National Risk Signatures and Human Embryonic Stem Cell Research in Mainland
China 1
Margaret E. Sleeboom-Faulkner
Department of Anthropology, University of Sussex, UK
ARTS C209
University of Sussex
Brighton
BN1 9SJ
UK
Tel: +44 1273 873392
E-mail: [email protected]
1
This is an electronic version of an article published in Health, Risk & Society, volume
12, issue 5, 2010. Health, Risk & Society is available online at:
http://www.tandfonline.com/doi/abs/10.1080/13698575.2010.509491
1
Abstract
The international development of human embryonic stem cell research has become
closely tied to global bioethics, which places moral responsibility on stem cell
researchers. This article argues that the development of bioethical regulation of human
embryonic stem cell research is better understood by approaching the institutionalisation
of bioethics in terms of risk perceptions of stem cell scientists. Eschewing approaches
that understand bioethical risk as a mere matter of morality or as a social construct, this
article emphasises the materiality and strategic reasoning of bioethical views on risks
associated with human embryonic stem cell research. Such an approach allows the
identification of forms of risk rooted in the everyday practice of Chinese human
embryonic stem cell research, including moral risk (as a violation of cultural values),
material risk (in relation to the distribution of material resources and wealth), political
risk (in terms of the political economy of bioethics and public debate) and reputational
risk (in terms of personal and national honour).
Although this analysis builds on Tom Horlick-Jones’s concept of risk signatures
of new technologies, which emphasise the capacities of different technologies to
engender and delimit the particular social and cultural interpretations of the risks they
generate, the article reveals the existence of a certain global awareness among stem cell
scientists of risk signatures. They display a creative and strategic awareness regarding the
possible opportunities and constraints the risk signature of human embryonic stem cell
research affords in their particular institutional context compared to those of others
abroad and at home in different environments. The existence of this form of reflexivity
requires recognition and methodological accommodation.
2
National Risk Signatures and Human Embryonic Stem Cell Research in Mainland
China2
I Introduction
Bioethics discussions of international science collaborations and debates on the ‘risk’ of
applying new technologies often treat bioethical regulatory issues as a matter of morality
(Döring & Chen 2002; Sleeboom-Faulkner 2004; Qiu 2006; Sleeboom-Faulkner 2008).
Nevertheless, awareness exists among social scientists of the influence of historical
factors and political economy on attitudes towards risk. Thus, Ulrich Beck’s notion of
reflexive modernity states that the central problem of Western societies is no longer the
‘distribution of goods’ (wealth, employment in conditions of scarcity), but the
minimisation of risk as exemplified in the admonitions of environmental movements,
which is contrasted with the possible notions of risk in other societies (Beck 1992; Beck
2007 [1999]). However, the idea that basic bioethical guidelines for stem cell research
should be followed internationally is widespread. For instance, the guidelines of the
International Society for Stem Cell Research (ISSCR) (Daley et al. 2007) presume that
moral and bioethical considerations are shared equally on a global level. To put into
perspective the difficulties related to such recommendations in the context of a large
developing country, this article emphasises some of the material aspects of the risk
perception of human embryonic stem cell research, examining the readings by Chinese
2
This article has benefited from research support provided by the Netherlands Organisation of
Science (NWO) and the ESRC (RES-350-27-002; RES-062-23--0215). I am very grateful to the
reviewers and Alex Faulkner for their helpful comments on this article.
3
stem cell scientists of the risks associated with stem cell research and the creation of
bioethics institutions.
The article shows that the understanding of bioethics in China benefits from a
risk-based approach, as it allows the identification of various notions of risk that together
can explain attitudes towards the bioethics of stem cell research in China: moral risk as a
violation of cultural norms, material risk in relation to the distribution of material
resources and wealth, and political risk in terms of the political economy of bioethics and
public debate together explain the ambiguity of the meaning of bioethics of human
embryonic stem cell research in China.
Theory: Risk signatures and reflexivity
To understand discussions about the bioethical acceptability of new technologies, we
need to take into account the various ways in which bioethical problems are delineated,
experienced and recognised by the people involved in their use. This article does this in
terms of the reported interpretations of risk by stem cell scientists. Though
constructionism has shown the socially negotiated nature of risk assessment of new
technologies (Douglas & Wildavsky 1982) and the risks we associate with them,
depending on our ways of seeing things, we interpret them differently. For instance,
induced pluripotent stem cells (iPS) might be regarded as less risky compared to somatic
cell nuclear transfer, just because it does not make use of the embryo. If taken to its
extreme, however, this approach risks losing track of the specific nature of technological
artefacts (Nishikawa et al. 2008). Applied to the example, our assessment would not take
into account other risks associated with iPS, such as the risk of developing tumours.
4
Though agreeing that risk assessments are socially negotiable, Tom Horlick-Jones insists
that we should not lose sight of the specific nature of technological artefacts when
examining risk categories, or what he calls the ‘risk signature’ of new technologies. Thus,
discourses about the risk of iPS and human embryonic stem cell research only make
sense in the context of the conditions and practices that constitute these technologies,
which analysis requires familiarity with and empirical knowledge of the ways in which
this particular technology is used in the laboratory. An engagement with risk signatures in
practice shows the constraints and opportunities afforded by the developing practices of a
new technology, and demonstrates the limitations of the materiality of the technology and
the institutional framework, including research regulation, placed upon its social and
cultural interpretations. Although this study builds on Horlick-Jones’s notion of risk
signature (Horlick-Jones 2007), this article argues that risk signatures are not
straightforward combinations of material and institutional capacities. Without taking into
account stem cell scientists as reflexive agents, an observer would miss the crucial point
that scientists act upon their knowledge of a number of risks identified in practice, i.e. the
non-sociologists’ recognition of risk signatures. In fact, this study on scientists’ views on
and experiences with human embryonic stem cell research in China found great
awareness of the institutional constraints, the availability of human biomaterials,
laboratory equipment, research funding and the sensitivities regarding human embryonic
stem cell research. Ample research on human embryonic stem cell research in Europe, the
USA, and elsewhere in Asia yielded similar findings (Bender et al. 2005). This article
emphasises that among scientists a global awareness and reflection exists of the different
5
risk signatures of the ‘same’ technology, i.e. human embryonic stem cell research, in
different global institutional settings.
The awareness of the global multiplicity of the risk signatures of human
embryonic stem cell research actually plays a crucial role in risk perceptions and
estimations of the prospect of a technology. In the case of human embryonic stem cell
research, this form of double reflexivity is crucial to understanding the views held and
choices made by stem cell scientists in Mainland China, who take advantage of the
different risk signatures of human embryonic stem cell research in the USA, Europe and
elsewhere, and the different research conditions in urban and rural China. In this case,
then, the practical reasoning of everyday life is moulded by the global conditions in
which various risk signatures develop and take shape. Although the risk signatures of
human embryonic stem cell research carry ‘real’ risk in the sense that embryos and
women run the risk of being used and exploited, these risks are interpreted, appreciated,
and weighed against other risks which are shaped and framed by national risk signatures.
