and social, political and religious tensions.

As we see in Graph 3, levels of acceptation are high. Around 68% are favorable towards investigation with non-embryonic stem cells and 63% for the use of embryonic stem cells. However, it's not unconditional support. It varies by country and depends on the legislation and control that governments exercise over the investigations. It is limited by the subordination of research to its respective legislation and controls. In fact, approval percentages under strict laws reach 44% for human enhancement and 54% for investigations with non-embryonic stem cells. Thus, governance is essential in these investigations. And as such, regulation of stem cell investigation varies in European countries. A striking aspect of these investigations on an international level is the diversity they have achieved in a short period of time. There are many countries, like Israel, Sweden and Singapore, that concentrate their economic efforts in specific niches of these technologies. Others, like China and Korea, lacking experience in biomedical investigation and development, have constructed investigative installations that are competitive. Nevertheless, other countries like the United States, Germany and Australia, among others, have seen their investigations hindered due to religious and political

*"Q: Nowadays it is possible, for example, to introduce genes of corn in potatoes to increase their nutritional value. Would you be willing to consume this type of potatoes?"* 

Table 3. Attitude towards the consumption of transgenic products (Atienza & Luján, 1997)

*"Q: Please tell me whether you tend to agree or tend to disagree with the following statement: I would buy genetically modified fruit if it tasted better."* 

Biomedical investigation has had more support than agricultural applications of biotechnology, and has a huge social and economic impact. Its hopeful aspect as a cure for illnesses and improving people's quality of life has been influential in this. However, it appears that regenerative medicine, specifically, also arouses controversies and social,

As we see in Graph 3, levels of acceptation are high. Around 68% are favorable towards investigation with non-embryonic stem cells and 63% for the use of embryonic stem cells. However, it's not unconditional support. It varies by country and depends on the legislation and control that governments exercise over the investigations. It is limited by the subordination of research to its respective legislation and controls. In fact, approval percentages under strict laws reach 44% for human enhancement and 54% for investigations with non-embryonic stem cells. Thus, governance is essential in these investigations. And as such, regulation of stem cell investigation varies in European countries. A striking aspect of these investigations on an international level is the diversity they have achieved in a short period of time. There are many countries, like Israel, Sweden and Singapore, that concentrate their economic efforts in specific niches of these technologies. Others, like China and Korea, lacking experience in biomedical investigation and development, have constructed investigative installations that are competitive. Nevertheless, other countries like the United States, Germany and Australia, among others, have seen their investigations hindered due to religious and political

 Yes 39.6 No 48.3 DK/NA 12.1

Unit: percentages.

Unit: percentages.

(European Commission, 1996)

political and religious tensions.

**3.2 The promise of stem cell research** 

 Tend to agree 28 Tend to disagree 50 DK/NA 22

Table 4. Attitude towards the consumption of transgenic products II

debates on the use of human embryos for investigation, therapeutic cloning and the generation of hybridoma cells.

Graph 3. Levels of approval of biomedical research and synthetic biology, EU 27 (European Commission, 2010b)

In fact, although research with stem cells (embryonic or adult) appears to be an important source of knowledge to improve therapies and fight against illnesses, moral aspects exist that determine the support of some citizens for embryonic stem cell research. The policies of scientific popularization assume that a higher level of scientific knowledge among citizens can help in having greater support for investigation. In fact, some studies have shown that the opinion that citizens have about certain controversial investigative subjects, as is the case with stem cells (SC), isn't influenced by the information they receive but rather by moral or religious aspects (Nisbet, 2005). Nor does it seem correct to assume that a higher level of scientific knowledge is associated with more support for SC research. It's possible that individuals who are more informed have a firmer position, whether in favor or against SCs (Bauer, Allum y Miller, 2007).

In Spain, there is an average understanding of the properties of embryonic stem cells. According to the BBVA study, 2009, 41.9% of those surveyed knew that stem cells can be transformed into various types of different cells and change into specialized tissue like muscles or nerves, but didn't know that the extraction implies the destruction of embryos. Spain (along with the Czech Republic) is the country that most supports research with embryonic stem cells that are only a few days old, in hopes of finding effective treatments as soon as possible for illnesses such as Parkinson's, Alzheimer's or diabetes, at 6.8 (on a scale of 0 – 10 where 0 means complete disagreement and 10 means complete agreement). This can be interpreted to mean that acceptance increases when medical benefits are specified in possible treatments for illnesses that citizens consider important. And this is consistent with Spain being one of the countries that least considers research on days-old

Crossings on Public Perception of Biomedicine: Spain and the European Indicators 195

30

40

67

50

0 10 20 30 40 50 60 70 80 90

2010 2005

Graph 4. Levels of approval for human embryonic stem cell research, 2005 and 2010.

