Team:NUS Singapore-Sci/Cas Asks Survey

NUS Singapore Science: #CasAsks
In #CasAsks, we aim to set the groundwork for our project by collating perceptions and misconceptions from the various stakeholders, such as the general public of Singapore and experts in the scientific field. Such insights were crucial in shaping the direction of our project this year, where we decided to focus on RNA editing since it has potentially lesser ethical concerns compared to “permanent edits” in DNA.

We took a bottom-up approach in our survey process, starting from collecting survey data from individuals of different walks of life about genetic engineering. There is a need for the public to understand the implications of genome editing as they will be the eventual consumers of the technology. From our survey analysis, we surfaced knowledge gaps, uncovered misconceptions and had a better understanding of the public’s degree of acceptance towards genome editing techniques.

Then, we collated opinions from scientists and bio-ethicists and consulted board-members from our local bioethics regulator, Bioethics Advisory Committee on the potential use of genome editing for a variety of applications and what the technology can do or cannot do. After hearing from the public, we transmitted some of their voices/concerns to the professionals. We aim to facilitate the communication of genome editing between the science experts and the general public using our sets of video. The experts were posed a series of questions regarding the science of genome editing and its potential ethical issues. Their valuable input were then channelled into the development of #CasTalks, an online media channel to educate the public about misconceptions of genome editing.
Understanding Community Sentiment: Misconceptions and public opinion on genome editing technology
The CRISPR-based technology has become a hotly discussed topic in the science community due to its vast potential to make previously impossible feats possible. These includes the creating “designer babies”, curing of existing genetic diseases and improving genetic traits in living organisms, especially in the agriculture sector. However, serious questions remain on whether such DNA editing methods are ethical, specific and safe. This calls for an urgent need to examine the public perceptions, misconceptions and fears towards genome engineering technology.

Early this year, we carried out a survey in Singapore with the aim to understand the perceptions of the public regarding genetic engineering and some of their misconceptions. The objective of our survey is to gain data in order to develop appropriate tools and future education plans to improve the public’s understanding towards genetic engineering.
Demographics
We surveyed participants aged 18 and above. From a total of 366 respondents, majority of our participants (59.6%) fall in the range of 18-24 years old, followed by 25-34 years olds (18.3%), 35-44 years old (10.7%), 45-54 years old (7.9%) and above 55 years olds (3.6%).
Misconceptions about Genome Manipulation Technology
A basic survey to identify common misconceptions about genome editing among the general public in Singapore was performed. We asked a series of 10 true or false questions, to identify if our respondents know the validity of these statements. All questions relate to the topic of genes, genome editing and gene therapy. We then rank the misconceptions and will debunk the top 6 in this post.

Following the analysis of the survey responses, we then spoke to a number of experts and researchers working in the field of genome editing on their views of using the CRISPR-Cas9 editing system. We also consulted scientists to obtain a professional view on how to debunk such misconceptions. Videos on #CasTalks were made as a tool to communicated misconceptions and break down complex Science theories into relatable concepts. These media will aid the correction of misconceptions and thus give the public a better idea of what gene editing is.

RANK 1 (76.5% WRONG): Gene therapy is an experimental technique that introduces genetic material into cells to enhance the physical characteristics of the individual.

This statement is false. Gene therapy is a therapeutic technique used for disease treatment through the delivery or removal of genetic material in a patient. It is not for the purpose of enhancement which is defined as a modification to non-pathological traits. We postulate that respondents have misconceptions on the definitions of gene therapy and genetic enhancements. They may have equated the concept of improving a disease condition to that of enhancement. This misconception is further reflected in our follow-up question where we asked them to define “enhancement” in the context of genome editing.

While there is consensus that “enhancement” is an improvement upon an existing condition, from “bad”/”not ideal” to “good”/”ideal”, there is a myriad of differing views on what the improvement can refer to. Some respondents comprehend genetic enhancement as similar to therapeutics, while others view it as cosmetic changes and physical features. The misconception of the term can thus be dangerous.

RANK 2 (53% WRONG): Gene functions are modular and changes are predictable.

