Establishment of High School Bioethics Education Network

- Yukiko Asada & Darryl Macer
Institute of Biological Sciences, University of Tsukuba,
Tsukuba Science City 305, Japan
(Emails: asada@bombyx.biol.tsukuba.ac.jp
asianbioethics@yahoo.co.nz)

Eubios Journal of Asian and International Bioethics 7 (1997), 73-77.


Background

Bioethics education is essential to satisfy the goals in bioethics, for example, making decisions about the use of science and technology more democratic. The International Bioethics Education Survey conducted in 1993 found 80% of biology and social studies teachers who responded from in Japanese high schools thought bioethics education is needed (1, 2). However many teachers said that they needed more resources or materials to teach, so in 1994 we developed teaching materials for bioethics (16 A4 pages), and distributed them to 500 teachers who had requested a summary of the survey. English originals were also sent to Australian and New Zealand school teachers, and are available on Internet .

Very few teachers send back comments on the teaching materials, so a follow-up survey to investigate their use was conducted, finding that many thought the materials were too complex. Additionally several teachers were interviewed, to seek their advice. Some teachers sent their own teaching materials, or comments from students who answered the questions, and a collection of these is maintained. We revised the teaching materials in January 1996 including figures and illustrations to make them more attractive. The revised teaching materials were then announced by sending a fax to all high schools in Japan (5000+). Over 800 replies were received requesting materials, which were sent free of charge to the teachers. We do receive some comment sheets from students who used these sheets, but not very much feedback.

Network Establishment

In addition to the advertisement for receiving teaching materials we also reported the availability of the report from the International Bioethics Education Survey (reference 1), and an announcement of the establishment of a bioethics education network. There are currently 40+ members of this network, from both biology and social studies backgrounds, and it is also on the Internet (in Japanese, ).

One of the basic purposes of the network is that isolated teachers will be encouraged by exchanging ideas and information with each other. The 40 teachers come from 14 different prefectures mainly in the Kanto area (centred around Tokyo). The network has had three bimonthly meetings, in which 12-20 teachers participated in. This paper introduces some of the lessons we have learnt from these meetings, which may be useful for those in other countries.

First meeting

The first meeting was held on a Saturday afternoon, 7 December, 1996, at the University of Tsukuba. 7 biology and 7 social studies teachers participated in the meeting, and traveled to Tsukuba (about 60km from Tokyo). This was the first time for many of the teachers to meet so it was more an introduction and orientation for the network.

The members from different fields aim to deepen their one main common interest, bioethics education, but in the first meeting there was no atmosphere to freely exchange ideas and discuss issues. By the time 3 hours had passed there was barely time for each member to introduce themselves, and to share some of the goals and hopes that they expected of the network. One of the keys to deeper discussion on bioethical issues is creation of a good atmosphere. Teachers are not used to open exchange of views, and the multidisciplinary group was also unique in the Japanese tradition. On one hand, the teachers seemed to be very against authoritarianism, for example, they were very concerned that bioethics discussions these days are led by experts, and the general public has difficulty to follow them. On the other, the teachers seemed to rely on the authoritative expecting us to lead the discussions, as seen in the way they talked in the meeting. They expressed their frustrations, but never explicitly explained its reasons nor suggest alternatives.

Despite the restive mood, the teachers wanted to continue the meetings in the network bimonthly. It was thought that this was often enough for people with busy schedules who had to travel some distance to a central location. It was also decided that a school in Tokyo would be more central and convenient.

Some of the comments received from the teachers are below. One of the key conclusions of that meeting was to find a way to allow teachers speak frankly with interaction with each other in constructive dialogue and developing approaches together.


Expectations (before the 1st meeting)

"What would you like to discuss at the meeting, what would you expect etc.?"

"Bioethics education as a rebirth of ethics education" - an appeal to curriculums (the Ministry of Education).

Our school has just started bioethics education, therefore, I don't know much about it. I would like to study various knowledge and teaching methods.

I have been dealing with "brain death and organ transplantation" and "assisted reproductive technologies and artificial insemination" in biology classes. I would like to know in which subject teachers deal with [bioethics] in Japan.

Comments after the 1st Meeting

Points of discussions should be clearer. First of all, what is the biggest issue we have to think of, and what is going to be done for it. I cannot see what kind of meetings we are going to have, without talking over these matters.

What does bioethics education aim for? Does it try to spread "scientific view towards life" or a view towards life which controls science? Also, does it demand for standardizing views towards life socially, or widening individual choices?

How should bioethics education be? Do we try to transfer and spread a certain ethics, or nurture ethics of each student?

Self determination: Though the word, "self determination", is used quite often, is it really possible? In my viewpoint, as a responsible person for students under age, at least the self determination of my students is too dangerous.


