BIOETHICS - AN INTRODUCTION

Michael Burnham and Rod Mitchell
1992 Woodrow Wilson Biology Institute

Objectives

The list of global, national and local environmental and medical bioethical dilemmas is real and endless, a final ending being Bioethical decisions which will impact us all with possibly devastating results. As a society, a nation, a world community, we have simply two choices: to be proactive or reactive in responding to these potentially unavoidable results. And therein we as educators have a challenge. As Van Potter said in reference to world survival, "To future generations, ignorance, superstition and illiteracy are the greatest barriers to a hopeful future for our descendants." (Potter, 1988). When 52 percent of American teenagers believe in astrology and, as reported in The American Biology Teacher, 34 percent of biology teachers polled thought psychic powers could be used to read peoples' thoughts, 29 percent felt we could communicate with the dead, and 22 percent believed in ghosts, we clearly have work to do. (Gallop Poll, 1984, ABT Editorial, May, 1989).

Over the past 15 years scientists and educators have discussed teaching bioethics or values in conjunction with biology. (Vollrath, 1990, Bronowski, 1990, Longino, l990, Musschenga, 1985). The major scientific and science educational organizations have become increasingly aware of the necessity to dispel the notion that there is a dichotomy between values and biology and to promote a better understanding of their integration. (AAAS, l989; NABT 1982; BSCS,1982; Hastings Institute, 1980; Woodrow Wilson Foundation, l991). It is the intention of this paper to encourage the development of bioethical curricula, even within a demanding teaching load. Bioethics is not only an essen-tial part of the teaching of biology at the secondary level, but it is also a unique opportunity to relate the subject content more closely to students' lives while examining the priorities which affect the long term survival of the planet. It presents the possibility to look again at what we teach and perhaps make a shift in emphasis which will bring about the marriage of biology and ethics. We also hope to present a teaching model which might bring about this union.

Reasons For Teaching Bioethics:

There are several reasons for making this shift to the integration of tradional biology with values or ethics. Perhaps the most obvious to students is the fact that many of the value-rich issues in their lives are related to content in biology, and that much of traditional biology involves value-laden topics. Such topics as environmental degradation, species diversity, fetal tissue transfer, or the new reproductive strategies are only a few of the many which could be mentioned. In many cases the students are already aware of the importance of these topics in their lives. These topics also can serve as a vehicle to get students involved in issues of which they had little previous understanding or awareness.

Today, many scientists and science teachers question the long standing belief that the "content" of science is void of presuppositions, personal or societal values, and subjective interpretation. Yet, even recently, this empirical, "objective," value-free or at least value-neutral nature of science and its processes was advocated. (Hafele 1976, U.S. Office of Technology Assessment 1977, Burnham 1979, Starr & Whipple 1980, et al). However, and especially with the advent of the "New Biology," these assertions overlook the unavoidable presence of value-based science. (Brown 1992, Bronowski 1990, Carpenter 1972, Musschenga 1985, Edge 1986, et al). Our "facts" are not purely objective entities but rather, and importantly, colored by our values. Science and how it is used by its very nature is laden with constitutive and contextual values; it is endemic to theoretical and applied science Ñ to science in the classroom! (Brown 1992, Shrader-Frenchette 1991, Edge 1986). To illustrate: How do scientists determine procedures when deciding when evidence is sufficient to accept or reject a hypothesis? Why do we use the 5% level to reject the null hypothesis (why not 1, 6, 8 or 10 percent)? Why do we use three standard deviations to affirm a positive ELISA protein assay? In risk assessment, how do we objectively determine acceptable risk? When is testing enough when determining the safety of a new drug? Looking internationally, objective values of occupational standards for air pollutants are debatable. Levels of benzene exposure measured in mg/cu. meter of air, for example, differ country to country: Italy 20 mg, USA 30 mg, Germany 50 mg, Japan 80 mg. (Kasperson, 1991). Even nationally, OSHA, EPA, and NRC all have different environmental and occupational standards for numerous hazardous substances (Derr et al. 1981). A 1983 British study to correlate lead emissions to public health found no significant quantitative connection; however, the scientific commission's recommen-dation was to phase out lead based gasoline! (Mayo, 1991). In short, the content of science - its new information and findings - are NOT free of the values that encompass them!