This is false. While gene modules and regulatory networks exist, the functions and most gene functions are mediated through highly complex biochemical networks that depend on many factors, such as the presence of other genes and their variants, the environment, the age of the organism. It is true that molecular biologists have striven to build artificial experimental systems to control and minimise variation from the external factors, however the complex nature of gene interactions cannot be ignored and dismissed. Respondents might not comprehend the idea of “modularity” of genes, which refers to the ability to function as discrete, individual units. Furthermore, this genetic paradigm that gene functions are constrained and discrete is what is being taught in schools and presented to the public, perhaps partly due to the nature of scientific publications and popular science articles.

From our interview with Dr. Kon, she debunks the misconception as “In the cells, genes never function in isolation. They are always part of a network of many other genes.”. An expert bio-ethicist, Dr. Ho, mentions that “one of the concerns of scientific colleagues working in the field is to ensure that there is proper communication with the public in order for them to understand what is currently achievable and what are the challenges ahead.”. If the public has set an unrealistic expectation of the technology, they might misunderstand the level in which the technology can currently do. As such, proper public education and engagement is necessary.

RANK 3 (52.5% WRONG): Current genome editing techniques are able to edit or make changes to all genetic information in the cell.

This statement is false. Respondents may not be aware of the level of current genome editing techniques and their possible effects on cellular system. At our current level of research in genome sequences, we are unable to sequence every part of the genome, much less edit all parts of the genome. As of now, we do not know exactly how many genes there are, with the lack of detection methods for non-coding gene sequences.

RANK 4 (39.9% WRONG): Recently, scientists have discovered a method (genome editing) to change gene sequences by making precise DNA base changes. One such method is to use a DNA modifying enzyme and a specific guide molecule to make precise changes to specific genes.

This statement is true. It is likely that respondents may not be unaware of the recent developments in molecular biology fields. Furthermore, they may not understand the technical aspects of DNA editing, like “DNA modifying enzymes” and “guide molecules”. The knowledge of such terminology might require formal education in Biology.

RANK 5 (38.8% WRONG): Many diseases are associated with mutations in our genes. Hence, a distinction made between “normal” and “mutant” genes/traits can be observed. Do you think the “normal” trait refers to a wide spectrum of makeup or one ideal makeup state?

The answer is “wide spectrum”. This question investigates if individuals understand the idea of mutations being deviation from the norm. This begs the question of what exactly is regarded as normal. The “normal” distribution of any trait like height, skin color and strength covers a wide spectrum and can be affected by many factors, both genetic and environmental. Hence, “normal” is a spectrum and not an ideal state. Respondents may have been misguided since many diseases are often associated with mutations or “mutant” genes, this has given the word “mutation” or “mutant” a negative connotation. At the same time, disease treatment methods are commonly understood as reverting the “mutation” back to “normal” which may have perpetuated the understanding of “normal” being an ideal state.

RANK 6 (36.1% WRONG): DNA bases in a gene cannot be changed or altered in our body.

This statement is false. We deduce that respondent might not have knowledge of current gene editing techniques, or aware of the spontaneous mutations that happen in our body all the time. It is important for people to understand that intrinsically, our genes can be altered either related or non-related to environmental factors. It is possible that during replication, there exist extra insertions, accidental deletions or mispairing of bases to one another. From our interview with Dr. Autios, he mentions that “Everybody carries different mutations. If you spend too much time on Sentosa on the beach, you will have lots of mutations on your skin cells.” Drawing from the example given, DNA bases can be altered by exposure to external agents of genetic change, known as mutagens. A mutagen very close to everyone will be ultraviolet radiation from the sun.

Opinions on Applications of Gene Editing
Aside from identifying misconceptions, we wanted to gauge the public’s perception on applications for gene editing. From our survey results (Figure 4.), 90% of respondents supported the use of gene editing for therapeutic purposes. This depicts that the majority of the public is receptive towards gene editing being used clinically.

The potential for genome editing is endless but many relevant issues on safety and ethics are raised as well. The concepts of genetic enhancements, genome editing and its associated ethical concerns will be further discussed in our #CasWrites section.
Opinions on Public Engagement
95% of our respondents agree that public engagement is necessary and important in navigating the ethics of human genome editing techniques. Here are some opinions we gathered in our survey.
With the rapid advancements of genome editing techniques, do you the relevant authorities should consistently engage the public for their views and opinions? Further discussion about public engagement can be found in #CasWrites.

In addition, our team recognises the need for public engagement, thus we dedicate #CasTeaches to engage students.