EU27 UK Spain Denmark Estonia Netherlands France Belgium Sw eden Portugal Hungary Italy Finland Greece Ireland Luxemburg Lithuania Latvia Malta Poland Cyprus Czech Republic Germany Slovekia Slovenia Austria Romania Bulgaria Iceland Norw ay Turkey Sw iterland Croatia

% of respondents (European Commission, 2010b)

53 53 55

56 53 51

66

65

66 66

> 77 79

74

75

77 74

63

59 60

53

58 57 54

embryos as being an unacceptable interference in the natural processes of life (4.9; only Denmark is lower, 4.7).

Spain is also one of the countries where research with embryonic stem cells is considered very useful (6.4 on a scale of 1-10, only superseded by Denmark and Sweden, 7.0) and isn't imbued with important risks (5.0), superseded only by Denmark (5.5), Holland (5.2) and the Czech Republic (5.1). The idea of usefulness is quite established, although this doesn't suppose the disappearance of the perception of risk or immorality. Only in certain countries (such as Austria, Germany and Poland) is immorality a more significant feature than usefulness, according to BBVA, 2009.

The financial restrictions on embryonic stem cell research in the United States may have inspired other countries, many of them in Asia, to promote this investigation through specific initiatives for regulations and financing. In spite of the limitations on federal financing, the United States has developed good alternatives such as, for example, through industry or philanthropic investment. In Europe, nevertheless, many countries show strong support for stem cell research. A good example of this is the United Kingdom and their efforts to create transparent policies. Their main installations are located in London, Cambridge and Edinburgh. Sweden has developed dozens of cell lines, carrying out the first studies on the transplant of fetal cells in the treatment of Parkinson's disease, thus stimulating the use of these cells in the treatment of neurodegenerative disorders. Germany, which has legal barriers on research done with embryonic stem cells, has established excellent centers in Berlin and Munich for the study of somatic cells and their potential use in regenerative medicine.

Cooperation and diffusion among countries is one of the characteristics of this research at the European level. The European Science Foundation launched a program, *EuroStells*, for the analysis of comparative research between stem cells obtained from different sources. The *Sixth Framework Programme* backed the development of a database for embryonic stem cells. Currently, scientists and communicators from 90 laboratories are gathered for the *VIIth Framework Programme* to do collaborative work. Nevertheless, European policies haven't managed to smooth over the different policies between countries.

The governments of many countries in Asia and Oceania have demonstrated extraordinary support for the development of stem cells and their application. China, Korea, Singapore, India and Taiwan have invested in this research since 2001. Japan and Australia have built large foundations in basic biology and clinical development in order to create the main stem cell institutes in Kyoto, Kobe and Melbourne. In 2007, a research network was created between Asia and the Pacific (SNAP), launched by scientists in eight countries, but without reaching competitive levels. At the national level, many of the Asian countries have organized strong national societies, which is the case in Singapore, Taiwan and Korea.

Graph 4 shows the level of support that embryonic stem cell research had between 2005 and 2010. Around 55% of people in 19 countries support this research. Support has risen eight points or more in Estonia, Finland, Greece, Ireland, Latvia and Slovenia. On the other side, it has gone down another eight points or more in Hungary, Italy, Poland, Cyprus, the Czech Republic, Germany, Slovakia and Austria. As such, the graph points to future controversies.

embryos as being an unacceptable interference in the natural processes of life (4.9; only

Spain is also one of the countries where research with embryonic stem cells is considered very useful (6.4 on a scale of 1-10, only superseded by Denmark and Sweden, 7.0) and isn't imbued with important risks (5.0), superseded only by Denmark (5.5), Holland (5.2) and the Czech Republic (5.1). The idea of usefulness is quite established, although this doesn't suppose the disappearance of the perception of risk or immorality. Only in certain countries (such as Austria, Germany and Poland) is immorality a more significant feature than

The financial restrictions on embryonic stem cell research in the United States may have inspired other countries, many of them in Asia, to promote this investigation through specific initiatives for regulations and financing. In spite of the limitations on federal financing, the United States has developed good alternatives such as, for example, through industry or philanthropic investment. In Europe, nevertheless, many countries show strong support for stem cell research. A good example of this is the United Kingdom and their efforts to create transparent policies. Their main installations are located in London, Cambridge and Edinburgh. Sweden has developed dozens of cell lines, carrying out the first studies on the transplant of fetal cells in the treatment of Parkinson's disease, thus stimulating the use of these cells in the treatment of neurodegenerative disorders. Germany, which has legal barriers on research done with embryonic stem cells, has established excellent centers in Berlin and Munich for the study of somatic cells and their potential use

Cooperation and diffusion among countries is one of the characteristics of this research at the European level. The European Science Foundation launched a program, *EuroStells*, for the analysis of comparative research between stem cells obtained from different sources. The *Sixth Framework Programme* backed the development of a database for embryonic stem cells. Currently, scientists and communicators from 90 laboratories are gathered for the *VIIth Framework Programme* to do collaborative work. Nevertheless, European policies haven't

The governments of many countries in Asia and Oceania have demonstrated extraordinary support for the development of stem cells and their application. China, Korea, Singapore, India and Taiwan have invested in this research since 2001. Japan and Australia have built large foundations in basic biology and clinical development in order to create the main stem cell institutes in Kyoto, Kobe and Melbourne. In 2007, a research network was created between Asia and the Pacific (SNAP), launched by scientists in eight countries, but without reaching competitive levels. At the national level, many of the Asian countries have organized strong national societies, which is the case in Singapore, Taiwan and Korea.

