Table IV.
Domains of the reasons provided in favour and against using GM.
| Domain* | Examples of reasons provided | |||||
|---|---|---|---|---|---|---|
| In favour | Condition | Against | ||||
| Reason | Citation | Reason | Citation | Reason | Citation | |
| Safety of the individuals concerned | GM would pose limited health risks but those are acceptable considering the benefits | ‘I would certainly take the risk; the alternative is way too dangerous’ (#295, E_NMD) | I would only use GM if it would not pose unacceptable health risks | ‘If it would be a 100% safe, I would consider it’ (#559, E_INT) | GM would pose unacceptable health risks | ‘You know what you have, but not what you’re going to get [from the GM], and that could be worse.’ (#31, S_NMD) |
| Effectiveness | GM would cure the cause of the problem | ‘This way you tackle the root of the problem and are not just relieving the symptoms like we’ve been doing so far’ (#402, S_NMD) | I would only use GM if it would be an effective treatment | ‘A condition would be it having a reasonable chance of success’ (#158, S_NMD) | GM would not allow for me to become a full genetic parent since modified genes are passed on | ‘The child would be partially mine, partially my wife’s and partially of science and I wouldn’t want that’ (#885, E_INT) |
| Quality of life of the individuals concerned | GM would prevent disease’s suffering in upcoming generations | ‘To improve the health of upcoming generations’ (#987, E_NMD) | I would only use GM if it would improve my/my child’s quality of life | ‘Only for serious diseases that cause lots of limitations’ (#169, E_NMD) | GM would eliminate some of the joys of parenthood | ‘It’s precious not to know what your child will be like’ (#1011, E_INT) |
| Existence of a clinical need or alternative | GM would not be inherently different than currently accepted vaccines and medications | ‘We also have vaccination programs. This is a logical next step’ (#804, E_HIV) | I would only use GM if the risk of acquiring the disease is high | ‘If I would live in a country where HIV is more prevalent’ (#678, E_HIV) | GM would not be acceptable as there are alternatives available to obtain the same result | ‘My kid should just learn to use a condom’ (#520, E_HIV) |
| Biodiversity and ecosystems | GM would not affect biodiversity | ‘It won’t overrun species of wheat with gluten’ (#914, W_GLU) | I would only use GM if it would not do ecological harm | ‘If it doesn’t harm nature’ (#839, W_GLU) | GM would reduce human diversity which is important for the functioning of society | ‘If we’ll end up with only scientists, we’ll miss the rest very badly and mankind will still go extinct’ (#113, E_INT) |
| Animal homo sapiens (i.e. relating to effects on humans as a species) | GM would improve mankind’s chance of survival | ‘Building better people and a stronger future for our species’ (#990, E_HIV) | I would only use GM if there was no alternative to eradicate the disease | ‘As long as there are no other cures for HIV, this is the only way to get to a disease-free world’ (#908, E_HIV) | GM would have negative long-term consequences for society | ‘Wasn’t there a movement that was pursuing this last century, which only brought death and destruction (1940–45)?’ (#365, E_INT) |
| Human life and dignity | GM [of the germline] would not affect a human because the embryo does not yet have that status | ‘An embryo is not a fully grown human. Before it is actually born, it may still be modified.’ (#627, E_NMD) | I would only use GM if ethical issues were addressed | ‘Of course, you’ll have to ask the ethical questions…’ (#367, W_GLU) | GM incites the ‘yuck-factor’ (i.e. a feeling of horror, revulsion, or disgust) | ‘Modifying human embryo’s gives me the chills’ (#509, E_INT) |
| Trust in regulation | GM would not be offered unless it was established as being a good treatment | ‘If it is allowed, it’s safe’ (#698, W_GLU) | I would only use GM if it would be well-regulated | ‘If it’s well monitored by the government’ (#905, W_GLU) | GM would be subject to special interests (commercial, regimes, terrorist), which may cause exploitation of vulnerable individuals | ‘It won’t be long until governments will interfere and start making rules. The chance that totalitarian regimes will misuse it is huge’ (#683, E_INT) |
| Justice | GM would improve equality as everyone would have access to beneficial genetic traits | ‘Because the sick want healthy children just like anyone else (#414, E_NMD) | I would only use GM if not using it would make me fall behind | ‘If the rest of the world is doing ‘it’, you have no other choice’ (#587, E_INT) | GM would increase segregation | ‘Being strong and smart are important conditions for a good and successful life. I wonder what happens if you can buy those things. I imagine it will cause segregation. A gab between those who can afford it, and those who can’t’ (#608, E_INT) |
| Costs | GM would lower healthcare costs | ‘Such a disease entails substantial societal costs. If this leads to a more productive life and less (medical) expenses, this is a win-win situation’ (#241, S_NMD) | I would only use GM if costs of GM are not high for the individual | ‘Depending on how much it would cost…’ (#934, E_HIV) | GM would increase healthcare costs | It would make healthcare, which is already too expensive, entirely unaffordable (#842, S_NMD) |
| Slippery slope | GM would strictly be applied to those purposes considered acceptable | ‘A list of which diseases are and are not allowed will have to be created. No matter how bad some cases may be, you don’t want to just do everything’ (#429, E_NMD) | I would only use GM if it would not change societal norms and induce a slippery slope effect | ‘As long as modification doesn’t become the norm’ (#438, E_NMD) | GM would start a slippery slope towards morally unacceptable applications | ‘If you allow this, where will it end?’ (#587, E_INT) |
| Argument of nature | GM would merely raise the speed and efficiency of a naturally occurring process | ‘Mankind will always be evolving whether we speed this up with GM or not, we’ll become smarter anyways’ (#883, E_INT) | I would only use GM if the extent of the manipulation is limited | ‘I also want them to have their own characteristics so I wouldn’t do too much with it [GM]’ (#776, E_INT) | GM would be too unnatural | ‘It’s important to, however hard it is, respect nature’s boundaries and not to bend them for your own benefit’ (#975, S_NMD) |
| Parental rights and duties | GM is a moral obligation as I do not have the right to withhold my child from the possibilities created by germline modification | ‘Allowing your child to be born with an abnormality if you could have done something should be a crime. They should put these people in prison and make them pay for the health expenses for life’ (#631, E_NMD) | N/A | N/A | GM is unacceptable as I do not have the right to decide on modifying genes on behalf of my unborn child | ‘You shouldn’t be allowed to decide that for your unborn child’ (#359, E_HIV) |
| (Reproductive) autonomy | GM would fall under my right for autonomy and thus should not be prohibited | ‘My body, my life, my decision’ (#755, S_NMD) | I would only use GM if it remains a free choice to do so | ‘I should never be required to do it. It will become problematic once e.g. health insurance starts demanding it and there will be social pressure’ (#755, E_NMD) | GM would create choices and thereby responsibilities that people are not able to carry out | ‘Once you will have these choices, you may experience guilt complexes for things you attributed to if they go wrong. That’s why you shouldn’t be asked in the first place’ (#245, E_NMD) |
*See Supplementary Table SI for all reasons provided.
W_GLU: Response to the scenario ‘I would eat modified wheat if I would be gluten intolerant’.
S_NMD: Response to the scenario ‘I would cure own neuromuscular disease to prevent ending up in a wheelchair’.
E_NMD: Response to the scenario ‘I would modify my embryo to prevent passing on a severe neuromuscular disease’.
E_HIV: Response to the scenario ‘I would introduce resistance to HIV in my embryo’.
E_INT: Response to the scenario ‘I would increase the intelligence of my embryo’.