And finally, the awareness of these national risk signatures in a global context enables
stem cell scientists to use concepts of risk reflexively and strategically, which is
expressed in their relative appreciation of bioethical research regulation, reputation,
funding, reproductive resources, and opportunities for collaboration as discussed in this
article. Reflexivity and strategic reasoning, then, are crucial to understanding the views
held and choices made by stem cell scientists in Mainland China, as they take advantage
of the different risk constellations of human embryonic stem cell research in affluent
welfare societies and in China as a developing country, and in urban and in rural
environments within China. In this case, then, the strategic reasoning of stem cell
6
scientists at work is informed by the global conditions in which various risk signatures
develop: an awareness of the interplay of a manifold of local risk constructs engendered
and shaped through the material realities of risk signatures.
Background: Risk and bioethics in affluent welfare societies and in China
In the 1990s, when public mistrust of science in the West was soaring, it became clear
that scientists’ insistence on separating nature and society into worlds governed by
different laws was not consistent with their social concern and worry about public
attitudes (Cunningham-Burley & Kerr 1999). Though regulatory and advisory
committees in the West attempted to deal with the issue of public trust (Jasanoff 2005:
Ch. 10), mistrust of these committees led various countries to study the impact of society
on science. In the USA and Europe, several initiatives aimed to engage the public in
debates on bioethics and to stimulate focus group discussions of stem cell research (see
Mulkay 1993; Holland et al. 2001; Bender et al. 2005; Parry 2006). These views are
based on observations that assume the perceived need for and existence of public debate
and the relevance of its impact.
Human embryonic stem cell research has been controversial in many societies due
to varying views on the value of the embryo and on the ethical derivation and use of the
embryos and oocytes required for the research. This controversy has been and still is
expressed in the form of protest movements and organisations that aim to deal with these
perceived risks. In the UK, the Warnock Report, which reacted to the particular problems
associated with embryo research, recommended the establishment of the licence
authority, which materialised in the shape of the Human Fertilisation and Embryology
7
Authority (HFEA) in 1990. This included an attempt to measure the public barometer to
attain publicly acceptable regulation (Franklin & Roberts 2006: 3–5). The HFEA devised
bioethical guidelines that would regulate the sourcing of biomaterials and the behaviour
of stem cell scientists, while taking into consideration shifts in views among the public.
Such bioethical regulation is also important to funding agencies, such as Wellcome Trust
and the European Framework Programmes, that wish to protect their reputation and do
not want to be seen to subsidise bioethically tainted research.
However, the conditions and regulation for human embryonic stem cell research
in Western countries varies enormously. Due to the various ways in which the status of
the embryo is defined and perceived, regulation for human embryonic stem cell research
varies from prohibitive (Germany, Poland, Italy) to permissive (UK, Sweden, Belgium).
What these countries have in common, however, is a relative clear frame that defines,
regulates and supervises conduct in the field of stem cell research and the procurement of
embryos and oocytes. Furthermore, the scientists and institutions in these countries
usually place great value on the reputation of themselves and their institutions. Some
countries with strict regulation for human embryonic stem cell research, such as
Germany, actually prohibited German scientists from engaging in human embryonic stem
cell research in more permissive countries (Weber & Wilson-Kovacs 2008). Similarly,
when considering international collaborations, the Medical Research Council (MRC) in
the UK does not fund research that moves to, for instance, China for the reason of looser
regulatory conditions or the application thereof (CURE 2009: 3). For this reason, most
stem cell scientists have little to gain by thinking of constructs to realise plans violating
regulation either within or outside their home-base institution. In other words, the field of
8
bioethics, especially in affluent welfare societies, has become part of industrial and
science development strategies that regard ethical production as a major asset, often
integrated with the production process (see Franklin 2003; Finegold et al. 2005).
Unethical production, then, has become a liability.
In a developing country such as China, however, the risks involved in human
embryonic stem cell research differ from those prevalent in affluent societies. Due to the
varying local circumstance for conducting human embryonic stem cell research, the
relatively permissive regulation for human embryonic stem cell research in many
research centres, and the limited supervision, stem cell research in China takes on many
different forms. As will be discussed below, reputation, lagging behind other research
centres, and the ineligibility for funding are directly related with establishing bioethics
institutions and are of more variable consideration when planning a human embryonic
stem cell research project compared to affluent welfare societies, where it is in the
interest of the researcher to more or less follow national regulation and institutional
convention.3 In other words, the risk signatures associated with human embryonic stem
cell research in China and in affluent welfare societies differ, due to, first, varying risk
perceptions (social risk constructions) and awareness of human embryonic stem cell
research, second, a ‘real’ tangible difference in institutional and material provisions and
safety standards, and, third, the different socio-economic circumstances in which oocytes
and embryos for human embryonic stem cell research are sourced. Stem cell scientists are
highly aware of such differences. In China, relatively many scarce resources have been
invested into the life sciences, most of whose resultant products are not expected to
3
Nevertheless, variation exists between Germany and the UK in regard to the strictness with
which researchers adhere to regulation (Webber & Wilson-Kovacs 2008).
9
benefit the health of the Chinese population. This policy is also controversial among
scientists (Blumenthal & Hsiao 2005; Sleeboom-Faulkner & Patra 2008). When in human
embryonic stem cell research couples and individuals with little or no healthcare
coverage are asked to contribute to the development of the life sciences by ‘donating’
oocytes and embryos, or by participating in research as experimental subjects, Chinese
patients are confronted with different sets of considerations and interest compared to
patients in affluent welfare societies. The risk signature of human embryonic stem cell
research is partly shaped through such sourcing. Moreover, in China public debate on
human embryonic stem cell research is hardly recognised as a part of the policymaking
on human embryonic stem cell research. Public debate on stem cell research in itself is
considered as a political risk that could potentially undermine human embryonic stem cell
research in China, and will be shown as part of China’s national risk signature for human
embryonic stem cell research.
Method
This paper draws on two years of research on international science collaborations in stem
cell research in China, from 2006 to 2008, which involved fieldwork, archival research
and interviews with over forty scientists from various stem cell laboratories, hospitals and
research institutes in China. The scientists were approached initially through contact with
bioethicists at the Chinese Academy of Medical Sciences. After having established a few
contacts, I was introduced to other scientists through the snowball effect and by my
initiative to contact authors of articles on stem cell research. The institutes visited include
the Chinese Academy of Science, National Institute of Biological Sciences (NIBS) and
10
Beijing University in Beijing, the Shanghai Academy of Sciences (SAS), Fudan
University, Xinhua Hospital of Jiaotong University, and Ruijin Hospital in Shanghai,
Union Hospital, Tongji Medical College (Huazhong University for Science and
Technology) and Wuhan University in Wuhan, Institute of Reproductive and Stem cell
Engineering, Central South University Reproductive and Genetic Hospital ITIC-Xiangya
in Changsha, Zhong Shan First and Second Affiliated Hospitals and Renmin University
in Guangzhou, and science and health institutions in Hainan.
