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13. Note that the Boston and Dublin examples represent extremes.In crafting their own policy recommendations, students should beaware of possible policy options between the extremes.For example, it is possible to craft policies that allow individuals to optout of vaccination while requiring evidence of a strong commitment toopting out and proof that the individuals understand the consequences.Fewer people opt out in states that require parents to take moresteps before being granted an exemption.Activity 7:Introducing the Final AssessmentEstimated Time: 10 minutes, plus time to write policy12Procedure1. Tell students that now they are ready to craft and justify a policyrecommendation to their state public health department.An appropriate policy depends on the characteristics of the disease and vaccine in question. As students learned on Day 1, diseases and vaccines vary widely. In their policy statements, students will only consider the vaccines currently recommended by their state.2. Introduce the assessment task by distributing Master 2.13:Vaccine Policy Letter Assignment.3. Tell students they will be taking a position on the ethical questionas it applies to vaccination for currently mandated vaccines for publicschool enrollment in their state:Under what circumstances, if any, should a state grant exemptions to its school vaccination policy?Emphasize that it’s important for students to take into accountethical considerations and accurate supporting scientificinformation when making their recommendations.See Teacher Support MaterialsYou may wish to go over your expectations with studentsbefore they get started. A rubric to help you assess studentunderstanding is available online at http://science.education.nih.gov/supplements/bioethics/teacher.4. Remind students of the three different types of exemptions—medical, religious, and philosophical—used in the United States.Module 2 2-29NoteThis question assumes thateveryone is vaccinated unlessexempt.3456
5. Tell students that their policies should address each of these typesof exemptions and clearly state the kinds of exemptions thatshould be permitted, under what circumstances, and why.6. Ask students to reflect on the following questions as they prepareto write their own policy recommendations: Are all reasons foropting out of vaccinations equally acceptable? Are some reasonsmore acceptable than others? What are the pros and cons ofdifferent policies?7. Share additional information about philosophical exemptions.Be sure to emphasize the fifth bullet below: states that add extrasteps to opting out have fewer people doing so.• Many states have considered bills to allow more exemptions(12 states in 2003 and 8 in 2004).• Thirteen of the states that offer religious (but not philosophical)exemptions lack any authority to deny an exemption request—theymust give exemption to whoever asks.• Some states have adopted philosophical exemptions becauseindividuals who don’t belong to organized religious groups (andtherefore can’t get the documents allowing them a religiousexemption) may still have religious beliefs. Individuals who objectto vaccinations for reasons besides religious ones may also be ableto use these exemptions.• States differ in how difficult they make it for people to get anexemption. For example, in some states, people who requesta religious exemption must provide an affidavit affirming thatvaccination conflicts with “tenets and practices of the churchor religious denomination of which the applicant is a member.”In other states, they simply have to declare that they have areligious objection. Likewise, in some states, people requesting aphilosophical exemption must sign a form describing the benefitsof vaccination, whereas in other states, they need only provide awritten statement that they object to vaccination.• States that add extra steps to opting out have fewer people doingit. Therefore, some policymakers are now encouraging states torequire people to take extra steps to ensure that exemptions are notgranted too readily.8. Review the questions on Master 2.13 to be sure studentsunderstand them.ClosureMention the idea of balancing respect for persons, fairness, and responsibilityto the community, identifying this as a key ethical theme ofthis module. Ask students how their understanding of this topic hasdeepened as they explored relevant facts, stakeholders, and ethical considerations.2-30Exploring Bioethics
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NIH CurriculumSupplement SeriesGrad
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Education Development Center, Inc.D
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This material is based on work supp
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About the National Institutes of He
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Introduction
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activity of assessing different rea
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teaching strategies that will help
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2. The ability to distinguish an et
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quence of choosing one path over an
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Table 1. Assessing Student Justific
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Challenges in TeachingBioethics and
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How Exploring Bioethics Can HelpFor
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Prompts to encourage students to re
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Table 2d. Students say they already
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Resources forTeaching BioethicsBeau
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Table 3. Ethical Issues and Curricu
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Each module is divided into three d
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Table 4. Alignment with NSES Life S
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About the Web SiteThe Web site for
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1Module 1Bioethics Concepts and Ski
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• apply important ethical conside
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In Advance1Copies, Equipment, and M
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Teaching Sequence1Day 1: What’s i
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new medication, she is able to stay
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6. Read the list of Round 1 questio
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• With respect to performance enh
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LE/LE/LLE/LPoint out that some of t
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Organizer for Day 1: What’s in a
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Day 2: Four Key Questions1PurposeDa
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4. Emphasize that when bioethicists
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15. Ask students to list as many et
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Organizer for Day 2: Four Key Quest
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Page 76 and 77: References and Resources1Informatio
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Page 82 and 83: Round 4Q9Should embryonic stem cell
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Page 88 and 89: Carl’s CaseCarl listened to his t
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Page 92 and 93: adopting vaccination policies that
Page 94 and 95: In Advance1Copies, Equipment, and M
Page 96 and 97: Teaching Sequence1Day 1: Exploring
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Page 104 and 105: Day 2: Community Immunity1PurposeOn
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Page 112 and 113: Tell only the students who were tag
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Page 122 and 123: Ask each member of the pair to read
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Page 126 and 127: Get Kids Vaccinated or ElseGet Kids
Page 128 and 129: Name(s)Station 2—Vaccine RisksDir
Page 130 and 131: Station 1: Vaccine-Preventable Dise
Page 132 and 133: MumpsBefore the mumps vaccine was i
Page 134 and 135: Station 2—Vaccine RisksNote: Like
Page 136 and 137: Smallpox VaccineThe smallpox vaccin
Page 138 and 139: Station 4—ExemptionsExemptions vs
Page 140 and 141: State Exemptions Allowed as of Fall
Page 142 and 143: Name(s)What are the ethical conside
Page 144 and 145: Vaccination Status CardsVaccinated
Page 146 and 147: Opting Out of a Vaccine—Variables
Page 148 and 149: Measles in DublinIn 2000, an outbre
Page 150: What are some of the different pers
Page 153 and 154: Issues Explored• What is the fair
Page 155 and 156: Day 3—What Is Your Recommendation
Page 157 and 158: Teaching SequenceNoteAssign this ho
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6. If it does not naturally arise,
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Criteria relevant to allocating liv
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Organizer for Day 2: Identifying St
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Day 3: What Is Your Recommendation?
