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About the ModulesGoalsThe purpose of this curriculum supplement is to introducestudents to bioethics as a field of inquiry and toenable them to develop ethical reasoning skills so theycan move beyond “gut reactions” to more nuanced positions.The supplement will help students achieve the fivemajor goals outlined below.Goal 1Recognize the interrelationship among science,society, and ethical considerations.Students will understand that the process and discoveriesof science have social and ethical implications that aninformed public and scientists need to address. They willalso recognize how scientific data can and should informethical analysis and public policy making.Goal 2Develop the ability to recognize importantbioethics concepts and ways of thinking.Students will understand that the four key questions andrelevant ethical considerations can guide them as theyanalyze bioethical issues.Goal 3Develop critical-reasoning skills, especially theability to justify an ethical position.Students will cultivate habits of mind and skills so thatthey can reason about ethical issues and develop wellinformed,well-thought-out reasons. These skills includebeing able to identify ethical questions, gather relevantscientific facts, consider who or what could be affected bythe way questions get resolved, identify relevant ethicalconsiderations and apply them to the problem, and justifya position in line with these considerations. Studentsshould also consider whether their justifications for theirpositions on different issues are consistent.Goal 4Recognize the importance of scientificknowledge in bioethical decision making.Students will understand the importance of applyingscientific knowledge to making informed decisions aboutbioethical issues. The curriculum supplement gives studentsthe chance to apply and reinforce important scienceconcepts and enhances their appreciation of and interestin learning science.Goal 5Enhance respectful dialogue among individualswith diverse perspectives.Students will grow in their capacity to discuss controversialissues with civility and respect for differentviewpoints, thus preparing them to be better citizensin a democratic, pluralistic society. Students shouldalso realize that their personal values are shaped bytheir cultural context.Overview of the ModulesTable 3 (pages 22–23) summarizes the ethical issuesand curricular connections for each module.This supplement comprises six modules. Module 1 is anintroduction to bioethics and to this supplement. It isimportant to teach Module 1 first because it presents aconceptual framework that students will apply in all thelater modules.Modules 2 to 6 can be taught in any order. The frameworkpresented in Module 1 includes four key questionsand core ethical considerations, which are commonissues that people ought to take into account whenfaced with an ethical choice.It is important to teach Module 1 first because itpresents a conceptual framework that studentsthen go on to apply in all the later modules.Introduction21
Table 3. Ethical Issues and Curricular ConnectionsModule Ethical Issues* Curricular Connections1. Bioethics Conceptsand SkillsThis module introduces a problem-solvingapproach that students can use when facedwith ethical decisions. It includes answeringfour key questions and paying attentionto core ethical considerations (respect forpersons, harms and benefits, and fairness).Each student uses these questionsand considerations to develop a wellreasonedjustification about the ethics ofenhancement in sports. Extension opportunitiespromote discussion of other kindsof enhancements in cognitive and artisticperformance. This module should be taughtfirst because it introduces a method ofbioethical inquiry that will be applied to allthe other topics.••Nature of science (empiricism)Steroids and hormones2. Balancing Individualand CommunityClaims: EstablishingState VaccinationPolicies3. Allocating ScarceResources: The Case ofOrgan Transplantation4. Weighing Benefits andHarms: Ethical Issuesin Genetic TestingModule 2 emphasizes the core ethicalconsiderations of respect for personsand fairness, and students wrestle withthe tension between individual freedomand community well-being. Each studentmust determine, and justify, how he or shewould balance individual and communityclaims about a hypothetical communitycontroversy involving mandatory schoolvaccination policies.After briefly exploring a range of historicalcases in which decisions had to be madeabout the allocation of a scarce biomedicaltechnology, students focus on the task offairly distributing organs that are in shortsupply. With the consideration of fairnessin mind, each student must take a fullyjustified stance about what he or she seesas the fairest distribution policy.Students consider respect for personsand recognize and weigh all harms andbenefits in order to make a fully justifiedrecommendation about genetic testingfor a teenage member of a hypotheticalfamily. Because some of the genetic testsare predictive rather than diagnostic, eachstudent also grapples with how best toproceed given the inherent uncertainty ofthe situation.••••••••••••••••••••Community (herd) immunityEpidemicInformation about specific diseasesInterpreting dataNature of infectious diseaseVaccines: impacts, benefits, and risksVaccines and immunologic memoryViruses and bacteriaImmunology: factors that determinewhether an organ is a good matchLiver: function, reasons for failure, transplantstatisticsOrgan systemsTransplant basics: which organs or tissuescan get transplanted? What factorsensure a better outcome?Alzheimer’s diseaseCancer biologyDNA: structure and mutationsGenetic testing: predictive vs. diagnosticMendelian genetics: recessivevs. dominantMutations: inherited vs. somaticPedigree interpretationRelationship among genes, proteins,and traitsContinued22 Exploring Bioethics
Page 1 and 2: NIH CurriculumSupplement SeriesGrad
Page 3 and 4: Education Development Center, Inc.D
Page 5 and 6: This material is based on work supp
Page 7 and 8: About the National Institutes of He
Page 10: Introduction
Page 13 and 14: activity of assessing different rea
Page 15 and 16: teaching strategies that will help
Page 17 and 18: 2. The ability to distinguish an et
Page 19 and 20: quence of choosing one path over an
Page 21 and 22: Table 1. Assessing Student Justific
Page 23 and 24: Challenges in TeachingBioethics and
Page 25 and 26: How Exploring Bioethics Can HelpFor
Page 27 and 28: Prompts to encourage students to re
Page 29 and 30: Table 2d. Students say they already
Page 31: Resources forTeaching BioethicsBeau
Page 35 and 36: Each module is divided into three d
Page 37 and 38: Table 4. Alignment with NSES Life S
Page 39 and 40: About the Web SiteThe Web site for
Page 42 and 43: 1Module 1Bioethics Concepts and Ski
Page 44 and 45: • apply important ethical conside
Page 46 and 47: In Advance1Copies, Equipment, and M
Page 48 and 49: Teaching Sequence1Day 1: What’s i
Page 50 and 51: new medication, she is able to stay
Page 52 and 53: 6. Read the list of Round 1 questio
Page 54 and 55: • With respect to performance enh
Page 56 and 57: LE/LE/LLE/LPoint out that some of t
Page 58 and 59: Organizer for Day 1: What’s in a
Page 60 and 61: Day 2: Four Key Questions1PurposeDa
Page 62 and 63: 4. Emphasize that when bioethicists
Page 64 and 65: 15. Ask students to list as many et
Page 66 and 67: Organizer for Day 2: Four Key Quest
Page 68 and 69: Encourage students to share example
Page 70 and 71: Activity 7:Using Ethical Considerat
Page 72 and 73: 4. Ask a representative from each g
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
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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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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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