A comparison of bioethics in school text books in India and Japan

Minakshi Bhardwaj & Darryl Macer,
Eubios Ethics Institute, P.O. Box 125,
Tsukuba Science City 305, Japan
Eubios Journal of Asian and International Bioethics 9 (1999), 56-60.


We can define bioethics as the love of life (Macer, 1998a). Bioethics involves the balancing of benefits and risks of choices. When we ask people what comes to their mind when they hear the term "Bioethics", we can see two distinct groups of answers. This was seen in the results of the International Bioethics Education Survey conducted in 1993 and 1996 (Macer et al. 1996; Pandian & Macer, 1998). In Australia, New Zealand and Singapore, more people wrote comments about how we should use life, that science raises issues, or how we should apply biotechnology, i.e. somewhat practical issues. However, in Japan and Tamil Nadu, India, more comments were general about the respect for life we should have. There were also a few other arguments, with some people mentioning specific issues in medical or environmental ethics or human rights.

While we cannot say that one answer is correct, we should say that we have to move beyond mere respecting life to practical decision making. We need to face practical dilemmas. In this analysis we can see some similarity in the higher proportion of respect for life issues found in Japan and India, making us ask whether there are further similarities between Japan and India in the attitudes to teaching and in the resources they use for teaching. Bioethics as a word or separate subject was not taught \so much in India, with only 16% of the Tamil Nadu biology teachers, half of the Japanese, and two thirds of the Australian and New Zealand teachers saying they had taught bioethics. However, more teachers had taught some social and ethical issues of the selected areas of science and technology that were asked in the survey, though still less in India then in Japan, Australia and New Zealand. In this paper we describe research in progress comparing the bioethical content of textbooks used in high schools in India and Japan, with some comparisons to New Zealand.

Bioethics education

The International Bioethics Survey conducted in 1993 in ten countries, asked the question whether students should be informed about social issues associated with science and technology so that they can participate in the contemporary debates. In Japan there was 90% agreement and in India there was 75% agreement (Macer, 1994). The International Bioethics Education Survey conducted in both countries found over 80% of the biology and social studies teachers thought that bioethics education is needed.

There are some general statements for education of values existing for many decades, but in practice they may have left a gap in preparing students for real-life dilemmas. The Japanese Law for the Promotion of Science Education (Rika Kyoiku Shinko Ho) of 8 August, 1953, starts with Article 1. [Objective]: In view of the fact that science education is most important as the basis for establishing a cultural state, this law, in conformity with the spirit of the Fundamental Law of Education and the School Education Law, has as its objective the promotion of science education, assisting the citizens to acquire scientific knowledge, skills and attitudes and to cultivate their ingenuity and creativity with a view to enabling them to carry on their everyday life in a more rational manner and to contribute to the progress of our nation.

There is strong international agreement for the teaching of ethics in science and it was included in articles 20 and 21 of the Universal Declaration on the Human Genome & Human Rights, adopted unanimously by 186 member countries of UNESCO on 11 November, 1997, as below:

20. States should take appropriate measures to promote the principles set out in the Declaration, through education and relevant means, inter alia through the conduct of research and training in interdisciplinary fields and through the promotion of education in bioethics, at all levels, in particular for those responsible for science policies.

21. States should take appropriate measures to encourage other forms of research, training and information dissemination conducive to raising the awareness of society and all of its members of their responsibilities regarding the fundamental issues relating to the defense of human dignity which may be raised by research in biology, in genetics and in medicine, and its applications. They should also undertake to facilitate on this subject an open international discussion, ensuring the free expression of various socio-cultural, religious and philosophical opinions.

While it is accepted that there is a need for bioethics education, the question is when? (Macer, 1998b; Macer, 1999). Our education for life takes place over the whole time for birth to death and during the formative years at home and at school or university. Some environmental programs have been devised for primary school students. At fist they may focus on not littering and not wasting water or food but not all attempt to instill the reasons for acting in this way into the minds and hearts of children. This may include the introduction of basic environmental cycles, describing endangered species and hands on experience in cleaning up the school and the community. However, to teach the more complex issues of the use of technology, and how to make reasoned decisions, more success can be expected at a later stage.

