Exploring Bioethics
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National Institutes of Health
Department of Bioethics

Exploring Bioethics

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Teacher's Guide

About the Modules

Goals


The purpose of this curriculum supplement is to introduce students to bioethics as a field of inquiry and to enable them to develop ethical reasoning skills so they can move beyond “gut reactions” to more nuanced positions. The supplement will help students achieve the five major goals outlined below.

Goal 1

Recognize the interrelationship among science, society, and ethical considerations.

Students will understand that the process and discoveries of science have social and ethical implications that an informed public and scientists need to address. They will also recognize how scientific data can and should inform ethical analysis and public policy making.

Goal 2

Develop the ability to recognize important bioethics concepts and ways of thinking.

Students will understand that the four key questions and relevant ethical considerations can guide them as they analyze bioethical issues.

Goal 3

Develop critical-reasoning skills, especially the ability to justify an ethical position.

Students will cultivate habits of mind and skills so that they can reason about ethical issues and develop well-informed, well-thought-out reasons. These skills include being able to identify ethical questions, gather relevant scientific facts, consider who or what could be affected by the way questions get resolved, identify relevant ethical considerations and apply them to the problem, and justify a position in line with these considerations. Students should also consider whether their justifications for their positions on different issues are consistent.

Goal 4

Recognize the importance of scientific knowledge in bioethical decision making.

Students will understand the importance of applying scientific knowledge to making informed decisions about bioethical issues. The curriculum supplement gives students the chance to apply and reinforce important science concepts and enhances their appreciation of and interest in learning science.

Goal 5

Enhance respectful dialogue among individuals with diverse perspectives.

Students will grow in their capacity to discuss controversial issues with civility and respect for different viewpoints, thus preparing them to be better citizens in a democratic, pluralistic society. Students should also realize that their personal values are shaped by their cultural context.

Overview of the Modules


Table 3 (pages 22–23) summarizes the ethical issues and curricular connections for each module.

This supplement comprises six modules. Module 1 is an introduction to bioethics and to this supplement. It is important to teach Module 1 first because it presents a conceptual framework that students will apply in all the later modules.

Modules 2 to 6 can be taught in any order. The framework presented in Module 1 includes four key questions and core ethical considerations, which are common issues that people ought to take into account when faced with an ethical choice.

It is important to teach Module 1 first because it presents a conceptual framework that students then go on to apply in all the later modules.

Table 3. Ethical Issues and Curricular Connections

Module Ethical Issues* Curricular Connections
  1. Bioethics Concepts and Skills

This module introduces a problem-solving approach that students can use when faced with ethical decisions. It includes answering four key questions and paying attention to core ethical considerations (respect for persons, harms and benefits, and fairness). Each student uses these questions and considerations to develop a well-reasoned justification about the ethics of enhancement in sports. Extension opportunities promote discussion of other kinds of enhancements in cognitive and artistic performance. This module should be taught first because it introduces a method of bioethical inquiry that will be applied to all the other topics.

  • Nature of science (empiricism)
  • Steroids and hormones
  1. Balancing Individual and Community Claims: Establishing State Vaccination Policies

Module 2 emphasizes the core ethical considerations of respect for persons and fairness, and students wrestle with the tension between individual freedom and community well-being. Each student must determine, and justify, how he or she would balance individual and community claims about a hypothetical community controversy involving mandatory school vaccination policies.

  • Community (herd) immunity
  • Epidemic
  • Information about specific diseases
  • Interpreting data
  • Nature of infectious disease
  • Vaccines: impacts, benefits, and risks
  • Vaccines and immunologic memory
  • Viruses and bacteria
  1. Allocating Scarce Resources: The Case of Organ Transplantation

After briefly exploring a range of historical cases in which decisions had to be made about the allocation of a scarce biomedical technology, students focus on the task of fairly distributing organs that are in short supply. With the consideration of fairness in mind, each student must take a fully justified stance about what he or she sees as the fairest distribution policy.

  • Immunology: factors that determine whether an organ is a good match
  • Liver: function, reasons for failure, transplant statistics
  • Organ systems
  • Transplant basics: which organs or tissues can get transplanted? What factors ensure a better outcome?
  1. Weighing Benefits and Harms: Ethical Issues in Genetic Testing

Students consider respect for persons and recognize and weigh all harms and benefits in order to make a fully justified recommendation about genetic testing for a teenage member of a hypothetical family. Because some of the genetic tests are predictive rather than diagnostic, each student also grapples with how best to proceed given the inherent uncertainty of the situation.

