Education is universally recognized as an inviolable human right in the Universal Declaration of Human Rights, the Conventions on Civil and Political Rights, the UNESCO Charter, as well as in the Japanese Constitution (Article 26), and the Fundamental Law of Education, (Beauchamp & Vardaman, 1994). It is a chance for people to satisfy their innate desire to learn, and to prepare for their future, and to enable them to make contributions to the future of society.
The objectives of bioethics education include to help people to become aware of and deal with their current bioethics dilemmas, and to prepare for future dilemmas. The rapid progress of science and technology has made people face how to wisely use applications. Until now, most of the decisions regarding bioethics policy have been made only by professionals, academics, and ministry officials. However, because bioethical issues impact upon all people, the public should actively join the discussion. Analysis of surveys among students, public, academics, and high school teachers, revealed that there is a variety of viewpoints in all of these groups (Macer, 1992). There was a reasonable level of "bioethical maturity" seen in all these groups who responded to the surveys, assessed as the balancing of benefits and risks of applications, and another measure of that maturity is the involvement of all groups in societal decision making (Macer, 1994). Policies should not be developed by small groups with narrow views.
While people have a right to reflect on their opinions in policy making, it could be argued that all have a duty to make a responsible decision for the range of bioethical issues. Our decisions affect not only our own individual life, but also our family, society, future generations, and other living organisms. Bioethics education is, therefore, essential for realizing democratic society, empowering individuals, and making informed choices about the use of science and technology. While half the respondents to the surveys may have been mature in the terms of the above definitions, ideally more of the people in society should be able and willing to be involved.
It is ideal if we all have a chance to study bioethics sometime in our life. The chance is in fact everywhere: at home, in school and a work place, through schooling and mass media, in such variety subjects as natural science, social science, and arts, in a range of ages, from infant to elderly generations.
In this bioethics education research, high schools were chosen because students at this age (15-18 years) have a reasonable level of academic and emotional maturity, although more researchers have focused only on university students. It may be easiest to start from students who have enough preparation to understand scientific facts that raise ethical questions, and to express their ideas by words. University students may be better prepared in this regard, and the curriculums in Universities may be more flexible than those of high schools. Bioethics education has been introduced by one of us, D.M. in the University of Tsukuba, since 1990, with inclusion in compulsory and optional classes allowing different extended courses of 12+ hours (Macer, 1997). Focusing on high schools in our research is a conscious decision to reach a greater proportion of the population, for example, in Japan, about 30% of people have a chance to study in Universities, while over 80% of people study in high schools.
This paper reports on an bioethics
education project in high schools, which started with surveys
in 1991 and 1993, and progressed through development of teaching
materials and informal contacts into a Bioethics Education Network
established in 1996. The progress results are given in the hope
that these might also be useful for those in other regions and
countries. The results may also be of use to any meeting on bioethics
among adults, not only for teaching purposes but also for clarification
of the range of views on basic issues. The research is aimed
to suggest a way to develop a forum for discussion on bioethics
education where all participants mutually learn and reexamine
how they learn, by which bioethics education could be most effectively
2. International Bioethics Education Survey & Development of Teaching Materials
In order to investigate how high school teachers thought about bioethics in education, and understand their expectations and needs for the future, the International Bioethics Education Survey was conducted in 1993 with three other colleagues (Asada et al. 1996; Macer et al. 1996). It found that 80-90% of biology and social studies teachers who responded from Australian, Japanese, and New Zealand high schools thought bioethics education is necessary. However 70-90% of the responded teachers said that they had insufficient resources or materials to teach these issues. The lack of discussion of bioethical topics in textbooks was also reported by Peters et al. (1997).
In response to the 1993 International Bioethics Education Survey and a following keyword analysis of a total of 38 1993-94 Japanese high school textbooks (Macer et al. 1996), in 1994 we developed a set of 16 page teaching materials on bioethics dealing with issues like assisted reproductive technology, animal rights, human genetic diseases, and genetic engineering. We distributed the Japanese version to 500 teachers who had requested a summary of the survey, and the English version to 160 teachers in both Australian and New Zealand. Like all of the activities, books, and newsletter discussed here, they are available on the Internet <http://eubios.info/TM.htm">.
There was little response to the teaching materials, thus in 1995 a survey of the use of the teaching materials was carried out for 441 Japanese teachers (response rate: 43%). The survey revealed a low use of the teaching materials, being 3-11% for each topic, and indicated that many thought the materials were too complex. Despite the low use of the teaching materials, 45% said that they would like to receive the revised teaching materials, and 25% said that they would like to meet us to discuss bioethics education (and 39% of those who had used the materials). In late 1995, interviews with four of these teachers were conducted, and the 37 teachers who said that they would like to meet us were sent another questionnaire to seek their ideas on improvement of the teaching materials. The interviews helped us to grasp a concrete image of formatting, designing, and wording for revision of the teaching materials. We revised the teaching materials in January 1996 to include figures and illustrations to make them more attractive.