University undergraduates are a good target, and postgraduates even better, but if we aim for public education then high school education can reach more of the community than university can. Most students attend schools but only a few attend university. Also parents can be reached indirectly via school lessons, accelerating the introduction of bioethics into the whole community. Thus this study focuses on the high school.

High School Syllabus in India

Since 1976 education has been a joint responsibility of the Central Government and the states, with the Central Government responsible for the quality and character of education. Free and compulsory education is given to all children up to 14 years of age. The National Council of Educational Research and Training (NCERT) was established in September 1961, and it develops curricula, syllabi and prepares textbooks for classes I-XII which form the basis for the study schemes provided by the Central Board of Secondary Education (CBSE) for the more than 5000 schools affiliated to the board.

This study focused on years VI-XII, the Secondary and Higher Secondary Schools. From VI-X General Science is taught, and in years XI-XII Biology is offered as a special course. From year VI private publications may be used but the CBSE syllabus must be followed. Inside social studies, history, civics, geography, economics and political science are taught.

In the latest Indian Central Board of Secondary Education (CBSE) Prescribed Syllabus for Class IX & X in Science (Code No. 086/090), ethics is included as a general objective of teaching science. In fact, we can see four of the seven objectives referring to ethical issues as follows:

- Develop scientific temper, attitudes and values such as open mindedness, intellectual honesty, suspended judgment, courage to question and respect for human dignity.

- Cultivate social, ethical, moral and aesthetic value which exalt and refine the life of the individual and the society.

- Appreciate the contributions of scientists and develop sensitivity to possible uses and misuses of sciences.

- Develop concern for a clean environment and preservation of the ecosystem.

In the CBSE Social Science Syllabus for classes IX and X we can see four bioethical objectives among the eight in the Geography Syllabus, namely:

- to develop an understanding of man and environment interrelationship at the global level.

- to develop an appreciation of the inter-dependence of nations and regions of the world.

- to develop an understanding and concern about growing world population and its impact on environment.

- to develop an understanding of the need for the protection of the environment and the conservation of nature and natural resources.

In the history and civics syllabus there is nothing directly related to bioethics, but in economics we can see one of eight objectives reading:

- to develop among students a passion for social justice and an urge to resist exploitation in any form by man or by the State.

In the Biology Syllabus for senior school, we do not see the same objectives of general science repeated, however one of the seven objectives reads:

- to realize Biology for rational living - removal of biases (sex, race, etc.) and correctiveness to superstition.

While we can see the above bioethics objectives in the syllabus, inside the exercises we can see scarce mention of ethics. There are several views of bioethics (Macer, 1998a), as shown below:

1. Descriptive bioethics: The way people view life, their moral interactions and responsibilities with living organisms in life.

2. Prescriptive bioethics: To tell others what is good or bad, what principles are most important; or to say something/someone has rights, & others have duties to them.

3. Interactive bioethics: Discussion and debate between people, groups within society, and communities about 1 and 2 above.

Scientific knowledge is generally taught as a descriptive science describing the natural phenomenon of life.

When we read Indian textbooks we can find numerous examples of prescriptive statements of ethics. For example, in the book, Living Science by A.C. Sehgal and Mukul Sehgal (Ratna Sagar Publications) for class 8, conservation is defined as "the wise and careful use of resources" (p.202). In another biology text for class 8, by Lakhmir Singh and Manjit Kaur, it tells us to avoid food wastage and spoilage in a number of concrete situations, including social and religious functions.

One more example of a prescriptive statement is in Our Civic Life by Romila Thapar, a textbook for class VI civics lectures and a government, NCERT Publication. It states that "When many people live together , they require certain rules to regulate human activity. Your school also has certain rules and every student has to follow these rules. It is necessary for each student to reach school in time. If the student does not reach school in time, he or she is punished".

