Lessons from Clinical Anthropology Classes for Undergraduate Students

- Shini'chi Shoji, M.D., Katuko Kamiya, PhD., Darryl Macer, PhD.
Institutes of Clinical Medicine, Social Medicine, Biological Sciences, at the University of Tsukuba,
Tsukuba Science City, 305, JAPAN
(Email : sshoji@md.tsukuba.ac.jp)


Eubios Journal of Asian and International Bioethics 6 (1996), 162-3.
Abstract

This multidisciplinary subject in clinical anthropology was started in April 1996 among 206 students distributed over all Colleges and Schools in the University of Tsukuba with the exception of School of Medical Sciences. After every class students write down their comments on a compulsory attendance slip, and these comments were examined. Female students agreed with the surrogate mothers and homosexuality more than male students. Male students denied childcare by homosexual parents more than female students. Sex selection insemination with the exception for disease prevention was denied by female students significantly more than male students.

Multidisciplinary subjects are included in the curriculum for undergraduate students in University of Tsukuba. From 1996 a new course on clinical anthropology was started. This course is one of the general courses, and for the general subjects. The aims of these general courses include: 1. to make students have a broad view of things; and 2. to learn the importance of interdisciplinary sciences.

This multidisciplinary subject in clinical anthropology was started in April 1996 after two years of trials in the School of Medical Sciences. The aims of the clinical anthropology classes are as follows, 1. consider humans through discussion about concrete cases relating to birth, aging, illness and death, 2. recognize diversity in values between individuals, 3. consider your own life, 4. consider the meaning of life or what is a useful life. Characteristics of these classes are to consider decisions for problems in concrete clinical cases or scenes instead of playing with words or theories, and that there should be no need for preliminary knowledge or expert knowledge.

The number of registered students for the clinical anthropology classes was 206 in the first term and 215 in the second term of the current year. The majors of the registered students were distributed over all Colleges and Schools in the University of Tsukuba with the exception of School of Medical Sciences, which has a compulsory course of clinical anthropology. The attendance rate of the clinical anthropology classes was on an average of 79.8% in the first term of 1996.

Clinical anthropology classes are conducted as follows, 1. presentation of a concrete clinical case or scene relating to birth, aging, illness or death, 2. presentation of typical opinions and necessary information, 3. free discussion of small group (10-12 persons) in each seminar room with the election of a chairperson and a recorder, 4. recorder of each group reports summary of discussion, 5. general discussion, 6. tutors present their own opinion clearly, 7. each student describes their own impressions.

After every class students write down their comments on a compulsory attendance slip, and these comments were examined. We analyzed impressions written by students of this classes, and found some interesting findings relating to gender and reproduction medicine, in a class on this subject. The level of significance used for these comparisons is p<0.05. During these class all three of us were present, but generally only the first two authors are teaching this course.

One case was as follows (a real US case): A single bank clerk (26 year-old male) was arrested. He beat his 6 week-old baby to death. He paid approximately 3 million yen to a surrogate mother for her pregnancy and to give birth, using his sperm. He had cared for the baby by himself. The beating happened when he was greatly perplexed by the baby's non-stop crying.

Female students agreed with the surrogate mother more than male students (Table 1). A generally accepted idea until the end of the Second World War in Japan was that, the most important duty of a married woman was to give birth to a child, especially a son, as an heir for her husband. After a half a century, even the younger generation, who were born after the war, may be influenced by this belief. Maybe an unmarried young woman may feel that if she cannot accomplish this duty, she hopes to achieve it by any means, even by using a surrogate mother. There was some evidence for this from the comments. This may be one explanation for the sex difference towards the surrogate mother. The percentage of agreement with a surrogate mother was much higher than previous reports in Japan (See EJAIB database). This may be due to lack of enough information of the socioeconomic aspects of surrogate mothers.


Table 1: About surrogate mothers (N who mentioned)
Agreement Denial No mention
Female 75 20 34
Male 21 16 16
p < 0.005

Social science 60 24 42

Physical science 33 12 8
p < 0.005


Table 2: About homosexuality (N who mentioned)
Agreement Denial No mention
Female 81 1 23
Male 30 7 11
p < 0.005
Social science 72 5 27
Physical science 37 3 7
N.S.
Table 3: About childcare by homosexual parents (N)
Agreement Denial No mention
Female 27 36 42
Male 8 19 21
p < 0.05
Social science 24 38 42
Physical science 11 15 21
N.S.
Table 4: About sex selection insemination (N)
Agreement Denial No mention
Female 15 44 46
Male 12 12 24 p < 0.005
Social science 16 39 49
Physical science 10 17 20
N.S.
Physical science course students agreed with the surrogate mother more than Sociocultural science Course students. The former has a tendency to agree with making use of newly appearing technology over the latter.

Another case was as follows: A lesbian couple, one of which is the mother of the child, has brought up a girl as a family member. They now want another child. They ask to manipulate the sperm sample in a way so as to increase their chances to have a male child. Female students agreed with homosexuality more than male students, as shown by the results in Table 2. Among 153 students, 7 of the 8 students who denied homosexuality were male., almost all were male. Male students denied childcare by homosexual parents more than female students (Table 3).

Sex selection insemination with the exception for disease prevention was denied by female students significantly more than male students (Table 4). As the one who gives birth to a child, if the sex of her future child is determined by other persons, some students said that a woman feels as if she is no more than a tool. So more women may deny sex selection insemination. She hopes for the child born as providence of nature, which progresses inside her body, is kept as natural as possible.

We would appreciate feedback from readers who have had similar experience, and we recommend such courses for others to use. Students have said in their comments that they have found the cases interesting, and from the range of comments it is clear that the courses have accomplished the goal of making the students think.


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