Bioethics with Chinese characteristics: cultural contexts and modern trends

Although Chinese doctors are prohibited by law from reporting the sex of the unborn child, many practice it for bribes, which leads to selective abortions. Sometimes, this can end up with jail sentences for physicians Shi Weixing. (2000) Biomedical Ethics (Shengwu yixue lunli xue). P. 214.. But if the decision to make an abortion is not determined by unwillingness to have a daughter, the attitude is different. If married couple is just not ready to have a baby, �abortion can be carried out after consultation between the two parties�, - says Shi Weixing.

Genome editing issues appear in bioethical agenda more and more often.

In her article �n the gene rights in Chinese Medical Ethics journal (������w?�z?), Qu Na analyses potential of the contemporary gene therapy. She states that the unborn child must have the right to eradicate harmful genes and to be born completely healthy. But if we give parents and doctors an unlimited right to interfere with genome, and they would want to improve some qualities of the embryo, his/her rights will be violated. By doing so, they will �program� the child for a specific life scenario (here are some examples from the article: they will make the baby very tall, but he/she will want to have a profession where it will only interfere with his/her plans; they will �program� the baby to have white complexion, but he/she will prefer to have darker skin and hair to be more like parents) Na, Q. (2019) �The Establishment and Limitation of Gene Rights:

Consideration from the Perspective of Genetic Gene Therapy (Jiyin quan de zheng li ji qi jiexian - yichuan jiyin zhiliao jiaodu de si),� Chinese Medical Ethics (Zhongguo yixue lunlixue), 5: 602. . The author also points out at the dangers of genetic improvement: it may lead to the strengthening of social stratification and the decrease in the cultural diversity of mankind.

Finally, Taoist "natural" approach is also worth mentioning the. Of course, from its point of view, genetic enhancement will be inappropriate. The same can be said about surrogacy or, for example, donation of the genetic material for reproduction purposes (eggs or sperm). However, says Michael Cheng-Tek Tai, researcher in the field of medical ethics and Taoism, infertility should be cured as well as another illnesses, because all of them indicates �the disharmony of yin and yang, and the interaction of the Five Elements. Medical treatments to restore the natural flow of the Tao are always acceptable� Cheng-Tek Tai, M. (2009) �Natural or Unnatural - An Application of the Taoist Thought to Bioethics,� Tzu Chi Medical Journal, 21(3): 273..

Human Cloning

Human cloning is a unique bioethical issue. On one hand, it is not being practiced yet, and nobody seems to speak about its justification. However, this topic is discussed in almost all publications devoted to bioethics as a subject of speculative reasoning. Chinese segment is not an exclusion. Here, we see rather typical approach of Chinese scholars: they point to the serious ethical problems arising from human cloning, and at the same time discuss it the as if it were already in practice. It seems like they say �Nothing is possible!�

Kang Phee Seng, professor of Religion and Philosophy in the Hong Kong Baptist University, starts his article �Cloning Humans? Some Moral Considerations� from the counter-arguments to the typical fears. It is wrong to believe, he says, that the cloned person will be an exact copy of the �original�, this is refuted by monozygotic twins who can be not even similar in appearance and personality. With a rather ironic tone he supposes that people �may even perceive a clone as the reincarnation of the donor. In other words, Pol Pot of Cambodia may be resurrected and Hitler immortalized� Seng, K. (2004) �Cloning Humans? Some Moral Considerations,� p. 116. In Qiu R. (ed.) Bioethics: Asian Perspectives..

However, Kang Phee Seng also lists the dangers of cloning. Especially interesting for us are the issues related to family - he talks about many of them. Here are some examples of his concern. The clone of the father grows in the family as a child. If the couple divorces, children usually stay with her mother - but in this case, she could refuse to raise the clone of her ex-husband. Or, if a child is a clone of the mother, there is a potential danger that her father will be sexually attracted to her when she will grow up because he once felt in love with the woman with the same appearance. And finally, the second parent, if not genetically related to the child, can show no love to it.

The author enumerates many of the dangers associated with human cloning, but repeats again and again that a clone should be fully granted with all human rights and protections as any other person, just as if we were going to face these problems in the foreseeable future.

By the end, I will again present a Taoist point of view. If �myriad� of things are created by interaction of yin and yang, only two actors can create something natural and benevolent: in our case they are mother and father. But if someone is cloned, the tao of yin-yang or the law of nature is violated, therefore, it is inappropriate Qiu, R. (2006) �Cloning Issues in China,� p. 61. In Roetz, H. Cross-Cultural Issues in Bioethics. .

Social problems

In China, scholars rarely express an anxiety about severe social inequality that can come through technologies of human enhancement. The above mentioned Qu Na is rather an exception. At the same time, it is a frequent topic in the West discussed in religious and secular contexts.

However, the Chinese often pinpoint the economic problems related to euthanasia and its prohibition: Shi Weixing asserts that the right to choose is fundamental and inalienable, but he also draws attention to statistics of medical expenses. According to the scholar, a half of an average person's medical expenses in his life falls in its last year, and quarter falls on therapy and care services in the last week Shi Weixing (2000) Biomedical Ethics (Shengwu yixue lunli xue). P. 242.. Of course, all these problems exist in other countries as well, and the scholars recognize them. However, in Western textbooks, it is almost impossble to find something resembling this economic argument. That emphasises the �practical� aspect of the Chinese approach. Of course medical economy important for everyone, but Chinese ethisists do not hesitate to discuss it explicitely. Noting that the value of life in a vegetative state is zero or negative, Shi Weixing suggests that disabling life support in a rational and civilized way to end life.

