A PROCESS: FRAMEWORK FOR TEACHING BIOETHICS

William Smith
1992 Woodrow Wilson Biology Institute

"BIOSHOCK" might just be the word to describe the advances being made by science and technology. Transgenic animals, gene therapy, new prenatal and reproductive strategies, fetal tissue research, transplants, and more may cause biology teachers to begin changing the view of life and nature. This biotechnology may expand our knowledge, even stretch it, and give us new powers and freedoms, but at the same time it brings us new responsibilities.

What does all of the above have to do with education, the classroom, and teaching? Simply, in addition to biological knowledge and applications, teachers will need to present bioethics: "BIO" meaning life and "ETHICS" meaning the development of principles, rules, and ideals that give standards of good and bad, right and wrong.

The outcome will allow students to answer, "what should I do?" or "what ought I to do?", in terms of biotechnology and to do it with reason and to accept the answers they generate. A biological/bioethical student who can recognize ethical issues, who has moral imagination, who uses analytical skills, and who develops a sense of moral obligation and responsibility is a student who is ready for the challenges of biotechnology of the 90's and beyond. Can a biology teacher do this? Certainly.

BASIC STEPS IN THE PROCESS OF TEACHING BIOETHICS

The seven steps in conducting bioethical decision making in the class-room are researched, based and drawn by experience from individuals who deal with bioethics and the skill of decision making.

• Identification And Presentation
• Background
• Individual Value Clarification
• Small Group Discussion
• Class Discussion
• Closure
• Extension Or Implementation

A PROCESS: TEACHING BIOETHICS

1. Identification and Presentation

This step allows the student to determine if there is an ethical problem and what has to be decided by whom and what ethical problem(s) this decision seems to raise. The dilemma may be teacher directed from real issues or situations or from a case study. The dilemma may be read to the class as a whole , or else each student can read it for himself/herself. Identification is the first "cut". The presentation that follows will refine and revise the dilemma as the teacher leads the student to a better understanding of the situation and to exploring the ethical values and concepts that explain why the dilemma is a dilemma. Questions that might help the identification and presentation:

• what kinds of questions can be raised by this dilemma?

• who are the "participants" in this dilemma?

• what are the points of conflict?

• do you feel that these questions are hard to answer?

• will someone summarize the situation?

• what things have to be considered in making a choice?

• who is affected by the decisions?

• what ethical problems does the decision seem to raise?

Teacher Hints:

1. Now is an ideal time to get into the meanings of words. Please realize that the following words are difficult to define and their meanings are never determined once and for all, but definition is worked out by a process of dialogue, moral disagreement and debate.

   Morality/Morals - beliefs and standards of good and bad, right and wrong, that people actually follow in a society. Morality is the practice of what people do and believe.

   Ethics - the study of morality. It gives a philosophical account of justified behavior and belief. It spells out the reasons why a rational person ought to accept the answers he or she gets. It develops rules and ideals that spell out standards of good and bad.

   Values - names for states of affairs that conform to what is ethically right and that further the human good. They are prized and promoted, i.e., autonomy, honesty, justice, knowledge, etc.

2. Remember that resolutions are not yet being sought, dilemma is being set up with questions and answers.

3. Don't force immediate responses or responses from reluctant students. Use "wait time" and "think time" as part of the process.

2. Background Information

This step assesses factual information for the student who becomes the decision maker. This information base provides an understanding of the issue and the substantive content to develop the process in a bioethical situation. The background also serves to bridge the gap between the real world and the hypothetical dilemma that is simulated from a case study, a real situation or event. Thus the dilemma is real and not just a story. It reflects real societal concerns, values, and moral conflicts that arise from biotechnological activities.

Teacher Hints:

1. Select issues or case studies that you or your students find interesting, i.e., abortion, human genome, animal research, etc.

2. Background should not be all inclusive and should avoid too much technical detail. Remember the dilemma is an outgrowth from your content. It supports and reviews your content with a shift to bioethical decision making.

3. Include additional materials, readings, or exercises to help generate livelier discussions later and a diversity of perspectives.

3. Individual Value Clarification

This step establishes the personal values that seem relevant to the situation and allows the student to prize and promote personal patterns, "what kind of picture do I get of myself?" This step exposes one's self-concept, self-acceptance, self-esteem that lead to the confidence needed to make an ethical decision. "What ought I to do in light of who I say I am?"

Teacher Hints:

1. Don't skip this step even though it is time consuming.

2. For most students this is the first time that anyone has ever asked them to look at their own values. Allow them the time to express themselves.

3. There are many models to choose from to complete this value clarification. The John Hendrix model, included in this framework is recommended. It is included in this framework. Choose the one that works best for you or your students.

