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Station 4—ExemptionsExemptions vs. Opting OutAn exemption provides permission. To be exempt from a policy is to be permitted (allowed) not toact as a policy requires. The term “opting out” means choosing not to act as the policy requires. Youcan legally opt out if there is a legal exemption in place. You can also choose to opt out and be inviolation of the law.ExemptionsAll U.S. states have mandatory vaccination policies for public school entry and ongoing attendance.However, states differ in which vaccines they require and how strictly they enforce the policies.Many states allow parents to opt out of vaccinating their children, but these states differ in the typeof exemptions they permit and the process parents must go through to get an exemption.Research suggests that in states where documentation or extra steps are not required, morepeople opt out of vaccination. In 2003, about 38,000 children received exemptions from statevaccination requirements.There are three main types of exemption:Copyright © 2009 Education Development Center, Inc. Exploring Bioethics.Permission granted for classroom use.• Medical: To use this type of exemption, a person must obtain a medical document, signed by aphysician, stating that a vaccination would be harmful. This can be the case when a child is allergicto some vaccine components or has a weakened immune system, such as occurs during cancertreatment. All 50 U.S. states allow medical exemptions.• Religious: State laws vary widely; some states require proof of belonging to a particular religionwith written views against vaccination. As of 2007, all states except Mississippi and West Virginiaallowed religious exemptions.• Philosophical (personal belief): This is a very broad category. States that allow these exemptionstend to require specific proof of the person’s beliefs, such as a written statement signed by a witness. Insome of these states, individuals must object to all vaccines to use this exemption. Some states simplyrequire a parent’s signature on a preprinted form for a child to be exempt. Parents who are concernedabout risks of vaccines can sometimes use this category to opt out of vaccination programs.Master 2.6 (Page 1 of 3)
State Exemptions Allowed as of Fall 2008Copyright © 2009 Education Development Center, Inc. Exploring Bioethics.Permission granted for classroom use.State Medical Religious Philosophical(Personal Belief)Alabama • •Alaska • •Arizona* • • •Arkansas • • •California • • •Colorado • • •Connecticut • •Delaware • •Florida • •Georgia • •Hawaii • • •Idaho • •Illinois • •Indiana • •Iowa • •Kansas • •Kentucky • •Louisiana • • •Maine • • •Maryland • •Massachusetts • •Michigan • •Minnesota • •Mississippi•Missouri • •*Arizona offers a philosophical (personal belief) exemption for school but not daycare.ContinuedMaster 2.6 (Page 2 of 3)
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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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4. Ask a representative from each g
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Organizer for Day 3: Core Ethical C
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References and Resources1Informatio
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What Type of Question? ROUND 1—Et
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What Type of Question? ROUND 3: Eth
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Round 4Q9Should embryonic stem cell
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Oscar Pistorius—The Fastest Man w
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Four Key Questions and Statementof
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 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
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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 122 and 123: Ask each member of the pair to read
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 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
Page 173 and 174: Organizer for Day 2: Identifying St
Page 175 and 176: Day 3: What Is Your Recommendation?
Page 177 and 178: Activity 9:Understanding Past and C
Page 179 and 180: ClosureReinforce to students that t
Page 181 and 182: Ask students whether they think the
Page 183 and 184: Liver Function and FailureHepatitis
Page 185 and 186: Name(s)Banting decided that he woul
Page 187 and 188: 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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