Chapter 3. Chinese Bioethics in Practice: Legal Framework and Public Opinion

�China Will Always Be Bad at Bioethics� - this is the title of an article in Foreign Policy magazine published in April 2018. It represents a regular point of view of the Western media in recent years, and at first glance, this position may seem not so unreasonable.

Some foreign scholars take advantage of the fact that ethical regulation in China is not as strict as in their countries, so they conduct medical experiments there. This includes the well-known case of Italian neurosurgeon Sergio Canavero, who researches in the field of head transplantation at Harbin Medical University in China with the team lead by surgeon Ren Xiaoping. Spanish biologist Juan Carlos Izpis�a Belmonte conducts experiments on the first human-monkey hybrids embryo in China that provoked a public outcry in 2019 Regalado, A. (2019) �Scientists are Making Human-Monkey Hybrids in China,� MIT Technology Review. URL: [https://www.technologyreview.com/2019/08/01/652/scientists-are-making-human-monkey-hybrids-in-china/].. If anyone studies media publications on biotechnology, it may seem to them that all the most daring and even frightening experiments are being conducted in China.

An appearance of a hybrid embryo shocked many people in 2019. Still, back in 2003, the researchers of Shanghai Second Medical University designed the first human-rabbit embryo Weiss, R. (2003) Cloning Yields Human-Rabbit Hybrid Embryo,� The Washington Post. URL: [https://www.washingtonpost.com/archive/politics/2003/08/14/cloning-yields-human-rabbit-hybrid-embryo/8a032b32-9983-46ad-90c8-acbf585e77ed/]., and according to publications in Chinese media, this took place even earlier, in 2001 at Sun Yat-sen University of Medical Sciences. �Two experts successfully transplanted a child's skin cells into rabbit oocytes using nuclear transplantation technology. It is the first time in the world to clone human embryo using a combination of human and rabbit cells� �The Academicians Call into Question the Fusion of Human and Animal Cells and Believe it Would Undermine Ethics and Human Dignity� (Yuanshi zhiyi renchu xibao ronghe renwei jiang xiedu lunli he renlei zunyan),� Beijing Morning Post (�k������). URL: [http://news.sohu.com/55/74/news146647455.shtml]., - Beijing Morning Post (Beijing chenbao, �k����?) informs. Another typical example: two world-first pig-primate chimeras have been born at the State Key Laboratory of Stem Cell and Reproductive Biology in Beijing Le, Page, M. (2019) �Exclusive: Two pigs engineered to have monkey cells born in China,� New Scientists. URL: [https://www.newscientist.com/article/2226490-exclusive-two-pigs-engineered-to-have-monkey-cells-born-in-china/#ixzz6Kj4DB6XP]..

Without going into details of these experiments' scientific importance, let us note that they all took place in China and provoked a massive public reaction. Due to many publications in the Western media, China achieved a specific reputation as a constant source of scandalous scientific news and a country indifferent to ethics. The reasons for this lie in its political orientation, which I called �scientism� in the paper's second chapter, some particular features of its medical services market, ethical legislation, and regulations. One of the goals of this chapter is to show that it is too hastily to assert that �China Will Always Be Bad at Bioethics.� The current state and development of bioethics in China are complicated issues since it has various trends and currents that sometimes oppose each other. In the second chapter, I tried to show that the history of Chinese bioethics is not so much shorter than in the West. Even though Chinese bioethics has its distinctive features, it does not ignore the issues of general bioethics and pays close attention to them.

In this chapter, I am addressing the question of how Chinese bioethics is practiced and applied. Two main objects of the analysis will be the legislation and public opinion. Concerning the first aspect, I will list the major Chinese laws and regulations that make up the framework for the application of various medical technologies. The second aspect will be observed by considering some Chinese articles expressing the opinions of experts and journalists on outstanding bioethical cases that have attracted attention to China in recent years. To provide a more comprehensive picture, I have studied widespread reactions to relevant publications on the Chinese Weibo social network. It is also a valuable material for some conclusions about what is an attitude of Chinese citizens towards such kind of biotechnological �breakthroughs.�

3.1 Laws and Regulations in the Field of Chinese Bioethics

There are many laws and regulations that one can regard as managing bioethics. It is especially relevant for China, where transparent government's biopolitics takes place; the paramount example of this is its birth policy. Married couples in China should get a special certificate (zhunshengzhen, �y��?) before their child is born or immediately after that. Only after this procedure, a baby could obtain a household registration (hukou, ?��) �Shengyuzheng (Birth Certificate),� Baidu Baike Online Encyclopedia. URL: [https://baike.baidu.com/item/����?/8125515?fr=Aladdin].. Now parents do not need to get a medical certificate for this, as it was several years ago. Then, Article 10 in Law of the People's Republic of China on Maternal and Infant Health Care (Zhonghua renmin gongheguo muying baojianfa, ��?�l�����a����?�O���k) prescribed obligatory medical examination before marriage. People with severe genetic diseases could not be allowed to do this, except for cases when the man and the woman practiced long-term contraception or were sterilized Qiu, R. (2004) �Does Eugenics Exist in China? Ethical Issues in China's Law on Maternal and Enfant Care,� p. 186. In Qiu, R. (ed.) Bioethics: Asian Perspectives.. Article 18 of this Law strictly recommended to physicians to convince a couple of the need to terminate pregnancy in case the diagnosis showed that the fetus has some defects Ibid. . Article 9 does not allow people with infectious diseases to get married until they recover, and articles 9 and 38 prohibit marriage for HIV-positive individuals Ibid.. Obviously, in the discourse of this law, marriage is closely associated with the onset of sexual activity and childbearing (in fact, full legal procreation is possible only in marriage). That is why it is so important to be healthy at the time of the wedding.

