Misconceptions in stem cell research: The need for clarity through education

Transcription

1 Misconceptions in stem cell research: The need for clarity through education Vikki Blansit * B.S. Candidate, Department of Biological Sciences, California State University Stanislaus, 1 University Circle, Turlock, CA Received 5 April, 2017; accepted 19 July 2017 Abstract Stem cell research is one of the many controversial sciences in biological research. The use of embryos for research purposes is not a topic that can be taken lightly. However, if the findings from this research lead to treatments or even cures for debilitating diseases and contribute to our knowledge of how cancer develops and spreads, is it worth pursuing this kind of research? Many people are unsure about whether the benefits outweigh the ethical dilemmas. Will having enough education regarding the topic decrease its controversy? Or does the controversy stem from opinions that are already supported by accurate knowledge of the research? Through a survey of two groups at CSU Stanislaus, I was able to determine whether students have been provided enough information to make educated decisions or provide educated opinions regarding stem cell research. The first group consisted of 127 students majoring in biological sciences. The second group consisted of 165 students majoring in a field other than biological sciences. The subjects were asked to provide personal information, such as sex, age, religious views, ethnicity, and education. They were also asked to indicate where they get their information regarding stem cell research and how often they learn about the topic. Then they had to answer whether certain statements were true or false. Opinions on whether the research should be supported and whether it is worth funding were also collected. The data revealed correlations involving personal background and opinions/knowledge about stem cell research. One positive correlation was found in having a major or minor in biology and being able to be persuaded by accurate statements about the research. Participation in religious activities was negatively correlated with support for the research, having accurate beliefs about the research, and being able to be persuaded by accurate statements about the research. Those who self-reported as religious, and more specifically Christian, were less likely to support the research and have accurate beliefs about the research. The positive correlation between majoring or minoring in biology and being able to be persuaded by accurate statements about the research could be due to exposure to controversial topics. Exposure to accurate information about controversial topics in science could lead to more acceptance of this research. This could be done through alterations in the general education requirements for California State Universities to include more topics involving controversial research. Keywords: stem cell, controversy, education, religion Introduction New discoveries in science found through research and testing tend to create turmoil due to conflicting opinions from the public. Some can see the greater good in the research, while others fear the possible immoral and unethical steps taken to reach these discoveries. Stem cell research is one of the sciences with this problem. The public is divided between the supporters of the research and the opposition. The variables that play a role in the conflicting viewpoints have yet to be fully explored. Previous studies have generally found correlations between religious affiliations and attitudes towards stem cell research. If education plays a role in the attitudes towards stem cell research, then one can conclude that there is a need for stem cell research education in order to gain support for stem cell research. Background Given all of the mixed opinions about the topic of stem cell research, it is important to understand what the science is really about. Stem cells could be imagined as the building blocks of nature. They have the ability to produce any type of cell in the body and are the first cells that lead to the development of a fetus and ultimately a baby. Stem cells are also found in certain areas of the body where they help in tissue repair and renewal. The types of stem cells can be arranged in three categories including embryonic, adult, and induced pluripotent ( Stem Cell Information, 2015). Embryonic stem cell research has been an area of controversy in this field. Embryonic Stem Cells (ESCs) used in research are created in-vitro (in a lab dish). An egg is fertilized and becomes an embryo. The inner cells, or inner cell mass, of the embryo during the blastocyst stage are stem cells. These cells differentiate into all the types of cells found in the * Corresponding author. vblansit@csustan.edu 13

2 body. The sources of the embryos used in the research are In-Vitro Fertilization (IVF) clinics. They are donated with consent by the patients who no longer need or want the embryos. The other options for the fate of these embryos are thaw and discard, donate to another couple, or freeze indefinitely. However, the options may vary depending on the clinic (Lyerly et al., 2008). Embryonic stem cell research results in the destruction of an embryo, which is a major ethical hurdle the science faces. The question of when life begins has been an ongoing debate. Those who consider the destruction of an embryo as taking a life generally oppose embryonic stem cell research, but may support adult or induced pluripotent stem cell research. While these two other areas of research are beneficial, embryonic stem cell research is still needed in conjunction with them. Adult/Somatic Stem Cells (ASCs) are undifferentiated cells found within a tissue or organ. They can differentiate to yield some or all of the major specialized cell types of the tissue or organ. They normally maintain and repair the tissue they are found in. They were once thought to be specialized, but now it seems they are able to differentiate into other tissues (transdifferentiation). Some