This project to develop teaching
materials and the network continues to be supported by the Japanese
Ministry of Education, Science, and Culture to allow all schools
in Japan access to these materials. All 5,510 of Japan's high
schools were informed by fax (5192) or letter (318) of the revisions
to the teaching materials (total school number=5517; 7 schools
were not accessible neither by fax nor by mail). We subsequently
received over 800 requests for the revised materials and sent
these free of charge to the teachers.
3. Network Establishment
Purpose of the Network Establishment
One class of the comments made in the bioethics surveys of teachers in 1991 and 1993 in Japan, the interviews with the teachers in 1995, and at numerous occasions by teachers at conferences, was a desire for personal support in bioethics education. Increased interactions with high school teachers who had been interested in bioethics education supported the idea of network establishment.
In order to encourage isolated teachers
by setting up the possibility for them to exchange ideas and information
with each other, the Bioethics Education Network was established
in December, 1996. We announced the establishment at the same
time as we sent the revised teaching materials to over 800 high
schools in Japan in March 1996. We also distributed announcement
letters in meetings and conferences where bioethics may be of
interest to participating teachers, such as the 60th National
Meeting of Association of Japan Biology Education in January 1996
(300 announcement letters were distributed), a Meeting of Association
of Environmental Education in May 1996 (30 announcements distributed).
To become a member, people submit a simple registration form.
There is no special requirement nor fee to become a member.
The network is open for anybody who is interested in bioethics
education, although the primary focus is bioethics education in
high schools (Asada and Macer, 1997).
Network members' characteristics
The Bioethics Education Network has 47 members (as of September, 1997), from a wide range of specialties and backgrounds. Table 1 and 2 show the characteristics of the 41 members who responded to a survey of the network members conducted in October 1997 (response rate: 89%; 42 replied, 1 disagreed with their information being used for the research). The network consists mostly of high school teachers and 20% were female. The members came from 14 different prefectures, mainly from the Kanto area. The average age is 40 years old, ranging from 24 years old to 60 years old. 44% of the members had postgraduate degrees, equally balanced between natural science and non-natural science fields. Among the 41 members, a total 28 members have attended the network study meeting at least once.
Of 36 high school teachers 17% were female. About 60% are natural science teachers (mainly biology; 20 biology teachers and 1 physics teacher) and about 40% are social studies and ethics teachers. The average age is 40 years old, the same as the International Bioethics Education Survey. Many teachers have much experience in teaching, as 16 years in average (minimum 1 year, maximum 38 years). 44% of the teachers had postgraduate degrees, which was higher than 18% in the 1991 and 1993 surveys.
There was a wide range of diversity
in size and types of school, including the frequency of students
continuing to college or University (from 2% to 100%). The diversity
may suggest that bioethics could occur in various environments,
unlike the view that bioethics needs a "wealthy" condition.
The network has had nine bimonthly
meetings from its establishment in December 1996, until March,
1998, and 12-23 persons participated each time. Some teachers
travel at their own expense for several hours to attend regularly.
All meetings have been held on Saturday afternoons, a time most
popular for teachers, and a summary of details is in Table 3.
The first meeting was held on December 7th, 1996, at the University of Tsukuba. Seven biology and 7 social studies teachers joined us to participate in the meeting, traveling 60km from an area north-east Tokyo.
The first meeting was held in response to teachers' strong desire to meet as a group. Teachers we had talked to before the establishment of the network rarely had a clear view how to develop the network. They, however, often expressed a wish to "get together" with others who share similar views on bioethics education. The network aimed at more than information transfer, which can happen if researchers prepare everything. Therefore, the first meeting was arranged to seek feedback from the teachers on how to progress.
The members, whose fields range from biology to social studies, aim to deepen their one main common interest, bioethics education. Since this was the first time for many of the teachers to meet each other, the first meeting served more as an introduction and orientation for the network. Being the first meeting, creating an atmosphere in which participants could freely exchange ideas and discuss issues proved difficult. Within the 3 hours, members had barely enough time to introduce themselves and share their expectations for the network. One of the keys to developing deeper discussion on bioethical issues is the creation of a good atmosphere among discussion participants. The teachers in our group are not used to an open exchange of views, and the multidisciplinary group was also unique in the Japanese tradition. We also faced the problem that on the one hand, the teachers were concerned that bioethics discussions are always led by experts, and the general public has difficulty in following them, while on the other, the teachers seemed to continue to expect so-called experts to lead their discussions, as evidenced in the way they talked in the meeting.
Despite the restive mood, the teachers
wanted to continue meeting bimonthly. They considered this often
enough for people with busy schedules who had to travel some distance
to a central location. They also decided that a school in Tokyo
would be more central and convenient. One of the key conclusions
of that meeting was to find a way to allow teachers to speak by
frankly interacting with each other in constructive dialogue and
developing approaches together.
