The Role of Means and Goals in Technology Acceptance

viewpointviewpoint The role of means and goals in technology acceptance

A differentiated landscape of public perceptions of pharming Rafael Pardo, Margret Engelhard, Kristin Hagen, Rikke Bagger Jørgensen, Eckard Rehbinder, Angelika Schnieke, Mariana Szmulewicz & Felix Thiele

ost pharmaceuticals are either agriculture or medicine. In light of the often explanatory variables. Finally, we included chemically synthesized small mol- hostile public reaction to other applications a number of specific scenarios for our inter- Mecules or are derived directly from of biotechnology, a better understanding of viewees to consider: various plants and natural sources such as plants and human the public’s views and attitudes to pharm- their mode of cultivation—open fields, con- blood. An increasing number of drugs com- ing might help to guide the interaction of the tainment, confinement—and the types of prising recombinant proteins, antibodies research community and industry with the animal and medium—such as milk, egg, and nucleic acids are also produced in public at large. urine and blood—in which the protein or living organisms that have been geneti- drug is produced. cally engineered for the purpose (Walsh, …a better understanding of the 2006). In parallel to this growing market of early two decades ago, Dancker so-called biopharmaceuticals (Lawrence, public’s views and attitudes to D. L. Daamen and co-authors (1990) 2007; Ledford, 2006), research has focused pharming might help to guide Npostulated that general attitudes on the development of improved produc- the interaction of the research towards science and technology are unstable tion platforms, notably genetically modi- community and industry with and weak theoretical constructs. Although fied plants and animals. Recombinant the public at large these are assumed to have a universal scope, biopharmaceuticals have, for example, been they nevertheless fail to aggregate and expressed in maize kernels, tobacco leaves, account for the public’s views on a range of goat’s milk and chicken eggs (Giddings Here, we present public perceptions of disparate scientific areas. Analyses, accord- et al, 2000; Dove, 2000). The production plant and animal pharming in 15 advanced ing to this line of reasoning, should focus on of recombinant pharmaceutical proteins industrial societies—12 European countries an intermediate level between views on sci- in higher organisms is termed ‘pharming’, plus Israel, Japan and the USA—that repre- ence at large and specific scientific develop- a portmanteau of pharmaceuticals and sent a spectrum of social values and socio- ments, namely clusters or subsets of science farming, which reflects the combination of economic conditions (for full details, see that share several attributes, such as repro- ‘red’ (biomedical and/or pharmaceutical) supplementary Methods online). Previous ductive technologies, computer and com- and ‘green’ (agricultural and/or food) bio- social research into pharming has been lim- munication technologies or nuclear energy. technology. The idea behind pharming is ited to qualitative analyses or surveys of In turn, the literature on attitudes towards that it will enable the faster, more flexible regional samples in the USA, which have biotechnology has shown that a distinction and cost-effective production of pharma- focused largely on public attitudes to “plant must be drawn between the two subsets of ceuticals compared with current synthetic molecular farming” (Kirk & McIntosh, 2005; ‘green’ and ‘red’ biotechnologies, as these production processes. Einsiedel & Medlock, 2005; Nevitt et al, tend to meet with opposing public percep- The use of recombinant DNA technol- 2006; Knight, 2007). By contrast, our study tions—negative and positive respectively ogy to alter organisms for a specific pur- was designed with a broader scope in terms (Gaskell et al, 1997; Frewer et al, 1997; pose has raised its fair share of controversy. of the societies studied, sample size (1,500 Fischhoff & Fischhoff, 2001; Sturgis et al, While initial public resistance to producing respondents in each country) and coverage 2005; Pardo & Calvo, 2006). biopharmaceuticals in lower organisms has of both plant and animal pharming. We also Pharming is situated somewhere between largely disappeared—for instance, synthe- used a more complex and robust set of met- the red and green groups of technologies, sizing human insulin in bacteria—there is rics through which to assess views and atti- and might elicit both positive and negative still considerable opposition to genetically tudes, taking multiple measures of both the responses. Our study therefore addresses the modified higher organisms and their use in dependent (‘support of pharming’) and crucial question of whether we are facing a