believe these stem cells can replace embryonic stem cell research, but the science is still not fully understood and scientists cannot produce all cell types and tissues using ASCs. There are many questions still needing to be answered involving ASCs, including, how many types exist in the body, how they evolve during development, what controls their behavior, where they are specifically located in the body, and the process of differentiation into specific cell types or tissues. It may be possible to improve the process of differentiation of these ASCs to become more efficient and reliable in tissue repair within our bodies if we better understand how they work ( Stem Cell Information, 2015). For now, embryonic stem cell research is still needed. Induced Pluripotent Stem Cells (ipscs) come from the reprogramming of adult cells (normal body cells) to become ESC-like cells. The adult cells were thought to have a set fate, but it has been discovered that they can be de-differentiated and reprogrammed. By turning on or off certain genes, these adult cells could express genes or factors that reflect that of an ESC. This technique showed significant results when these cells were tested. They were able to produce all three germ layers, produce stem cell markers, and were able to produce many tissue types when injected into a mouse embryo early in development. The tissues from ipscs would be nearly an identical match to the recipient, avoiding the risk of rejection, since the procedure would utilize the recipient s own body cells. Some believe this research could replace the use of embryos, but much more research is needed before this can be used in transplantation medicine. For now, viruses are being used to reprogram the cells, which has been rather imperfect resulting in abnormalities such as cancer. There is research being done on alternatives to these viruses ( Stem Cell Information, 2015). Stem cell research has much to offer the medical field. It may help to increase our understanding of how diseases occur and lead to better treatment therapies. This research could also be a major breakthrough in regenerative medicine. Regenerative medicine is the process of replacing damaged cells or tissue in order to restore it to normal function. Stem cell research could be used to test new drugs for safety and effectiveness, avoiding risk to a subject. This research will hopefully contribute to our knowledge of how cancer develops and spreads, since cancer is thought to involve the problem of differentiation and cell division. This could also further our understanding of birth defects for the same reasons. Stem cells have already been applied in medicine. The use of bone marrow transplants has been used for years. If a disease is being treated with bone marrow, then it is being treated with adult stem cells. Cord blood stem cells, or hematopoietic stem cells, are the same stem cells found in bone marrow. These stem cells give rise to all types of cells found in the blood: red blood cells, white blood cells, and platelets. These are used in therapies for certain blood diseases such as leukemia, anemia, and lymphoma. There are clinical trials with stem cells from cord tissue. A few of the many clinical trials include Alzheimer s disease, autism, Type 1 diabetes, multiple sclerosis, and lupus. ESCs have not been used in human trials. However, there are promising results in animal trials. If scientists perfect the process of directed differentiation in ESCs, they may be able to apply the technique to a treatment of certain diseases like diabetes, spinal cord injury, Duchenne muscular dystrophy, heart disease, vision loss, hearing loss, and others ( Stem Cell Information, 2015). Despite all the negative attention stem cell research has acquired, the potential benefits far outweigh the harmful effects. The medical leaps taken from the use of stem cell research are profound and still progressing. Methods Two groups at CSU Stanislaus were surveyed. The first group consisted of 127 students majoring in biology. The students were surveyed from three of the BIOL 1050 lectures. This course is a required prerequisite for the biological sciences major. The survey asked subjects to self-report their major, in case there were students in the course that had a major other than biological sciences. Extra credit was offered for participation in this survey from all the professors teaching the course. The second group consisted of 165 students majoring in a field other than biological sciences. These students were surveyed from PSCI 1201 and BIOL PSCI 1201 is a required general education course, so there is generally a wide range of majors from this class. BIOL 1010 is one 14

3 of the biology courses students can take to fulfill a general education requirement. The students that take this course are not likely to be biological science majors, since the same general education requirement is fulfilled with the prerequisite BIOL 1050 course. Extra credit was offered from the professors teaching these courses for those who chose to participate. The survey was accessible through Google Forms, one of the services that Google offers. Anyone with a CSU Stanislaus address who was sent a link of the survey could participate in the survey. The professors sent the link to the students through their CSU Stanislaus . The responses were anonymous, unless the student requested extra credit. In these cases, students had the option to include their school ID and the last name of the professor offering the extra credit. While the students responses were not entirely anonymous with this option, the information was immediately decoupled from the survey responses and only the student ID numbers were sent to the professors who offered extra credit so it could be awarded. The anonymized responses were saved in an Excel spreadsheet on a personal password-protected computer to prevent any personal information being exposed. The survey included several sections, among them personal information, background knowledge of and attitude towards stem