Network members' characteristics from the survey response (N=41)
|Occupation:||High school teacher||88|
|School teacher except high schools||5|
|Field of Bachelor's degree:||Science||33|
|Field of Master's degree/Ph.D.:||Science||50|
|Number of meetings attended:||0||32|
|High school characteristics|
|School type:||Public (National)||80 (11)|
|Junior-senior high school (N)||4|
|Average percentage of students in March 1996 who went to university/colleges 35|
|High school teacher characteristics|
|Main subject taught:||Biology||56|
Individual network member characteristics
Code: B: biology teachers including other natural science teachers; S: social studies teachers;
M: members who are not high school teachers
Education: (2) indicates that a person has two degrees.
Master's includes people who are currently enrolled in a Master's Degree Program.
Numbers of meetings attended: excludes the 7th meeting which was
JAB Annual Conference
Since the first meeting, our primary focus has shifted more to getting all members to actively participate. To effect this, we applied some discussion strategies often used in development education and environmental education (For example, ECOM, 1996). Such strategies include setting clear objectives, making participants write down all their ideas on paper, having a speaker on one theme at each meeting, having a discussion in groups of four or five and later sharing ideas between groups, and setting time limits for discussions and thinking.
The objectives of the second meeting were to find out what are the fundamental issues in bioethics education and how the network should deal with them, and to apply ideas gained from meeting discussions to daily educational settings. The speaker was Ms. Izumi Ohtani, whom we had known from the beginning of bioethics education research in 1991. Ms. Ohtani has been teaching bioethics in classes like Ethics and Contemporary Social Studies in Civil Education for 10 years.
At the second meeting, we first explained the meeting's objectives, and then encouraged participants to brainstorm for ideas and write down whatever they thought. This enables more effective discussion and means the spirit of a network can be maintained even when the majority of teachers are unable to attend each meeting.
Another feature of that second meeting,
and of meetings ever since, is a period for ice-breaking. First
all participants form pairs and introduce each other, 1-2 minutes
per person. For this self-introduction, we allow time for introducing
oneself, and then for listening to one's partner. Next, the pair
joins another to make a group of four people, and within each
group, each person introduces his or her partner to the other
pair. This group of four work together throughout the meeting
during times for reflection and discussion following the talk
by one member. In subsequent meetings, members pair up with new
partners so that they gradually come to know all members of the
group. However, as seen in Table 3, there have been some trends
for members to be in the same groups.
Being encouraged by the dramatic change in atmosphere in the second meeting, we have basically used the same style in following meetings. As speakers, the member teachers in biology and social studies have taken turns, and participants implicitly express their desire to introduce what they have done, and whose talk they would like to listen to. Our role as facilitator is to sense a shared wish and to encourage teachers to make presentations. It is still rare for teachers to volunteer.
At the third meeting another keen bioethics educator with whom D.M. and Y.A. have had contact for several years, Mr. Hiroaki Koizumi spoke. He teaches Japanese history, which is a subject that some teachers had said may also be useful for teaching bioethics. This time we examined what is a disease, and how students or their families with some diseases can be considered in classes.
The theme of the fourth meeting was animal experiments, and a biology teacher, Mr. Kohji Suzuki, demonstrated a cow's eye dissection experiment. The reason why Mr. Suzuki became interested in bioethics education was a dilemma to teach "respect for life" by killing animals. Together with comments for the first and second meetings, he sent the Bioethics Education Research Group a brief report of his experiment classes with results of student questionnaires about animal experiments. Reading the report, D.M. and Y.A. encouraged him to present his experience in our meeting. He suggested we talk after sharing an "experiment" together.
There was some discussion about dissection of a frog, but for ethical reasons of minimizing harm decided by D.M. and Y.A. together with Mr. Suzuki, it was decided four cow eyes would be sufficient to teach the principles. The four cow eyes were provided by Mr. Suzuki through a routine procedure of his school. For this dissection we used a biology classroom using his normal class materials, then returned to the ordinary classroom where we could resume our normal roundtable shape to stimulate discussion. The dissection practice successfully gave a strong impression especially for the social studies teachers, and the difference between the general hesitation of the social studies teachers and routine acceptance of the biology teachers contributed to fruitful discussion.
At the fifth meeting we had another founding social studies teacher, Mr. Kaneo Inoue, lead discussion on the topic of environmental ethics as a speaker. It was a good opportunity for the participants to examine how bioethics education could introduce environmental and environmental ethics education.
The theme of the sixth meeting was brain death, which was one of the major triggers revealed in discussions and in the self-evaluation survey for teachers to begin to deal with bioethical issues in class. A biology teacher, Mr. Naoki Shiraishi, one of the teachers who has participated in the all meetings, presented his experience of teaching brain death, with a VTR that he had used in his class. One of the questions he raised was whether acceptance of brain death varied according to students' scholastic ability, which brought a stimulating discussion among teachers from different schools. In addition, due to the familiarity of the issue for many teachers, they did not need to be bothered with understanding the issue itself, but rather, they came to know the importance to deal with a topic from various aspects in different subjects. It became a shared desire as a group to seek a way to cooperate with teachers in various subjects on a topic in bioethics. We suggested that each teacher bring a colleague teacher in a different subject from their school to our meetings. Due to lack of interdisciplinary tradition in Japanese high schools, however, this has not realized so far.