Second meeting

The second meeting was held on 15 February, 1997, with 4 biology and 9 social studies teachers participating. The materials and agenda were sent out as for the first meeting, beforehand. Our focus was to enable teachers to "discuss" issues. We applied some discussion styles often used in development education and environmental education. The main differences we brought in the second meeting were: to set clear objectives; to make participants write down as many ideas and discussions on paper as possible; to have a speaker on one theme; to have a small group (e.g. 4 persons) discussion and later share ideas between groups; and to set time limits to discuss and think.

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 the discussion at the meeting for daily educational settings. As the speaker, we asked a member which we had known from the beginning of bioethics education research in 1991, Ms. Izumi Ohtani, who has been teaching bioethics in classes like Ethics and Contemporary Social Studies in Civil Education for 10 years.

At the second meeting, first of all, we explained the objectives, and suggested dividing all participants into groups to discuss issues. We then also encouraged them to write down what they thought, in order to make use of our discussion, and importantly so that the majority of teachers who were unable to attend each meeting could also share the ideas. We recorded the meeting with the consent of the teachers to better prepare records also. Teachers were asked to write their comments at any time during the meeting. The comment sheet consisted of two parts; one for giving suggestions for the report of the second meeting, and the other for giving comments which would not appear on the report. The comment sheets were anonymous, and collected after the meeting.

For ice-breaking all participants formed pairs, and introduced each other, 1-2 minutes each person. For this self-introduction, we gave separate time for introducing oneself, and listening to the partner. Then, two pairs became a group of four people, and within each group, each person tried to introduce their partner to the other two. Each meeting that follows, different people form pairs, to help get to know each other.

Ms Ohtani is a very enthusiastic bioethics educator, and she gave us a presentation which examines the roles of education in bioethics, and the roles of bioethics in education based on her own rich experiences in bioethics education. After 40 minutes, we worked in the groups for 45 minutes. First we individually wrote down what are the fundamental issues in bioethics education and how the network should deal with them on pieces of sticky papers ("post it" - square papers for notes). Then, through explaining each word on paper, we stuck them to a big piece of paper, which was given for each group. We also tried to write down additional ideas and discussions on the big paper by color pens, linking the individual comments.

After the allocated time, all the participants circled around each paper, sharing discussions and ideas between groups. We came to know that the four groups discussed the issue from different viewpoints, and exchanged ideas freely. After the sharing the ideas between groups, we came back to the groups of 4 again, and tried to sum up the group discussion on each paper, reflecting the comments of people and ideas stimulated by discussion with other groups. Due to lack of time, we could not refocus the meeting individually, so that the refocusing sheets were sent back to us afterwards.

It would be fair to say that this was the second meeting, so that teachers had some readiness to talk to each other. However, this discussion style seemed to help teachers very much to naturally speak out. The effectiveness of the style is also seen in comments from teachers, some of which are below.

Comments after the 2nd Meeting

Knowing Ms. Ohtani's wonderful practices and many handouts, I deeply felt that bioethics is an issue of decision making, and often does bioethics suffer between love for oneself and love for others. In bioethical settings, in order to better make decisions, nurturing personalities are definitely required. I felt that we need to have a humble view towards human beings, which humans are merely a member of ecosystem as other animals and plants are, and we also die anyway someday.

The methods, that we first discuss within small groups, and then, explain what we have talked to others, will be able to be applied in various settings.

Although views of biology and ethics towards the same theme (topic) are quite different, I think mutual communication is necessary. On the other hand, I think we have not examined enough even in a subject, we need to promote class examination etc. in these two regards.

When we had a group discussion, I raised a question if humans are really able to make autonomous decisions. Although I was afraid that nobody might take the question seriously, I felt supported to know that there are several teachers who share the same view.


Third Meeting

We had the third meeting on the 19 April, 1997, having another keen bioethics educator with whom we have had contact for several years, Mr. Hiroaki Koizumi, as a speaker. He teaches 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 dealt with in classes. We followed the same discussion style as in the second meeting. Below are a larger selection of comments.

In his talk Mr Koizumi suggested the possibility to deal with bioethical issues in history classes, especially in Japanese history. From the talk he extended the scope of the group, from focusing on biology and social studies or ethics classes, which have a perspective on the future, to encompass the past, and a broader range of classes.


Comments in the Reflection Sheets

1) What did you notice and learn in the meeting?

[I realized that] bioethics education can be done in cultural history study in Japanese history. [I wonder if] the difference between "normal" and "abnormal" is merely relative, and majorities claim to be "normal". [I wonder if] hospitalization societies increase diseases.

Although my viewpoint has been mostly biological, I felt a need to look at [issues] from cultural and historical aspects. However, assuming I obtain broad knowledge, I am already worried about how to sort them out. It is difficult to fuse biological aspects and cultural aspects.

I deeply regret that I have not thought of bioethics by myself. Especially, listening to Mr. Koizumi's presentation, I felt so. I would like to train myself to think of [issues] deeper in every day life.