The issues discussed with scientists relevant to this study concern their motivation
for conducting particular forms of stem cell research, their experience abroad, the merits
of bioethics and the (dis-)satisfaction of scientists with current regulatory provisions for
human embryonic stem cell research in the People’s Republic of China (PRC), and their
support for public debate on stem cell research. As this article aims to discuss the
dynamics of risk perception in bioethical regulation, and not persons, the interviewees in
this article have been made anonymous. A thorough search, however, could yield the
names of some of the interviewees, as they may be well known. Nevertheless, none of the
interviewees objected to their interview being recorded or quoted. The research upon
which this study is based has been through ethical review at the University of Sussex.
Approximately half of the interviews with Chinese scientists the author conducted in
standard Chinese (putonghua); the other half were conducted in English. I have used
pseudonyms for all interviewees quoted in this article. Although some of the interviewees
indicated that they could be quoted in public documents, it is not the aim of this article to
attract attention to the interviewees as individual researchers.
11
The second part of this article discusses scientists’ views on stem cell research regulation
in China from global, national, provincial and local perspectives, and the efforts put into
tackling ‘bioethical risks’ in the light of increasing demands for bioethically responsible
scientific products. To show how local and national risk signatures can shed light on the
relationship between international developments of bioethics and the local conditions in
which bioethical guidelines are received, an open approach to the delineation of forms of
risk perception was adopted. The third part of this article discusses scientists’ views on
public participation in debate on human embryonic stem cell research, and to what extent
they perceive this as a support or threat to their work. The final part of the paper
discusses why the risks associated with public debate on human embryonic stem cell
research constitute a strategic part of the national risk signature of human embryonic stem
cell research in China.
II Research regulations of stem cell research and human embryonic stem cell
research: international, national and local factors in scientists’ risk perception
China has invested relatively many resources in the advancement of stem cell research
and has put considerable efforts into developing cutting-edge research on a global level.
As discussed below, global awareness of bioethical and research issues also generated the
need to adopt international regulatory standards. In Part II, I aim to show the strategic
awareness of Chinese scientists of the different conditions in which human embryonic
stem cell research develops internationally, and in urban and rural areas within China.
12
These differences constitute divergent risk signatures and are crucial to scientists’ views
on bioethics and the risks they perceive in their work.
Human embryonic stem cell research in China: economic reform and scientific
ambition
China is a large developing country with a population of over 1.3 billion people. A large
part of the population still lives on the edge of poverty and a majority has insufficient
access to modern medicine (WHO 2002, 2007). At the same time, China is the world’s
most rapidly industrialising country, with a fast-growing pool of scientific and technical
professionals increasingly proficient in English. Furthermore, China has a rapidly
growing pharmaceutical industry, has built up enormous capacities in the life sciences,
and has a swiftly growing information technology sector of global importance. Rather
than understanding China’s stem cell research policies in the context of an absence of
moral scruples about embryo research or in the context of the duty to cure debilitating
and incurable disease, they should be seen in the light of policies of innovation and
development (Pun 2003).
When in 2001 President Bush announced a moratorium on the federal funding of
stem cell research, China, as some other countries in Asia (India, Singapore, South
Korea, Japan and Taiwan), denied any engagement with the ethics that had informed the
decision. In fact, they were ready to jump into the bioethical vacuum it had created
(Sleeboom-Faulkner & Patra 2008). This vacuum was alleged to be a result of Western
moral scruples about using fertilised human cells, allegedly absent in the East.
Protagonists of human embryonic stem cell research and stem cell research indicated the
13
suitability of their cultural background. Thus, some Chinese scientists claimed it to be
common knowledge that: ‘In the Confucian tradition, human beings achieve personhood
only when they’re able to participate in society’. In this view, foetuses are not human but
part of nature (Mann 2003), while according to other ‘socialist’ oriented scientists, human
life starts at birth with ‘social personhood’ [shehuiren] (interviews with e.g. Li and Luo,
27 March 2007).
Although the view that the Chinese embryo is invested with little human value
among Chinese people should be strongly doubted (Nie 2005), the question of the moral
status of the embryo has hardly played a role in China’s efforts to stimulate stem cell
research. There have been no debates on human embryonic stem cell research and stem
cell research involving the non-expert public, though investments in the life sciences have
been justified by referring to curing serious and debilitating diseases. But these arguments
may have been exaggerated, considering the widely acknowledged failure to provide the
majority of the population with adequate basic healthcare (Wang et al. 2007; Chan et al.
2008: Ch. 7). Nevertheless, the Chinese government has set up state-of-the-art
laboratories for stem cell research, creating university appointments with tempting perks,
and provides the funding to establish new biotech firms and research centres with worldclass facilities.4 In fact, the increased investment into the life sciences serves China’s goal
4
E.g., the Beijing- based National Institute of Biological Sciences (NIBS). The Ministry of
Science and Technology and the Beijing Municipal government invested 500 million RMB (62.5
million US dollar) into the newly inaugurated institute (People’s Daily Online, 25 December
2005).
14
of becoming a world leader in this prestigious, promising and cutting-edge area of
research.5
In the 1990s, large parts of the financial budget were allocated to the advanced
sciences, in particular the life sciences. The investment of resources into the life sciences
and human embryonic stem cell research in particular grew rapidly. Though most
research is focused on agricultural technology, Beijing spent millions of dollars annually
to advance biomedical research. Between 1996 and 2000, the central government
invested over 1.5 billion Yuan (US$180m) in biotechnology, as part of its main
programme to kick-start the sector. From 2000 to 2005, the government provided
research in biotechnology with about 10 billion Yuan.6 Funding for research and
development (R&D), then, has shot up, both as a percentage of the GDP and in absolute
terms. In February 2006, the State Council issued the National Medium- and Long-Term
Programme
for
Science
and
Technology
Development
(2006–2020)
[Guojia
Zhongchangqi kexue he Jishu Fazhan Guifan Gangyao (2006–2020)]. China plans to
become an innovative nation in the next 15 years and a world power in science and
technology by the middle of the twenty-first century. The Outline Programme announced
that the annual R&D is expected to be 900 billion Yuan in 2020, or 2.5 per cent of its
GDP, while progress of science and technology is expected to contribute 60 per cent or
5
The regrouping of CAS Institutes into the Shanghai Institute for Biological Sciences also serves
this goal (Triendl 1999).