The seventh meeting was held as one session of the 9th annual conference of Japan Association of Bioethics. The conference was held November 1st and 2nd, 1997, at the University of Tsukuba, having two sessions on bioethics education; one for university teaching, and the other for high school teaching. As a sign of the residual resistance to academic/teacher interaction, some academics were reluctant to include high school teaching as a session but D.M. as conference chairperson could force its inclusion. Four papers were read by members of the network, three of them teachers, presenting their experience. As the session was held immediately after the session for bioethics education in universities, faculty members as well as high school teachers attended the session. The presentations given by the high school teachers informed people that bioethics education has been started in high schools. Positive feedback also encouraged member teachers. Some of them had worried if they would seek cooperation with the academics, in their words, "the authoritative". Several new members joined at the time of the conference, and a few older members also participated without giving a paper. A further paper in a session on genetics was given by another teacher member of the network, and he reported strong interest in the session discussion.
The eighth meeting was held under a theme of bioethics education and comprehensive learning. Four biology and four social studies teachers, three members who were not high school teachers, and one student from our laboratory participated. The speaker for the 8th meeting, Mr. Hiromi Tanaka, has been practicing "comprehensive learning" for 10 years in his school as a whole (Abiko et.al. 1997). Comprehensive learning tries to teach an issue interdisciplinarily through various teachers and people inside and outside of a school. In a report of 1997 the Central Council for Education considered it one of the new attempts for secondary education (Yomiuri Shinbun, 18 November, 1997, p.8).
Mr. Tanaka's report of an interdisciplinary teaching on such bioethical issues as sex selection, prenatal diagnosis, and organ transplants and definition of death suggested a further possibility for participants to expand bioethics education. Reflecting upon discussions in the previous meetings, the participants had prepared to think of the possibility practically, in other words, in a balance of benefits and difficulties or disadvantages.
At the ninth meeting, we had a biology
teacher, Ms. Naoko Makimoto, who had worked with Mr. Tanaka for
comprehensive learning in the same school. She introduced her
rich experience in teaching contemporary social issues in biology
classes. This time we tried to learn from her practice, and examine
what we practically can do in the future as a network.
Bioethics Education Network Newsletter
In order to offer a forum for communication
between the network members, in June 1997, we began to publish
the Bioethics Education Network Newsletter in Japanese.
It is also on the Internet <http://eubios.info/
networkJ.htm">. Four issues have been published, in July,
September, December, 1997; and March, 1998. The newsletter includes
reports of former meetings, including the comments written in
the post-it papers that were stuck on the group papers, all other
comments on the other response forms from teachers, information
on teaching materials for bioethics education, and announcements
about following meetings. The newsletter is hoped to become an
active discussion place to compensate for each meeting's limited
time-frame and for the physical distance separating member teachers.
Education Network Meetings
|7/12/96||Introduction||S5, S6, B7, S9, B12, B14, S18, B21, S30, B34, B35, S37, B39, S46, L1, DM, YA (No separate groups)|
|15/2/67||What is||Izumi Ohtani||S18, B29, B39, L1|
|bioethics||S6, S26, S37, S46|
|education?||B12, B30, S42, DM|
|B35, G1, G2, YA|
|19/4/97||Disease||Hiroaki Koizumi||S6, S18, B33, B35|
|B4, S42, S46, DM|
|S5, S26, B32, YA|
|17/5/97||Animal||Koji Suzuki||S18, S42, YA|
|experiment||B7, M28, B35, S37|
|S6, S9, S20, B33|
|S46, G3, DM|
|12/7/97||Environmental||Kaneo Inoue||B4, S9, B32, M47|
|ethics||S6, S18, B35, L2|
|S26, S30, G2, L3, DM|
|S1, S42, L4, YA|
|6/9/97||Brain death||Naoki Shiraishi||B33, B35, S46, DM|
|S42, M28, YA|
|S6, B32, S31, L5|
|1-2/11/97||9th JAB||No separate groups|
|6/12/97||Comprehensive||Hiromi Tanaka||S18, S25, B32, M36, L5|
|learning||B4, B35, G5, G6|
|B34, S42, S46, YA|
|7/3/98||Societal issues||Naoko Makimoto||B4, B39, L6, YA|
|in biology||B32, G7, L7, DM|
|classes||S9, B23, S26, B33|
|S18, S42, L2, L8|
|B34, M36, G8, L4|
|S6, S31, B35, L9|
Number: Number of participants including DM & YA, sometimes some participants left the meetings before group discussion so they may not be in the groups.
Group members: B: biology teachers including other natural science teachers; S: social studies teachers; M: Members who are not high school teachers; G: participants who are not members; : undergraduate/graduate students in DM's laboratory
G: "Grouping", if each group in the meetings could cluster comments (marked ), or could not (marked X).
R: "Relating", if each group in
the meetings could find relationships between comments (marked
), or could not (marked X).