A process of obtaining zhunshengzhen is different for married and unmarried couples (in the latter case, it is much more complicated and demands medical confirmation of the paternity). By law, all babies should have the same rights, but in reality, it is not exactly true �How to Apply for the Birth Permit for Children Born out of Wedlock (Feihunsheng zinu de zhunshengzheng ruhe banli),� Hualu Magazine, 21.05.2019. URL: [https://www.66law.cn/laws/493812.aspx].. Since the goals of my research do not demand to go into detail, we needed this example only to underline the fact of how different legal issues in bioethics can be.

Now we proceed to the essential topics in bioethics - bioethical research involving human subjects and embryos, reproduction technologies, and human enhancement. Legal regulation of the field starts in 1998; the same year, the Ministry of Health established its first ethics committee. It is almost 20 years later than in the US, where first committees started to appear in the late 1970s, and in the late 1980s, over 60% on large American hospitals had their own ethics committees Aulisio, M. (2016) �Why Did Hospital Ethics Committees Emerge in the US?�, AMA Journal of Ethics. URL: [https://journalofethics.ama-assn.org/article/why-did-hospital-ethics-committees-emerge-us/2016-05]. In China, by early 2010, only about half of the Chinese provinces had set up ethics committees in hospitals.

Unlike the law on Maternal and Infant Health Care, which presents some specific regulations and restrictions, the Ministry of Health's Interim Regulations for Ethical Review of Biomedical Research Involving Human Subjects (1998) gives nothing that can stand in opposition to �Western� legal systems. It prohibits (Chapter 8 Article 25):

- All scientific experiments related to human asexual reproduction;

- All research using human embryos and aborted fetuses;

- Import and export of aborted fetuses and organs;

- Sale or/and purchase of human cells, tissues, and organs.

The Clinical Drug Trial Guidelines released in 1999 address to the Helsinki Declaration and CIOMS's (Council of International Organization of Medical Sciences / World Health Organization) International Ethical Guidelines on Biomedical Research Involving Human Subjects. It claims that, according to this international document, �all research involving human subjects must comply with the ethical principles elaborated in, i.e., justice, respect, maximum benefits to human subjects, and avoidance of harm as far as possible� Qiu, R. (2006) �Cloning Issues in China,� p. 57. In Roetz, H. Cross-Cultural Issues in Bioethics..

One of the most critical and detailed regulations in the following decades was 2003's Guidelines on Human-Assisted Reproductive Technology released by the Ministry of Health. It prohibited:

- Sex selection without medical indications;

- Surrogate motherhood technology;

- Donation of human embryo;

- Human egg plasma and nucleus transfer technology for reproduction;

- Creation of a hybrid using human gametes and gametes of other species; likewise the implantation of gametes, zygotes, and embryos of other species into the human body;

- Implantation of human gametes, zygotes or embryos into the ?body of other species;

- Manipulation of the gene in human gametes, zygotes or embryos for reproduction;

- The fusion of sperm and egg of close relatives; in the same period of treatment the gamete or zygote must be derived from the same male and female;

- Transfer of gamete, zygote or embryo to other people;

- Research without the patient being informed and without her or ?his free consent;

- Research on human chimera embryo;

- Human reproductive cloning Ibid., p. 66. .

There are two major aspects we should emphasize considering this list. First is that it absolutely supports the course of all general bioethical concerns and prohibit all controversial biomedical activities. Second, which is, in my opinion, a huge factor in the shaping of Chinese bioethics, is that regulations and laws are not strictly applied, and penalties for the relevant offenses are quite selective. Here are three typical examples proving this statement.

China was the first country where the government gave official approval for a gene-therapy treatment. It is a comparatively new, experimental, and risky technology that demands serious control. To avoid untested therapy in medical practice, in 2009, China restricted the regulation of these therapies. However, according to Qiu Renzhong, that year, there were �more than 100 institutions in China that continue to charge patients thousands of dollars for unproven stem-cell treatments� Cyranoski, D. (2009) �Stem-Cell Therapy Faces More Scrutiny in China,� Nature, URL: [https://www.nature.com/articles/459146a]..

The second example is euthanasia. Today it not legalized in China, and responsibility for completing this procedure is determined under Article 232 of Chinese Criminal Law (��?�l�����a���Y�@, latest 2017's version). Full text is the following: �Whoever intentionally kills a person shall be sentenced to death, life imprisonment, or fixed-term imprisonment of more than ten years; if the circumstances are less serious, imprisonment of more than three years and less than ten years shall be imposed� Criminal Law of the People's Republic of China (Zhonghua renmin gongheguo xingfa). URL: [https://duxiaofa.baidu.com/detail?searchType=statute&from=aladdin_28231&originquery=�s�Y�@�t���S�O�\��&count=1&cid=44c1d146805db411b3d1ffa09c8ef0c3_law].. Thus, the physician will be sentenced to at least three years in prison. But despite the illegality and the fact that doctors can face a prison term for carrying it out, euthanasia is widely practiced in China. Da-Pu Shi and Lin Yu state that according to public polls, 64% of Chinese medical personnel witnessed euthanasia in the clinical practice Shi, D., Yu, L. (2004) �Euthanasia Should Be Legalized in China,� p. 166. In Qiu, R. (ed.) Bioethics: Asian Perspectives. .

