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

Activity 9:Understanding Past and Current UNOS PoliciesEstimated Time: 15–20 minutesIn this activity, students will have a chance to compare the past and currentUNOS policies. Ultimately, they will decide which is better, and they willmake recommendations about how the policy should be further modified.ProcedureNoteBe sure to cover up the portionsof Master 3.10 that you are notreading aloud.Tip from the FieldDepending on your teaching style,you might want to use voiceinflections to emphasize key pointsas you read aloud—as a newscastermight—to keep students engaged.1. Display the transparency of page 1 of Master 3.10: The UnitedNetwork for Organ Sharing (UNOS)—Two Policies, and read the topparagraph (about UNOS) aloud.Remind students that the reason UNOS divides the country intolocal and regional areas is to minimize cold ischemic time (the timebetween when an organ has been removed from a donor and whenit is transplanted into the recipient’s body). For livers, the medicallyacceptable limit for cold ischemic time is 12 hours. Flying a liver fromNew York to California takes many hours, for example, significantlylowering the chance of transplant success.2. Uncover and read aloud “Pre-1998 UNOS Liver-Allocation Policy,”Facts 1 and 2.3. Ask students which ethical criteria were given priority in thispolicy. Students will likely mention criteria such as “whoever is sickest,”“whoever lives closest,” and “whoever has been waiting the longest.”4. Ask students which ethical criteria are not included. Students willlikely mention criteria such as “whoever will likely live the longest” and“whoever has most worth to society.” Students may also make note ofthe fact that the policy doesn’t judge people on the basis of age or thereason why they have experienced liver failure.5. Ask students, “Do you think the past UNOS policy was fair?” First,have students, working in pairs, share their thoughts for oneminute each. If you have time, bring the class back together for avery brief discussion.Here, students might say that inappropriate criteria were considered,appropriate criteria were not considered, or appropriate criteria wereconsidered but given too much or too little weight. The goal is simply toprovide a few minutes for student reflection. Students will have moretime to consider this question as part of the module’s final assessment.6. Uncover and read aloud “Current UNOS Liver-Allocation Policy,”Facts 1 and 2, on page 2 of the Master 3.10 transparency.3-26 Exploring Bioethics