6
Mainly through the funding schemes of the Ministry of Science and Technology (MOST, over
5.7 billion Yuan), the China Petrochemical Development Corporation (CPDC, 1 billion Yuan),
the National Science Foundation of China (1.5 billion Yuan), the Chinese Academy of Sciences
(500 million Yuan) and local governments (1 billion Yuan) (Finpro, available at:
www.finproevents.fi/tiedostot/ default/finpro1000000260.pdf).
15
more to the country’s development.7 Together with IT, the Outline emphasises
biotechnology as its main priority. To facilitate the development of the life sciences, the
government has developed bioethical guidelines for various research fields, including that
of human embryonic stem cell research.
China, as a large developing country, having invested many scarce resources into
stem cell research, is taking a gamble in its attempt to become among the world’s most
advanced life science powers. For this reason, relatively favourable conditions for the
stimulation of human embryonic stem cell research were welcomed. In this context, the
official Chinese press presented the use of embryos in research as unproblematic,
mobilising cultural and historical categories that ‘proved’ the lack of religious dogmatism
regarding embryos in Chinese tradition. Paradoxically, bioethical guidelines had to be
introduced and bioethics taught for China to become among the world’s avant-garde of
human embryonic stem cell research. The bioethical comparative advantage had turned
into a disadvantage, which regulators, politicians and scientists have attempted to
remedy, but not without causing confusion and generating ambiguities. It is these
ambiguities and confusion that have determined the conditions for China’s national risk
signature to develop. While research regulation is a relatively invariable part of research
practices in European countries, its variable conditions in China involve risks related to
the loss of international reputation, lagging behind in scientific competitiveness, failing to
acquire research funding and harming the interests of patients.
7
Available at: http://www.gov.cn/english/2006-02/09/content_183426.htm.
16
The risk of losing international reputation
Internationally oriented human embryonic stem cell researchers are pioneers in setting up
bioethics institutions in China, and the vast majority of stem cell scientists interviewed
for this study are supportive of the adoption of bioethical guidelines. Most principal
investigators (PIs) have completed their higher education in Western countries, where
they have gained experience with bioethical regulation. Nevertheless, without exception,
all interviewed PIs found that bioethical regulation is hard to implement in China.
Though most PIs showed awareness of bioethically problematic research in other
laboratories, their own labs were usually presented as exemplary. Behind this push for
adopting bioethics regulation lie the concerns expressed by most scientists not to fall
behind scientifically advanced countries for regulatory reasons.
Stem cell research PIs rarely express dissatisfaction with China’s current
bioethical research regulation for stem cell research. Complaints voiced concerned other
researchers and difficulties of implementing research guidelines. Thus, a cloning expert
from Beijing, Prof. Zhao, was worried about the reputation of the ‘good’ researchers and
wanted to regulate the field of stem cell research in such a way that all researchers will
start implementing guidelines. Zhao explained:
Some [foreign] people think that in China it is really nice to do some stem cell
research because of the ethical attitude. I don’t think so…. You really should
think about the international world. Is it true or is it good or not. We need to get
some law and regulation…. This is my attitude and this is what we talk about with
the government. (Zhao)
17
A majority of stem cell scientists said of themselves that they regard following
(international) research guidelines as conducive to a good reputation – in fact, to be seen
not to follow bioethical guidelines is a risk to one’s profession. However, setting up a
bioethics committee is no easy matter. The difficulties in the road of establishing research
guidelines and a bioethics infrastructure are often presented as the result of sustained
ethical struggle. For instance, a stem cell scientist from Beijing, Prof Zhou (a
pseudonym), helped set up an institutional review board (IRB) in his hospital after he
returned from the USA in 2002. To show that IRBs do not vet every application as
positive, Zhou pointed out that he was instrumental in helping his colleagues becoming
bioethical. Such help is not always welcome. When using bone marrow stem cell therapy
for diabetes patients, the performing physician was upset when he was told to start
keeping precise records:
I basically say that you have to keep records…. The doctor that performed the
work hated all this. It was quite a gruelling experience for him. Overall, I felt
comfortable about this…. I really have to be ready [prepared], because our initial
trial was with diabetic patients, so you don’t have to go through a lot of safety
issues. I need to defend myself against that kind of thing…. (Zhou)
Another pioneering stem cell researcher from the provincial city of Wuhan, Professor Hu,
indicates the difficulty of implementing the existent regulation on oocyte donation:
18
… even in a big hospital they do not have an IRB committee. Only at your request
‘Why don’t you make a file?’ [will they make one]. They don’t have a record of
meetings, they don’t have a document. From my understanding, they do only in
my university and in my hospital. My case is the first to get [local] government
approval based on [following] procedures. Hopefully the current minister of
health can promote this. He is very good and has a medical background. (Hu)
When asked if the IRB consists of people from different social backgrounds, Hu explains:
Because I am the first one to go through this kind of guidance, I ask people if they
studied ethics and behavioural science and people in the department. It is the first
time they have basically organised this kind of committee. The Agency of Health
of Hubei province is very happy about this, because they have learnt how to do
this now. Also the newspaper in Hubei province said this is the first case that
follows these procedures. (Hu)
It is clear from these accounts that the scientists, all of whom have learnt their
profession abroad, regard losing their reputation as a major risk, and are willing to put
considerable efforts into installing IRB committees. As setting up IRBs in one field, e.g.
stem cell research, may lead to similar efforts in other fields, it may entail an unsettling
reconfiguration of local power relations and research oversight. Additionally, the
accounts above indicate the existence of a marked difference in the stages of regulatory
efforts in a research hospital in a large city, such as Beijing, and in a major provincial
19
city, such as Wuhan. In the view of stem cell researchers, then, China runs a special
reputational risk in the field of the bioethical regulation of human embryonic stem cell
research (Larkin 2003) – especially, as it is a variable and specific to the field of human
embryonic stem cell research, it is part of China’s national risk signature.
The risk of lagging behind
Policymakers and scientists keep a keen eye on global competition and look out for
opportunities for collaboration in the life sciences. Regulation partly serves to lower the
risk of disqualification in international competition, causing China’s life sciences to lag
behind. At a national level, within China, falling behind national development also forms
a risk. In China, national financial resources concentrate on an increasingly small area of
scientific research in a context of international competition and direct knowledge
exchanges among an increasingly small number of academic institutions (Hong 2008).8
This makes the distribution of funding resources crucial to contenders at the national
level and hard for most of the provincial contenders. Although there is some cooperation
between stem cell research groups in the major stem cell regions of Beijing, Shanghai,
Tianjin and Guangzhou (and perhaps Nanjing and Changsha), there is also much
competition for research funding and great inequality of its acquisition between
geographical regions. Thus, resource allocation is problematic for provincial cities. Prof.