The third example I want to give is the abovementioned experiment on the combination of human and rabbit cells that took place at Sun Yat-sen University of Medical Sciences in 2001. The next section presents the analysis of this case in terms of people's opinion, and now we will focus on one quote of the researcher who conducted the experiment. He said: �Now this matter is very controversial. If we have had an opportunity to sit and discuss it, and if after this detailed discussion, everybody will speak out against placing human skin cells in animal oocytes for therapeutic cloning, and as the law prohibits it, too, I will obey. But I believe that a patient with a heart muscle necrosis who can get a good heart by taking a small piece of his skin will not accuse the doctor of moving his skin cells into the oocytes of the rabbit� Jia, H. (2001) �Parties Debate Whether Human-Rabbit Cell Fusion Insults Human Dignity (Gefang zhenglun buxiu shifou rentu xibao ronghe xiedu renlei zunyan),� Sina Tech (xinlang keji). URL: [https://tech.sina.com.cn/o/2001-09-16/84853.shtml].. What is interesting here, the doctor is fully aware that he has committed an illegal action. He acknowledges this, saying that the topic of his research requires discussion. The situation shows a particular attitude to the government's regulations: scientists know about them, but seem not taking into account that it can have a real impact on their work. Though, as in the case of euthanasia, these genetic experiments can lead to selective penalties - we will see it regarding the high-profile case of biologist He Jiankui.

I have one more thing to add in this section concerning this name. Three months after He Jiankui announced the creating of two genome-edited babies in November 2018, National Health Commission of the PRC (Guojia weisheng jiankang weiyuanhui, ����?�Ͱ��d�e??) drafted new Regulations on the Clinical Application of New Biomedical Technologies. It put gene editing, stem cell therapy, gene transfer technology in the list of high-risk biomedical technologies that must be strictly revised (but not prohibited!) and approved by the Health Department of the State Council, pass academic and ethical review �New Regulations are Coming to Regard Gene Editing (Guanyu jiyin bianji, xingui yao laile,� �l�lʵ�飨Renren shiyan ), 02.03.2019. URL: [https://www.renrenlab.com/news/3075.html].. Until now, no press releases announced that this draft became an official regulation. However, this step of the government allows us to regard the case of He Jiankui as important.

3.2 Public Opinion: Arguments Pro et Contra Biotechnologies

The following section of the chapter will address issues of public opinion. Using Chinese media materials and comments of the users on Weibo social media platform, we will try to understand the attitude of people towards different bioethical issues and classify their pro et contra arguments.

Case Study �1. He Jiankui's experiment

�No one should expect to design a baby anytime soon. It will probably be years before gene-editing techniques tested in animals can be shown to work in humans� Harmon, A. (2017) �Human Gene Editing Receives Science Panel's Support,� The New York Times. URL: [https://www.nytimes.com/2017/02/14/health/human-gene-editing-panel.html]., - says an author of the article in New York Times magazine in 2017. That time, a significant breakthrough in the history of biotechnologies took place. The US's National Academy of Sciences issued a report saying: �Scientists should be allowed to modify human embryos to eliminate devastating genetic diseases.� Such treatment was only allowed if �alterations designed to prevent babies from acquiring genes known to cause �serious diseases and disability,� and only when there is no �reasonable alternative.�

Thus, the author of the article notes, American scientists have finally received government support for the research work that is already underway in Sweden and China. He also specifies the reasons that could have pushed the government towards this decision: �A more pragmatic concern driving the committee was the likelihood that the new technology would be adopted in countries like China, where some pioneering research on editing human embryos - without the intent to gestate them [emphasis added] - has already occurred� Ibid.. This statement put this political event to a long line of decisions that were made as an �answer� to China. In my opinion, many political actions in these two countries are done competitively and �in response� to each other.

And just a year after this publication was released, in November 2018, Chinese biologist He Jiankui announced at the International Summit on Human Genome Editing in Hong Kong that he and his team at Southern University of Science and Technology in Shenzhen successfully edited the genome of three babies, making them resistant to HIV/AIDS. Two of them have been born healthy that year. One of the babies' parents is HIV-positive. Thus, they have become the first genome-edited people in history, and the incident caused a big international scandal. Scientists, ethicists, institutions, and media both in China and abroad massively criticized the experiment. It is worth underlying that the reaction in the country was very sharp: the same day of the announcement, on November 26, a joint statement signed by 122 Chinese scientists was published on Weibo, expressing firm opposition and strong condemnation of his research �Why Do We Oppose `gene editing' of babies? The Reality Can Be More Frightening than We Used to Think (Wei shenme women fandui jiyin bianji yinger? Zhenxiang bi ni xiangxiangzhong geng kepa),� Shengming Shibao (����ʱ��), 30.11.2018. URL: [https://www.cqcb.com/yangshen/2018-11-30/1273056_pc.html].. As a result, in December 2019, a court in Shenzhen sentenced He to 3 years in prison and fined him 3 million yuan Normile, D. (2018) �Chinese Scientist Who Produced Genetically Altered Babies Sentenced to 3 Years in Jail,� Science. URL: [https://www.sciencemag.org/news/2019/12/chinese-scientist-who-produced-genetically-altered-babies-sentenced-3-years-jail#]. . Two of his colleagues were also pleaded guilty. They got shorter jail sentences and lesser fines.