5. Development of Individual Thinking
To investigate if, and how, the network meetings had changed the way participants approach bioethics, analysis was performed on individual comments written and handed in during the Bioethics Education Network meetings and the self-evaluation survey conducted in Autumn 1997. 13 members were selected as a subject of the individual analysis, who met the following conditions: 1) members who attended meetings and submitted their comments twice or more, and 2) members who returned the self-evaluation survey, and gave an approval of use of their comments for an educational purpose.
Observation of the 13 members experience
of the meetings, and analysis of all the comments made in any
written form at the meetings, and recalling their oral comments,
suggests the following learning process:
Frank and relaxed atmosphere
Feeling of community
Learning new perspectives and new knowledge
Reflection of one's own life, questions, and interests
Development of ideas
All 13 members expressed a feeling of community. A frank atmosphere and the feeling of community in the meetings encouraged teachers to share with others. As valued by all 13 members, the multidisciplinary environment of the meeting participants gave them a chance to learn new knowledge and new perspectives. All members experienced the learning process until this stage, so that the network meetings could be said to have been successful to offer a mutual learning place for participants to learn new knowledge and perspectives.
Below, we would like to introduce observations of individual experience of the meetings of four members, B35, S46, S5, and B33, as examples of the impact the meetings are having.
B35, who attended all meetings, came to the first meeting with two fundamental interests. First, how a view towards life that people instinctively acquire in their daily life (in his words, "an instinctive view towards life") and a view towards life that is scientifically correct (in his words, "a scientific view towards life") can meet. In the self-evaluation survey, B35 defined bioethics as "What a desirable relationship (?) is between an 'old' view towards life that is acquired 'instinctively' through daily living experience, and a 'scientific' view towards life (new view towards life) that contradicts the former." The issue of brain death was a representative topic for him in this regard. In fact, B35 said in the self-evaluation survey that the brain death issue brought him to bioethics. From this perspective, B35 was also specifically interested in such questions as "What is death?" and "What is a relationship between a parent and children?" The other fundamental interest B35 had was discrimination.
In the first orientation meeting, B35 found that many participating teachers had a similar interest to his idea on the views towards life, and he wished to hear more about their ideas. B35 was also interested in exchanging thoughts on concrete class practice in this regard. For his other interest, discrimination, on the other hand, B35 did not feel the same interest was shared with others, but still hoped to talk about the issue.
In the second meeting where we listened to rich teaching experience of bioethics education from Ms. Ohtani, B35 was especially interested in the changes in response of Ms. Ohtani's students. B35 wondered if students' response would be changed in a different school. Reflecting on his own teaching experience, at the same time, B35 felt a need for continuous communication with students. This type of self-reflection was one of his features throughout the meetings. B35 expressed a desire for the members to make a class plan for their classes, and exchange ideas.
In the second meeting, B35 also suggested that meetings could be separately held for biology and ethics teachers under the same theme, as B35 felt their approaches were too different. B35 thought that ethics teachers tended to seek something systematic, and their discussion was often abstract. B35 also found that a systematic aspect had been lacking in his classes, and when trying to reflect on the advantages and disadvantages of the ethics approach, B35 said, "[In a class] I would like to start from a point, 'What do you do?'"
In the 3rd meeting that we examined what a disease is, B35 had a chance to develop one of his fundamental interests, discrimination. Although in the first meeting B35 could not feel that other member teachers shared a similar interest, at this time B35 felt that they did have a similar interest in common. B35 again expressed the desire to examine a concrete class practice. B35 had always been a good model of a learner, who tried to think both abstractly and concretely simultaneously. His comment in this meeting showed his efforts to relate issues to his daily life: "Whatever a situation may be, I will mention the issue [discrimination and disease] to both teachers and students, and think about it with them." Regarding differences between biology and social studies teachers, around this meeting B35 seemed to take the difference positively, and found it interesting that [we] use biological issues and develop them ethically.
In the 4th meeting, B35 related one of his fundamental interest, views towards life, to a discussion on respect for life. Especially, opinions from social studies teachers seemed to help him to think on the issue from different perspectives.
The topic of the 5th meeting, environmental ethics, was a new issue for B35. When a member teacher mentioned environmental ethics in the first meeting, B35 wrote that he had not known anything about environmental ethics, and wished to learn in the coming meetings. Compared to themes of the other meetings, the issue of environmental ethics did not seem to directly affect his fundamental interests. However, the topic helped him to develop ideas on teaching practice. B35 gave a rather concrete idea of teaching environmental issues in a cooperation between biology and social studies. B35 suggested specific topics in environmental education such as a balance between nature and humans, and how much food for humans can be supported in an ecological pyramid, and examined which aspects could be taught in biology, social studies, and ethics.