  • Alzheimer’s disease
  • Cancer biology
  • DNA: structure and mutations
  • Genetic testing: predictive vs. diagnostic
  • Mendelian genetics: recessive
    vs. dominant
  • Mutations: inherited vs. somatic
  • Pedigree interpretation
  • Relationship among genes, proteins,
    and traits
  1. Research Ethics: The Power and Peril of Human Experimentation

Students learn that research with humans has led to widespread benefits but can also lead to abuse and harms if certain protections are not in place. Students consider factors that make research most respectful of all individuals, including ensuring voluntary and informed consent.

  • Nature of science: research design, how experiments are done, the need to test one variable at a time, the need for comparison (or control) groups, and intervention vs. observational studies
  • Study design: controlled studies, placebos, randomization, and blinding
  1. Modifying the Natural World: Human Responsibilities toward Animals

Students examine human responsibilities to the rest of the natural world, particularly with respect to the modification of animals for human purposes. They grapple with harms and benefits to animals and humans and whether respect for persons should be adapted and extended to other species. Because scientists might not yet completely understand the modification’s effect on the animal or on the environment, each student must grapple with uncertainty when justifying his or her decision about which kinds of modifications to animals are and are not ethically appropriate.

  • DNA, RNA, protein, traits
  • Ecosystem
  • Genetic modification and gene insertion methods
  • Implications of scientific interventions
  • Mutation
  • Phenotype, genotype
  • Population dynamics
  • Selective breeding, monoculture

*Although each module touches on each of the three core ethical considerations (respect for persons, minimizing harms while maximizing benefits, and fairness), the most relevant considerations within each module are noted in bold.

Using the Modules


As you review the modules, you will find that each one contains several major features.

At a Glance

summarizes the module.


In Advance

offers lists of the items needed to carry out the module. These include photocopies and transparencies, materials and equipment, masters, and teacher support materials. Each module is divided into three days of class, each about 45 minutes long.

Each module is divided into three days of class, each about 45 minutes long.

The day begins with a description of the purpose of that day’s activities and which of the four key questions and ethical considerations students will take up that day, followed by these sections:

Icons

appear throughout the activities. They alert you to teaching aids that can help you implement the activities and enrich student learning.

Assessment Icon Assessment

Indicates steps in the activities that you can use as assessments, including informal indicators of student understanding, and the final assessment at the end
of the module.

Ethical Considerations

Indicates where in the text a particular ethical consideration is covered in depth.

Respect for Persons
Harms and Benefits
Fairness
Responsibility
Authenticity


Web Icon More on the Web

Indicates when further student or teacher support is available on the Web.

Note Icon Note

Offers further explanations, teaching hints, or implementation suggestions.

Module Icon See Module 1

Reminds you to complete Module 1 with your students before starting any of the others.

Reference Icon See the Introduction

Indicates when you can find further information in the Introduction about a particular feature, which you should be sure to refer back to.

Web Materials Icon See Teacher Support Materials

Indicates when teacher support materials are available. The materials are only on the Web site, so the See Teacher Support Materials icon is always accompanied by a More on the Web icon (www.). These materials include answer keys and in-depth ethics content. They are important and very helpful. Check them out! Go to http://science.education.nih.gov/supplements/bioethics/teacher.

Tip Icon Tip from the Field

Indicates when teachers from the field test had information that could be helpful as you implement the module.

References and Resources appears at the end of each module. It lists the sources used in the module and resources to go to for further information.

Masters to be photocopied for students are located at the end of each module as well as on the Web site.

Teacher Support Materials—including answer keys, background information on different topics, and extension activities—are available on the Web site: http://science.education.nih.gov/supplements/bioethics/teacher.

Alternative Ways to Implement the Modules


You should begin with Module 1, because it provides the background necessary for student understanding of the subsequent modules. However, you can teach Modules 2 to 6 in any order. Table 3 on pages 22 to 23 summarizes the ethical issues the modules highlight and their connections to topics in biology.

Each module consists of three 45-minute class sessions and, usually, some homework. You can teach each module’s three days consecutively or integrate pieces of the modules into existing units. You can use a scenario from a module as an introduction to one of your biology units, teach that unit, and then return to the remaining ethics sessions at the end.

For example, Module 4 addresses the topic of genetic testing, so you could integrate it into an existing Mendelian genetics unit. Day 1 of Module 4 could begin the genetics unit. Although students would not yet have an understanding of recessive and dominant modes of inheritance, they could grasp the idea of the purpose of a genetic test and would likely be drawn into the unit by discussing some of the related ethical issues. Furthermore, students would be likely to ask questions about inheritance patterns while working through Day 1. From there, the class could transition into the unit on genetics, and the pedigrees from Day 2 could be integrated into the discussion of inheritance. Toward the end of the unit, students could tackle Day 3 of the module and complete the final assessment. In this way, the bioethics module becomes a “wrap-around” for the longer genetics unit.