Next, in this section, I will examine public reaction on this incident, classify and analyze their �pro� and �contra� arguments. It is worth noting at the beginning that in the materials studied, I founded both condemnation and support of He Jiankui, but the former was much more common, and the latter is more likely to be an exception. However, there is a tendency (and this can be applied to all three analyzed cases): scientists, ethicists, and politicians condemn He Jiankui personally, but they do not criticize his sphere of research. The situation is similar to, for example, cloning or head (brain) transplantation issues discussed in the second chapter. Shi Weixing and other ethicists say these operations raise many serious questions, but nobody says it is impossible or will not happen in the foreseeable future. In an article in Shengming Shibao newspaper (Life Times, ����??) that provides the collection of opinions on the case, all experts speak out against He Jiankui's experiment. Still, no one speaks out against technology he used in general. And yet, the scientist is strictly condemned. Wang Yuedan, a professor in the Department of Immunology at Beijing University School of Medicine, said to Shengming Shibao reporter: �His approach is extremely inappropriate, even reckless� �Why Do We Oppose `gene editing' of babies? The Reality Can Be More Frightening than We Used to Think (Wei shenme women fandui jiyin bianji yinger? Zhenxiang bi ni xiangxiangzhong geng kepa),� Shengming Shibao (����ʱ��), 30.11.2018. URL: [https://www.cqcb.com/yangshen/2018-11-30/1273056_pc.html].. Qi Ming, a professor in the Department of Medicine at Zhejiang University, noted that He had chosen healthy embryos with no congenital diseases or defects, so this gene editing is entirely unnecessary. There are much more safe, simple, and cheap ways to prevent a baby from being infected by an HIV-positive parent. In the language of the US Academy of Sciences, He had a �reasonable alternative.�

Instead, he opened a kind of Pandora's box: now people will wonder when they will be able to choose children's appearance or, for example, make perfect soldiers Ibid. .

Professor Han Yunyun from the Huazhong University of Science and Technology mentioned that if the experiment's goal was to prevent babies from getting infected with HIV, the risk children were exposed to was higher than the potential benefits. Besides, with this artificial mutation, not only them but also their future offspring could be affected, which makes He's responsibility too heavy � `Gene Edited Babies' Incident Shocked the Society, Wuhan Professors Have Something to Say (Jiyin bianji yinger� shijian zhenjing shehui, wuhan jiaoshou you huashuo),� Wuhan Broadcasting Station (�����㲥����̨) , 27.11.2018 [https://baijiahao.baidu.com/s?id=1618271920772228692&wfr=spider&for=pc].. Dozens of such commentaries from Chinese physicians, scientists, and ethicists were published in media the same day or in the next couple of days after the historic announcement. It was important for Chinese Academia to show how much they value their reputation and the compliance of their work with international standards. Southern University of Science and Technology hired authoritative experts to set up an independent committee to conduct an in-depth investigation and to release relevant information. In the early hours of November 27, Shenzhen Science and Technology Commission stated that the committee had never established He's project.

Almost all critical arguments cited above are the same as in Western media (illegality, danger to the lives of babies, lack of transparency, peer review and even such a delicate moment that, due to social pressure on people with HIV in China, the requirements of the principle of informed consent could not be met - they were a sort of forced to join the experiment.) Some speakers drew attention to the poor self-judgment of He Jiankui, who was obsessed with the �heroic feeling of `the world's first,' and likely never thought he might be in trouble� �Editorial: in Gene Editing Babies Incident, Meaning is More Important than Sensation (Sheping: jiyin bianji yinger shijian, lixing bi shanqing zhongyao),� Huanqiu Shibao (The Global Times). URL: [https://baijiahao.baidu.com/s?id=1618217542772075821&wfr=spider&for=pc].. All these arguments appeared not after, but at the same time and even earlier than in Nature, The Washington Post, The Independent, and all other authoritative Western media.

Almost all reviews from the scientific community are negative, but in Chinese media, we can also find supporters of He's experiment.

The author of one of the articles I studied gives a fairly obvious argument from the field of development of scientific knowledge: its evolution cannot be stopped. Moreover, he adds, biotechnology, artificial intelligence, and space technologies will be the three major areas that affect human development in the future. He writes: �Humans have never been comfortable with the status quo. The development of gene-editing technology is a trend. If people do not conduct this experiment today, can we be sure that they will not do it in the future? Even if He Jiankui had not done it, would Li Jiankui, Huang Jiankui, or anything else not have done it?� �Was He Jiankui Wrong? Humans Are not Those Creatures Who Is Satisfied with Status Quo, the Development of Gene Editing Technology Is a Trend (He Jiankui cuole ma? Renlei bushi anyu xianzhuang de shengwu, jiyin bianji jishu fazhan shi qushi),� // �œ_���� ( Kandian kuai bao), 28.11.2018. URL: [https://kuaibao.qq.com/s/20181128A0O91E00?refer=cp_1026].

He also cites nuclear technologies as an example. Even being aware that they can be extremely disastrous if treated inappropriately, they can bring many benefits to humankind. �Similarly, says the author, the development of biotechnology may also bring unexpected diseases, even infectious diseases, but after continuous clinical trials, it can also be used for human medical treatment� Ibid..