Han, director of a research lab in a provincial city, explains:
8
In the mid-1980s the government cut research funding (known as ‘shock therapy’) to push
research units to the market. A decentralisation of science institutions meant that provinces and
municipalities made available large sums of research funding, especially in the more prosperous
regions (Hong 2008: 582).
20
So while we applied for funding, with Deng Hongkui and Li Lingsong, the guy
from Guangzhou said, ‘In China, funding from central government, 50 out of 100
Yuan will go to Beijing because they are government-ranking officials, and also
the government does everything first for Beijing; 25 will go to Shanghai.
Nationwide the remaining 25 goes to the remaining cities, to Hangzhou,
Guangzhou, these coastal cities. Then the local government gives you a one-toone match. But here when we get one dollar we only get 80 cents, because the
local government, the hospital and the university, will try to get these 20 cents.
(Han)
Although these numbers may be inaccurate, there are clear differences between the
amounts of government funding for innovation in the life sciences in different
geographical regions (Hong 2008). There are also constraints on the knowledge flow
between geographical areas:
It is first from the USA. Then it comes to Beijing. Then scientists work on some
papers, digest some ideas. Then they try to influence government. Then they write
down the guidance for the government. When people get to apply for a grant, they
have first inside information. We are just to get very small grants. (Han)
Another stem cell scientist from a research hospital in Beijing, Prof Zhu, commented:
The problem is that people close to the government get the funding. (Zhu)
21
As with other scientists in provincial cities, Prof. Han is worried about inequality:
… because there are no equal rights for all people or scientists in China. We have
only few resources as small or remote cities, compared to big cities, such as
Shanghai. We have to create some new way. (Han)
The ‘inequality’ between geographical areas and political location is linked to
government science policies and has consequences for the ability of scientists to set up a
robust infrastructure for bioethical research. To stem cell scientists in the provinces, on
average, there is less funding available. This inequality is not uncommon for developing
countries, and might decrease over time. But for now, it means that stem cell researchers
in ‘remote’ and ‘provincial’ areas remain in relative isolation that, according to a
regulator cum stem cell researcher from a metropolis, Professor Pu, are hard to control.
Such a dubious reputation is a great disadvantage to stem cell researchers who put much
effort into changing the problematic image of stem cell research in China. Nevertheless,
the relatively isolated areas are not expected to yield bioethical stem cell research. This
illustrates the dislocated nature of bioethics within China: national guidelines are not
expected to be effective in all stem cell research centres. In fact, to be associated with the
areas lagging behind greatly lessens the chances of attracting scientists, conducting
promising collaborative research or publishing in well-reputed journals. In this sense,
lagging behind is part of China’s local risk signatures.
22
Risking research funding
The socio-geographical background of research centres in China forms a source of risk to
stem cell researchers when they apply for funding. Recognised by most stem cell
scientists, much resentment persists among the less fortunate about policies that privilege
a few national centres of stem cell research. In March 2007, internet blogs and articles
[wangzhang] named and accused stem cell researchers of misusing government funding
and making false promises when applying for research funding (Chen 2007). Although
much of the discussion is based on speculation, it is clear that government fundingstrategies have changed as a result of the problem at issue: the overconcentration of
funding on relatively few scientists. Now, instead of very large grants, smaller sums are
allocated to less ambitious projects, or alternatively, large sums of funding are awarded to
consortia of small projects. Thus Professor Zhao from Beijing was recently awarded 200
million Renminbi (RMB – China’s currency), which will be distributed among 30
projects over five years. However, some critical voices among scientists, though hardly
audible, still disagree with the country’s financial policies. One stem cell researchers was
very critical of the enormous investments channelled into human embryonic stem cell
research. Dr Bing, a returnee stem cell scientist with an international publishing record,
was very outspoken on the government support for Li and Sheng in private:
They come back together to cheat the government. This is disclosed on the web.
So people hate them. Some people are very rich; some people are very poor. The
poor people also pay very much tax. This is a bad thing. (Bing, Transl. by author)
23
This stem cell scientist, who feels strongly about his impoverished peasant family, is
worried about the distribution of research resources among scientists:
Now the Chinese government realises this…. Now the level is much higher, so
they can see what is good research. But if you compare [China] with the USA,
then they [Chinese scientists] are just like students. In China, they are at the
beginning. But you have to do things step by step. Also they hurt and impaired the
scientific environment, because the resources are limited. Big scientists get
money, but other scientists work very hard but do not get any support. (Bing,
Transl. by author)
‘Big scientists’, here, in particular refers to scientists who try to get ahead internationally,
rather than looking after their researchers at home. Most PIs are scientists that have
returned from a research period abroad and are in their 40s now. The number of returnee
scientists is still low (Cao 2004), and the ones that do return often maintain strong links
with their foreign university, sometimes to such an extent that they need replacements to
look after their students and to do their experiments in China. Some researchers complain
about the quality of the supervision of work in a Chinese stem cell lab, especially those
led by absentee PIs, referring to it as ‘muddling along’.9
The experience of one rural city researcher, Dr Zhang, provides a glimpse into the
research experience of a rare home-trained researcher who has published in international
9
This phenomenon was corroborated as common in labs in Shanghai and Beijing, also by the PIs
themselves.
24
journals (as first author). He first expresses his dismay with the scale on which money is
spent emulating foreign research experiments:
You will have observed that in China there are many researchers doing research.
But there are not many research results to speak of. Many of the researchers
repeat the experiments that you foreigners have done…. There are many medium
project grants. It is not you yourself who is paying. And many projects are done
by group teams; they are not done by individuals. Everyone looks at a different
aspect. And you have to learn the technology. (Zhang) [Transl. by author]
Secondly, Zhang doubts that this is helpful to individual researchers and the atmosphere
in the lab:
You can see that many people are very nervous. So often when you do
experiments you just have to feel your way around [mosuo] the situation. Some
people have already explored the area, but others have not. If you have already
found out about it, then it is of course not very difficult. But in China, some
people envy [duji] you, and they do not want you to surpass them. So if you do
not get their help, then you just to have to grope around yourself. Not all people
are like that; some people are very warm. There are all kinds of people. (Zhang)
[Transl. by author]
25
Finally, he indicates that he has experienced doubt about the reliability of research results
generated in such atmosphere:
You see the results obtained in articles and see that they are different from the
results you have. Then you don’t know how they correspond to the experiments.