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Activity 9:Understanding Past and C
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ClosureReinforce to students that t
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Ask students whether they think the
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Liver Function and FailureHepatitis
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Name(s)Banting decided that he woul
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Name(s)The COC distributed the peni
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Name(s)The Admissions and Policy Co
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Liver and Liver-Transplant Fact She
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The Liver and Liver Transplants—C
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Patient ProfilesAnitaAnita is a 19-
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Additional Patient InformationAnita
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The United Network for Organ Sharin
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Comparing the Past and Current UNOS
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1Module 4Weighing Benefits and Harm
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An optional extension activity incl
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In Advance1Preparing the Envelopes
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Teaching Sequence1Day 1: Deciding t
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6. Explain that each student should
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Activity 2:Introducing Max’s Thyr
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See Teacher Support MaterialsSupple
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ClosureTo close the class, remind s
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1Activity 2: Introducing Max’s Th
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Activity 5:Who or What Will Be Affe
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Activity 6:Exploring the Relevant E
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11. Give each student a copy of Mas
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1Ask students, “What are some rea
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5. Have students, in pairs, quickly
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ReflectionDisplay the posters from
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1Reflection: Have students view the
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1Retinitis PigmentosaFoundation Fig
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Alzheimer’s Disease and Genetic T
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Name(s)Now, on your own, answer the
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Name(s)Max’s Family Tree on His M
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Genetic Testing—Key Concepts• S
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What Impact Would Max’s Newly Dis
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Your Tentative ThoughtsName(s)1. Do
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Ethical Questions• Who should dec
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Extension (Optional)About Retinitis
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Issues Explored• Why is it import
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Key Science Knowledge*• Nature of
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Teaching SequenceDay 1: Research wi
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13. Ask students, “Should I just
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Some students in the treatment grou
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it is ethically acceptable. For exa
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Students should recognize that rese
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ClosureAsk the class whether they t
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Organizer for Day 1: Research with
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Activity 4: Returning to Your Decis
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5. Discuss the results with the who
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5. Summarize two key points about r
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• The Belmont Report has served a
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Organizer for Day 2:Harms and Benef
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Day 3: Analyzing the Willowbrook Ca
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Deciding on and Recording Main Poin
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Organizer for Day 3: Analyzing the
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Willowbrook StudyCenters for Diseas
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Asthma Simulation OutcomesYou were
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Name(s)Reflection Questions1. Aside
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Letter to ParentsThis is the letter
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What Are the Relevant Ethical Consi
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Name(s)(Fill out with your partner.
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Name(s)(Fill out individually.)Your
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Issues Explored• Should there be
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Key Science Knowledge*• DNA, RNA,
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4. Ask students for their prelimina
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8. Tell students to come to the nex
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Day 2: Deepening Your Thinking—So
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You may wish to note that• Cases
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2. Direct students to turn to their
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Organizer for Day 2: Deepening Your
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Day 3: Making a Recommendation—Se
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Those cases where students do not t
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3. Ask a representative from each g
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Activity 9: Returning to Alba’s C
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1Ear MiceBBC News. 2002. Artificial
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Alba’s CaseSince the early 1990s,
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Dyed FeathersPeople dye bird feathe
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Giant Panda BreedingThe giant panda
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Mad-Cow-Disease CowsMad cow disease
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Purebred DogsHumans have geneticall
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Spider-Silk GoatsSpider silk is str
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VealVeal is meat from calves that i
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Assessing Harms, Benefits, and Pote
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Final Assessment of Alba’s CaseRe
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This curriculum supplementwas devel
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