If we evaluate this statement in terms of bioethics methodology, then we again see the supremacy of the consequentialism over principlism. Goodwill and good consequences are what matters, not following the rules and regulations. He Jiankui himself uses the same rhetoric. In the video message released before the announcement of the results of his experiment on November 26, he said: �When you will hear accusations, please, do not forget that there are still many silent families who watch their children suffering from genetic diseases� �Editorial: in Gene Editing Babies Incident, Meaning is More Important than Sensation (Sheping: jiyin bianji yinger shijian, lixing bi shanqing zhongyao),� Huanqiu Shibao (The Global Times). URL: [https://baijiahao.baidu.com/s?id=1618217542772075821&wfr=spider&for=pc]..

Here are some other �pro� arguments from Jia Hepeng, Editor-in-Chief in Science News (�Ȋw�V��)magazine: scientific community is conscious and provides a deterrent for the unethical research, so the field of genetic enhancement will also be controlled; even the most primitive technologies such as metal weapons could lead to catastrophic consequences (genocide in Rwanda is an example); people who can afford themselves using gene technologies will not take serious risks, so there will be no superhumans in the nearest future; due to the interdependence of science and society, the former will not make something unexpected. To conclude everything, the consequences of He's work are much exaggerated Jia, H. (2018) �Does Babies' Genome Editing Incident Means that Scientific Development Is Uncontrollable? (Jiyin bianji yinger shijian fasheng, shifou yiweizhe kexue fazhan buke kong?),� Guoke Wang Magazine (��?�), 06.12.2018. URL: [https://www.guokr.com/article/445797/]..

Some journalists support He Jiankui. Doing so, they explicitly admit that they represent a �minority,� go against the tide and respond to mass criticism. If we turn to the opinion of people not related to science, those who simply read the news, we will see approximately the same picture. The majority of people condemn both the experiment and its leader, expressing dissatisfaction with the violation of the law and even fear. To illustrate this work, I collected typical examples of public opinion in the following way: in one of the most popular social networks in China, Weibo (which is often called analogous to Twitter) I found popular publications on the respective topics (here, we determine popularity in a way that is classic for social networks - by the number of likes and comments) and selected popular comments.

Many commentators of articles related to He Jiankui were surprised by such a short jail sentence: �Tomb robbing, which destroys the previous culture, can be sentenced to death, and genetic programming, which threatens human life for three years?; �It's crazy, only three years�; �only three years ... I was sentenced to three years for stealing a motorcycle�; �If this is a red line, then this sentence is too light,� etc. Some users are concerned about the human gene pool that can be damaged in such an artificial way. Some accuse He in pursuing fame and fortune while violating national regulations. There are also reputation damage regrets: �It really discredits Chinese life sciences, now it is difficult for foreigners to believe us.� Cheering comments are scarce. Most often, they appeal to the personal qualities of the biologist, for example: �Outstanding scientists can do things other people can not.�

Case Study �2. Head Transplantation Experiments of Sergio Canavero and Ren Xiaoping

For several years, public attention is drawn to advanced and controversial experiments of Italian and Chinese surgeons: their work at Harbin Medical University proceeds in the direction of human head transplantation. �I have seen many such patients. Their bodies are ill, but their brains are fine. They show a strong desire to live on. So finding a solution for them is the goal and significance of our study,� explains Ren Xiaoping Yan, A. (2017) �Human Head Transplant Still Some Way Off, Chinese Surgeon Ren Xiaoping Says,� South China Morning Post. URL: [https://www.scmp.com/news/china/society/article/2120912/human-head-transplant-still-some-way-chinese-surgeon-ren-xiaoping]..

Canavero and Ren have already performed successfully, according to their own words, head transplant operations on dogs and monkeys, and after that - on human corpses �Head Transplant Breakthrough Claimed: Doctors Ren Xiaoping and Sergio Canavero Say They Repaired Fully Severed Spinal Cords in Animals,� South China Morning Post, 29.03.2019, URL: [https://www.scmp.com/news/china/science/article/3003740/head-transplant-breakthrough-claimed-doctors-ren-xiaoping-and]. Results were published in a peer-reviewed American medical journal Surgical Neurology International Ibid.. The central pathos of the work is that Canavero criticizes and refutes the prejudices of scientists who believe that the human spinal cord cannot be repaired and connected to the brain after the head transplantation. He states that this is entirely possible, and the advent of such medical technology is just around the corner.

Doctors say their work is �unprecedented,� while Canavero often underlines that it takes place in China: �China has indicated it intends to lead, not follow, the US in all the major scientific and technological frontiers over the coming decades� Ibid.. It seems this has some diplomatic meaning: the Chinese are pleased to have such advanced research conducted in its institute so that scientists can count on government and academic support. He is excited and can not wait to make the planned scientific breakthrough, claiming it will happen �soon� Yan, A. (2017) �Human Head Transplant Still Some Way Off, Chinese Surgeon Ren Xiaoping Says,� South China Morning Post. URL: [https://www.scmp.com/news/china/society/article/2120912/human-head-transplant-still-some-way-chinese-surgeon-ren-xiaoping]., however, without any specification. Ren is not so bold in his statements, but he also expressed confidence in the necessity and possibility of solving this scientific problem. �I am a scientist, not an ethical expert. What I should do is to solve scientific and technological problems in the head transplant surgery,� Ibid. he said. It is also worth mentioning that there is a possibly meaningful coincidence that can have some meaning: both Ren Xiaoping and He Jiankui came back to China after long-term studying and working in the US.