Sometimes they have just been made up. (Zhang)[Transl. by author]
Such accounts are not rare, but they are not expressed in public. Although the high-risk
funding bias in favour of foreign-trained scientists in the metropolises is changing into a
policy of spreading risk over the main metropolises of Beijing, Shanghai and Guangzhou,
stem cell research in large provincial cities is still regarded as a risky target for
investment. Policies to counteract the presumed existence of bioethically incorrect
practices seem to be low on the political priority list. Therefore, not only do stem cell
researchers recognise diverging risk signatures of human embryonic stem cell research in
the privileged metropolises and rural areas, policymakers do so as well: They argue that
the bioethicality of human embryonic stem cell research in the former is better observed
but in principle do not exclude rural centres from funding. Stem cell scientists therefore
can improve their chances of acquiring funding by considering the establishment of
bioethics institution, using them, publishing in international peer-reviewed journals,
collaborations with well-reputed hospitals or other research centres, and finding research
partners abroad.
26
Risking stem cell research or patient health?
Not all Chinese scientists are in support of funding human embryonic stem cell research.
Some actually regard investing large sums of scarce financial resources into human
embryonic stem cell research as a national gamble. To them, the adaptation of bioethical
standards to facilitate human embryonic stem cell research makes little sense in the
context of an obviously bioethically skewed healthcare system. In fact, they regard the
funnelling of scarce resources as a risk to the entire Chinese population. Thus, one former
human embryonic stem cell research, Dr Zheng, opines:
I think that stem cell research now has a lot of money. But there are so many poor
people. It is a problem. It has many prospects, however. On the other hand, there
are many backward areas. The development of the economy is not the issue. [The
problem is that] We cannot look after the patients. (Zheng) (Transl. by author)
This ex-stem cell researcher cum physician is very clear about what he thinks ought to be
government priorities regarding research and scarce expertise:
In Wuhan there is much interest in human embryonic stem cell research, but
clinical research is most important. human embryonic stem cell research you can
use for all kinds of disease. But controlling the development of the stem cells is
very difficult. It is very slow and complex development. It is very costly. It also is
risky, and may take generations to succeed.... But there are so many patients.
There is a great need for new drugs. But the wages of doctors are low. The
27
Chinese economy is the third in the world now, following the USA and Germany
and Japan [sharing no 2]. But its investment into medicine.... In Africa the
medical situation is also very bad. But Africa is the poorest country [sic] in the
world (Zheng) (Transl. by author).
To this physician cum researcher it is absolutely clear that human embryonic stem cell
research is not going to be of any use to his current patients:
But in China there are so many people. It is too difficult to maintain enough
doctors and nurses. Still, life is most important. That is the case in every country.
But one’s own life still takes the first place. So people invest in themselves. But
one must be kind to people [liangxin]. I give you an example. There is the
problem of antitoxins. Did you study medicine? Well, you have to be very careful
with antitoxins [kangmeisu]. You cannot use them in a sloppy manner. There can
be many side effects. Still, we use them very much. Sometimes it would be better
to take X-rays. But they are very expensive. One [X-ray] costs over 100 Yuan. So
we don’t use them very much…. (Zheng) (Transl. by author)
This point reflects the outrage of some researchers with the relatively lavish funding
available to stem cell research. But the outrage is hardly related to using embryos or
foetuses for research, as researchers are used to their availability on demand (Zheng:
‘how many do you need?’). Instead, it is aimed at channelling scarce public resources
from healthcare to an area that promises widespread relief from a range of diseases. To
28
the quoted researcher, the problem is that funds are misdirected. He therefore articulates
the idea that ‘healthcare reform takes longer than the realisation of the dreams of stem
cell science’. Using bioethical methods to create products that improve health can hardly
be persuasive to a population that clearly lacks healthcare facilities for simple diseases
and hygiene (Blumenthal & Hsiao 2005; Liu & Rao 2006; Wang et al. 2007; Chan et al.
2008: Ch. 7).
The argument made here is not that the healthcare system should be reformed
before human embryonic stem cell research is funded, but that the unequal provision of
healthcare in the immediate environment is not conducive to the sense of bioethical
justice for quite a few individual scientists – usually those no longer or not engaged in
human embryonic stem cell research. As a result, meticulous implementation of research
regulation seems futile to them. China’s national risk signature for human embryonic
stem cell research in this sense is characterised by a conflicting distribution of health
facilities receiving reproductive materials for research into therapies that are not likely to
ever reach the donors. Nevertheless, bioethical guidelines for stem cell research are
supported by most.
III Public debate as risk
In the third part of this article, I examine why scientists generally regard public debate on
the bioethics of human embryonic stem cell research in China as a risk to their
profession, even though their adoption of bioethics institutions is crucial to its
maintenance. It will become clear that public debate is an important part of the national
risk signature of human embryonic stem cell research (among other potentially
29
controversial subjects). This is especially so because public debate could potentially harm
the reputation and therefore funding of human embryonic stem cell research; it could also
affect policies on healthcare funding and research regulation. According to a majority of
stem cell scientists, the incorporation of public discussions into bioethical policymaking
is unnecessary and, according to some, even a risk to the quality of academic debate on
bioethics.
Perceived division between scientists and ordinary people [laobaixing]
Discussing public debate with stem cell scientists in China requires clarifying the general
perception of the term among intellectuals. Asking stem cell scientists about public
debate [gongkai de bianlun] on human embryonic stem cell research, it becomes clear
that the concept of ‘public debate’ is not necessarily associated with the broad public.
Responding to the question ‘does China have public debate on stem cell research’, the
following answers were common:
•
Yes, I think so. I went to a conference where there was much discussion on
this. (Zhai) [Transl. by author]
•
You can look on the web, there you can see…. It is interesting for the college
students. Here, people live together in the dormitory. They can discuss this
over night. (Bing, Transl. by author)
Indeed, the majority of scientists pointed out that public debate could be found on the
web and in the newspapers, mainly pertaining to debate among intellectuals. There is a
30
sharp division in the eyes of scientists between scientists and the man on the street
[laobaixing]. Asked whether ordinary people [laobaixing] should have a say in creating
bioethical regulation, there is great variety of opinion among scientists. Some views are
encouraging of public debate:
•
Ordinary people must also have the right to talk about it. They have the
responsibility to talk about this. (Bing) [Transl. by author]
Some views indicate strong doubt about the wisdom of involving the masses:
•
I think they also need a say, but it could lead to forbidding stem cell research
like in the USA. (Shi) [Transl. by author]
Some views doubt the ability of the masses to understand the main issues:
•
They might lower the level of discussion. (Pu) [Transl. by author]
Some scientists worry that the laobaixing will be cheated:
•
If we explain exactly what stem cells do to all the people, there are some
people who use it to make money. They say that their medicine consists of
stem cells and make money with it. (Wu) [Transl. by author]
31
Some views that doubts the interest of laobaixing in the discussion:
•
They have more important things to do, such as looking after themselves,
making money. (Su) [Transl. by author]
•
They are more interested in the price of houses. (Lai). [Transl. by author]
The vast majority of scientists did not count the views of non-intellectuals as part of
public debate. When asked to think about reasons for including them, the vast majority of
stem cell scientists found reasons to exclude them, while it occurred to none that public
trust in science could be important. Stem cell scientists in China, rather than the social
‘alter-ego’ of a critical public, focus on the government as a source of criticism and
appreciation. This has consequences for the way they evaluate the role of the public in
bioethical issues of human embryonic stem cell research, and to what extent they regard
the public debate as a risk factor. The national risk signature of human embryonic stem
cell research in China then proceeds from a situation in which public debate is kept at
bay. As scientists are aware that in other countries controversies have resulted in tighter
research regulation, the majority of stem cell scientists argue at great length why the
public should have no voice in the debate.
