Right or wrong? You decide
Nobody said solving ethical issues is easy. Take a complex scientific topic, communicate several different points of view in a manner understandable to anyone, and then have a meaningful debate about it. In two hours?
Walking through the bright doors of the Dana Centre, I expected another typical lecture-debate: speakers on stage, taking turns to drip-feed information to a puzzled lay audience. It was with some surprise that I sat down in front of a board-game and several bits of coloured card. No nodding off at the back here I would have to engage my brain.
DECIDE is the first in a series of debates at the Dana Centre based on a game called Democs. Part card game, part policy-making tool, it "enables small groups of people to engage with complex public policy issues", according to the blurb. The game is part of an initiative to try to engage the public in a range of science policy issues, including stem cells, nanotechnology, and genetic testing. Dana is one of 13 institutions in 11 European countries taking part, with the results compiled and displayed online.
The topic chosen for this session couldn't have been more complex. Xenotransplantation, the transfer of animal cells, tissues, or organs to humans, has all kinds of repercussions. Is it safe? Will new viruses develop because of human-animal interactions? Can we justify yet another use of animals as human commodities, bred solely for our benefit? Would you still feel `human' if you had a pig's heart? But with only one organ for every five who need it, researchers are understandably looking into the possibility. The Department of Health even has its own advisory body on the matter, UKXIRA (UK Xenotransplantation Interim Regulatory Authority). Yet the question remains as to whether members of the public would accept such an idea. This is where DECIDE comes in.
The placemat-like board sets the scene. Several policy positions are laid out, ranging from "it's just wrong" to "as long as it's safe". Players are dealt different information cards detailing points of view, facts, and moral and scientific issues to consider. The group takes time to read out their cards and works to `cluster' related cards together, stimulating debate in the meantime. A couple of `experts' are on hand to give explanations, in this case from the Immunology department of Hammersmith Hospital. At the end, each group tries to come to some agreement.
My table had a real mix of people: a young couple, and old couple, a couple of Americans, a textiles student, an IT worker and all here for an "interesting night out". The rules were at first difficult to get to grips with, as well as the sheer number of cards. But once we'd figured out what we were supposed to do, a few opinions ignited the discussion.
A former vegetarian argued passionately for the good treatment of animals in preparation of xenotransplant surgery. He rightly asked: "Where does the buck stop? When can you not have any more replacement hearts?"
"Who decides who gets them first?" I interjected. Another girl wondered whether refusal of an animal organ might reduce your chances of getting a human organ.
The lady next to me asked if we could ever know that the animals were `disease free', holding up an information card that said some diseases are harmless in animals but may be dangerous in humans. The crossover of pig retroviruses is the current worry, particularly given the recent bird flu pandemic. "Nellie doesn't care," replied another man, holding up a story card with the plight of a mother whose son will die without a new heart. We all wondered if more could be done to encourage human donors when was the last time you saw an advert for organ donors?
All the while, the animal rights issue hung heavy in the air. Xenotransplantation might be another stamp of approval for the `animals as commodities' school of thought. As the ex-vegetarian put it, "You can't deny it's another market for animal death." And what of animal rights extremists?
The bell signalled an end to our lively discussion. Each group read out their response, some deciding the risk was too great, but most in favour of a careful approach provided more research, strict regulation, and the welfare of animals was taken into account.
"Interesting, informative and fun" was the common consensus on the event. I certainly agree. You're far more likely to remember things you have argued passionately about, than stuff that is just read out to you in a monotonous voice. Moreover, there is a sense of `empowerment' which comes with actively taking part in decision-making on an important topic. The question is whether anyone of importance, government or otherwise, takes note. Public engagement is all well and good, but if the opinions don't count, it's as useful as a fish on a bicycle.
DECIDE is available for download at www.playdecide.org