It will be superfluous to say that surgeons have many opponents, but, according to the objectives of our study, I will focus on the arguments of the Chinese.

As for the �soon� statement, some authoritative Chinese scholars have a completely different opinion. Yin Mei (���~), Chairman of the Harbin Medical University Medical Ethics Expert Committee, dean of the Faculty of Humanities and director of the Institute of Medical Ethics at the same university, said that �it may take 50 years, 100 years or even longer for the application of `head-changing technique' � Wu, Y. (2018) �Where Is the Ethical Review of the `Replacement of the Body': the Hospital and Harbin Medical University Ethics Committee Said There Were Not� (�Yiti huantou� zai na lunli shencha de: yiyuan he hayida xiaoji lunli wei jun fouren),� Dongfang Wang. URL: [http://news.eastday.com/s/20171128/u1a13461963.html]..

Huang Jiefu, a high-level medical official who was mentioned above as a person who played an unprecedentedly important role in Chinese policy on organ transplantation (and therefore his opinion is precious in this case) claimed that head transplantation could not be allowed at all: �Liver transplantation is for patients with liver failure, and kidney transplantation is for patients with kidney failure. After changing the liver and kidney, you are still yourself. But if you changed the head, who are you now? Ibid.. Zhang Tiankan, Deputy Editor of Encyclopedia Knowledge (�S�Ȓm?) magazine, who used to work at the Institute of Medical Information of the Chinese Academy of Medical Sciences, said that there are too many objectives to such operation, it is definitely not rationalized at the moment and should firstly become a subject of the most extensive ethical review. It is still unclear what health conditions can be enough to conduct such a risky operation, how the fact that if the operation fails, the patient will inevitably die, etc. Zhang, T. (2017) �Should Head Transplantation Operation be Performed? Ethical Review is Essential (Huantoushu gai bu gai zuo, lunli shencha bi buke shao),� Sike News (�v�q�V��). URL: [http://sike.news.cn/statics/sike/posts/2017/11/219526981.html].

However, there are people at Harbin Medical University who support the research, arguing that science is of the highest value. Cao Depin, Vice President of the institution, said that he sympathizes with this scientific enterprise: �The fact he raised this initiative indicates his will to innovate and desire to discover. If we do not support his research, we are all mediocre. Who will innovate and who will explore?� Wu, Y. (2018) �Where Is the Ethical Review of the `Replacement of the Body': the Hospital and Harbin Medical University Ethics Committee Said There Were Not� (�Yiti huantou� zai na lunli shencha de: yiyuan he hayida xiaoji lunli wei jun fouren),� Dongfang Wang. URL: [http://news.eastday.com/s/20171128/u1a13461963.html]..

For the most part, comments on social media show fear and skepticism. The users write: �Although I feel that technology is cooler than medicine, it is still psychologically unacceptable... I feel terrified�; �For the first time horrified by human advanced medical treatment�; �What a terrible thing it is to turn science fiction into reality. The end of the world is not something natural; it is the self-destruction of humanity�. Many share Huang Jiefu's concern about the patient's personality: �I just want to know who will be this man who changed his head? A or B? Isn't the brain a place to store memories? Would the original memory affect the personality of the man who changed his head? I need an explanation�.

Typically Chinese experts who gave commentaries to the case in newspapers and magazines have not mentioned possible social problems, but such people are numerous in Weibo. �Rich people can do whatever they want,� writes one of them. Another predicts ironically: �In the future, many young and middle-aged people will disappear for no reason, and many rich and mighty people's health will get better and better.� Positive comments often have patriotic component: �I admire my country, in my country we set up scientific experiments prohibited in the United States so that we can attract American scientists to come to China to conduct experiments�� And as elsewhere, there are scientific-oriented arguments. Thus, Weibo user accuses the others: �Even success make people frightened!�.

Case Study �3. Creating human-animal hybrid embryos

As a third example, I have chosen not one, but some similar researches related to nuclear transfer and hybridization of human and animal cells. They can be designed both using human embryos injected by animal cells and vice versa, animal embryos injected by human somatic cells. We have already mentioned these incidents in the beginning of the chapter: in 2001 at Sun Yat-sen University of Medical Sciences and in 2003 Shanghai Second Medical University scientists designed human-rabbit hybrid embryos, and in 2019, Spanish biologist Juan Carlos Izpis�a Belmonte said in an interview with Spanish journal El Pa�s, that his team conducted a controversial breakthrough experiment and created the world 's first human-monkey chimera embryo - in China. All these experiments have the ultimate goal: to find a tool for creating organs suitable for transplantation to humans. As I have already mentioned in the first chapter, the shortage of such organs is very serious in all countries and, most likely, will only increase in the future. The last experiment I have listed, while not less controversial, seems more perspective to many scientists because monkeys and humans are the closest biological relatives, and their hybridization has more chances to be successful. Unfortunately, in all English-language and Chinese-language articles I have observed, there were no details about the research, what Chinese institute it hosts, who participates in it from the Chinese side, etc. The only thing we know (and only from Chinese media) is that Chinese scientists completed the research Tencent News, 02.08.2019, URL: [https://view.inews.qq.com/w2/20190802A0NET100?tbkt=C0&openid=o04IBAEM5zA4s5ASkqbFmX2XpfO0&uid=&refer=wx_hot]. .