Conditional support for public debate on stem cell research
It should be emphasized that these opinions represent the views of interviewed stem cell
scientists and are not necessarily those of the laobaixing. For the laobaixing interviewed
on this topic (mostly manual workers in the city), though in possession of only a little
32
knowledge about stem cell research, many were much interested in the ethics of embryo
and oocyte donation and the creation of human clones and cybrids. The question arises
here whether scientists emulate government views in underestimating the ability and
interest of the masses in matters of science regulation. When asked if there should be
public debate about stem cell research in China, scientists expressed a conditional need
for public debate on stem cell research:
•
If it would be conducive to creating clear guidelines: So that we know what
we must do to do our work. So I think we should talk about these issues (Jing)
[Transl. author]
•
If the public is educated: But if everyone starts to get involved in it, it may be
difficult. (Lai) [Transl. author]
•
If official authorities channel the discussion :In China you have the Peoples
Congress. They have representatives that can deal with the issues of the
people. (Sun) [Transl. author]
•
If the opinions can be standardized: There are also people who oppose
therapeutic cloning. There are various opinions. We try to normalize it, but in
fact there is disagreement. (Tai) [Transl. author]
•
If it leads to the adoption of regulation. (Lu) [Transl. author]
There were only two unconditional responses, albeit self-conscious ones:
33
•
Of course. For all we do is for the patients and we always listen to their views.
I don’t want to say that we are representative, however. (Zhai) [Transl. author]
•
No, because the international stem cell organisation already has stem cell
research guidelines (Du)
Although, when pressed, stem cell scientists could think of reasons for holding public
debate, in the first instance they regard debate as limited to the participation of
intellectuals. Nevertheless, scientists could think of a limited number of ways in which
public debate would include the ‘masses’ without threatening their work. This would not
basically alter the national risk signature for human embryonic stem cell research in
China.
The organisation of debate on stem cell research in China
Some stem cell scientists, particularly internationally active PIs, have ideas about how
debate could and should be organised in China. Some emphasise the role of the
government. One leading scientist from Shanghai, Prof. Jing, claimed that:
Our government recently started a project to ask people from all walks of life
about their attitude... They give a sum of money for researching people’s views on
this. They are still doing it. (Jing) [Transl. by author]
In Wuhan, a large industrial city in the inland Province of Hubei, this view seems entirely
out of place. A leading scientist in Wuhan thinks that the government should create open
34
discussion about oocyte donation, embryo donation, informed consent, the distinction
between therapy and human experimentation, and other bioethical issues, but he does not
think that general open debate is possible in China:
Now only a few people decide things and make a discussion. (Hu)
In even more isolated areas, a leading stem cell scientist cum reproductive doctor
expressed disillusionment about the ability of the government to organise bioethics
discussions. He advised emphasising the training of physicians instead:
Well, I think it is more important that the government encourages more general
moral attitudes. I think it is even more important that medical schools emphasise
moral education more. (Hui) [Transl. by author]
The reason for this call for government intervention is that S3, together with many other
scientists, believes that ordinary people’s education and culture do not teach them how to
make balanced bioethical judgements:
It is not very easy. For there are many elements in Chinese traditional culture that
are not very rational or ethical. In Chinese tradition, it is possible that the desire to
have more children is emphasised over human rights. Chinese traditional culture
is based on the household not on the individual. (Hui) [Transl. by author]
35
Bioethics aimed at autonomous individuals, according to this scientist, is not suitable to a
rural environment where the attitude towards the family household is crucial. Research
into public attitudes toward stem cell research is also rare in metropolises. In China’s
main cities with flourishing stem cell research, one can find some debate about stem cell
research among intellectuals, while in provincial cities scepticism even about the
existence of political will to hold such debates prevails. In remote rural areas, such debate
is thought to be unthinkable due to the ‘low’ cultural and educational backgrounds and
poverty. In such a situation, the set-up of bioethical institutions in stem cell research
centres has occurred in the first instance with formal research regulation and without
public debate. But since a movement of bioethics supported by international bioethics
groups has gained more recognition, scientists’ autonomy and views on bioethics are
being challenged – and so is China’s national risk signature of human embryonic stem
cell research.
Bioethics communication and the role of scientists in stem cell research debate
Among scientists one can find great variety of attitudes towards public discussion, but
there is general agreement about the difficulties in communication between the press and
bioethicists. While only a few stem cell scientists make an attempt to support the
discussions on stem cell research, some take an active part in the discussion:
If we are going to push the development of stem cell research, we need to have
such debate. For the more people understand, the more support you get. In my
36
case, it is so. This is why, if I have some time, I write small articles for the paper.
(Deng)
Others are optimistic about the role that scientists could play:
Scientists should guide the discussion. Scientists should first discuss this with
social scientists and then maybe get a deep understanding and then send it to the
media and the newspaper in an article. (Bing)
However, the majority of stem cell scientists, for reasons explained in the earlier section,
think that public discussion would currently be unhelpful. Although bioethicists are
sometimes engaged to get political support and maintain good relationships with hospitals
(Du), most stem cell scientists feel they are little understood by them and have little faith
in their basic knowledge of science (Zhao; Du; Hu; Hui). One prominent scientist, who is
not alone in having engaged in debate with non-scientists, finds discussion with
bioethicists on therapeutic cloning a waste of money and time:
If you talk to people and they never take your idea, it is a waste of time. I was
involved in two ethics conferences, both in Shanghai. I was the only scientist
involved. I gave two different presentations on cooperation between ethics and
science. But each time, when the experts and lawyers asked questions, I
understood that they understood nothing. (Zhao)
37
The difficulties this scientist experiences seems to be linked to the difference in
interpretation of bioethical issues at home and abroad:
It is different when I talk about it in Europe. In the EU committee, after I gave a
similar speech, I got feedback. Real communication. That is why I think that in
China maybe in the future we need some new people, perhaps some scientists, and
they really need to cooperate with foreign experts, not only do the translation.
(Zhao)
China’s bioethics debate among experts on stem cell research is not coordinated well.
Zhao’s experience raises the question whether Chinese bioethicists are able to mediate
between scientists and regulatory political organs to facilitate international collaborations.
