<strong>Exploring</strong> <strong>Bioethics</strong>Developed under a contract from the<strong>National</strong> Institutes <strong>of</strong> Healthin collaboration with theDepartment <strong>of</strong> <strong>Bioethics</strong> at the <strong>NIH</strong> Clinical Center<strong>Education</strong> Development Center, Inc.55 Chapel StreetNewton, MA 02458-1060
<strong>Education</strong> Development Center, Inc.Development TeamMildred Z. Solomon, Vice President, and Director <strong>of</strong> the Center forApplied Ethics; Associate Clinical Pr<strong>of</strong>essor <strong>of</strong> Medical Ethics,Departments <strong>of</strong> Anaesthesia and Global Health and SocialMedicine, Harvard Medical SchoolJacqueline S. Miller, Senior Research Scientist,Center for <strong>Science</strong> <strong>Education</strong>Katherine F. Paget, Senior Research Scientist,Center for <strong>Science</strong> <strong>Education</strong>Erica Jablonski, Research Associate, Center for <strong>Science</strong> <strong>Education</strong>Jean Doherty, Project Coordinator, Center for Applied EthicsProduction TeamKerry S. Ouellet, Center for <strong>Science</strong> <strong>Education</strong>—Editing,Production ManagementKim Elliott, www.thewordmechanic.com—EditingJessica Grant, Graphic Design Specialist—Print Design and LayoutNeptune Web—Web Site DevelopmentWriting TeamIntroduction: Mildred Z. Solomon; Jeanne Ting Chowning,Director <strong>of</strong> <strong>Education</strong>, Northwest Association for BiomedicalResearch, Seattle; Elizabeth Crane, <strong>Science</strong> Teacher, BrooklineHigh School, Brookline, MA; Laura Bishop, Research Associate,Library and Information Services, Kennedy Institute <strong>of</strong> Ethics,Georgetown University, Washington, DCModule 1: Jeanne Ting Chowning and Mildred Z. SolomonModule 2: Jeanne Ting ChowningModule 3: Rupali Gandhi, Medical Ethics Fellow, Harvard MedicalSchool, and Fellow in Cardiology, Boston’s Children’s Hospital;Matthew B. Frank, Medical Ethics Fellow, Harvard Medical School,Boston; Elizabeth Crane; Julie Tannenbaum, former Fellow,Department <strong>of</strong> <strong>Bioethics</strong> at the <strong>NIH</strong> Clinical Center, andcurrent Assistant Pr<strong>of</strong>essor <strong>of</strong> Philosophy, Pomona College,Claremont, CA; and Kim ElliottModule 4: Elizabeth CraneModule 5: Jeanne Ting ChowningModule 6: Robin Solomon, former Clinical Ethics Fellow,St. Joseph’s Hospital and Medical Center, Phoenix; JulieTannenbaum; and Laura Bishop<strong>National</strong> Institutes <strong>of</strong> HealthBruce Fuchs, Director, <strong>Office</strong> <strong>of</strong> <strong>Science</strong> <strong>Education</strong>David Vannier, Program <strong>Office</strong>r, OSEBarbara Houtz, <strong>Education</strong>al Consultant, OSECindy Allen, Editor, OSEEzekiel Emanuel, Director, Department <strong>of</strong> <strong>Bioethics</strong> at the<strong>NIH</strong> Clinical CenterKatherine Adikes, Fellow, Department <strong>of</strong> <strong>Bioethics</strong>Carrie Thiessen, Fellow, Department <strong>of</strong> <strong>Bioethics</strong>Julie Tannenbaum, former Fellow, Department <strong>of</strong> <strong>Bioethics</strong> atthe <strong>NIH</strong> Clinical Center, and current Assistant Pr<strong>of</strong>essor <strong>of</strong>Philosophy, Pomona College, Claremont, CAAlan Ho<strong>of</strong>ring—Cover Illustration, Medical Arts andPhotography Branch, <strong>NIH</strong>Lynne Komai—Cover Design, MAPBField-Test TeachersPatrick Alarcon, The Academy <strong>of</strong> Information Technologyand Engineering, Stamford, CTLeslie Van Blaha, Montgomery Blair High School, Silver Spring, MDRoger Blevins, Huron High School, Huron, OHJack Boroditsky, St. John’s–Ravenscourt School, Winnipeg, MB, CanadaDwight Brown, Bountiful High School, Bountiful, UTHeidi Busa, Marcellus High School, Marcellus, NYCatherine Elwood, Central High School, Manchester, NHRick Featherstone, Oakland Schools Technical Campus NW, Clarkston, MIBarbara Frasco, Haddon Township High School, Westmont, NJKelly Gallo, Magruder High School, Rockville, MDTracy Gaskin, Baltimore Polytechnic Institute, Baltimore, MDCynthia Gibson, The Classical Academy, Colorado Springs, COMary Glodowski, Juanita High School, Kirkland, WAKenneth Gracz, T. Wingate Andrews High School, High Point, NCRobin Greig, West Ashley High School, Charleston, SCMary Halsall, Mariemont High School, Cincinnati, OHSteven Harshfield, Sequoyah High School, Claremore, OKKathleen Howard, Horace Mann School, Riverdale, NYJoyce Kent, New Rochelle High School, New Rochelle, NYSue Kite, Walt Whitman High School, Bethesda, MDMary Kroll, West Islip High School, West Islip, NYLaura Lanwermeyer, Moscow High School, Moscow, IDNicole Lener, McGraw Central School, McGraw, NYLaura Montgomery, Francis Howell North High School, St. Charles, MOLisa Moran, Mount Sinai High School, Mt. Sinai, NYMary Ann Murrow, Spring-Ford Senior High School, Royersford, PABirgit Musheno, Desert Vista High School, Phoenix, AZSusan Neumann, Model Lab