How to teach about AIDS in High School Ethics Class - To think how society should be and how human beings should live

- Izumi Otani,
Kokubunji High School, Tokyo, Japan

Eubios Journal of Asian and International Bioethics 10 (2000), 13-15.
1. An outline of this study

I have been involved in developing and practicing bioethics education for these ten years. Considering this experience, I want to propose a class program that contains not only gaining precise information about HIV/AIDS but also thinking with high school students how society and human beings should be in this era when we have to deal and live with AIDS.

2. Background of this study

As the "present-day plague", HIV/AIDS has been discussed sometimes with fear, sometimes with curiosity, and in many cases with prejudice. But after several panics happened, in Japan AIDS education in health education classes at elementary, junior high, and high school become popular, little by little now. And as civics classes of high school, in 'present society' and 'politics and economics' classes, AIDS is taught as a medical accident. But many worry that in this context the essential problems of AIDS have not been discussed.

In this paper, I want to report a teaching program of ethics in civics taking AIDS as a main topic, with universal issues of HOW people and society should be. It includes issues such as the cultural history of disease, psychological structure of prejudice, information and panic, alienation and evasion, politics of sexuality.

3. Purpose of this study

By dealing with AIDS, a very trendy disease, in the subject of 'ethics' is to conceive how human beings should live and how society should be. In this way we can avoid a kind of limitation. The treatment in the classes of AIDS as a medical accident, it concentrates on preventing the spread of AIDS. And by treating as an interdisciplinary field, my class program centered on proposing how to be and how to live as human-beings. And at the same time this class program can be developed into comprehensive learning all-round study, now drawing the attention in the new course of study.

4. An outline of the lecture

4-1 Attendees

An ethics special lecture 'living now with AIDS' aimed at third grade students in high school was held in fiscal years 1995, 1997 and 1999. Students who attended are very active students hoping to study further in various fields: medical science, pharmacology, nursing, pedagogy, welfare, psychology, sociology, science, engineering, etc. The number of attendees in each fiscal year, was 31 students in 1995, 26 in 1997, and 33 in 1999. In fact the total number of students in my school in one grade is 320, so about a tenth of all students attend this class.

4-2 Devices for operation of class

4-2-1 Teaching materials

Teaching materials are printed synopsis of lectures I made. In order to make this synopsis, not only books or newspaper articles, but also the latest statistics from the Internet home pages of the Ministry of Health and Welfare and other Ministries. Also, I made every effort to get every article about AIDS when it broke out, and analyzed them carefully and made use in class.

On the Nifty Serve AIDS Forum, there is a very active discussion going on, and in favor of anonymity of computer network, its participants include HIV positive people. By analysing and informing students of the discussion there I made students think how to it is to live with diseases in this network era.

4-2-2 Reaction paper and class news

In order to follow up the lecture and exchange ideas, I made class news. Students must hand in reaction papers containing their opinions and thoughts about the lecture within two days after the class. Class news contains students' opinions, teacher's comments on them, information of related topic, movies and books, so that this paper could inspire students intellectually.

Exchanging opinions on class news is welcomed on the whole. There are many advantages: students who are not good at saying their opinions in the class or expressing themselves in the class can get a chance to say their opinions, and students can get to know various opinions from other students. Also, the class news can refer to some topics which are difficult to take up in class because of its limited time. And students enjoyed it.

4-2-3 Year plan

I tried not to lead the class in one direction but to do classes along with students' responses and interests.

At the beginning of the fiscal year, I made a rough plan for the year. But I continued to change it along with students' responses and interests because I value them. So that when there was a big difference between the students interests / responses and my plan, I modified my plan to satisfy the students needs. When the fiscal year was half over and the end of the year approaches, students whose entrance exams are around the corner come to take a utilitarian view of things and tend to skip classes. But attendees of this class weren't absent when the entrance exams are at the corner. On the contrary, students made comments like: "I often lose myself because the exams make me nervous, but when I attend this class, I come to myself", or "By attending this class I get energy to study for entrance exams."