single, undifferentiated and holistic evalu- Table S2 online). Although this suggests that contrast, the views that animal pharming is ation of pharming, or potentially varied, in the trade-off between means and ends “playing God”, will “transmit diseases from nuanced and plural perceptions. Indeed, the perceived utility has a significant role, animals to humans”, is a “product of the the results show that even a biotechnology the correlation matrix indicates that many arrogance of scientists” and that this area is subset such as pharming elicits markedly other evaluative angles reinforce or diminish a “product of the interests of a small number different responses from the public, depend- the level of support. The perception that the of pharmaceutical multinationals” display ing on both the goals and the specifics of the technique is of interest to a few multinational relatively low levels of correlation with means—that is, the types of animal being companies is, however, weakly correlated support for animal pharming (supplemen- used, the medium in which the drug is pro- with pharming support and in contrast with tary Table S2 online). Trust in the regulator, duced, the plants used and where these the genetic modification of food crops, does although it reaches the mid-point or above plants are grown. This highly differenti- not seem to influence the public’s perception in six out of 15 countries, is significantly ated landscape of perceptions of pharming of pharming. lower than in the case of plant pharming has important implications for how those (supplementary Table S5 and Fig S3 online). working in the field engage with the public Pharming is situated somewhere As the mean values of virtually all evaluative (Knight, 2006). criteria in most countries indicate a conver- The public tends to approach pharm- between the red and green gent negative view of animal pharming, this ing like any new and complex subject: by groups of technologies, and translates into a low level of support in spite using different evaluative perspectives simul- might elicit both positive and of the perceived usefulness (supplementary taneously (Pardo et al, 2002). Our study negative responses Table S6 and Fig S4 online). sought to explore these perspectives, from the Reservations about biotechnology are abstract—pharming for unspecified biomedi- considerably attenuated or even dispelled cal goals—to a more specific set of scenarios The means and ends trade-off falls in contexts where two conditions are met. that ranged from fighting critical diseases to towards the side of acceptance when plants First, the development in question is geared treating minor ailments and cosmetic appli- are being genetically modified to obtain towards achieving biomedical goals: health cations. In addition to these two perspectives, pharmaceutical drugs. The dominant view is is among the most prized desires of the pop- we explored how two types of variable affect that this is a “useful” technique that should ulation. Second, it does not involve the utili- public attitudes towards pharming. The first be “supported” and although it is perceived zation of animals, save for a few exceptional concerned specific attributes relating to the as going “against nature”, it is not consid- cases. This condition highlights the different biotechnology being considered: is it useful, ered to be either “immoral” or “reckless”. status accorded to plants and animals in moral, reckless, natural, risky; does it involve Perceptions of “risk” are more divided. The most societies, which generates starkly con- ‘playing God’, ‘scientific arrogance’, the majority do not believe that plant pharming trasting attitudes towards the modification of interests of pharmaceutical multinationals; for pharmaceuticals is a product of the “arro- their genetic blueprints. in the case of animal pharming, is it incom- gance of scientists” (supplementary Fig S1 patible with the dignity of animals or does it and Table S3 online), and they trust the laws ften the arguments for and against cause animals to suffer? The second assessed and controls established by each country’s biotechnology remain relatively the influence of more abstract factors such government to regulate it (supplementary Oabstract and tend to be defined as individual worldviews, including percep- Fig S2 and Table S4 online). by the trade-off between the type of goals tions of nature and values, scientific knowl- As with plants, public perception of pursued, biomedical in our case, and the edge and trust in the scientific community the usefulness of animal pharming shows methods applied—genetic modification of and regulatory agencies. the greatest correlation with support in most plants or animals. Yet, from an analytical countries: between 0.6 and 0.7. In this case, standpoint, and for the purpose of commu- majority of individuals have a nega- however, another perception of a similar nication with the public, it is interesting to tive perception of the genetic modi- magnitude arises, but in the opposite direc- gauge the sensitivity or elasticity of people’s Afication of organisms, although this tion: the view that it “is an unacceptable attitudes in response to the presence of more critical view has softened during the past five exploitation of animals” produced values specific goals and means. A low response years. A large body of social research has between 0.6 and 0.7 in nine out of the 15 to these specifics would suggest we are up been dedicated to understanding the reasons countries. Obviously the usefulness of the against evaluative structures of a holistic or for opposition to this promising technology goals being pursued does not fully outweigh ideological kind, resistant to change and (Bauer & Gaskell, 2002; Priest, 2001; Sturgis concerns about the treatment of animals as favouring confrontation rather than dialogue et al, 2005; Gaskell & Bauer, 2006). These production facilities. In principle, this dual with the public. studies have singled out a lack of perceived perception could generate ambivalent atti- Specific goals are either medical—the utility as one of the most powerful factors. tudes. The negative correlation values of treatment of a particular disease—or socio- Our own data confirm that the perception of support for this type of pharming with the economic, for example the increased pro- usefulness has the strongest correlation with perception of “immorality”, “risk” and “reck- duction of biopharmaceuticals or cost savings support for plant pharming in all countries lessness”; and with the ideas that it goes relative to other production platforms. The (from 0.6 to 0.8 on a scale from 0 (totally dis- “against nature”, is “incompatible with the analysis of the means must factor in the type agree) to 10 (totally agree); supplementary inherent dignity of animals” and will cause of plants to be modified and their cultivation Table S1 online), with a similar result seen in them a great deal of “suffering”, are equal site, or the animal species and the medium in the case of animal pharming (supplementary to or higher than 0.5 in most countries. By which the drug is obtained.