Graph 4 shows the level of support that embryonic stem cell research had between 2005 and 2010. Around 55% of people in 19 countries support this research. Support has risen eight points or more in Estonia, Finland, Greece, Ireland, Latvia and Slovenia. On the other side, it has gone down another eight points or more in Hungary, Italy, Poland, Cyprus, the Czech Republic, Germany, Slovakia and Austria. As such, the graph points to future controversies.

managed to smooth over the different policies between countries.

Denmark is lower, 4.7).

in regenerative medicine.

usefulness, according to BBVA, 2009.

Graph 4. Levels of approval for human embryonic stem cell research, 2005 and 2010. % of respondents (European Commission, 2010b)

Crossings on Public Perception of Biomedicine: Spain and the European Indicators 197

chronic illnesses or disabilities, whose current medical treatment doesn't offer a solution. As a result, patients and their families spend many hours surfing the internet looking for stem cell treatments for their particular illness. They're attracted by advertisements on the internet, blogs, articles in national and local magazines and other press, while treatments are publicized as having been successful in Mexico, Russia, India, China, Africa and other countries. Often they'll find not one, but dozens of options, generally in countries where there isn't legislation that controls the activity. Clinics also know how to change their name and country quite rapidly if there's an attempt to discredit them. A patient's secondary effects are often difficult to prove, patients are reluctant to show they've gotten worse, and they rarely admit that they have not benefited from the treatment. One of the reasons is the feeling they have of having paid a huge sum of money for something that hasn't worked, or also the placebo effect that for some ailments can lead to significant, if temporary,

The report from 2010 seems to open a third period of falling optimism between 2005 and 2010, at least by one point, as can be seen in Graph 6 (European Commission, 2010). We can continue talking about optimism, but the changes that arise in biotechnology and genetic engineering, and the tendencies the surveys are currently showing, is what especially interests us. If we pay attention to Graph 6, the rise in optimism for wind, solar and nuclear energy in this last period contrasts with the fall in optimism for Computers and Information

Graph 6. Trends in the optimism index of certain technologies (European Commission,

improvements.

2010a)

**3.3 A future third period?** 

One of the factors not included in the Eurobarometer, but adds clues to the perception of this type of research, is the evaluation of the use of induced pluripotent stem cells (iPS), which would avoid the use of embryonic cells and, as such, close many debates. According to the study by the Fundación BBVA, acceptation increases in the case of techniques that don't harm or destroy the embryo.

Graph 5. Situation without destruction of the embryo. 0 signifies completely unacceptable from a moral perspective and 10 completely acceptable. (Fundación BBVA, 2008)

The polarization of political and public opinion around the ethical questions related to research with embryonic stem cells has contributed to the growth in interest in obtaining adult stem cells. The defense of the use of embryonic cells tends to ride on its potential future use for cellular transplants. If there were equivalent alternatives, it would be more complicated to defend the use of human embryos in order to get stem cells from them. In this sense, induced pluripotent stem cells could change the terrain of the ethical debates. Those opposed to the use of embryonic stem cells might interpret the results of the research done with stem cells (adult or derived from umbilical cord blood) in a more optimistic way than the experiments show. In the same way, defenders of human embryonic stem cells might be less open if the potential risks of these cells in clinical use were considered. Private clinics operate precisely in this confused space, confronting a medical necessity that millions of patients with incurable diseases demand. Commercials for stem cell clinics often represent the patients as being responsible for their own destiny, while portraying standard clinical medicine as reactionary. They appeal strongly to the needs of patients, some with chronic illnesses or disabilities, whose current medical treatment doesn't offer a solution. As a result, patients and their families spend many hours surfing the internet looking for stem cell treatments for their particular illness. They're attracted by advertisements on the internet, blogs, articles in national and local magazines and other press, while treatments are publicized as having been successful in Mexico, Russia, India, China, Africa and other countries. Often they'll find not one, but dozens of options, generally in countries where there isn't legislation that controls the activity. Clinics also know how to change their name and country quite rapidly if there's an attempt to discredit them. A patient's secondary effects are often difficult to prove, patients are reluctant to show they've gotten worse, and they rarely admit that they have not benefited from the treatment. One of the reasons is the feeling they have of having paid a huge sum of money for something that hasn't worked, or also the placebo effect that for some ailments can lead to significant, if temporary, improvements.