In the 6th meeting, B35 had a chance to present his teaching practice and ideas on the issue of brain death. Although B35 said that B35 could not have a clearer idea for his questions on a relation between an "instinctive view towards life" and a "scientific view towards life" even after his presentation and discussion with others, B35 seemed to have developed practical aspects. Ms. Ohtani's talk in the second meeting brought him a special interest of a possible difference of students' responses in different schools. B35 thought that we would be able to find a clue how we could teach bioethics, through teaching the issue of brain death with the same teaching materials. B35, in fact, offered copies of the video to the participants that B35 had been using in his class and also had all participants watch during his presentation. This could be considered a further step for him, not only examining his ideas nor talking to others, but suggesting practical possibilities to others.
In the 8th meeting where we discussed benefits and difficulties of "comprehensive learning" from Mr. Tanaka's experience as a school, B35 seemed to reach a conclusion of how bioethics education can be conducted interdisciplinarily. Saying, "I feel like being able to see a common direction [for bioethics education].", B35 suggested that each subject be responsible for its strength within a cooperation of a systematic bioethics education plan. B35 also expressed a difficulty of how bioethics education could seek a united goal while keeping its diversity.
Overall, the meetings seemed to give him broader perspectives on bioethics education. In the self-evaluation survey B35 answered that his ideas on bioethics education had been changed through the network activities, saying, "[Bioethics] may deal with broader issues than I thought." As the most valuable thing to join the network, B35 wrote, "[My] viewpoints became broader, and I have been able to know various ideas." His comments throughout the meetings showed his change as B35 evaluated himself.
As B35 wrote in the self-evaluation survey that his expectations before joining the network were information exchange about teaching practice and examination of class methods, one of his basic interests was how B35 could actually teach bioethical issues in his class. The multidisciplinary environment of the network naturally made him think which subjects more suited to the teaching of bioethics. First B35 felt that biology and ethics were too different to find the common term to discuss bioethics education. However, B35 later came to a conclusion that bioethics could be better taught in an interdisciplinary environment, in other words, while each subject makes best use of their strength, collaborating with each other in a systematic bioethics education. In the self-evaluation survey B35 also mentioned that students' response is important to develop bioethics education.
An interesting feature of his thinking pattern was that except for the 6th meeting on environmental ethics, B35 could relate his basic interests to every topic in each meeting. This meant that B35 said he did not learn new knowledge and perspectives topically, but B35 reflected his continuous interests to each issue. It was not observed, however, that his idea had been developed in a way that the meetings had given him clearer ideas for his fundamental interests, views towards life and discrimination.
S46 attended all meetings except the 5th meeting. S46 became interested in bioethics education in 1996 when he received an announcement letter for the establishment of the Bioethics Education Network. In the self-evaluation survey, he said that he expected to learn basic knowledge about bioethics in general from the network. As this expectation illustrates, his attitude towards the meetings was trying to learn new knowledge and perspectives in bioethics and bioethics education. Consistent with his comment in the survey that his ideas had not been changed through the network activities, the analysis did not reveal he had developed an idea in a specific direction. However, in the self-evaluation survey, S46 suggested a future plan of bioethics education, giving a specific topic in his teaching subject, social studies.
As S46 pointed out as the most valuable thing in the network, he also enjoyed the interdisciplinary environment of the meetings. At the second meeting S46 commented that "[I realize that] there are many teachers in biology who have similar consciousness to social studies teachers." During later meetings there was a general trend among members to consider the diverse background of the members as an advantage and try to make the best use of it. In his case, the meetings could be said to serve as an introduction of bioethics and brought him to make a plan of actual practice.
S5 joined the network with a specific interest how we could look at "life" in the contemporary Japanese society where a propaganda, "respect for life", is superficially highly regarded. As evidence of repeating the same comment in the self-evaluation survey 10 months after his participation in the network, the meetings did not seem to change or develop his fundamental interest. S5 attended the 1st, 3rd, and 5th meetings. S5 could relate his interest to the topic of the 5th meeting, diseases, and found that the issue of diseases has a potential to give many specific teaching topics in accordance with his interest. In the self-evaluation survey, S5 said the network activities had changed his ideas to make him feel that he should try teaching bioethics anyway.
B33 attended the 3rd, 4th and 6th meeting. Her overall change was well described in her comment in the self-evaluation survey that the most valuable thing in the network was, "Listening to opinions and thoughts of many people, viewpoints for myself to deepen my ideas increased." Her comments in each meeting suggested that B33 learned new perspectives in the interdisciplinary environment of the network, however, in the 6th meeting B33 also gave a comment that every time the meeting made her to think and broaden her views, but B33 was at a loss what she could do in practice.
As the above observations describe,
no definite sign of development of an idea in bioethics in general
was observed among the members. In order to not only broaden
our knowledge or perspectives but deepen ideas, self-reflection
may be essential. "Self-reflection" means if one could
relate newly learned knowledge or perspectives to one's daily
life, questions, and ideas. Having specific questions seemed
to help some members to examine the questions over and over from
different perspectives and with new knowledge brought by each
meeting. For example, three members, B35, S5, and S37, who came
to the meetings with specific interest in bioethics/bioethics
education showed they learned a new issue through their basic
questions. Having specific questions that may be fundamentally
asked in almost all topics dealt in bioethics is a sign of a strong
desire to seek an answer or better understanding of the questions.