Some books actively promote debate. In Moral Sciences for class VI by Lalita Sen, the preface explains "To make the right choice and not to stand for truth in spite of opposition are not always easy decisions". The book includes 17 short case studies, each making a moral lesson. Moral sciences are taught in years VI-VIII, but there is nothing compulsory in years IX and X, but some in the general studies classes in years XI and XII. In the book Our Country Today by D.S. Muley et al., a civics book for class VIII, the section on the "Arms Race" highlights the class to have a debate on "Whether India should have a nuclear bomb? Discuss in class."

In a section entitled "Two sides of the coin" discussing science in a book of Science for class IX by D. Balasubramian et al. published by NCERT, we see little real discussion of the benefits and risks. It does introduce some concept of technology assessment, e.g. "But an understanding of the effects of using technology is coming rather slowly. Now we are realizing yet another aspect" (p. 263). However, it has an optimistic view, at the later part of the section, "It takes time to learn how to use technology" (p. 265).

In the book Living Science, on the positive side some practical means are included to give students ideas on what they can do, e.g. "Not just mean switching off lights or fan when not needed or using less water, but also developing methods of doing things where less resources are used. For example, using public transport or cycling instead of using a car, saves petrol" (p.207), also it is against using air conditioners and offers methods for recycling.

There are statements urging action as found in a geography class IX book by NCERT. Humans are at the cross-roads of choosing their future path of action. It goes on to the present moral choice, there is the choice to develop resources at a much reduced pace taking steps to conserve resources, reduce growth of population and wasteful consumption. The reason given for this is "It will help protecting the environment - for our future generation."

Results of keyword analysis

The results of keyword analysis are in the Table. For each keyword there are three percentages, first no mention, second some lines, and third, about a page or more. The left-hand column notes if the keyword is discussed more in India (I) or Japan (J) or the same (=). Other topics are still under analysis. The results from Japan come from Asada and Macer in Macer et al. (1996).

In India the results come from analysis of 1997/1998 textbooks for each year of study, individually: 3 NCERT General Science years 6-8; 3 privately published General Science years 6-8; 2 NCERT General Science years 9-10; 4 NCERT Biology years 11-12; 3 Private Moral science years 6-8; 9 NCERT Social studies year 6-8; 6 NCERT Social studies year 9-10; and 8 NCERT Social studies year 11-12. The analysis was made in schools used in Delhi area, noting that the NCERT textbooks are used nationally at more than 5000 high schools. Computers are discussed in separate books in India, including some private texts in accordance with CBSE syllabus. Animal experiments are generally discussed in practical activities in India. We are also looking in more detail at the terms pollution, environmental conservation and human diseases, which are quite broadly discussed.

Nuclear power is included in this paper on bioethics, for not only does it affect life and the environment, it is a frequently cited example of the negative side of science. Table 1 reveals it is found in a number of books. Muley et al. as discussed above use it as a discussion point, it is also found in New Zealand (see section below). Sudip et al. India: Constitution and Government, a Civics text for Class IX (NCERT), report on science "modern science has developed weapons which are qualitatively different" (p. 99), comparing to previous warfare.

In India there was only discussion of organ transplants once in the biology text for class XII. However, it is found frequently in Japanese books. There was more discussion of sex selection in Indian text books when compared to Japan, which does represent a need for ethical consideration given the practice continues in India. However, organ transplant issues are also important to discuss in India.