Listening to Mr. Koizumi's presentation, which he examined the most familiar issue, "health and disease", from various aspects, I realized that it contains many fundamental issues, which I had not seen before because of the close relationship between disease and ordinary life.

Thinking of "diseases", rich topics are coming out. Especially, [we can see] human nature in cultural (and historical) cases and pieces. I thought "diseases" should not only be something nasty, and something which should be eliminated and expelled, but should also be dealt as a "theme" which we examine how to face and relate to (including how to overcome).

[I leant that] the cultural history of diseases can be a viewpoint penetrating histories. Dr. Macer's positive attitude towards gene screening, and many participants' (including myself) negative attitude. [We will have] debate, someday!?

[I realized that] others also have the similar questions. We did not reach to examine how we can reflect for classes. We need to examine topics which we can show students a little more convincingly.

It was interesting to know social studies teachers' viewpoints are different, and at the same time, I am glad to notice that there are various points of view.

How can we obtain a viewpoint to look at diseases and/or being sick as a whole and part? How can we consider an essential meaning of recovering, and a meaning of treating? How can we make the very human value, disease, relative? This relates to the establishment of the Western medicine and modern Japanese efficiency, which introduced it. [I wonder] if life recognizes oneself as life, as a brain is aware of brains? What cannot do this is human beings.

I realized the richness of Japanese history. Although it would be dependent on human convenience anyway, considering diseases both in biological and social aspects, the best way would be living together.

2) How can you make use of what you realized and learnt today in your everyday life?

When I talk to children, I will be careful about standardizing majority ideas in our society. I will be cautious of being stereotyped.

First of all, I will study history and culture. Also, communicating with people, who have very different ideas from mine, and who I cannot agree with at first, I will try to lower a standard of common factors I can share with others. I feel there are something I can learn about discrimination (I need a lot of energy to do so, though).

(1) Discrimination against diseases. (2) Distinction between the handicapped and the normal. (3) I am frightened and shudder at the fact of the persecution of Jews during the plague epidemics in Europe (the dread of prejudice).

Since this is a theme which is near to students, I would like to apply this to, and think of broad and deep study plans.

The world of diseases can become a trigger to deepen our awareness of daily life. -try to find teaching materials.

[I would like to] appreciate abnormality which facilitates a reform. I would like to learn about Down's syndrome.

At least, ethics and biology teachers should talk and discuss more for contents of bioethics classes and the development of its teaching materials.

First of all, [I would like to] talk to both other teachers and students, deal with it as a topic, and think about it together. [I would] not talk of ethics directly, but I would like to accumulate facts that everybody has diseases, and set a framework to start to talk.

I thought I should try to talk to other teachers in my school more. I thought today's discussion style (group discussion and sharing, and using post-it) can be applied for classes.

First of all, I myself have to change, and also, I should be conscious about my prejudice views and examine them.

3) Other impression, opinions, etc.

I learnt very much from people in different majors.

I will not be able to find my conclusion for sometime (forever??). I will continue to think. I feel that continuing to think, itself, is "being alive". Thank you very much for the valuable time.

Is a challenge for conservative discrimination against new thoughts abnormal? What can be commonly understood is normal, and what cannot be, in other words, objections are abnormal. It would be nicer, if we can have more participants. Please consider teachers at a distance, who wish to join.

I felt that looking [at issues] as a taboo leads to discrimination. I wonder if we can develop discussion from concrete classes. I feel it is good to start from biological topics and then develop ethically.

I am pleased to know that there are many people other than myself who are interested in bioethics and try in practice. I find it interesting there are approaches not only in biology and ethics but also in other subjects e.g. Japanese history.

I wanted to examine how to deal with in classes more.

General comments

Suggestions for the report of the 3rd meeting

Assuming that normality and abnormality, and diseases and health are not opposing ideas but relative ideas, living with something heterogeneous have to be naturally considered. If this is true, issues like sex selection and genetic screening are unnatural. More discussions are needed.

Listening to the boom in antibacterial protection, I remembered a story that a decrease of parasites have brought a increase of pollen allergy. I would like to think of classes pointing out a mistake to think of human bodies separating from microbes attached to them, as an independent existence. Is prevention "good" ethically? If "isolation" of untreatable diseases leads to discrimination, isn't it "not good"?

I thought bioethics education is dealt with in "biology" and "ethics", today we listened to an approach in "Japanese history". I learned that there are various approaches. In my school, [students are] divided into natural science course and arts course in the third year, and "ethics" is only for the arts students and no natural science students learn it. In my personal opinion, I wonder whether the students who need ethics are the students in the natural science. Since in the current educational curriculum there are students who graduate from high schools without ethics education, I am concerned about the next national curriculum.

Comments from Group Discussion Sheets (4 persons per group)

Group 1: 1) What is a disease?

