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Ask each member of the pair to read a different story now. Page 2-28, Step 6In a whole-class discussion, elicit initial reactions to the stories. Page 2-28, Step 7Draw a line to represent a range of possible policies. Ask where on the linestudents would place each example (smallpox, measles) and why.Ask students to describe the roles of the state and respect for persons in eachcase, and then where on the line Maryland’s and their own state’s vaccinationpolicies should go.Ask students questions about respect for persons and vaccination policy in general.Tell students that the examples represent extremes and that there are policyoptions between those extremes.Activity 7: Introducing the Final AssessmentEstimated Time: 10 minutes, plus time to write policyTell students that they are ready to craft and to justify a policy recommendationto their state public health department.Give each student a copy of Master 2.13. Remind students to include ethicalconsiderations and scientific information in their recommendations.Review these three exemptions: medical, religious, and philosophical. Tellstudents to address each one in their policies.Ask students to reflect on these questions as they prepare to write their ownpolicy recommendations: Are all reasons for opting out of vaccinations equallyacceptable? What are the pros and cons of different policies?Page 2-28, Steps 8–9Page 2-28,Steps 10–11Page 2-28, Step 12Page 2-29, Step 13Page 2-29, Step 1Page 2-29, Steps 2–3Page 2-29, Steps 4–5Page 2-30, Step 6123Share additional information about philosophical exemptions. Emphasize thatfewer people opt out in states that add extra steps to the process.Review the questions on Master 2.13.Closure: Mention the idea of balancing respect for persons and responsibility to thecommunity. Ask students how their understanding of this topic has deepened.Homework and Final Assessment: Have each student write a policyrecommendation to the state public health department, referring to Master 2.13.The recommendation can also be in the form of a speech or a newspaper letter tothe editor.Extensions (optional):1. Generate or research additional examples of vaccine policies.2. Explore the concept of responsibility more deeply with students, possiblyreferring to the Responsibility Prompts and Scenarios, available online.3. At the end of Activity 7, deepen and extend the discussion by asking students more questions.Page 2-30, Step 7Page 2-30, Step 8Page 2-30Page 2-31Page 2-3145Module 2 2-33Involves copying a master6
References and ResourcesGeneralCenters for Disease Control and Prevention. Atkinson, W., Hamborsky, J., McIntyre, L., and Wolfe,S., eds. 2008. Epidemiology and Prevention of Vaccine-Preventable Diseases. 10th ed. 2nd printing,Washington, DC: Public Health Foundation. Retrieved October 13, 2008 fromhttp://www.cdc.gov/vaccines/Pubs/pinkbook/default.htm.Centers for Disease Control and Prevention and the World Health Organization. 2001. Smallpox:Disease, Prevention, and Intervention Training Course. Slide 17. Retrieved August 12, 2008, fromhttp://www.bt.cdc.gov/agent/smallpox/training/overview/pdf/eradicationhistory.pdf.Centers for Disease Control and Prevention. 2007. Possible side-effects from vaccines. RetrievedAugust 12, 2008, from http://www.cdc.gov/vaccines/vac-gen/side-effects.htm.Centers for Disease Control and Prevention. 2007. Vaccines and preventable diseases. RetrievedAugust 12, 2008, from http://www.cdc.gov/vaccines/vpd-vac/default.htm.Centers for Disease Control and Prevention. 2007. What would happen if we stoppedvaccinations? Vaccines & Immunizations. Retrieved August 12, 2008, fromhttp://www.cdc.gov/vaccines/vac-gen/whatifstop.htm.Centers for Disease Control and Prevention. 2008. Hepatitis B overview and statistics. RetrievedAugust 12, 2008, from http://www.cdc.gov/hepatitis/HBV/HBVfaq.htm#overview.Hilleman, M. 2000. Vaccines in historic evolution and perspective: A narrative of vaccinediscoveries. Vaccine, 18: 1436–1447.Kleifgen, B. 2007. The ethical challenges of vaccines—vaccination requirements and exceptions.Retrieved August 12, 2008, from http://www.vaccineethics.org/issue_briefs/requirements.php.Malone, K.M., and Hinman, A.R. 2003. Vaccination mandates: The public health imperativeand individual rights. In Law in Public Health Practice (pp. 262–84). New York: Oxford UniversityPress. Retrieved August 12, 2008, from http://www.cdc.gov/vaccines/vac-gen/policies/downloads/vacc_mandates_chptr13.pdf.National Network for Immunization Information. 2006. Immunization issues: Communityimmunity. Retrieved August 18, 2008, from http://www.immunizationinfo.org/immunization_issues_detail.cfv?id=26.Park, A. 2008. How safe are vaccines? Time Magazine, May 29. Retrieved August 12, 2008 fromhttp://www.time.com/time/health/article/0,8599,1808438-1,00.html. (Diagram at http://www.time.com/time/magazine/pdf/20080604_vaccines.pdf.)Wasley, A., Grytdal, S., and Gallagher, K. 2008. MMWR Surveillance Summary: Surveillance forAcute Viral Hepatitis—United States, 2006, March 21. Retrieved October 13, 2008, fromhttp://www.cdc.gov/mmwr/preview/mmwrhtml/ss5702a1.htm.Wynia, M. 2007. Mandating vaccination: What counts as a “mandate” in public health and whenshould they be used? The American Journal of Bioethics, 12: 2–6.MeaslesBritish Broadcasting Corporation News. 2000. Measles Outbreak Feared. 2000. Retrieved August12, 2008, from http://news.bbc.co.uk/1/hi/health/769381.stm.Centers for Disease Control and Prevention. 1991. Measles outbreak—New York City, 1990–1991. Morbidity and Mortality Weekly Report, 40: 369–372. Retrieved August 12, 2008, from http://www.cdc.gov/mmwr/preview/mmwrhtml/00001980.htm.2-34 Exploring 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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Encourage students to share example
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Activity 7:Using Ethical Considerat
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Page 74 and 75: Organizer for Day 3: Core Ethical C
Page 76 and 77: References and Resources1Informatio
Page 78 and 79: What Type of Question? ROUND 1—Et
Page 80 and 81: What Type of Question? ROUND 3: Eth
Page 82 and 83: Round 4Q9Should embryonic stem cell
Page 84 and 85: Oscar Pistorius—The Fastest Man w
Page 86 and 87: Four Key Questions and Statementof
Page 88 and 89: Carl’s CaseCarl listened to his t
Page 90 and 91: 1Module 2Balancing Individual and C
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
Page 98 and 99: the key stakeholders, and taken int
Page 100 and 101: You may wish to highlight the dange
Page 102 and 103: ClosureAsk students to reflect on t
Page 104 and 105: Day 2: Community Immunity1PurposeOn
Page 106 and 107: 10. Ask all students in the class t
Page 108 and 109: • While an unvaccinated person’
Page 110 and 111: ClosureRecap for students that the
Page 112 and 113: Tell only the students who were tag
Page 114 and 115: 5. Divide students into pairs, and
Page 116 and 117: 17. Share with students that becaus
Page 118 and 119: 13. Note that the Boston and Dublin
Page 120 and 121: Teaching StrategiesYou may want to
Page 124 and 125: 1Centers for Disease Control and Pr
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
Page 159 and 160: Teaching Strategies: Jigsaw Techniq
Page 161 and 162: Some students might think that the
Page 163 and 164: 11. Explain to students that they w
Page 165 and 166: Inform students that they will now
Page 167 and 168: 2. Tell them that one liver has bec
Page 169 and 170: 6. If it does not naturally arise,
Page 171 and 172: 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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