There was greater diversity of topics in the final year (year 12) biology books in India than in books for earlier years, and this content will depend upon the syllabus for each year. Besides the environmental subjects that will be considered in further research, the following subjects were found in the 1997 NCERT and Private textbooks on General Science (years 6-10) and Biology (years 11-12) examined in India:

Year 6: Only biodiversity and pollution in general

Year 7: Pesticides, AIDS

Year 8: Pesticides, Nuclear Power, AIDS

Year 9: Pesticides

Year 10: Pesticides, Nuclear Power

Year 11: Pesticides, Nuclear Power, Biotechnology, Genetic Engineering, Eugenics

Year 12: Pesticides, Nuclear Power, AIDS, Biotechnology, Genetic Engineering, Biological Pest Control, In vitro fertilization, Abortion, Contraception, Genetic conservation, Prenatal diagnosis, Bioethics

Two thirds of the Indian text books did not mention contraception (Table 1), although in April 1980 a National Population Education Project was implemented by NCERT on behalf of the Ministry of Human Resource Development, via the Ministry of Health and Welfare. This has included integrating population education in the syllabi and textbooks. It is also being expanded to include more HIV/AIDS education, which may increase the proportion of books which mention AIDS from the rather few to date.

D. Balasubramanian et al. Science for Class IX General Science (NCERT) have an extended discussion of the history of technology and science, and conclude with a discussion of population problems: "Science and technology grew very fast during the past 200 years. It takes time to learn how to use technology properly. Let us take an example. After the Second World War, that is, after 1945, several new medicines were discovered. Plague, pneumonia, tuberculosis, small pox, malaria and many other diseases are no curable. Surgery has become much safer than it used to be. Infection can be controlled with the family of drugs called antibiotics. Child birth is also safe and sure. Does this mean that the birth rate has come down? Before these medicines were discovered, the world population was rather steady, with the birth rate and the death rate matching each other. Now the death rate has gone down. If we still maintain the same birth rate, the population will grow very rapidly. Figure 21.2 shows [population from 1800 to 2000AD]" (p. 265). They also give a further example explaining exponential growth, and urging population control.

The book, B.S. Pradesh, India: Economic Geography for Class X Geography (NCERT, p. 140) discuss the issue in a prescriptive manner: "Can small national population and big families ever go together? Prosperity arrives only where the nation and families both move in one direction. Population can be stabilized in the long run only if every family will have no more than two children who would fill in the vacuum created by parents as and when they pass away. This is why we speak of a two child family as a national norm." They then go on to discuss China's one child policy, describing how it will be to China's advantage over India in prosperity.

The same book (p. 128) also discusses genetic engineering as the first example of technology in the same chapter on "Nurturing our human resources", mentioning "They have reached a stage of genetic engineering with the help of which they are able to develop improved strains of plants and domestic animals. We have now heavy yielding and early maturing varieties of trees, shrubs, vegetable and flower plants. Poultry, fish, cattle and other domestic animals have now been turned into highly efficient machines as it were to give us far more eggs, proteins, milk, meat and wool etc.".

The keyword castes was found in half the social science text books in India and a third of the books in Japan mentioned Douwa kyouiku which is also related to discrimination of a caste of society. In Sudip et al. India: Constitution and Government, a Civics text for Class IX (NCERT), they have over a page on castes, e.g. "One of the great problems facing our democracy has been the rigid caste system. It had divided our society into so called high and low castes." (p. 80). They explain and defend the affirmative action system for Scheduled Castes, which assigns seats in government and educational institutions. They also discuss inequality of women at length. The class VIII book for Civics has separate 4 page mini-chapters on "The Caste System" and "Untouchability".

A comparison with selected New Zealand texts

In Japan many teachers have expressed reservations about the exam-based learning at school restricting the inclusion of bioethics topics into science books (Asada & Macer, 1998). However, a comparison of the keyword content (of those listed in Table 1) of three New Zealand text books that were designed for student exam study found they also suffered from a lack of ethics content. The brief results were:

Year 10 General Science [Hannay, B., Howison, P. & Sayes, M. Form 5 Science. Study Guide (ESA Publications (NZ) Ltd. 1996)]

Half a page on artificial insemination for cows

Three pages on AIDS/HIV and prevention

One third of a page on nuclear power in the section on risks of science...

One page on benefits and risks of science (including a question), which reads:

"Scientific discoveries have changed people's lives dramatically and the pace of change seems to be increasing. Most changes are of great benefit to society:

- Medical advances have produced antibiotics, vaccines, X-rays, transplant operations and much more.