In biology, we are faced with an information explosion which is almost incomprehensible. Mager states that the amount of information available in biology doubles every three and a half years. (Platt, l992). The idea that we can somehow endow our students with all that there is to know in biology has long been recognized as a no win strategy. This recognition was the father of a revolution in secondary science curricula which began in the mid 1960's with the advent of Biological Sciences Curriculum Study and the companion curricula reforms in the other sciences. These curriculum reforms recognized the importance of process and the strategies for collection, compilation and interpretation of data. Today, the realization is that critical thinking skills of ethical analysis are the same as those emphasized in this process-oriented method of teaching science. In fact, the integration of ethical decision making into biology curricula only reinforces the critical thinking procedures which are a foundation of the process-oriented teaching reforms of the l960's. We would like to suggest that the content/process approach of the l960's should now make the transition to a content/process/ values approach in the l990's.

Unlike puberty and other physical developmental stages which our students seem to transcend without our help, values as a component of decis-ion making must be taught and schools are one of the appropriate places for this education to take place. It is not the intention of the biology class to usurp the domain of the family, church or other institutions. Some might be wary of values orientation, saying school is not the place to promote values. We disagree and would like to make the distinction between values and doc-trine. There is no place for doctrine, at least in the public schools. However, schools already promote the basic values of nonmalfeasance, benevolence, fairness and truthfulness. These are universal values which structure the rules and behaviors students are expected to obey while they are at school.

What is Bioethics?

In tandem, the investigations of biology, scientific technology, and ethical issues combine to form a new science called "bioethics." Although many definitions are possible for this multidisciplinary science, we have chosen to use Van Potter's definition. In 1971, he coined the term "bioethics" saying that it is "Biology combined with diverse humanistic knowledge forging a science that sets a system of medical and environmental priorities for acceptable survival."

Foremost, the definition is contextual in the here-and-now. It establishes the premise that we operate through "humanistic knowledge" - the rejection of superstition; where human-kind is in control of its own destiny; that our actions are based in moral principles and ethical thinking. (Kieffer, 1992). It provides a "system" approach (scientific methodology) to medical and environmental priorities. Also, it gives us an over-arching context of survival. But what is "acceptable" survival? As stated in his 1988 book Global Bio-ethics, Van Potter points out that survival without qualification is meaning-less. He offers five categories of survival: mere survival, miserable survival, ideal survival, irresponsible survival, and acceptable survival. (pg. 43-53). Of the latter, acceptable survival refers to a sustainable society within a healthy ecosystem.

Going further and to summarize, it is our contention and from an educational perspective, that this view of bioethics is eminently useful in promoting critical thinking at many levels. It allows for greater accessibility to the content through connectivity rather than stand-alone units. It engages the content and process of real life situations (present and future) where decisions have real consequences, seldom with risk-free outcomes. Finally, it promotes a focusing framework that places the biology that we teach in a more fully integrated form with the issues that student quickly relate to.

The Model

To bring about a bioethical approach to teaching and to realize the opportunities it presents, we are suggesting that a paradigm shift is necessary in how we teach children. This shift involves a revised model or a new sequence of components that should be used to help students engage biology, Figure 1. We would like first to describe the model's components and then suggest its rationale and value to students.

Figure 1

Each cycle of the model begins with a FOCUS OR OBSERVATION. This can be student or teacher initiated. The teacher might describe a situation, show a video, have students read a newspaper article, or respond to a question. The purpose here is to engage the student.
From the focus a QUESTION should be asked or a HYPOTHESIS proposed. What would happen if such were the case? How does this work?
Next is the data generating stage. Here is where new CONTENT is collected. It is also where the VALUE CONTEXT of the question is described. The relative amount of these two components will vary depending upon the hypothesis or question. If the question, for example, involves the merits of killing insects for a collection, the value component may be quite large. However, if our question involves types of insect mouth parts as depicted in a text book, the value component would be quite small.
The ANALYSIS and ETHICAL DELIBERATION component is the action component of the model. It should be where the most learning takes place. Here the student is asked to weigh the relative merits of both content and value components of the question asked. The impor-tance of this process cannot be under-estimated and both the data of the content and the value nature of the question must be scrutinized, using the most rigorous and critical procedures available to the student. The teacher's task is to help the student become more proficient with increasingly more sophisticated analytical procedures. This procedure will often expose a variety of options.
As a result of the analysis a DECISION is made or DESCRIPTION of the solution is produced. The student has chosen the best option among those available. This decision or description should only be perceived as final for this cycle of the model. The question will be returned to when new information is available or as it becomes a focus due to another set of observations. One might describe this as the product of the model. However, rather than think of this as a point of closure, we might think of this as a pause. Any description or decision should lead to a new observation or focus and the model would once again be placed in motion. This makes the model cyclic and, in reality, as long as there is new content, the model is returned to and the student goes through it again and again. (see Figure 2). All decisions and descriptions are open to re-examination and modification as new content becomes available to the student. Likewise, as the student continues to use the model, her or his values are refined and analytical skills are expanded.