The repeated process of examining the same question from various
aspects may help to develop an idea. Whether somebody asks a
specific question or not, may not actually mean the person has
or does not have a question. However, in analysis it is
assumed that a person who expresses a question in words has examined
their study to some degree. It would be interesting if the future
network meetings could help participants to realize their fundamental
questions that penetrate through bioethical issues.
6. Analysis of groups
To investigate if, and how, the network meetings had changed the consensus on bioethics education as a group, analysis was made from the comments on pieces of papers produced in each meeting and the self-evaluation survey conducted in Autumn 1997. This was made through a comparison of answers to the following questions in the self-evaluation survey conducted in Autumn, 1997, and the number of meetings attended by the members:
-Have the network activities changed your ideas on bioethics education? If yes, how?
-Have you tried something new in your class since you joined the network? If yes, what?
-What did you expect for the network before your joining?
-What do you expect for the network in the future?
-What is the most valuable
thing that you have experienced through the network activities?
Effect of attendance
Analysis of factors behind members attendance was made. The major obstacle to attend the study meetings was physical distance (Table 4). With a few exceptions, e.g. strong enthusiasm for a six times more repeater, it is hard for most of the members to use their own expenses and time to travel hundreds of kilometers.
Attendance at a meeting may have helped to change ideas of bioethics education, considering 38% of non-attendees said they have changed their ideas compared to 46% of attendees. However, members who attended only one meeting had changed least.
If a member has made a new attempt in bioethics education has a similar tendency to idea change and attendance. Overall, however, the members do not appear to have come to a stage to try something, but are still in a stage of thinking, examining, and sometimes planning.
Table 5 shows the two most frequent answers to questions on expectations that the members had before joining the network, expectations for the future network activities, and the most valuable rewards that the members have experienced through the network activities. Overall, the members had expected both emotional and practical support from the network. They are continuously expected both for the future. Interestingly, as the rewards after joining the network, many members pointed out emotional support, including a comment like, "I am inspired by other teachers.", rather than technical support.
A comparison of expectations and
rewards between attendees and non-attendees of the meetings (Table
5) revealed that emotional support was what the meetings offered
most. While non-attendees suggested practical aspects more than
the emotional support as the rewards they received from the network
activities, more attendees noted the emotional support. As read
in the non-attendees' expectations for the future, they hope to
have more communication, attending meetings that could be held
in other areas and develop to consider members at a long distance
more. Increased attendance does not bring a significant difference
to the members' attitudes towards the network
Analysis of comments written on the group papers produced in meetings
The discussion format using big pieces of paper (about A0 size) started in the second meeting. In each meeting, participants were divided into 3-6 groups with 3-5 people a group, following a period of "ice-breaking". After a presentation, all participants individually wrote comments on pieces of sticky papers, "post-it", square papers for notes. Then, through explaining each word on the paper, we stuck them to the big piece of paper, each group linking the ideas of the members. We also tried to write down additional ideas and connections on the big "comment paper" by color pens.
Table 3 summarizes group discussions in each meeting. As the first meeting served as an introduction and orientation to the network, we did not produce any written comments as a group, only tape recording it. The first meeting is not, therefore, included in this analysis, neither is the second one. Due to the inclusion of the 7th meeting in a session of the 9th annual conference of the Japan Association of Bioethics, the 7th meeting is not included in this analysis of groups. The 2nd, 3rd, 4th, 5th, 6th, 8th and 9th meetings are, given as, subjects of this group analysis. The average numbers of comments per participant in each meeting does not necessarily correlate to the interest in, nor stimulation brought about by, the meeting topics.
As asked in each meeting, participants tried to group comments and find relationships between the grouped comments and/or each comment. "Grouping" and "Relating" in Table 3 show if each group in the meetings could cluster comments and/or find relationships between them (marked ), or could not (marked X). This indicates that about 70% of the groups could cluster comments, and often tried to find relationships based on the clusters. By looking at the members in each group we could find that all except one group that showed relating or grouping included either S42, or one of us. Therefore this grouping and relating may be due to individual stimulation. However, one of the most regular active participants, B35, was not generally found to be in a group that showed grouping or relating of the comments, so this may also not be a good measure of analytical ability. It is also difficult to see progress in members, considering that 3 of the 4 groups in the second meeting showed grouping, but after that it did not increase, and was only seen with the presence of one of the 3 members.
Together with the
results of the self-evaluation survey, it seems that attendees
of the network meetings had enjoyed the brain-storming style of
discussion in the multidisciplinary environment, but it could
not observe whether they and how they had developed or deepened
ideas. The group analysis with the big pieces of papers did not
indicate the idea change observed in the individual analysis of
many members that a collaboration of diverse subject teachers
could bring better bioethics education. Not every participants
could be expected to regard the same question as most important.