4-3 Class development

Preface : the code 21st century, the end of the century

Introduction: VTR 'And the band played on '

I Disease "AIDS"

1. to know AIDS itself

What is AIDS? /the source of the infection / condition of infection /the infection route

II Disease "AIDS"

2 its history and its condition now, origin/ spread / the present situation and future / metaphors told by its history

III Why we could not prevent its spread?

1. what can be seen through the VTR 'And the band played on '

2. 'And the band played on 'in Japan - AIDS as a medical accident

3. the structure of medical accidents

4. a point of contact - blood donation and blood transfusion

Discussion: whether to tell blood donors the results of his/her HIV inspection?

IV Law which prevents AIDS

1. What is the problem of the AIDS prevention law

2. What we experienced by the leprosy prevention law

3. What can be seen through the leprosy and AIDS prevention law

V How is AIDS /HIV reported?

VTR: Please hug me and kiss me

1. How AIDS is reported

2. How AIDS is described?

VI Information and Panic

1. the side of sender and the side of receiver

2. a media named 'Rumor'

VII Psychological structure of prejudice

1. people who have prejudices

2. what will be put in the voidness of 'I'

-disagreeables of a sense of superiority and justice

VIII Why sexuality is a taboo?

VTR: Philadelphia

1. How the taboo of sexuality formed ?

2. Why sexuality is taboo

3. History of sexuality

4. taboo of sexuality 1: homosexuality

5. taboo of sexuality 2: logic and ethics of prostitution

6. metaphors of sexuality, metaphors of AIDS

Final: To live individually

1. selection of information and mind control

2. contemplation on love- merits and demerits of love 5. Impressions after the years class

5-1 AIDS education has taken root?

It is 20 years since a new disease AIDS become common. In Japan, after several panics AIDS education in elementary, junior high, and high schools has been required and held. As a result, especially through health education, an outline of AIDS is known generally. And today, whenever AIDS is referred to, discrimination and prejudice to PWA/PWH are also referred, and 'education' to conquest bias or discrimination is held. Therefore, AIDS education has fixed and gained fruits to some extent. But how about the real shape of that 'fix'?

I want to take an example to see that. Students who have learned an outline of AIDS would answer the infection routes correctly. Actually, 90% of attendees could answer correctly. But at the same time, 60% of them said AIDS is a hereditary disease. Why does such contradiction happens?

One of the infection routes is mother to child infection, or vertical transmission. Students memorize this word correctly and write on the answering paper. But few students understand really what 'mother to child infection' really means concretely. As the result, AIDS infects from a mother to a child, is confused as a hereditary disease. At this stage, few students notice whether AIDS is a hereditary disease, what is the difference between hereditary disease and infectious disease, or the contradiction of their idea. Without noticing that contradiction, they could answer true or false tests of health education. It is typical case of the failings of Japanese memorizing education.

5-2 "Discrimination and prejudice are bad" is the true intention of the students?

Almost all of the attendants say discrimination and prejudice against persons with AIDS (PWA) and persons with HIV (PWH) are bad from the beginning of the year.

From this fact too, it is obvious that present AIDS education has fixed and gained fruits to some extent. And if above statement is true, why do PWA/PWH people still hesitate to come out? Are cleverly disguised discrimination still held?

In this class, I spent a lot of time to make students notice their hidden prejudice and discriminatory thinking and their true intention behind their surface saying "discrimination and prejudice are bad." And there after questions such as "Why do we have prejudices?" "Who am I who has prejudices?" are added.

These questions made a big impact on the attendant students' identity sometimes caused existential confusion in their minds. But many attendants take them positively as their challenge towards themselves.

Questions over hidden prejudices are a universal problem not only limited to the problem of AIDS but can be said to all human rights problems. I want to make students value pursuing 'how our life and our society should be', beginning with noticing their hidden prejudices. 6. Problems to solve from now on

In this practice, what is lacked greatly is a relation between poverty and AIDS. It was in the rough plan at the beginning of the fiscal year, but while I do classes along with students interests, I couldn't include that topic effectively. But in the situation of AIDS in Asia and Africa, also in countries where economies are rich, the economic gap is closely related to problems of drugs and prostitution. I want to take this point into class not only referring to the economic side but also making connections to 'hidden prejudices' and 'surface identity gained from a sense of superiority'.

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