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Germany

Fun and Games With Moral Dilemmas

Should insurance companies record a patient's DNA? Should people use medicines that were derived from stem cell research? A new German online game, "gen.ethix," lets users ponder difficult bioethics questions.

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It may be possible -- but is it right?

Lisa and Monika's mother was not yet 50 years old when she was committed to a nursing home. The reason? She had Huntington's Disease, an illness in which the patient increasingly loses control of his or her body and mental faculties. Her two daughters have a 50 percent chance of getting the disease as well, which begs the ethical question: Should they undergo genetic testing for the disease?

This fictional situation is just one of several posed to people who play "gen.ethix." The online game -- only available in a German-language version -- asks players to make decisions on questions of the future of biotechnology.

Opportunities -- and risks

"We want to encourage people to think, to get them informed, and motivate the players to look at all the different arguments and form their own opinion," said Jörg Wadzeck.

Wadzeck is one of co-initiators of the project, which was put out jointly by the Bioethics and Science Communication committee of the German Human Genome Project, and the Department of Multimedia at Potsdam Technical College.

DNA, thumbnail

DNA solution in a pipette

The continued development of biomedicine leads to new opportunities and therapies -- but it also contains risks that we can't necessarily anticipate today. This is why it is so important that discussions on bioethics don't stay limited to professional circles, the project's initiators say.

Ali Ben Salem, bioethicist at the Max Delbrück Center for Molecular Medicine, says ethical arguments cannot be made in a theoretical vacuum. "An ethical judgement requires a real result. Without a practical reference, (making a judgement) isn't possible."

No answers, just information

Because of this, the researchers chose ethical problems that are reality based. The user moves a virtual character around the screen, choosing between different fictional cases. For example: What do I do if the insurance company tries to recruit me for a promising pilot project -- but in exchange wants to store my complete DNA sequence in its database? Can a medicine against Parkinson's Disease be used in good conscience when it was developed using embryo stem cells?

"We can't, and don't want to, give any answers to moral dilemmas," Wadzeck said. But while players have to find their own answers to the difficult questions, the game's producers give players help, by providing them with a wealth of information on the subjects at hand. Background data, interviews and personal commentaries from experts in the fields of research, politics, religion and ethics, covering all positions on the ethical spectrum, are provided.

All of the decisions and commentaries made by other players are saved -- anonymously, of course -- into an accessible memo bank ("memothek.") Some of the results have surprised even the scientists.

"The majority of people are much more open to biomedicine and new therapies than I would have thought," Salem said. In the fictitious case of Monika and Lisa, 71 percent of the players said they would seek a genetic test to find out whether they had a possible hereditary disease. Only a small percentage of users thought knowing they were going to get the disease would be a greater burden than not knowing.

Results skewed for age?

"We have noticed that the better informed the public is, the more distrustful it is," said the ethicist Salem when asked to explain why people seemed so open to biomedicine.

"The results are also skewed for age, because most of the players are under 40," Salem said. He attributed that to the age group using the internet.

Currently, the game is limited to three ethical conflict scenarios. Should it be expanded -- a question of finding the financing to do so -- Salem said the next theme would be on paternity testing.

"We choose examples that are straight out of real life, to get the public interested in questions of bioethics. The current debate on secret paternity testing shows that this topic is more acute than ever."

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