cell research, true or false statements, and final opinions. The subjects were asked for their sex, age, ethnicity, religious affiliation, how frequently they participate in religious activities, major, concentration, minor, total years of college completed, and if any degrees have been completed. The answer format ranged from multiple choice, fill-in-the-blank, and checkmark boxes. Possible ethnicities, religions, years of college completed, and degrees received all provided answers to choose from, as well as an option for other with a fill-in-the-blank box. The section for the participants knowledge of and attitude towards stem cell research asked how frequently they are updated on stem cell research, where they get their information regarding stem cell research, how well they understand stem cell research, and their attitude towards stem cell research. The frequency of being updated about the research, their understanding of the research, and their attitude towards the research were multiple choice questions. The possible sources of information regarding stem cell research had a list of checkmark boxes and an option for other with a fill-in-the-blank box. The true or false statements sent the subjects to specific pages, depending on their answer. For example, if the statement is false and the subjects answered true, they were sent to a page with information regarding why the statement is false with a citation from a scholarly source. The subject was then given the option to change his or her answer, then was sent to the next true or false statement. If the subject answered the question correctly the first time, they were sent directly to the next statement. The final opinions section asked the subject whether the benefits of stem cell research outweigh the ethical dilemmas and whether stem cell research should be funded. The answers were in multiple choice format and included yes, no, and I m not sure as possible answers. This survey was approved by the University Institutional Review Board. Participants The sample comprised of 292 participants, of which 71.9% were female. The average age of participants was years old (SD = 4.46) and the subjects ethnicity was as follows: 39.9% Hispanic, 19.4% Caucasian, 15.8% Asian, 7.9% Middle Eastern, and 2.2% African American, with an additional 14% reporting as multi-racial. Within the sample, 79.6% reported belonging to some type of religious denomination with 68.6% identifying as Christian (Protestant, Roman Catholic, or other). The remaining 20.4% identified as not religious. Results The study sought to assess what factors correlated with support for stem-cell research, having accurate beliefs about stem cell research, and being able to be persuaded by accurate statements about stem cell research. Several factors were expected to be related with these three different outcome variables, including participants educational background (i.e., whether or not they were pursuing a major or minor in biology, whether or not they were interested in, and knowledgeable about, stem cell research) and religious background (whether or not they were Christian and/or religious, how often they participated in religious activities). Gender and race were also examined as potential factors affecting attitudes and beliefs about stem cell research. In assessing support for stem cell research, no significant differences were found between participants with a major or minor in biology, compared to participants without a major or minor in biology. Similarly, it was found that self-reported interest or knowledge related to stem cell research was also unrelated to support for stem cell research. However, it was found that religious activities were negatively related with support for stem cell research, r (144) = -.38, p <.01. Furthermore, it was found that participants who self-reported as religious were less likely to support stem cell research (M = 2.34; SD = 0.48), compared to those who self-reported as not religious (M = 2.56; SD = 0.50), t (134) = 2.25, p =.03. It was also found that Christians, in particular, were less likely to support stem cell research (M = 2.34; SD = 0.48) than non- Christians (M = 2.50; SD = 0.51), although this difference was only marginally significant, t (134) = 1.82, p =

4 It was also found that participation in religious activity was negatively related with the belief that the benefits of stem cell research outweigh the harm, r (290) = -.20, p <.01, and the belief that stem cell research is worth funding, r (290) = -.17, p <.01. Christians were less likely to believe that the benefits of stem cell research outweigh the harm (M = 2.11; SD = 0.69), compared to non-christians (M = 2.47; SD = 0.55), t (271) = 4.24, p <.01. Christians were also less likely to believe that stem cell research is worth funding (M = 2.47; SD = 0.67), compared to non-christians (M = 2.71; SD = 0.46), t (272) = 2.95, p <.01. Religious participants were less likely to believe that the benefits of stem cell research outweigh the harm (M = 2.14; SD = 0.67), compared to participants who were not religious (M = 2.55; SD = 0.57), t (271) = 4.12, p <.01. Religious participants were also less likely to believe that stem cell research is worth funding (M = 2.48; SD = 0.65), compared to participants who were not religious (M = 2.80; SD = 0.40), t (272) = 3.52, p <.01. Neither gender nor race had any significant effect on support for stem cell research. To assess accuracy of beliefs about stem cell research, participants were asked to report whether five statements about stem cell research are true or false. On average, participants correctly identified 3.84 of the statements as true or false (SD = 1.11). Results showed that whether participants had a major or minor in biology was not predictive of how accurate participants were in their stem cell beliefs. Self-reported interest and knowledge related to stem cell research was also not predictive. However, participation in religious activities was negatively predictive of accuracy of stem cell beliefs, r (268) = -.17, p =.01. Likewise, it