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

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ForewordExploring Bioethics is the most recent addition to the NIH Curriculum Supplement Series. This series brings thelatest medical science and research discoveries from the National Institutes of Health (NIH) into the high schoolclassroom. NIH plays a vital role in the health of all Americans and seeks to foster interest in research, science,and medicine-related careers for future generations. The NIH Office of Science Education (OSE) is dedicated topromoting science education and scientific literacy.Exploring Bioethics gives students an opportunity to grapple with some of the most challenging and engagingethical issues our society is facing as a consequence of advances in the life sciences. We designed ExploringBioethics to complement existing high school biology curricula and to align with the National Science EducationStandards. High school science teachers, bioethicists, education specialists, scientists, representatives fromthe Department of Bioethics in the NIH Clinical Center, and curriculum-design experts from EducationDevelopment Center, Inc. (EDC), created it over three years. The collaborative development process includedgeographically dispersed field tests by teachers and students.The structure of these modules enables teachers to facilitate learning and stimulate ethical inquiry. Real-life casesintroduce a core set of ethical considerations that are important for analyzing ethical issues in medicine and thelife sciences. Design elements emphasize key bioethical concepts and analytic methods, cutting-edge sciencecontent, real-world scenarios, and built-in assessment tools. Activities promote active and collaborative learningto help students develop their ethical-reasoning and critical-thinking skills.Each of our curriculum supplements comes with a complete set of printed materials for teachers, includingextensive background and resource information, detailed lesson plans, and masters for student worksheets. TheWeb site accompanying Exploring Bioethics includes additional material such as sample answer keys, detailedbackground information, additional lesson extensions, updates, and corrections (as needed). The supplementsare freely distributed to educators across the United States upon request. They may be copied for classroom usebut may not be sold.We welcome your feedback. For a complete list of curriculum supplements and ordering information, or to submitfeedback, visit http://science.education.nih.gov or write toCurriculum Supplement SeriesOffice of Science EducationNational Institutes of Health6100 Executive Blvd, Suite 3E01Bethesda, MD 20892-7520We appreciate the valuable contributions from the talented staff at EDC. We are also grateful to the NIHethicists, advisors, and all the other participating professionals for their work and dedication. Finally, we thankthe teachers and students who participated in field tests to ensure that these lessons are both engaging andeffective.I hope you find our series a valuable addition to your classroom and wish you a productive school year.Bruce A. Fuchs, Ph.D.DirectorOffice of Science EducationNational Institutes of Healthv
About the National Institutes of HealthFounded in 1887, NIH is the federal focal point for health research in the United States. Today, NIH is one of theagencies within the Department of Health and Human Services. Its mission is science in pursuit of fundamentalknowledge about the nature and behavior of living systems and the application of that knowledge to extendhealthy life and reduce the burdens of illness and disability. NIH works toward meeting the mission by providingleadership, direction, and grant support to programs designed to improve the health of the nation throughresearch.NIH’s education programs contribute to ensuring the continued supply of well-trained basic research andclinical investigators, as well as the myriad professionals in the many allied disciplines who support the researchenterprise. These efforts also help educate people about scientific results so that they can make informeddecisions about their own—and the public’s—health.This curriculum supplement is one such education effort. It is a collaboration among the Department of Bioethics atthe NIH Clinical Center, the NIH Office of Science Education, and Education Development Center, Inc.For more about NIH, visit http://www.nih.gov.About the Department of BioethicsSince its establishment in 1996, the Department of Bioethics has revitalized bioethics activities at the NationalInstitutes of Health and launched a series of new educational and research initiatives. It has also continued toprovide ethics-related services to the NIH Clinical Center.A two-year fellowship program in bioethics draws promising pre- and postdoctorate scholars to NIH. The department’sconferences and courses focus on a variety of topics, from the ethics of human-subjects research to managed-careissues. Its research efforts are divided into three areas: health policy, human-subjects research, and genetics.The department participates in conferences on ethical issues sponsored by organizations outside NIH and, in aneffort to target the NIH intramural community, provides educational programs for nonbioethicists through severalinitiatives. Each fall, the Department of Bioethics offers a seven-to-eight-week program, Ethical Regulatory Aspectsof Clinical Research, to the NIH community. The course remains popular after nine years and is now requiredfor the Clinical Center Core Curriculum Certificate. In addition, four or five times a year, the department offersEthics Grand Rounds as part of the Clinical Center Grand Rounds Program. A medical staff member involved ina particular case presents the issues, and then a guest bioethicist comments briefly and presents a framework forthinking about those issues. This is followed by a Q&A discussion.The main clinical functions of the department are running the Clinical Center Ethics Consultation Service,providing ethicists to participate in various clinical rounds and to review protocols on each of the NIHInstitutional Review Boards, and participating on the Clinical Center Ethics Committee. The Ethics Committeemeets monthly, and its members also participate in ethics consults. The meetings are a forum for discussingcontroversial and new topics in human-subjects research, such as new guidelines about research with children.For more about the Department of Bioethics, visit http://www.bioethics.nih.gov.viExploring Bioethics
Page 1 and 2: NIH CurriculumSupplement SeriesGrad
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Page 5: This material is based on work supp
Page 10: Introduction
Page 13 and 14: activity of assessing different rea
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Page 27 and 28: Prompts to encourage students to re
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Page 31 and 32: Resources forTeaching BioethicsBeau
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Page 39 and 40: About the Web SiteThe Web site for
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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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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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