- Computers and information technology enable people to communicate instantly all over the world.

- Sewage treatment and clean water supplies are available in most developed countries.

- Crops and farm animals have been bred which can produce more food and are more disease resistant.

A few scientific discoveries have brought dangers as well as benefits. [9 lines on nuclear power]...After a scientific discovery has been made there is no going back. Once the knowledge has been gained, society must learn how to cope with it safely.

The students are then asked to think on six possible technologies and whether they will be benefit to society, giving reasons for their answer (p. 28).

Year 11 Biology [Bunn, T., Form 6 Biology. Study Guide (ESA Publications (NZ) Ltd. 1997 for 1997 Sixth Form Certificate]

Three pages on pesticides

One and a half pages on biological pest control

Four lines on contraception, but with a scientific description:

"The contraceptive pill contains progesterone and oestrogen. Taking the pill every day maintains high levels of these hormones in the blood. High oestrogen levels prevent FSH production, no follicles mature and so no eggs are released from the ovary, preventing fertilization and pregnancy." (p. 250).

One page on genetic engineering

One paragraph on DNA fingerprinting

One page on kidney dialysis

Year 12 Biology [Bayley, M., Biology. Form Seven Student Notes (Addison Wesley Longman NZ Limited 1997)]

Two separate entries of a paragraph each on genetic engineering or recombinant DNA with some contrast:

"[Recombinant DNA] This is made by removing a gene from an organism - e.g., the human gene that codes for insulin - and introducing it into bacteria. ... The bacteria can now be used to produce the protein (e.g., insulin) for use by humans. [Genetic engineering] is the ability to move genes from one organism to another - see recombinant DNA" p. 85.

"[The Future Development of Humans - Phase Three - The Future] In this phase it is highly likely that humans will no just select genes, largely independent of the environment, but humans may be able to make new combinations of genes in different animals. This is already possible with bacteria in genetic engineering. Eventually humans may be able to make genes, and perhaps correct mistakes in genes. In other words, future humans may be able to control their biological evolution as well as their cultural evolution." (p. 119 - last paragraph of the book!).

With a concluding paragraph like that, one would have hoped that there had been some discussion of bioethics earlier in the book. However, that was the only mention. As the International Bioethics Education Survey revealed fortunately most teachers use supplementary materials to teach these issues (Macer et al. 1996), however, text book writers should not rely upon the coverage of bioethics in other subjects especially as students in the final years of school are choosing from a variety of elective subjects.


Table: Results of High School Textbook Analysis in Japan and India

Each subject has three values (%): no mention (100% written as N), lines, and pages. The column > refers to which country we see more mention, India (1998 text books) or Japan (1996 textbooks) .
Subject
Biology
General Science
Social Science
Japan
India
Japan
India
Japan
India
>No. books14 611 10913
IPesticides57 43017 50333664 03030 40N00 602416
IBiol. Pest. Control 937067 03391 90N0 0N0 0N00
IPrenatal diagnosis93 7083 1703664 0N0 0N00 N00
IAbortionN 0067 033N0 0N0 0N00 N00
IContraceptionN 0067 033N0 0N0 0N00 N00
JIn vitro fertilisation 6428767 33091 90N0 08911 0N00
JEugenics (Doiwa Edu) N0083 170N 00N0 0780 22N00
ICastesN 00N 00N0 0N0 067330 521632
IAIDS71 21767 033919 07010 20N00 N00
=Biotechnology57 142933 3333739 18N0 078220 9280
=Genetic engineering 14434333 175091 09900 108911 0N00
JGene therapy70 300N 00910 9N0 0N00 N00
mNuclear power86 14067 330819 96040 006733 66168

Discussion and conclusions

As a conclusion we have found some discussion of ethical issues in the textbooks used for science and social science in India. Half of the objectives of the Science Syllabus in India are related to the development of ethics. There will clearly need to be better incorporation of ethics into textbooks for these classes than that which exists today. We also could consider the mention of bioethical issues in other subjects. In Tamil Nadu a Tamil textbook includes a case discussing organ transplants, as does an English textbook used in Japan. There may also be enthusiastic teachers who teach using supplementary materials (Asada & Macer, 1998).