Figure 2 Cyclic Model

Pitfalls and Opportunities

There are some common pitfalls which educators experience when incor-porating values into their biology course, many of which can defeat the pur-pose of what we define as a bioethical approach. We would like to address a few below.

Case histories are commonly used by biology teachers to address bioethical issues. The danger is when they are periodically inserted and students are asked to shift gears for a day and then go back to content as usual. In our estimation this can easily leave the im-pression that there is only a connection between values and content in certain realms of science and implies a hierarchy with content being the primary component. This is not to imply that content and values must have a 50/50 status at all times. Some aspects of biology are weighted more heavily toward one or the other. However, continual presence of both imprints the integration necessary for bioethics to realize the opportunities it makes possible.
Another danger of the case history approach, especially when students are asked to assume certain roles, is to weaken the content component. To avoid this, teachers should monitor the presentation of content for misconceptions and make sure students have done their homework with respect to the scientific aspects of the question being studied.
Teachers should remain facilitators. Their role is to provide the opportunity for the students to engage content and values, but not indoctrinate or promote specific ethical positions. They should help students understand the content and technologies, and facilitate their analysis and critical thinking skills. They should promote the ex-ploration of higher and the less introspective of Kolberg's levels of thinking. However, the final choices must remain in the hands of the students.
Teachers should not confuse values clarification with ethical decision making. Ethical decision making goes beyond values clarification. It sets up a disequilibrium where students must analyze the pros and cons of the specific situation. Students make decisions among the best of several situations, realizing that the results seldom have one clear "right" solution. It involves the restructuring of priorities based upon an analysis of evidence and their values. This is not to say there is no place for values clarification. In some cases students are just begin-ning to establish their own identities and must start at this level. However, it should be the goal of the teacher to move the students along as much as possible toward a more analytical ethical decision making model.
Don't over-intellectualize the process or turn it into a game. If bio- ethics does not transfer into perceived and actual behaviors the long term opportunities it presents will be negated. Acceptable survival is only possible if we behave according to the evidence of bioethical analysis. If we decide to believe one thing and do another, the process has not worked. A very practical way to address this issue is for the teacher to be willing to act as a role model. It also helps to involve students in practical projects such as recycling.

Opportunities in Teaching Bioethics

In deciding to teach biology from a platform of content/process/values, we are presented with an important opportunity to affect change within our students. This opportunity has immediate and long term components. First is the possibility of making clear connections between content/process in the daily lives of our students. Too, it asks students to consider critically all sides of a bioethical issue and to look for the best possible solutions. In the long term, the hope is to move students toward working and promoting acceptable survival of their planet.

Specifically, we offer the following list of benefits, in no particular order, to a teaching methodology using this approach:

raises student and teacher awareness of the role of science in personal, social, economic, and political realms

problem solving is in response to human needs

teacher/student relationship becomes more collaborative

content is not isolated--it has significance because of its further connections

there is a thematic organization of the content rather than moving in an often unconnected linear fashion; one can loop back to previously studied material many times

students learn how to use scientific knowledge and skill in their personal and social lives

students have greater opportunity to do meaningful cooperative work

curricular design and student work draw on the interdisciplinary aspects of all sciences as well as from areas of social sciences, and other's

content is viewed through the impact of technological change

content is not looked at as finite and education becomes a life long process

ambiguity is looked at as an opportunity to evaluate and select the present best solution and not as a barrier to learning

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