Navigating sensitive topics: Ensuring clarity and emotional care in survey research

In September 2024, the National Centre for Social Research (NatCen) conducted a survey amongst its Opinion Panel members on attitudes towards xenotransplantation on behalf of the London School of Hygiene & Tropical Medicine (LSHTM) supported by the National Institute for Health and Care Research (NIHR).
Building on earlier ethical reviews from the 1990s, this study is the most up-to-date of its kind in Europe and offers the first representative UK data on public views toward xenotransplantation
Xenotransplantation – which involves the transfer of living cells, tissues, or organs between species, typically from pigs to humans – has long been seen as a potential solution to organ shortages. However, its emergence raises complex ethical questions and concerns about global health equity.
The survey explored the public attitudes towards xenotransplantation, including awareness of the concept, willingness to accept animal organs (such as genetically modified pig hearts or kidneys), and views on ethical, religious, and safety concerns. It also examined how support varied across demographic groups and whether attitudes changed after respondents received more information.
Fieldwork for this study was conducted using the NatCen Opinion Panel – a random-probability panel of people recruited from high-quality, random probability studies such as the British Social Attitudes survey. The data was collected between 30th August and 29th September 2024 using a sequential mixed mode design (web and telephone).
The survey began by exploring general attitudes to human organ donation and transplantation. It then asked about religious and moral beliefs, dietary practices, and views on related scientific and medical issues such as genetic modification and the use of animals in healthcare. Next, the concept of xenotransplantation was introduced, followed by questions on awareness, and levels of support or opposition. Respondents were asked whether they would accept a pig organ transplant, under what circumstances, and their concerns. Subsequent sections explored treatment prioritisation, impact of pig organ availability on the NHS on human donation attitudes. Finally, the survey assessed shifts in views and attitudes following the provision of information.
Recognising the sensitivity and complexity of the topic, the survey used plain language and allowed respondents to express both support and concerns. For more information on the questionnaire development, read our blog here.
Out of 5,986 panel members invited to take part, 3,193 completed the survey – yielding a 53% response rate. Of those who completed the survey, 3,043 took part online while 150 by phone.
The data was weighted to be representative of the UK adult (18+) population.
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