Table 4: Factors related to meeting attendance revealed in survey response (%)
|Number of attendances|
|Average age (yr)||40||39||41||40||41||43|
|Teaching experience (yr)||16||16||16||16||16||18|
|% Students for Universities||35||37||33||37||37||20|
|Average number of degrees held (/person)||1.5||1.5||1.5||1.3||1.5||1.6|
|Have the network activities changed your ideas on bioethics education?|
|Have you tried something new in your class since you joined the network?|
Table 5: Expectations and rewards
|Expectation before||Class practice (1)||Information (1=)||Communication (1)|
|Communication (2)||Communication (1=)||Class practice (2)|
|Expectation||Class practice (1=)||Communication (1)||Class practice (1)|
|for the future||Communication (1=)||Expansion/development (2)||Communication (2)|
|Best rewards||Communication (1)||Information (1)||Communication (1)|
|from joining||Inspiration (2)||Class practice (2=)||Inspiration (2=)|
|the network||Newsletter (2=)||Interdisciplinarity (2=)|
Mutual communication seems to be necessary for effective bioethics education. The individual and group analysis of the network activities found members regarded the opportunities for communication offered from the network to be rewarding and enriching. They supported the assumption in the network activities that bioethics education could be most effectively developed in a "bioethical" environment, that is, all participants mutually learn and reexamine how they learn. The analysis also gave some suggestions for the future network activities and how bioethics could be learnt in a group study.
The comparison on ideas of attendees and non-attendees of the network meetings suggested that the meetings served mostly as emotional support rather than technical support in educational practice. The best predictor of participation in the network meetings was access to the meeting place.
The analysis of the group discussion indicated that the brain-storming discussion style helped participants to enjoy and make use of the interdisciplinary environment of the network, however, while anecdotal and observational data suggests discussion has deepened and developed, the written comments so not prove this. In the future the network has several additional goals. While most groups have understood how to cluster and relate ideas to each other, a further next step may be to add more focus to identifying the most important questions to discuss given the limited time schedule. Another area is the development of a number of research projects on the impact of different bioethics education methodology strategies in the classroom.
The analysis of individual experiences of the network meetings suggested that most of the attendees came to think that bioethics could be best taught when teachers from many subjects make best use of their strength, collaborating with each other in a systematic educational plan. It took a year to come to this shared desire, and that is also why comparisons of class practice will be examined in the next phase of network growth, as hoped for by many members. The network activities since its establishment in December 1996 have prepared a good base for expansion of bioethics education in practice. Members also mentioned that the network from now on could consider students more.
The individual analysis also indicated a route of individual idea change that the network members may have followed: a feeling of community led by a frank atmosphere encouraged the members to talk to each other, and the multidisciplinary environment of the network helped them to learn new perspectives and knowledge topically. Analysis of written comments from members did not unequivocally show a sign of development of specific ideas. However, some of the comparisons indicated that having specific questions that may be fundamentally asked about almost any topics dealt in bioethics, and repeatedly examining the same questions from various aspects may help idea development. Future network meetings may also help participants to realize their fundamental questions.
One important lesson from the Bioethics Education Network is that there is no golden scheme that gets all participants involved in discussions. Rather, key observations learnt through the network's activities are: establishing a group spirit and trust among members, thoughtful investigation of members' backgrounds and situations, and patience to wait for members to start to speak out. While these observations might appear self-evident, they are often neglected while people search for ready-to-use methods.
The findings and lessons from the Bioethics Education Network also provide clues on how people can more actively participate in discussions on a range of other issues. A fundamental prerequisite is a trust in people's ability to think, and to treat all equally. Once a forum is set with enough time and community spirit, people in the forum would naturally begin to learn from each other. Occasional self-evaluation and analysis can help people to develop their ideas by themselves. While it is true that there is another important question how people who have no interest in social issues have become aware of those issues, we could also hope to link and encourage people who have already been interested in those issues by setting up a forum.
Some bioethicists and bioethics
educators became to realize the importance of involvement of the
general public into bioethical discussions, however, it often
happens that the very person who expresses this sentiment in a
meeting brings a paternalistic framework. To avoid this scenario,
educators themselves need to reexamine how they learn. This research
shows those bioethicists who lack a trust in people's ability
to think, or those who avoid interacting with the general public
who are not called experts in the field of bioethics, that a group
of people can work together to study bioethics issues constructively.
Bioethicists should try to be self-consistent, if bioethics seeks
to realize their ideals in the daily practice. We hope this bioethics
education network will continue to be a forum not only for exchanging
practical information, but also for letting participants reflect
on themselves. In this way, the experience should help us all
This research could not be
conducted without warm support from members of the Bioethics Education
Network. We would like to thank all for their enthusiasm, patience,
cooperation, and provision of the meeting place at Nihonbashi
High School and Kojimachi Gakuen Girls' High School. We also
thank Ms. Hiroko Obata for assistance with this project in 1996.
This research was only possible with the support of grants #07680193,
#08680195 from the Japanese Ministry of Education, Science, Sports,
and Culture to D.M.
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Please send comments to Email < Macer@sakura.cc.tsukuba.ac.jp >.