Methods to assess the teaching of

bioethics

Fumi Maekawa & Darryl Macer

Some questions of bioethics education…

• “Does education actually work?”• “What impact does education have on

the minds of the receivers, and providers?”

• “When is the best time?”

• "What is the preferable way to teach bioethics?”

Method

• In order to examine these questions, long-term analysis of the homework and comments that students gave in all the bioethics classes, since 1990, in the University of Tsukuba has been conducted.

Classes include:1) Required classes among third year

biology students of thirty lectures, once every week. Usually three times a term, students are asked to write a report on some topic in genetics, bioethics and biology. This class started in 1990, and at periods it was among second year students.

2) Optional classes open mainly to undergraduate students, of ten lectures. One is called Bioethics, and the second, Bioethics and Genes. About half the students in the biology program take these courses. Every year there are a few non-biology students who choose to take this lecture.

3) Graduate courses in environmental ethics and bioethics, of 10 lectures, each lecture being 3 hours. Environmental Science students mainly take this course, but it is open to others.

Development of analytical methods

• Sort the photocopies of all homework.

The coding for each report is year, class, and report number. For example, 00BG2 will be a Bioethics and Genes class, second report in the year 2000.

• Compare common ideas and thoughts expressed in student reports

• Personal moral development• Thematic comparisons• Compare reports with the

teaching materials and method used.

Results

Total number of undergraduate reports

• Scientific English 2055

• Bioethics 584

• Bioethics and Genes 463

Coding systemThe following evaluation criteria allow

primary analysis of each report. BV Both sides of viewPO Personal vs. other person’s view SF Scientific facts mentioned or notEB Environment & biocentric ideasUV Utilitarian viewsR RightsPK Specific bioethics principles and

keywordsNI Number of different ideas in one

report

Example comments

"Animals are life as we are. I think all life should be allowed to live. So I think that they have a right to live. " (R)

" I thought my knowing was worth dissecting without consciousness. " (UV)

" We have legal rights which shield us from unjust things. Instead of it, we have to fulfill duties. " (PK)

Example comments

" I don’t agree to give animals legal rights. But I think that we should not kill animals uselessly (BV) and it is important we protect the environment. " (EB)

" All cells of transgenic animals have injected genes. Injected genes can be expressed in specific tissues with proper promoters. " (SF)

" If I were used in such an experiment with no pain, how would I feel? " (PO)

Example of one report"We can make an animal that feels no pain, and we use it for

experiments. We can suffer pain as the same of all animals. Because of knowing self-pain, we can understand how much animals feel pain. (MI1) And we are uncomfortable seeing animals that feel pain.

Is it right that we use animals that feel no pain? I think painless animals are the same as dead animals. When we make animals painless, we kill the animals. (MI2) Animals that feel no pain are not living things. I think of the mistake that we may use this animal or experiment when animals don’t feel pain.

How much does it matter when I don’t feel pain? I would not understand suffering disease. I would not understand injury. I would not understand death. I hate that we think we may use this animal if this animal feels no pain. (MI3) I consider that we must recognize the use of killed animals when we use animals that feel no pain. I think hypocrites use animals that feel no pain. "

Bioethical Maturity

A person, or a society that can balance the benefits and risks of

alternative options, and make well-considered

decisions.

Individual analysis results example

BV PO SF EB UV R PK NI98B1 N Y N N N N Y 798B2 Y Y N N N N N 598BG1 Y N N Y N N Y 898BG2 N Y N N N N Y 799E2 Y Y N N N N Y 599E3 N N Y N N Y N 699E5 Y Y N N N N Y 599E6 Y N N N N N N 599E7 Y Y N N N Y Y 799E8 Y Y N N N N Y 6

MI1 MI2 MI398B1 Don’t want active

euthanasiaBeing alive is the

best self loveFeel pity for family

and relatives98B2 Wonderful to bare

child with ARTChildren having only

one parent shouldnot increase

ART after carefulconsideration

98BG1 Harmful toecosystem

Mice might beharmful to human

society

Should be patentedunder strict

condition98BG2 Help live positive

and full lifeCan think and learnabout disease before

symptoms

Can declare myopinion to family

clearly99E2 Shouldn’t be biased

when thinkingMust get and give as

much data aspossible

Risks and benefits ofGM food

99E3 High risk ofinfection, right to

hopeful care

Pigs have beeneaten; known virus,bacteria, parasites

Primates bannedfrom transplant,can’t overlook

99E5 Benefit in medical &pharmaceutical

fields

Geneticdiscrimination may

happen; employmentdenied

HGP useful forhuman evolution

research

99E6 Genes don’tdetermine everything

We are influenced bythe environment

Analyzing genes isjust an expectation

99E7 Basic right to knowinformation

Labeling needed;some product may

offend personalbelief

Fear of big companycontrol all food

production

99E8 Take pre-symptomatic tests

for AD

Make decision bymyself, declare how

to be treated

Govmt. Should makea law to prohibit

abuse

Thematic comparisons

Reports with similar themes are analyzed to investigate opinion changes through time, and with teaching materials and methods.