“To what extent do you think it is acceptable or not to genetically modify PLANTS to obtain drugs and treatments for the following purposes? Please use a scale from 0 to 10, where 0 means you find it totally unacceptable, and 10 means you find it totally acceptable. You may, of course, give any number between 0 and 10.”

To treat To treat To obtain anti- For vaccinating To treat life-threatening diseases dotes or medi- adults before they minor diseases in children cines to counter travel to areas ailments the effects where there is a of biological risk of contracting weapons certain diseases

Total Europe 6.8 6.4 6.0 5.8 4.9 Denmark DK 7.8 DK 7.1 DK 6.9 DK 6.6 DK 5.9 The Netherlands NL 7.5 NL 7.1 NL 6.5 NL 6.4 NL 5.9 Czech Republic CZ 7.5 CZ 7.4 CZ 7.2 CZ 6.8 CZ 5.5 Sweden SE 7.4 SE 7.0 SE 6.1 SE 5.7 SE 4.4 Spain ES 7.4 ES 7.2 ES 6.6 ES 6.6 ES 5.7 Poland PL 7.2 PL 6.8 PL 7.0 PL 6.5 PL 5.4 United Kingdom UK 7.1 UK 7.0 UK 6.0 UK 6.4 UK 5.5 Ireland IE 6.8 IE 6.6 IE 5.9 IE 5.9 IE 5.0 France FR 6.4 FR 6.0 FR 5.5 FR 5.5 FR 3.8 Italy IT 6.1 IT 5.9 IT 5.3 IT 5.1 IT 4.5 Germany DE 6.0 DE 5.0 DE 5.1 DE 4.5 DE 3.5 Austria AT 4.8 AT 4.0 AT 4.2 AT 3.8 AT 3.3

Israel IL 7.9 IL 7.7 IL 7.7 IL 7.1 IL 6.0 United States US 7.4 US 7.2 US 7.0 US 6.9 US 6.4 Japan JP 6.4 JP 5.7 JP 5.6 JP 6.1 JP 5.3 0246810 0246810 0246810 0246810 0246810

To treat To obtain To help To delay To obtain non-serious food products people live the effects cosmetic diseases with beneficial longer of ageing products properties for health