Everybody has diseases and becomes older.

Extreme discrimination against "diseases" & "parasites"
Establishment of prevention medicine
"Isolation" brings discrimination
(diagnosis techniques)
Leads to genetic "treatment" and abortion

2) Have you ever had students and/or their families with "disease", and/or "discrimination" in your class? Tell me your experience please.

In my school, there is at least one student in a class, so that it is just natural.

4) Other things discussed

Can parasites be allowed to exist?

Good and bad of prevention (important/not good).

Prevention and isolation (collective benefits or individual rights).

[We are concerned about] a tendency that [people] believe they can control not only ecosystems but also "ecosystems" in their bodies.

To what extent mothers' decision making (about a fetus, a fertilized egg) can be allowed.

Group 2: 1) What is a disease?

Social aspects and biological aspects br> Human centered ideas mislead?

normality & abnormality - Question of numbers (relative)

A historical root of discrimination.

- Human genome Everybody has defects/ eugenics.

Business does not always necessarily equal to health and diseases

discrimination exists in every disease (cancer is worse than pneumonia?)

Diversity as a teaching material.

To think of meanings as a "theme".

4) Other things discussed

Era of infectious diseases / chronic disease / revival of infectious diseases.

How we can give up diseases = religion.

It is universal how we can overcome diseases in our consciousness.

Possibilities of various teaching materials: Ippen Jounin Eden; Yamai Soushi; Onono Komachi Souchi; Movies

Group 3: 1) What is a disease?

Every person has some defects (though there are differences in levels), and the development of medicine makes it possible to diagnose something which has not been able to be diagnosed as a disease before.

2) Have you ever had students and/or their families with "disease", and/or "discrimination" in your class? Tell me your experience please.

There are restrictions in school events if we have some students with handicaps. [We wonder if we] eliminate the handicaps at teachers' convenience.

3) Who can we deal with students and/or their families with "disease", and/or "discrimination" in your class?

How can we discuss diets with classes and obese students?

Make students think about AIDS with an example of Mr. Kawada.

(Being discriminated during the fact is hidden, being supported once "coming out".)

4) Other things discussed

The belief in health is brought by hospitalization society and competitionism.

Living and existing together with the handicapped and diseases


Fourth Meeting and Future

On the 17 May, the fourth meeting will be held, in which we will think about animal experiments. A biology teacher, Mr. Kohji Suzuki will demonstrate a cow's eye dissection experiment. There was some discussion about dissection of a frog, but it was decided 1-2 cow eyes would be sufficient to teach the principles, and cause less harm. For this dissection we will use a biology classroom for the initial part, then return to the ordinary classroom that allows tables to be moved into the roundtable shape to stimulate discussion, as we have always used.

In environmental education, which seems to more successfully widespread than bioethics education, we often get trapped in the situation where educators passively receive information from experts or authoritative figures (3). There is a danger that bioethics education could also bring a paternalistic framework, e.g. between academics and school teachers, school teachers and students. To avoid this scenario, educators themselves need to reexamine how they learn. We hope this bioethics education network would be not only a place for exchanging practical information, but also a place for letting participants reflect on themselves.


Invitation

The network is open for anybody who are interested in bioethics education, though our immediate intention is school education, especially high schools. If you are interested in joining us, please contact us. There will be a session of the 9th Annual Meeting of the Japan Association of Bioethics (1-2 November, 1997, in University of Tsukuba) devoted to school bioethics education.


Acknowledgments

This research was funded by grants-in-aid for scientific research from the Japanese Ministry of Education, Sports, Science and Culture to DM (1994, 1995, 1996-1998). We thank the help of Ms. Hiroko Obata during the preparation for the first two meetings of the network. We also appreciate the support of all the teachers in the network, and those who responded to the materials, especially Mr. Hiroaki Koizumi, Mr. Kaneo Inoue, and Ms. Izumi Ohtani in supporting the establishment of the network. We also thank the generous assistance of Mr. Tohru Yamashita, for providing a room for the meetings at Nihonbashi High School, Tokyo.

References

1. Darryl R.J. Macer, Yukiko Asada, Miho Tsuzuki, Shiro Akiyama, Nobuko Y. Macer, Bioethics in High Schools In Australia, Japan & New Zealand (Christchurch: Eubios Ethics Institute, 1996), 200pp.

2. Yukiko Asada, Miho Tsuzuki, Shiro Akiyama, Nobuko Y. Macer and Darryl Macer, "High School Teaching of Bioethics in New Zealand, Australia, and Japan", Journal of Moral Education, 25 (1996) 401-420.

3. Eiichiro "Atom" Haroko, "Technocracy to recourse" to "teacher initiatives": Toward an alternative organization of environmental education", Environmental Education Research: Tokyo Gakugei Univ. 6 (1996), 33-43.


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