Correlating Exploring Bioethics with National Science Education Standards
and State Standards


The National Science Education Standards (NSES), developed by the National Research Council (1996), describe the content every student should know and the inquiry skills every student should master. Tables 4 and 5 indicate the alignment of Exploring Bioethics with the grades 9–12 standards. Alignment of the supplement with every state’s science, math, and English language arts standards is available online at http://science.education.nih.gov/statestandards.

Table 4. Alignment with NSES Life Science Content Standards

Life Science

Standard C: As a result of their activities in grades 9–12, all students should develop understanding of

Correlation to Exploring Bioethics

The Cell
  • Most cell functions involve chemical reactions. Food molecules taken into cells react to provide the chemical constituents needed to synthesize other molecules. Both breakdown and synthesis are made possible by a large set of protein catalysts, called enzymes. The breakdown of some of the food molecules enables the cell to store energy in specific chemicals that are used to carry out the many functions of the cell.

Module 6

  • Cells store and use information to guide their functions. The genetic information stored in DNA is used to direct the synthesis of the thousands of proteins that each cell requires.

Modules 4, 6

  • Cell functions are regulated. Regulation occurs both through changes in the activity of the functions performed by proteins and through the selective expression of individual genes. This regulation allows cells to respond to their environment and to control and coordinate cell growth and division.

Modules
3, 4, 6

  • Cells can differentiate, and complex multicellular organisms are formed as a highly organized arrangement of differentiated cells. In the development of these multicellular organisms, the progeny from a single cell form an embryo in which the cells multiply and differentiate to form the many specialized cells, tissues, and organs that comprise the final organism. This differentiation is regulated through the expression of different genes.

Modules 4, 6

The Molecular Basis of Heredity
  • In all organisms, the instructions for specifying the characteristics of the organism are carried in DNA, a large polymer formed from subunits of four kinds (A, G, C, and T). The chemical and structural properties of DNA explain how the genetic information that underlies heredity is both encoded in genes (as a string of molecular “letters”) and replicated (by a templating mechanism). Each DNA molecule in a cell forms a single chromosome.

Modules 4, 6

  • Most of the cells in a human contain two copies of each of 22 different chromosomes. In addition, there is a pair of chromosomes that determines sex: a female contains two X chromosomes and a male contains one X and one Y chromosome. Transmission of genetic information to offspring occurs through egg and sperm cells that contain only one representative from each chromosome pair. An egg and a sperm unite to form a new individual. The fact that the human body is formed from cells that contain two copies of each chromosome—and therefore two copies of each gene—explains many features of human heredity, such as how variations that are hidden in one generation can be expressed in the next.

Module 4

  • Changes in DNA (mutations) occur spontaneously at low rates. Some of these changes make no difference to the organism, whereas others can change cells and organisms. Only mutations in germ cells can create the variation that changes an organism’s offspring.

Modules 4, 6

Matter, Energy, and Organization in Living Systems
  • All matter tends toward more disorganized states. Living systems require a continuous input of energy to maintain their chemical and physical organizations. With death, and the cessation of energy input, living systems rapidly disintegrate.

Module 3

  • The energy for life primarily derives from the sun. Plants capture energy by absorbing light and using it to form strong (covalent) chemical bonds between the atoms of carbon-containing (organic) molecules. These molecules can be used to assemble larger molecules with biological activity (including proteins, DNA, sugars, and fats). In addition, the energy stored in bonds between atoms (chemical energy) can be used as sources of energy for life processes.

Module 6

The Behavior of Organisms
  • Behavioral biology has implications for humans, as it provides links to psychology,
    sociology, and anthropology.

Modules
1, 2, 3, 5


Table 5. Alignment with Other NSES Content Standards

Other Content Standards Correlation
to Exploring Bioethics

Science as Inquiry

Standard A: As a result of activities in grades 9–12, all students should develop

Abilities necessary to do scientific inquiry

Modules 1–6

Understandings about scientific inquiry

Modules 1–6

Science as Technology

Standard E: As a result of activities in grades 9–12, all students should develop

Abilities of technological design

Modules 3–6

Understandings about science and technology

Modules 1–6

Science in Social and Personal Perspectives

Standard F: As a result of activities in grades 9–12, all students should develop understanding of

Personal and community health

Modules 1–6

Population growth

Module 6

Natural and human-induced hazards

Modules 2–6

Science and technology in local, national, and global challenges

Modules 1–6

History and Nature of Science

Standard G: As a result of activities in grades 9–12, all students should develop understanding of

Science as a human endeavor

Modules 1–6

Nature of scientific knowledge

Modules 1–6

Historical perspectives

Modules 1–6

 

 

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