Total Europe 4.8 5.0 4.5 4.2 3.4 Denmark DK 5.4 DK 5.2 DK 4.1 DK 3.5 DK 3.2 The Netherlands NL 5.7 NL 5.9 NL 4.6 NL 4.7 NL 3.9 Czech Republic CZ 5.6 CZ 5.9 CZ 5.8 CZ 5.5 CZ 4.3 Sweden SE 4.7 SE 4.4 SE 3.4 SE 3.4 SE 2.3 Spain ES 5.9 ES 6.4 ES 5.4 ES 5.4 ES 4.7 Poland PL 5.4 PL 5.7 PL 6.0 PL 5.6 PL 4.9 United Kingdom UK 5.3 UK 5.4 UK 4.4 UK 4.2 UK 3.3 Ireland IE 4.9 IE 5.4 IE 4.8 IE 4.2 IE 3.3 France FR 3.8 FR 4.1 FR 3.6 FR 3.4 FR 2.6 Italy IT 4.5 IT 4.5 IT 4.6 IT 4.2 IT 3.4 Germany DE 3.4 DE 3.9 DE 3.4 DE 3.3 DE 2.5 Austria AT 3.3 AT 3.3 AT 3.2 AT 3.0 AT 2.6

Israel IL 6.5 IL 5.7 IL 6.5 IL 6.3 IL 4.9 United States US 6.2 US 6.4 US 6.1 US 5.8 US 4.9 Japan JP 4.8 JP 4.6 JP 4.2 JP 4.5 JP 4.3 0246810 0246810 0246810 0246810 0246810

Fig 1 | Acceptance of plant pharming for biomedical purposes

The purpose of the drug that is produced counteract the effects of biological weap- more so, for obtaining cosmetic products has a significant effect on the acceptance ons, and vaccines noticeably increase is rejected by a majority in all the soci eties and/or rejection of pharming with regard acceptance. Perceptions become more var- studied (Fig 1). In most countries, respond- to plants, and a moderate effect with ied for purposes such as cures for minor ail- ents also tended to accept plant pharming regard to animals. Treatments for life-threat- ments. The use of plant pharming to produce for the production of cheap drugs for ening and childhood diseases, antidotes to drugs for anti-ageing purposes and, even less developed societies and to overcome

