teaching bioethics for undergraduates: is it necessary?

Teaching Bioethics for Undergraduates: Is It Necessary?

Nahed Moustafa- MDProf.& Head of Forensic Medicine& Clinical

Toxicology Unit, FOM-SCU, EgyptCertified Trainer of Research Ethics- USA

Dr. Nahed Moustafa FOM-SCU

Objectives:

Bioethics for undergraduates:

Why?

How?

When?


Definition:

“Bio”: means life

“Ethics”: means the development of principles, rules that give standards of good and bad, right and wrong.

“Bio-shock”: might just be the word to describe the advances being made by science and technology


Why Bioethics?

1- Identify the major structural components of the country health care system

2 -Identify ethical responsibilities of the physicians that serve the community

3 -Identify several ethical principles& regulations that are relevant to practice

of medicine


Why Bioethics? (cont.)

4 -Develop strategies for resolving conflicting responsibilities( margin&

mission)

5 -Need of information about both the science & the ethics



As a part of a liberal education, an undergraduate course in bioethics should aim to prepare students for life as an engaged citizen in a free society by developing skills in critical thinking and encouraging engagement in the deliberation of issues in the area of medicine and biotechnology


Fortunately, continuing development in medicine & biotechnology offer an abundance of ethical issues to debate

So

Teaching bioethics in the undergraduate setting is about paying attention to these debates and having a stake in their outcome



Basic Issues of Bioethics

1 -Physician patient relationship

2 -Confidentiality

3 -Informed consent

4 -Certificates

5 -Medical responsibility


Controversial Issues of Bioethics

1 -Death & end of life

2 -Euthanasia

3 -Assisted reproduction & surrogacy

4 -Abortion

5 -Stem cell research

6 -Human cloning (therapeutic &reproductive)


Controversial Issues of Bioethics

7 -Organ transplantation

8 -Genetic information & bio-banks

9 -Animal experimentation

10 -Research ethics


Teaching Bioethics: When?

* Early or late?

* Separated or integrated?

* The traditional method:

first the theory, then the case

* The case based approach:

first the case, then the theory


Teaching Bioethics: How?

There are numerous methods that can be used to study bioethics. Here are some suggestions:

1 -Case studies.

2 -Debate.

3 -Student led seminars.

4 -Journal article writing.


Teaching Bioethics: How? (cont.)

1 -Case studies: resources such as:

newspapers, law journals & can be fictional cases designed by the teacher.

Student may work in small groups.



Choice of the case:

* of current interest

* authentic but anonymous

* suitable for the age group

* ethically provocative


Case Study:

The 41-year- old woman’s brain was heavily damaged following momentary heart failure in 1990,leaving her in a persistent vegetative state for 15 years able to breathe on her own but reliant on an artificial feeding tube. Her husband (legal guardian) decided to remove

his wife’s feeding tube but her parents refused .



2 -Debate:

Choose a statement to be debated and assign students aside to argue

e.g. ”Resolved genetic screening for the purpose of sex selection should not be permitted”



Cloning:” Is there a significant difference between cloning sheep for pharmaceutical production &cloning

humans”?

Fetal tissue transplantation:” Does a fetus have rights? If so, what are they & who is responsible for representing the

interests of the fetus ”?



Euthanasia:” What is the right to die? How does withdrawing or withholding treatment differ from physician assisted

suicide”?

AIDS:” Should developing countries be able to benefit from AIDS research when their citizens serve as research

subjects”?



3 -Student-led seminars:

Small groups of student research a particular topic then lead a one or two day class discussion. May need one day teaching about the technology involved.

Then exploring the ethical questions



4 -Journal article writing:

Have students write their thoughts down rather than voicing them in class


Teaching Bioethics: How? (cont.)Outlines of the process

Regardless of the methodology chosen, certain steps are common to bioethical discussion:

1 -Articulate the dilemma:

“phrased as statement or question”, should summarize the problem clearly.



2 -Identify the stakeholders in the decision:

Who has a vested interest in the outcome?

Encourage students to think of as many

stakeholders as possible .



3 -Present possible solutions:

Again, there is always more than one solution to an ethical dilemma.

Students should be encouraged to describe as many possible outcomes as they can.



4 -Rank the possible solutions from the best to worst.

Choose the one which seems to make most sense to you as an individual



5 -Explain ( WHY) your choice seems

like the best to you.

WHY OR WHY NOT?


Conclusion

1- It is very important to relate teaching bioethics to real life by basing it on cases the students can recognize from their experience or which they might encounter

later on in their professional life .


Conclusion (cont.)

2- Great emphasis have to be put on the importance of group work and practical exercises rather than just lectures.

This would be applied both when teaching bioethics & when teaching how to teach

bioethics .


Conclusion (cont.)

3- The future teachers of bioethics should

put themselves in the position of the

students and see how the exercises

worked in practice

Dr. Nahed Moustafa Dr. Nahed Moustafa FOM-SCU FOM-SCU

teaching bioethics for undergraduates: is it necessary?

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