School, Richmond, KYLaura Reysz, Lawrence Central High School, Indianapolis, INJamie Ritchey, East Central Senior High School, Tulsa, OKNancy Rozak, Plymouth North High School, Plymouth, MARachel Sanders, Springfield South High School, Springfield, OHMisty Scevola, Meek Pr<strong>of</strong>essional Technical High School, Portland, OREdward Scovell, Friends Seminary, New York, NYMary Simmons, Wm. J. Palmer High School, Colorado Springs, COTiffany Smith, Cedar Grove High School, Ellenwood, GAVicky Sweezy, Prospect Mountain High School, Alton, NHBonnie Walter, Archbishop Alter High School, Kettering, OHPatricia Zeck, Northwestern High School, Kokomo, INKaren Zohar, Aspen High School, Aspen, COCover: Representation <strong>of</strong> green fluorescent protein (GFP), found naturallyin some jellyfish, and photograph <strong>of</strong> Alba, the fluorescent rabbit, intowhich scientists inserted the GFP gene. GFP, <strong>NIH</strong> Medical Arts; Alba,courtesy Eduardo Kac.Acknowledgments: We are grateful to Margaret Battin, Nancy King,Eric Parens, Ben Wilfond, and Matthew Wynia, leaders in bioethics whokindly reviewed early drafts <strong>of</strong> this material, providing invaluable insights.During the development <strong>of</strong> the field-test version, we also benefited fromreviews by scientists, teachers, and others. Specifically, we would liketo thank Elise Cooksley, Doug Diekema, Mary Glodowski, Lori Harper,Wendy Law, Laurie Matthews, Bryan Roberts, and Lola Szobota.<strong>NIH</strong> Publication Number 09-7386ISBN: 978-0-89292-550-6Please contact the <strong>NIH</strong> <strong>Office</strong> <strong>of</strong> <strong>Science</strong> <strong>Education</strong>with questions about this supplement atsupplements@science.education.nih.gov.
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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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You may wish to highlight the dange
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ClosureAsk students to reflect on t
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Day 2: Community Immunity1PurposeOn
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10. Ask all students in the class t
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• While an unvaccinated person’
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ClosureRecap for students that the
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Tell only the students who were tag
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5. Divide students into pairs, and
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17. Share with students that becaus
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13. Note that the Boston and Dublin
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Teaching StrategiesYou may want to
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Ask each member of the pair to read
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1Centers for Disease Control and Pr
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Get Kids Vaccinated or ElseGet Kids
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Name(s)Station 2—Vaccine RisksDir
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Station 1: Vaccine-Preventable Dise
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MumpsBefore the mumps vaccine was i
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Station 2—Vaccine RisksNote: Like
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Smallpox VaccineThe smallpox vaccin
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Station 4—ExemptionsExemptions vs
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State Exemptions Allowed as of Fall
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Name(s)What are the ethical conside
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Vaccination Status CardsVaccinated
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Opting Out of a Vaccine—Variables
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Measles in DublinIn 2000, an outbre
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What are some of the different pers
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Issues Explored• What is the fair
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Day 3—What Is Your Recommendation
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Teaching SequenceNoteAssign this ho
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Teaching Strategies: Jigsaw Techniq
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Some students might think that the
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11. Explain to students that they w
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Inform students that they will now
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2. Tell them that one liver has bec
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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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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