was found that Christians correctly identified fewer statements as true or false (M = 3.71; SD = 1.17) than non-christians (M = 4.18; SD = 0.88), t (251) = 3.19, p <.01. It was also found that those who self-reported as religious correctly identified fewer statements (M = 3.74; SD = 1.14) than those who self-reported as not being religious (M = 4.32; SD = 0.82), t (251) = 3.40, p <.01. As before, no relationships were found with gender or race. If participants held inaccurate beliefs about stem cell research, they were directed to corrective statements, which contained accurate information about stem cell research to correct for these inaccurate beliefs. Participants were asked if they were persuaded by each of these corrective statements. From this, it was calculated what percentage of the time participants were persuaded by these corrective statements. On average, participants were persuaded 41.26% of the time. An independent-samples t- test revealed that participants with a major or minor in biology were more likely to find corrective statements persuasive (M = 46.91; SD = 45.75) than those without a major or minor in biology (M = 35.84; SD = 40.89), although this difference was only marginally significant, t (196) = 1.80, p =.07. Correlational analyses revealed that neither interest, knowledge, nor support for stem cell research was related with the persuasiveness of the corrective statements. It was found that participation in religious activities was negatively related with finding the corrective statements persuasive, r (197) = -.14, p =.05. However, neither being Christian nor being religious in general was related with the persuasiveness of corrective statements. Once again, gender and race had no discernable effect. Miscellaneous Findings Participants who had a major or minor in biology reported greater knowledge about stem cell research (M = 2.05; SD = 0.66), compared to participants without a major or minor in biology (M = 1.79; SD = 0.61), t (290) = 3.55, p <.01. Participants who had a major or minor in biology reported greater interest about stem cell research (M = 2.10; SD = 0.83), compared to participants without a major or minor in biology (M = 1.67; SD = 0.61), t (290) = 4.68, p <.01. Belief that stem cell research is worth funding was found to be positively related with the number of statements participants correctly identified as true or false, r (268) =.29, p <.01. It was found that the belief that the benefits of stem cell research outweigh the harm was positively related with the number of statements participants correctly identified as true or false, r (267) =.13, p =.04. Conclusions and Implications A possible hypothesis from these results is that biology majors are more likely to be persuaded by accurate statements about the research due to exposure of controversial research topics and scientific information. By altering the general education requirements, more students could potentially be exposed to these topics. California State Universities require that all majors take specified courses in various disciplines as GE requirements. One area for CSU Stanislaus is B2 Biological Sciences under Natural Sciences and Mathematics. The courses listed vary depending on academic year. They are rudimentary courses that skim the basics in fields involving biology (i.e., genetics, botany, zoology). These courses could expand their topics in controversial areas of research in these fields. The added exposure could have an influence on the opinions and on the understanding of stem cell research and furthermore, influence the support for the research. Discussion The survey has several inevitable drawbacks. One involves the perspectives of the subjects. Some of the questions require a subjective response, disabling accurate 16

5 interpretation of the results. For example, one of the questions asks how frequently the subject stays up to date on stem cell research. The options were always, often, sometimes, rarely, and never. The responses to this question were based on opinion rather than fact. Another drawback involves the qualitative analysis. It is difficult to assess the subjects understanding of the research. There was a subjective question regarding how well the subject feels they understand stem cell research and there were five questions used in determining the subjects understanding. This is not enough information to determine one s understanding of the research. The survey has a slight bias, which might have influenced the subjects answers. This may have skewed the data. The survey was geared more towards supporting the research, as opposed to being against the research or References Lyerly, A. D., Steinhauser, K., Voils, C., Namey, E., Alexander, C., Bankowski, B., Cook-Deegan, R., Dodson, W. C., Gates, E., Jungheim, E. S., McGovern, P. G., Myers, E. R., Osborn, B., Schlaff, W., Sugarman, J., Tulsky, J. A., Walmer, D., Faden, R. R., & Wallach, E. (2008). Fertility patients' views about frozen embryo disposition: Results of a multi-institutional U.S. survey. PubMed, 93(2), doi: /j.fertnstert remaining neutral. Those who had yet to form an opinion could have been swayed towards supporting the research. The sources of information regarding stem cell research do not necessarily constitute accurate or inaccurate information. For example, a professor could provide inaccurate information regarding the research or non-scholarly media may provide accurate information regarding the research. The participants were all from CSU Stanislaus and, therefore, represented a specific population. Those outside of the university were not represented. This includes various education levels, religious views, ages, ethnicities, and even geographic location. Males were underrepresented in the sample. Females made up 71.9% of the sample, which could have altered the results. Murnaghan, I. (2014). Creating embryonic stem cells without embryo destruction. Retrieved from creating-embryonic-stem-cells-embryo-destruction.html Stem Cell Information. (2015). Stem Cell Basics. Retrieved from 17