describing the background circumstances, examples of open comments and explanation of the categorization. This provides some data that allows us to actually look at the bioethical decision making of ordinary people, and to examine the question of the universality of responses to genetic disease and biotechnology. This data finds the complete range of comments for most questions is seen within the samples from any one country or group. In every society there are people who want to use new genetic techniques such as prenatal genetic screening, and there are some who reject the concept of selective abortion. In all societies we see high support for gene therapy, or making disease-resistant crops, as could be expected.
Attitudes to people suffering from disease may be affected by the use of genetic screening, but further studies over time will be needed to see whether there are significant attitude trends. In most countries the majority of respondents express sympathy. In practice, however, we may not always see such an attitude. This type of study is one approach to address some of these questions. The results are also being used in an attempt to develop a method for assessing the general 'bioethical maturity' of different societies, which includes the ability to balance benefit and risk; discretion between enhancement and therapy; and the balance between autonomy and freedom/restriction.
The most important message of this survey is that people in different countries share very similar images of life and similar diversity of views on most of these issues of bioethics associated with genetics. The main difference may be in the acceptance of selective abortion, but even people saying they were very religious also supported this. Any universal ethics must include some respect for informed choices of people, and the range of choices people desire is transcultural. Policy should reflect the universality of diversity and reasoning.
The social consequences of biotechnology depend on the society that we make. Individuals in different countries share similar attitudes to these questions, but already the social systems in Asia and Oceania are different. Despite the similarity in the views of individuals, the social system in Japan and some other countries is constructed differently, and may not represent the views of the public. 23 However, universal attitudes reviewed in some parts of the International Bioethics Survey, when compared to other international surveys, suggest that we have to reconsider our view that different social systems are the result of differences between peoples; in fact the different social systems may occasionally be used in attempts to establish differences. Universal bioethics already exists at the level of individual decision making, and therefore it is certainly possible to develop social and educational systems to allow universal ethics at the higher level of social systems.