shortages, whereas views are more divided Preferences for one or other method of differences in the mean values of support for about obtaining cheaper drugs for the popu- production to obtain a given medicine with animal pharming (supplementary Fig S14 lation of the advanced world (supplementary an identical composition show a precise and information S4 online). Fig S5 online). hierarchy: a clear majority of citizens prefer A general predisposition to feeling threat- drugs to be isolated from wild plant species, ened by potential risks—or “general fear”— …the results show that even followed at a distance by chemical synthe- was not mirrored in predispositions towards a biotechnology subset such sis and the genetic modification of plants. pharming (supplementary information S5 Genetic modification of animal cells in cul- online). By contrast, a higher level of elemen- as pharming elicits markedly ture and, even more so, of whole animals tary “scientific knowledge” increases support different responses from the is seldom chosen as a desirable source in for pharming, although the size of its inde- public, depending on both most countries (supplementary Table S8 and pendent contribution is small (supplementary the goals and the specifics of Fig S11 online). The predisposition to person- information S6 online). the means ally use biopharmaceuticals derived from pharming is consistent with the dual views on …the public do not adhere to plant and animal pharming: positive for plant ideological or undifferentiated The goal is also a significant factor in pharming and negative for drugs obtained the acceptance of animal pharming, albeit through animal pharming (supplementary arguments, but are rather open against a background of overall rejection. Table S9 and Fig S12 online). to different scenarios and, The only purpose that generates a moder- accordingly, to argumentation ate level of support in almost all countries ur results—that public opinion and dialogue is the treatment of serious diseases and, in differentiates according to the some countries, childhood diseases (Fig 2). Ospecific means and aims of pharm- Furthermore, the majority of respondents ing—indicate that the public do not adhere Finally, regulatory “trust” is a key vari- in nearly all countries disapprove of the to ideological or undifferentiated arguments, able to account for predispositions to genetic modification of animals to attain but are rather open to different scenarios pharming (Siegrist, 2000; Priest et al, 2003). socioeconomic goals, including producing and, accordingly, to argumentation and dia- A high level of trust in regulatory agencies drugs for the populations of less developed logue. Yet, in addition to evaluative angles might substitute or compensate for a mod- countries (supplementary Fig S6 online). at a short distance from pharming, a charac- est level of understanding of all the com- terization of public perceptions in this area plexities when evaluating research areas he specifics of the means used needs to include more general or distant such as pharming. Differences in the level also determine the level of support factors that are known to shape attitudes of support of both plant and animal pharm- Tfor pharming. In the case of plant towards biotechnology, and which tend to ing, by level of trust in national regulatory pharming, one particular aspect—the be more resistant to short-term change. The agencies, are statistically significant and of place where the plants are grown—further following results refer to the consolidated considerable magnitude (supplementary differentiates citizens’ views: all soci eties European sample. information S7 online). Trust in other organ- find the use of containment in green- The worldviews that people hold about izations also makes a marked difference houses acceptable and reject cultivation in the effects of scientific and techno logical in support for pharming; specifically, trust open fields, even when distant from fields developments on their lives have an impor- in the National Ministry of Health and in with non-genetically modified plants. Less tant role. Individuals with an optimistic national scientific institutions translates as a intensely, the type of crop also produces view of technological progress also take higher level of acceptance (supplementary a differentiated response, with a clear a more favourable view of a particular, information S8 online). preference for non-food plants (supple- although controversial, technology such as mentary Table S7 and Figs S7,S8 online). pharming (supplementary information S1 here are large differences in the Against a background of negative views online). Another important worldview is the perceptions of animal and plant on animal pharming in almost all the soci- perception of nature and naturalness and Tpharming in the 15 countries that we eties studied, the use of fruit flies and, to the role of science and technology in its studied. The USA, Israel, Denmark, Spain, a lesser extent, mice, meets with moder- transformation (Sjöberg, 2000; Siipi, 2008). Poland and the Czech Republic express ate acceptance in some countries. The A more romantic vision of nature translates the most positive views of plant pharm- use of fish inspires widespread rejection into less support for both types of pharming ing: it is considered to be very useful with in most countries (supplementary Fig S9 (supplementary information S2 online). no high risks, and against nature but not online), a reaction that is even stronger in Views and attitudes towards animals immoral. A second group— formed of the the case of sheep, cows, pigs and chim- also affect support for their genetic modifi- Netherlands, the UK, Ireland, Sweden, Italy panzees. Opposition also varies accord- cation to obtain biopharmaceutical drugs and France—approves of plant pharming, ing to the medium in which the drug is (Crettaz von Roten, 2008). A view of greater albeit with less intensity: it is perceived as produced; it is less intense when the drug “animal–human closeness” tends to be asso- very useful, not immoral, but anti-natural, is to be obtained from the milk or egg of ciated with less support for animal pharming and there are divided opinions about the genetically modified animals than when (supplementary Fig S13 and information S3 risks entailed. At the other end, Germany, it is to be obtained from the urine or blood online). In particular, attitudes towards Japan and, in particular, Austria, mainly (supplementary Fig S10 online). animals’ rights to life generate considerable reject plant pharming: they perceive it as

“To what extent do you think it is acceptable or not to genetically modify ANIMALS to obtain drugs and treatments for the following purposes? Please use a scale from 0 to 10, where 0 means you find it totally unacceptable, and 10 means you find it totally acceptable. You may, of course, give any number between 0 and 10.”

To treat To treat To obtain anti- For vaccinating To obtain life-threatening diseases dotes or medi- adults before they food products diseases in children cines to counter travel to areas with beneficial the effects where there is a properties for of biological risk of contracting health weapons certain diseases

Total Europe 5.4 5.1 4.6 4.2 3.6 Spain ES 6.6 ES 6.3 ES 5.7 ES 5.5 ES 5.4 Czech Republic CZ 6.2 CZ 6.3 CZ 5.9 CZ 5.3 CZ 4.4 Denmark DK 6.2 DK 5.6 DK 5.2 DK 4.7 DK 3.9 Poland PL 6.0 PL 5.6 PL 5.7 PL 5.2 PL 4.4 The Netherlands NL 5.6 NL 5.1 NL 4.5 NL 4.0 NL 3.7 Sweden SE 5.3 SE 5.1 SE 4.1 SE 3.4 SE 2.7 United Kingdom UK 5.2 UK 5.2 UK 4.2 UK 4.2 UK 3.6 Italy IT 5.1 IT 5.1 IT 4.3 IT 4.3 IT 3.7 Ireland IE 5.1 IE 5.0 IE 4.3 IE 4.1 IE 3.8 Germany DE 5.0 DE 4.2 DE 4.0 DE 3.4 DE 3.0 France FR 4.5 FR 4.3 FR 3.6 FR 3.6 FR 2.6 Austria AT 3.7 AT 3.1 AT 3.0 AT 2.7 AT 2.5