An article in Chinese Bulletin of Life Sciences (Shengming Kexue, �����Ȋw) notes that four days before the results of the experiment were announced, on July 26, Japan released a regulation that officially permits experiments on creating a human-mouse hybrid embryo. The author supposes a little bit ironically: �Perhaps it was a coincidence� �Spanish Scientists Create Human Monkey Hybrid Embryos in China, Has Frankenstein Become Closer to Us? (Xibanya kexuejia zai zhongguo chuangzao renhou zaijiao peitai, kexueguairen li women geng jin le ma)?�, Sohu Science (�r�ωȊw), 08.08.2019. URL: [https://www.sohu.com/a/332223756_104952?_f=index_news_23].. It indicates that not only China-US rivalry matters in the development of biotechnologies and bioethics in China.

When the first hybridization took place (let us remind that then - as now - this activity was illegal), it was strictly condemned by former dean of the Chinese Academy of Medical Sciences, vice president of the Chinese Medical Association Ba Denian (�b���N). He claimed that this research is a huge and dangerous challenge for science. �I was shocked to hear the news. Are these cloned cells human cells or livestock cells?� he said �The Academicians Call into Question the Fusion of Human and Animal Cells and Believe it Would Undermine Ethics and Human Dignity� (Yuanshi zhiyi renchu xibao ronghe renwei jiang xiedu lunli he renlei zunyan) // Beijing Morning Post (�k������). URL: [http://news.sohu.com/55/74/news146647455.shtml].. Chinese scientists cited both probable and partly fantastic dangers. For example, they argued, that some currently unknown rabbit diseases could be transmitted to humans, just like HIV might have been originated from African orangutans. Or these embryos can be implanted into a human uterus, that will be extremely blasphemous to human dignity Jia Hongbing (2001) �Parties Debate Whether Human-Rabbit Cell Fusion Insults Human Dignity (Gefang zhenglun buxiu shifou rentu xibao ronghe xiedu renlei zunyan),� Sina Tech (xinlang keji). URL: [https://tech.sina.com.cn/o/2001-09-16/84853.shtml]..

However, some scientists evaluated the experiment as a significant breakthrough. Professor Zhao Nanyuan from Tsinghua University is one of them: �Caution is necessary, but it is ridiculous to make traffic rules before the car has appeared. To verify the transmission route of hepatitis, the United States found 20 volunteers to drink the stool filtrate of infected persons. Science sometimes comes at a price.�

Finally, the organizer of the experiment Chen Gugu, appeals to the ethics of using human embryos, which is quite rare for Chinese scientists. Gene therapy is very promising, but it raises ethical questions because of the destruction of human embryos, he argues. But if you use animal embryos, for example, a rabbit, this problem will disappear. Ibid.

In searching for social media comments on the topic, we concentrated on the 2019's case of human-monkey hybridization, while it could have been challenging to find extensive discussions on the incidents that took place in 2001 and 2003.

The main motive for the comments is empathy towards future hybrids and fear: �It's too cruel to wait for him to grow up before taking the organs. This is a crime! When can humans stop being so selfish?�; �If I were a human monkey, I would ask why would I be a monster since I was born, and why would you humans kill me to save someone's life? Besides, monkeys have a little IQ, plus the gene, at least it will be 7-8 years old. . . Isn't it too cruel for a child?� Though, some consider the risks to the people to be more dangerous: �Producing new species is not the most terrifying, the most terrifying is whether the created cells will lead to human genetic mutations by medical treatment.� However, no such topic can be without at least some approving commentaries. Here, they also mostly refer to the significance of science: �Without scientific research, there would be human beings today?; �I suppose if there were no research from ancient times to the present, human beings would extinct because of smallpox more than two thousand years ago.�

After studying the opinions of scientists, journalists, and ordinary users of social networks, I confirmed my initial assumption that there are many more opponents of the controversial experiments in Chinese society than their proponents. One can conclude that as a rule, the object of criticism is particular people and incidents, not the scientific technologies that were used: people say that for them, the time has not come yet; they just lack critical reflection. Fear and rejection of such technologies are expressed mainly by people who are not engaged in science, for example, those who comment on the news on Weibo - which is not surprising. They say these experiments are unnatural and even signify the end of the world. Some also refer to the aggravation of social stratification: the technologies developed are exclusively for the rich. Among the positive reviews, two main types of arguments can be distinguished: (1) the development of science has the highest value, and besides, it is inevitable. Throughout history, it has been accompanied by risks, but they are necessary so that humanity can move forward and achieve prosperity. (2) Patriotic argument. It is remarkable that our country, say the Chinese, is ahead of scientific progress, which gives it a competitive advantage over other states.

3.3 Major Findings and Conclusions

What is bioethics if we speak about its Chinese version? The study of the topic has enabled the author to understand its diversity and complexity. The first thing that comes to our mind when we hear about bioethics is �academic discipline� - in both humanities and natural sciences. As I have shown in the chapter I of the thesis, from the very beginning of its history theologians and philosophers were engaged in its elaboration, but also, of course, ethicists with medical, biology and other scientific backgrounds took part in the process. Though, this integration is not always successful. Professor at Tsinghua University Zhao Nanyuan (?�쌳) complained: �There is a phenomenon in China: those who engage in ethics do not study natural sciences, and those who engage in natural sciences do not study ethics� Jia, H. (2001) �Parties Debate Whether Human-Rabbit Cell Fusion Insults Human Dignity (Gefang zhenglun buxiu shifou rentu xibao ronghe xiedu renlei zunyan),� Sina Tech (xinlang keji), 16.09.2001 [https://tech.sina.com.cn/o/2001-09-16/84853.shtml]..