Where do we learn bioethics and avenues for bioethics education

pp. 25-32 in Proceedings of the UNESCO International Bioethics Committee Sixth Session, Volume II (Paris: UNESCO, 2000).

Author: Darryl R. J. Macer
Institute of Biological Sciences, University of Tsukuba,
Tsukuba Science City, Ibaraki 305-8572, Japan
Fax: Int+81-298-53-6614
Tel: Int+81-298-53-4662
Email: Macer@biol.tsukuba.ac.jp
Eubios Ethics Institute <http://eubios.info/index.html>

Paper presented at UNESCO IBC 7th session

The first bioethical lesson I learnt was arguably the moment my umbilical cord was cut and I had to fend for myself. Suddenly I was an autonomous unit, and ever since I have been thinking of my life and survival. The second lesson came a few minutes later when I suckled my mother's breast, realizing my dependence upon others. A family is a unit of society, and we are not really independent , at least until much later. The next lesson may have been when I drank the substitute mother's milk formula from the bottle. We need to depend on others in the broader society.

Of course some philosophers would claim that the very "I" or "me", did not develop until a year or two after this. My point is that bioethics education starts with our birth and its effectiveness is relayed to when our eyes and ears are open. This is certainly earlier when I, as a teacher of bioethics, first meet a student. It is earlier than when I, as a father, first told my two year old daughter what I do and what I value, and when she could first say the word "bioethics"- though actually she says it better in Japanese.

Let us consider what you may more readily think of as a bioethics education. I will talk about the international teaching of bioethics to others. How do we form a mature society full of well informed and balanced persons? This is what I have called "bioethical maturity". Bioethically mature means a person, or a society that can balance the benefits and risks of alternative options, and make well-considered decisions.

The decisions do not need to be same every time, but well considered. A "good" decision for many issues of bioethics is not simply YES or NO. For example, should a fetus with a severe disease, like Tay Sach's disease, be aborted or not? This question that mothers face, with the support of their husbands, and may be others, can not be said to be YES or NO. Whatever the law is, or religious guidance, this decision to have an end of the life of your fetus because of considering the very life of the fetus, is not one which can ever be dogmatically said to be keep the fetus or abort the fetus.

Education of bioethics is to empower people to face moral dilemmas. Moral dilemmas come to everyone, we need not teach people that life has dilemmas. However we need to teach people that they will have less regrets if they consider the different sides before the decision is made.

Life cannot be just left to fate, because that choice, is itself is one moral choice. The mother who says I cannot decide so I leave it to God, is moral choice. The counselor, be they physician or priest, who says leave it to nature is making a moral choice.

Human beings as a moral animal, have to make these types of choices, once we have the knowledge. Some may say it is better not to know. This I would refute. Human beings are not passive stones in the river of life, moral agents. If we can make the life of another better, we have an obligation from love to do so. It is an obligation we must not escape.

Some would say that the dilemmas over abortion of a handicapped fetus is better not to give it to mother. The old fashioned paternalism found in all our societies, would try to insulate the people from facing such trauma of decision. However, the cruel fact is that if the knowledge is left until birth, the baby who is now a human in being and without argument a person, is often abandoned.

Bioethics education aims to make society mature so that no child will be abandoned or neglected. It also aims to make a society tolerant to respect diversity of persons, and diversity of decisions. Prenatal diagnosis gives us knowledge that should be used by the mother to prepare or abort at an early stage, for the best interests of the person the fetus would become.

How do we accomplish the education? When is the best time? Last year in Morocco at the 6th meeting of IBC I described part of our work with a high school education network in Japan. I have a network of almost 100 biology and social studies teachers who work together for learning how to better teach bioethics in high school classes. A few try in junior high school with 14 year old students. I have seen a contrast between the school rooms in New Zealand, where students talk more than the teacher, and Japan where the teacher dominates.

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. For example, 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.

The process of debate and discussion in a classroom is important for developing good minds to face bioethics dilemmas. It also develops tolerance. There are specific goals already found in some syllabus. For example in the 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 text books we may not see how to apply ethics to moral dilemmas. For that case-based discussion and current events can be useful. There any many possible classes where bioethics can be taught, and should be taught, not just in set curricula of science or geography or ethics.

University students are a little older and have experienced more things that can make them also good targets for focused approaches on bioethics. I have taught for 10 years university students in Japan, and we are trying to assess the impact of bioethics classes on people's reasoning. One point in common with school is that often students report they raised the issues with their family members. This is a type of public education.

General public education has many avenues through media. Still I think that family has a key role, and teachers, TV or magazines are no substitute. We cannot sit waiting for the media to do it, we have to teach ourselves and explore these issues together.

One further point I will mention is the UNECO/ IUBS Bioethics dictionary project to better educate across disciplines. This dictionary which will be released in the year 2001, will include a list of words, terms, persons and ideas which are related to bioethics in a broad sense, in agricultural, environmental, medical, and general science and technology fields. Each entry will have a brief definition, the ethical issues that have been discussed, and where to seek further reference. There is a need for such a document by biology students and educators, as well as persons in many fields. We envisage three distribution routes: on-line for free access; free hard copies, especially to developing countries; hard copies for sale, with publishers in different countries to make an affordable book for students.

Finally, modern life tends to alienate children from nature. Often students see videos or pictures rather than seeing the real forest or environment, wildlife is often seeing in story books or zoos. The bio of bioethics is life. We have to get out and learn where we as individuals and as a species, have come from. Already environmental ethics has started to be taught in primary schools.

We also need to see the full range of people in society, and understand how bioethics works in the context of relationships. There are strategies that have been developed and are being tested for small focus groups and classrooms. We need to share experiences, and encourage all who start to have passion for preparing a more bioethically mature society. I think teachers have a major role, but bioethics should be multidisciplinary, with many persons helping each other.

My conclusion is simple. We should all do bioethics education, as long as it doesn't do harm.

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