Israel IL 6.5 IL 6.4 IL 6.3 IL 5.4 IL 4.1 Japan JP 5.6 JP 5.1 JP 5.0 JP 5.3 JP 3.9 United States US 5.1 US 5.0 US 4.9 US 4.7 US 4.4 0246810 0246810 0246810 0246810 0246810

To treat To treat To help To delay To obtain minor non-serious people live the effects cosmetic ailments diseases longer of ageing products

Total Europe 3.1 3.1 3.2 2.9 2.1 Spain ES 4.1 ES 4.3 ES 4.2 ES 4.1 ES 3.1 Czech Republic CZ 3.7 CZ 4.0 CZ 4.4 CZ 4.2 CZ 2.7 Denmark DK 3.6 DK 3.5 DK 2.8 DK 2.3 DK 1.8 Poland PL 4.1 PL 4.0 PL 4.6 PL 4.2 PL 3.3 The Netherlands NL 3.4 NL 3.3 NL 2.8 NL 2.8 NL 1.7 Sweden SE 2.2 SE 2.0 SE 2.1 SE 2.1 SE1.0 United Kingdom UK 3.2 UK 3.1 UK 2.7 UK 2.5 UK 1.5 Italy IT 3.7 IT 3.7 IT 3.9 IT 3.5 IT 2.6 Ireland IE 3.1 IE 3.1 IE 3.4 IE 2.8 IE 2.2 Germany DE 2.3 DE 2.4 DE 2.7 DE 2.6 DE 1.7 France FR 1.8 FR 1.8 FR 2.1 FR 1.9 FR 1.3 Austria AT 2.3 AT 2.4 AT 2.4 AT 2.3 AT 1.7

Israel IL 4.1 IL 4.5 IL 5.0 IL 4.8 IL 3.1 Japan JP 4.4 JP 4.1 JP 3.5 JP 3.7 JP 3.6 United States US 3.6 US 3.6 US 3.6 US 3.4 US 2.3 0246810 0246810 0246810 0246810 0246810

Fig 2 | Acceptance of animal pharming for biomedical purposes

useful, but it is nonetheless viewed as risky, citizens in these societies see animal pharm- antidotes or medicines to counter the effects reckless and immoral. ing as risky, immoral and going against of biological weapons. These are countries In a generally unfavourable climate for nature, they also seem convinced about its with high levels of public trust in regulatory animal pharming, the countries that are least usefulness and accept it for specific bio- agencies and scientific institutions, and that critical are Spain and Israel, followed by the medical goals: the treatment of life-threaten- express positive expectations about science Czech Republic and Denmark. Although ing diseases, diseases in children, or to obtain and a generally high acceptance of the use of

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Rafael Pardo is at the BBVA Foundation, Madrid, Spain. E-mail: [email protected] Margret Engelhard and Kristin Hagen are at the Europäische Akademie zur Erforschung von Folgen wissenschaftlich-technischer Entwicklungen Bad Neuenahr-Ahrweiler, Germany. Rikke Bagger Jørgensen is at the Risø National Laboratory, Roskilde, Denmark. Eckard Rehbinder is at the Johann Wolfgang Rafael Pardo Margret Engelhard Kristin Hagen Rikke Bagger Jørgensen Goethe-Universität Frankfurt am Main, Germany. Angelika Schnieke is at the Technical University of Munich, Freising, Germany. Mariana Szmulewicz is at the BBVA Foundation, Madrid, Spain. Felix Thiele is at the Europäische Akademie Akademie zur Erforschung von Folgen wissenschaftlich-technischer Entwicklungen Bad Neuenahr-Ahrweiler, Germany.

Published online 18 September 2009 doi:10.1038/embor.2009.208 Eckard Rehbinder Angelika Schnieke Mariana Szmulewicz Felix Thiele