Moral education is emphasised in courses on ethics in Japan, and reaches all levels of school. In the 1983 syllabus guidance document, Course of Study for Elementary Schools in Japan (Ministry of Education, 1983, p.111), moral education is defined as "aimed at realizing a spirit of respect for human dignity in the actual life of family, school, and community, endeavoring to create a culture that is rich in individuality and to develop a democratic society and state, training Japanese to be capable of contributing to a peaceful international society, and cultivating their morality as the foundation thereof." Moral education includes respecting life, promoting good health and safety, having good manners, keeping neat and tidy, use goods and money well, to have independent thinking, respecting other's freedom, act cheerfully and sincerely, persistence, endure hardships, ability to be reflective, understanding, perform duties while asserting rights, love one's home and family, and people at school and school tradition, and the nation, and the world, with ability to make decisions for living, care for the weak, trust and help each other. In the same document, one of the goals of teaching "in the lower grades, one should learn to become intimate with nature and love and care for animals and plants with a tender heart, and, in the upper grades, to protect nature with love and care" (Beauchamp & Vardaman, 1994, pp. 264-5).

We can hope for integrated ethics education across the curriculum, and there is some evidence for this in environmental education. The Japanese Ministry for the Environment has published some materials for teaching about the environment. The 1986 Indian National Policy on Education provides that the protection of environment is a value which along with certain other values, must form an integral part of the curricula at all stages of education. A Centrally-sponsored program is currently underway, initiated in 1998 to assist state governments and voluntary organizations, called Environmental Orientation to Schools.

The keywords chosen for this textbook analysis were not all encompassing, but can be considered as markers of the breadth of issues discussed. Environmental and medical topics are both included, but more often than not, the ethical and social issues are not considered so deeply. Also the style that ethics is included in, as prescriptive statements, may not develop a bioethically mature individual who is empowered to balance principles of bioethics for facing difficult choices in the future.

Acknowledgments

We thanks the teachers who helped provide background for this study, and the access to the textbooks. We acknowledge the earlier work of Yukiko Asada and Hiroko Obata in analysis of some Japanese textbooks, as cited. We welcome further comments for this ongoing project.


References
Asada, Y., Akiyama, S., Tsuzuki, M., Macer, N.Y. & Macer, D.R.J. " High school teaching of bioethics in New Zealand, Australia, and Japan", Journal of Moral Education , 25 (1996), 401-420.
Asada, Y & Macer, D. " Establishment of High School Bioethics Education Network", EJAIB 7 (1997), 73-7.
Macer, D.R.J., Bioethics for the People by the People, (Christchurch: Eubios Ethics Institute, 1994).
Macer, D.R.J., Asada, Y., Tsuzuki, M., Akiyama, S., & Macer, N.Y. Bioethics in High Schools in Australia, Japan and New Zealand , (Christchurch: Eubios Ethics Institute, 1996).
Macer, D.R.J., Bioethics is Love of Life (Christchurch: Eubios Ethics Institute, 1998a).
Macer, DRJ. "Implementation of Medical Ethics Education", J. Medical Education 2 (1998b), 138-44.
Macer, DRJ. "Bioethics education, awareness of ethics and dissemination of knowledge", pp. 99-208 in Human Genome Research: Emerging Ethical, Legal, Social and Economic Issues, MGK. Menon et al., eds, (New Delhi: Allied Publishers Ltd. 1999).
Pandian, C. & Macer, D. " Bioethics Education in High Schools: An Investigation in Tamil Nadu with Comparisons to Australia, Japan and New Zealand", pp 390-400 in Azariah J., Azariah H., & Macer DRJ., eds, Bioethics in India (Eubios Ethics Institute 1997).
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