A prominent scientist from Guangzhou, Prof. Pang, expresses this problem:
On the bioethical level, we nearly have an exact copy of foreign bioethical
regulation. It is as if we are so stupid. You guys are so lazy. Can’t you set up your
own standards…? I would advice that scientists would get together and have a
debate in China with the people and set up its own rules on the basis of its own
ideas. So if you then criticise then I would defend China’s bioethics to the end.
(Pang)
Although the copying of foreign or international guidelines is common, Pang feels that
the reason for copying is that China lacks the coordination and communication necessary
38
to set up guidelines. Bioethicists, according to this scientist, try to prevent scientists from
setting up the regulations that are conducive to their work, such as allowing embryo
donation for compensation. Rather than scientists deciding about the contents of
bioethical rules, scientists comment, China’s chances to forge ahead in the field are risked
by copying international guidelines.
Discussion: National risk signatures and the subjective hierarchy of bioethical
murkiness
The ways in which Chinese stem cell scientists express their views on the risks related to
human embryonic stem cell research are clearly different from those of their colleagues in the
West, but also different from those of their colleagues in other branches of science in China.
Like the hackneyed views in the official press about China being a materialist country, stem
cell scientist echo that China has no relevant religious views on embryos and oocytes.
Understanding these ‘cultural views’ as social constructs sheds light on some of the social and
political contexts in which their views are formed. But such reflexive views are not sufficient
to understand the specificity of debates regarding human embryonic stem cell research. For
instance, why has human embryonic stem cell research generated problems, while embryo
research, which has been going on for decades in China, did not.
Analysis of human embryonic stem cell scientists’ risk perceptions of bioethics made
clear that their work concerns were too distant from debates on the ontological value of
embryos or oocytes for them to have any strong views about embryos and oocytes, including
the women scientists who claimed to speak for the embryos of IVF clients. If they did express
bioethical concerns, it was usually done in terms of bioethically correct notions of ‘the
39
embryo becoming human after fourteen days’ or in terms of the ‘importance of informed
consent procedures’. These findings point to a pragmatic attitude, which may be typical of
scientists working with embryos in general. However, the situational logic deployed by the
Chinese scientists was shaped not just by the nature of their job, their specific institutional
environment, and the concrete materiality of their technology as predicted by Horlick-Jones’s
concept of risk signature. Although these indeed condition their daily work and delimit the
possible meanings and interpretations of problems associated with embryo research, it was
crucially formed by their comparative theories on bioethics and material circumstances in
China and in other countries, at a global comparative level. As scientists’ decisions are based
upon this global awareness, their strategic thinking and action belong to a Chinese national
risk signature of human embryonic stem cell research.
Scientists engaged in human embryonic stem cell research identified various forms of
risk related to competition for funding and their reputation in the field of human embryonic
stem cell research. The failure to observe international research ethics counted as a major
reputational risk to obtaining funding and negotiating collaboration. The reputation of their
laboratory’s bioethics institutions was important to all interviewed stem cell researchers with
international ambitions, though references were made to the lack of these institutions in other
stem cell research centres. Relevant to the position of stem cell researchers in provincial
cities, a wide belief prevails that bioethical supervision becomes weaker the further one
moves away from the metropolitan centres such as Beijing, Shanghai, Tianjin and
Guangzhou. The murky reputation of provincial stem cell laboratories, according to stem cell
scientists at all levels, has led to a funding bias in favour of recognised metropolitan stem cell
research centres, which is seen to be discriminatory. Just as the reputation of stem cell lines
40
from Wisconsin as stable and trustworthy has worked against the acceptance of new stem cell
lines from other regions in the world, scientists from China’s provinces feel that a lack of trust
in their research and their research ethics has a discriminatory effect on their ability to
conduct research that will be recognised, and their chances of acquiring research funding.
Many scientists in this connection referred to the vicious circle of the knowledge-lag and
reputation.
Stem cell researchers identified public debate as another source of risk to human
embryonic stem cell research. Most stem cell researchers regarded public discussion on
research ethics as a liability and threat rather than as an asset and positive method for
familiarising the public with stem cell research and as an attempt to obtain public trust.
Among national bioethicists, non-stem cell scientists and the public, however, other forms of
risk may be of higher priority, such as the political risk associated with the donation of
embryos and oocytes for research in times of stringent family-planning; the risk of wasting
research money on human embryonic stem cell research rather than spending it on other
healthcare needs of the many; and the risk of losing international credibility as a collaborative
partner due to sloppy bioethics and opaque research conditions. Rather than issues of the
ethical status of embryos and oocytes, it is these various forms of perceived risk – together
with those experienced by human embryonic stem cell scientists – that can shed light on the
particular shape that human embryonic stem cell research has taken in China.
A main feature of the national risk signature of human embryonic stem cell research in
China is the awareness of the ambiguity of having opaque bioethical guidelines. This
awareness is of significance to the concept of risk signature introduced by Tom Horlick-Jones
(2007). In social science the concept may be valuable as a descriptive tool, but in the practice
41
of human embryonic stem cell research a layman’s notion of risk signature is employed in the
strategic reasoning of scientists aware of their environment. Such strategic reasoning takes
advantage of the ambiguity of the status of bioethics and the risks involved. On the one hand,
working according to bioethical regulation facilitates international collaborations and
participation in nationally funded projects on human embryonic stem cell research. On the
other hand, a majority of stem cell scientists is reluctant to engage in public debate on human
embryonic stem cell research and on becoming subject to bioethical supervision. This is so at
both national level and provincial levels. Thus, stem cell scientists generally regard losing
international competitiveness as a greater risk than failing to establish research based on
international guidelines at a local level. Similarly, at a provincial level, provincial scientists
regard falling behind national research institutions as a greater risk than lacking adequate
bioethical institutions at provincial and local levels of research. This means that if bioethical
institutions are set up, they are not always effective. This kind of bioethics is ambiguous, as
its existence assumes that it deals with the risks run by patients and donors, but its low
effectiveness minimises the potential risk of harming the development of human embryonic
stem cell research.
In short, the ambiguity of having bioethical guidelines in stem cell research centres
without transparency or supervision on its implementation facilitates China’s development in
the field, enabling collaborations with hospitals and research institutes on any of the levels. In
these circumstances, any interference by bioethicists could threaten this ambiguity by
levelling the playing field. For the ambiguity of the meaning of bioethics is ultimately made
possible thanks to the subjective hierarchy of bioethical practices in human embryonic stem
cell research. A hierarchy of perceived murkiness running from international stem cell
42
research downwards to the national-level labs of developing countries to provincial level ones
is both an attraction and a risk to international collaborators. In this sense the ambiguity
expressed by stem cell researchers is part of the risk signature of human embryonic stem cell
research strategically enabled by China’s politics of leaving stem cell laboratories in the field
to their own devices.
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