Common themes over the decade• GM foods

• When is it ethical to do prenatal diagnosis?

• Personal views on predictive genetic testing

• Animal rights and experiments

• Gene therapy

• Surrogacy and assisted reproduction

• Scientific responsibility

• AIDS

• Organ transplants and brain death

• Patenting of biotechnology

Topic No. Rep BV PO SF EB UV R PK NI

97B1 11 6 3 6 4 6 3 4 6.597B2 11 6 7 0 0 8 3 4 6.597B3 3 0 1 1 1 0 0 1 9.797BG1 8 7 4 3 8 4 1 0 7.497BG2 9 7 6 3 1 6 3 5 6.897BG3 1 0 1 0 0 1 0 0 698E1 12 8 8 3 1 12 1 3 6.698E2 9 3 2 4 1 4 1 0 5.198E3 12 12 9 2 6 11 3 3 6.798E4 8 7 5 0 0 7 1 2 7.198E5 11 2 5 2 5 3 0 1 5.998E6 1 0 1 1 0 0 0 0 898E7 5 4 3 3 1 3 1 0 6.8

Topic

FMI1 FMI2 FMI3

B1 Instinct not to eathuman

Humans aredifferent

If hungry, might eat

B2 Selling for profit isbad

Selling to help is ok Basic knowledgeimportant

B3 Developing vs.developed

BG1 Safety concern, forfuture

Gene pollutionaffect ecosystem

Risks>benefit,assessment

BG2 HGDP linked todiscrimination

Respect rights,indigenous

No privateidentification

BG3 Politics controleugenics

E1 Only for cure,hereditary

May lead toeugenics, bad

Fear to future sideeffects

E2 Check/cure disease Check temperament Don’t want to knowE3 Safety concern, long

term effectBenefit-riskassessment

Consumers’ rightsneeded

E4 To save human’slives, ok

Control amount ofresearch

No to animalexperiment

E5 Increase food &energy

For future, Protectenvironment,

Education & publicwelfare

E6 Science vs. religionE7 Safety concern, long

term effect

Animal rights and experiments: Report titles

• 01E4: My attitude to animal rights (N=27)• 01B1: My views on animal rights (N=11)• 00E4: We should do animal experiments. Yes or No

(N=25)• 00B1: What is our responsibility to a 20 year old

chimpanzee raised in captivity? (N=22)• 99E1: What are the similarities and differences

between humans and Chimpanzees? (N=32)• 99E3: Should we use pigs and other animals as

organ donors? (N=27)• 98E4: Should we research on live higher primates if

they have a risk to die? (N=38)

Animal rights and experiments: Report titles(continued)

• 95E7: What are the ethical concerns about doing an experiment on a cat that feels no pain?

(N=29)• 93B3: Animal rights (N=4)• 92E9: Ethical scores for animal experiments

(N=10)• 92B1: Is it OK to breed and farm a fast

growing pig made by genetic engineering?(N=20)

• 91E5: How do you feel about growing animals as bioreactors?

(N=20)• 91Q4: Do you think science should be able to

freely examine anything, and use any living organism as an experimental material?(N=10)

Both sides of view expressed (BV)

1991 13/20 (65%) 1995 23/29 (79%)2000 21/25 (84%)2001 26/27 (96%)

Rights mentioned (R)

1991 3/20 (15%) 1995 10/29 (34%)2000 9/25 (36%)2001 24/27 (89%)

Average number of ideas (NI)

1991 4.95 range 3-7

1995 4.21 range 3-6

2000 5.20range 2-10

2001 5.96 range 4-9

Possible reasons for the trends• Title of report

Wording of the title seems to shift students’ reasoning and expression

• Handout and content of classes

Still needs investigation, though expected to influence students more than the report title as a direct source of information. (search for similar ideas and wordings)

ConclusionsQualitative analysis of keywords and

ideas is more informative of human moral development than mere statistics

Multiple factors affect the students’ expression which may not be isolated and evaluated dogmatically