4. Small Group Discussion

This step allows individuals to speak out in a small non-threatening atmosphere where conversation is between student and student. The infor-mality of the group allows for entertaining unique or unusual ideas that would not be expressed in a large group. Small group also places more responsibility on each person to add to the group's activity. An underlying motive for this step is to expose the student to different values and opinions on the same issue. This creates a state of disequilibrium (shift in mental framework) that causes the individual to begin rethinking and restructuring thought, a basic premise of ethical decision making. A scribe should be selected to write down each person's comments and values. Things to be discussed: a statement about the dilemma, values to support statement, difficulties with the dilemma, any additional information that may have bearing on the dilemma. After each has expressed him/herself, proceed with group discussion that includes: why each group member supports their perspective, can they come up with alternative positions, "pros and cons" to each person's perspective? Now the group needs to come together with solutions or alternatives that they all can agree upon. They need a group consensus for each of the following: Did we identify the ethical problem that is important in the dilemma? Did we consider the factual information in our decision? Did we identify the " participants" in the decision? Did we identify the values at stake in the decision? Did we identify the options available in the decision? The scribe will write a response for each of the above on a piece of paper. This will be used in the class discussion.

Teacher Hints:

1. Make a short fact sheet to pass out in each group that surveys the information involved in the dilemma. Also a format sheet to each group as to what should be accomplished in the group.

2. Teacher must try to have students "see" perspectives, i.e., that seeing dilemmas or decisions as moral issues is "seeing" in many directions at once. "Seeing" beyond artificially narrow options and forced choices. "Seeing" acceptable alternatives, "seeing" more options. "Seeing" raises considerations of values, that there are implications "pro and con" in one's actions. "Seeing" that moral issues involve freedom, choices, and rights of individuals.

3. Role playing may be done in this step as an option to the above outline.

4. Ask someone in the group to be a "thorn". This student keeps the group focused on the issues at hand. This person may also play devil's advocate by injecting now and then "would you be willing to have this rule or decision applied to you?"

5. It is a good idea to check in on the groups from time to time and look for the presence of detachment or disequilibrium.

6. Allow discussion to continue as long as it is fruitful and students display an interest.

5. Class Discussion

This step allows the entire class to reconvene and to hear the solutions or alternatives made by the various groups. Discussion is generated as group reports are examined by the whole class. The discussion gives the opportunity for opposing views or to ask questions or to challenge the views, and to evaluate the effects and consequences of decisions. For some students it will be disequilibrium time again, while others will have support time. The key to the success in this discussion depends on "you the teacher". Draw on your strengths of being a biology teacher-maturity of judgement, logical reasoning, and mastery of your content matter. YOU CAN DO THIS. Open your students' minds to unfamiliar ideas and show them connections between decisions, actions, and consequences for self, for others, and for society as a whole. These questions must be addressed in the class discussion:

• have we considered all "participants" in the solution?

• is the solution fair to all affected parties?

• do the benefits outweigh the risks?

• can we live with our solution? Can others?

If the class, with consensus, can answer these questions with a yes, then the solution is acceptable; if no, go back and reach accord.

Teacher Hints:

1. Skillful questioning becomes the tool to aid students to think critically, analyzing the positions they take and the values inherent in their position.

2. Put students in "risk of learning" situations. Stimulate students' searching and stretching of self.

3. Do not preach, do not give definitive answers, do not impose your own personal moral beliefs during the discussion.

4. Look for a shift from autonomy to community responsibility.

5. Structure in a discussion is necessary, but structure should not hinder the flow of ideas.

6. Closure

This step ends with a firm agreed-upon conclusion(s) or with at least the feeling that something has been learned, understanding has improved, ideas have been clarified and students have been led to think. Be sure to review the process with the students. Metacognition (thinking about thinking) is just as important.

Run through the steps of the process and ask for clarification.

Teacher Hints:

1. The emphasis of the activity is on analyzing the reasoning process by considering different viewpoints and alternative choices. No one answer is correct or absolute; each position has merits and invites further investigation.

2. It may be appropriate at this time to point out some actual situations that resemble the above dilemma and discuss how they were resolved and what were some of the results.

3. The educational aim of this process is to enhance the students' ability to reason intelligently about the moral dilemmas and value conflicts inherent in the knowledge and applications of biotechnology.

7. Extension Or Implementation

This step is optional. You may wish to extend or elaborate the dilemma or cause individuals to become active by letter writing, writing an editorial, campaigning, picketing, etc.

References:

Barry Beyer. "Conducting moral discussions in the classroom." Social Education, April, 1976, 195-292.

Lawrence Kohlberg. "Moral stages and moralization: the cognitive- developmental approach." In Thomas Lickona (Ed.) Moral Development And Behavior: Theory, Research, And Social Issues. New York: Holt, Rinehardt and Winston, 1976.

Howard B. Radest, Can We Teach Ethics? New York: Praeger Publishers, 1989

"The Teaching of Ethics in Higher Education: A Report by the Hastings Center." Hastings-on-Hudson, N.Y.: The Hastings Center, 1980.

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