Exploring Bioethics - NIH Office of Science Education - National ...

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1Module 3Allocating Scarce Resources:The Case of Organ Transplantation2Four Key Questions • What is the ethical question?See theto Always• What are the relevant facts?IntroductionAsk YourselfFor more information about the• Who or what could be affected by the way the four key questions, see thequestion gets resolved? Introduction, page 5.• What are the relevant ethical considerations?3See Module 1Ethical Considerations Relevant to This Module*Students are introduced to thefour key questions and ethicalRespect for Persons • Are some ways of distributing organs moreconsiderations in Module 1.Modules 2–6 assume this priorrespectful than others?knowledge. We strongly recommendHarms and Benefits • What kinds of harms and benefits may come that you complete Module 1first with your students, beforeto people who need organs as a result ofstarting any of the other modules.different organ-distribution policies?Fairness*Bold items are emphasized in this module.• When there are not enough organs forpeople who need them, how should they bedistributed?• What is the fairest way to distribute organs?453-16
Issues Explored• What is the fairest way to distribute a lifesaving resource that is in short supply?• What criteria should people use when deciding how to allocate organs?At a GlancePurpose and RationaleAlthough the rules guiding the allocation (distribution) of a lifesaving treatmentmust be fair, there are many ways of understanding what it means tobe fair. This module challenges students to grapple with their own notionsof fairness and how those notions affect their decisions about what constitutesa fair allocation policy.OverviewKeeping in mind the ethical principle of fairness, students consider how toallocate scarce medical resources. They begin by analyzing historical cases—involving insulin, penicillin, and dialysis—that raise issues relevant to resourceallocation today. Then, they consider a current scarcity issue, allocating organsfor transplantation.To decide which of four hypothetical patients should receive a liver first, theyidentify the relevant facts and criteria and then select the criteria they thinkare most important. Finally, students review the liver-allocation policy in effecttoday and compare its criteria with the previous policy’s.Learning ObjectivesStudents will• recognize that although lives can be saved by using scarce medicalresources, their scarcity means that ethical decisions have to be madeabout how to distribute them fairly;• understand that while people agree that organs should be distributedfairly, determining which distribution criteria are fair is difficult;• learn and define at least six possible criteria for allocating livers;• identify which criteria they would prioritize in a liver-allocationpolicy; and• understand the current liver-allocation policy and recognize the criteriait prioritizes.Major ConceptsThrough engagement with historical and hypothetical cases, participationin a simulation, and analysis of past and current United Network for Organ3-2 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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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
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Carl’s CaseCarl listened to his t
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1Module 2Balancing Individual and C
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adopting vaccination policies that
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In Advance1Copies, Equipment, and M
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Teaching Sequence1Day 1: Exploring
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the key stakeholders, and taken int
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Page 104 and 105: Day 2: Community Immunity1PurposeOn
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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
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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 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 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
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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
Page 189 and 190: Name(s)The Admissions and Policy Co
Page 191 and 192: Liver and Liver-Transplant Fact She
Page 193 and 194: The Liver and Liver Transplants—C
Page 195 and 196: Patient ProfilesAnitaAnita is a 19-
Page 197 and 198: Additional Patient InformationAnita
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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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