article doi: 10.5504/bbeq.2011.0089 education & basic ......certainly, students may learn ethics...

2801Biotechnol. & Biotechnol. eq. 26/2012/1

Article DOi: 10.5504/bbeq.2011.0089 e&bS

eDUcAtiON & bASic ScieNce

Biotechnol. & Biotechnol. eq. 2012, 26(1), 2801-2810

Keywords: bioethics, undergraduate biology education, teaching bioethics, reflective approach

IntroductionDuring the past decades the rapid development of molecular biology and in particular of modern biotechnology has resulted in significant advances in the field of medicine, pharmacy, agriculture and food production. Genetic engineering continues to move out of the laboratory and into the public arena in the form of gene therapy, saving drugs and transgenic foodstuffs. New biotechnology is poised to become one of the most important scientific revolutions of the twenty-first century. It is believed that the human genome sequencing and its associated technologies will dramatically alter the way we fight diseases, grow crops and feed human population (19, 36). Even though these advancements have brought a lot of promises for human well-being, they have given rise to societal issues which embrace bioethical aspects, as well as cultural, legal and political ones. The risk presented by the introduction of potentially unstable genetically modified organisms (GMO) into the environment, the right to preserve the confidentiality of a person’s genetic information from their employers or insurance company, the right to abort a fetus found to have a genetic defect and the technological ability to clone embryos, are issues which concern not only technology but also moral and human values. These issues are only a small example for the many ethical concerns about genetic engineering, human genetics and genomics. Although the contexts of additional similar questions may differ, all they are contentious in nature, can be considered from a variety of perspectives, usually involve morality and ethics, and do not possess simple conclusions (8, 24).

So, in recent years the ethical topics in biosciences have become increasingly important in the field of science education as a vehicle for improving students’ scientific literacy (42), and as a means for promoting students’ ability in the future to make well-informed decisions with moral implication regarding the application of science and technology (26, 27). Given the frequency with which bioethical stories reach the front page of the popular press, there is a need for the young people to evaluate critically scientific data and information (23, 25), to appreciate the complexity of ethical issues and to avoid simplistic positions (27). The students, at present in school or during their further education, will encounter different forms of the new technologies, so they need to have the necessary knowledge, skills, and an awareness of the social and ethical impacts of these technologies, in order to be able to contribute to the emerging dialogue between policy-makers and citizens, and to make appropriate personal choices.

There is strong consensus among scientists that training in the socio-ethical implication of biosciences is necessary for the development of students into science professionals and well-educated citizens needed in the future (4). Moreover, it is recommended that science curricula at all levels of education should not only incorporate ethical issues of science (in this case, biosciences), but it should explicitly attend to (and not deny or overlook) the moral dimensions of these issues (15, 42).

However, most bioscience courses and undergraduate biology programs often present science as an objective search for knowledge and understanding, while the pragmatic realities that may compromise this objectivity are frequently ignored. Within these courses, students are not usually exposed to moral, ethical and human values discussion while learning biology (4, 46, 49). Certainly, students may learn ethics in courses on philosophy or related humanities, but this part

INTEGRATING A BIOETHICS COURSE INTO UNDERGRADUATE BIOLOGY EDUCATION

Teodora Aleksandrova Kolarova1, Iliya Dimitrov Denev2

1University of Plovdiv “Paisii Hilendarski”, Department of Botany and Methods of Teaching in Biology, Plovdiv, Bulgaria2University of Plovdiv “Paisii Hilendarski”, Department of Plant Physiology and Molecular Biology, Plovdiv, BulgariaCorrespondence to: Teodora Kolarova, Iliya DenevE-mail: [email protected], [email protected]

ABSTRACTThis paper provides a rationale for the inclusion of bioethics in the undergraduate biology education in Bulgaria. Thus, at the Faculty of Biology in the Plovdiv University “Paisii Hilendarski”, a bioethics course was established, designed to increase students’ awareness of social and ethical issues posed by advancement of the biosciences and particularly of modern biotechnology. The range of topics covered by a broader definition of bioethics is presented. A reflective approach to teaching in bioethics is proposed. It focuses on development and self-development of the students as active, self-regulated and autonomous persons able to make well-informed and morally justified decisions about socio-ethical issues in biosciences. Details in delivery of the course are described.

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of their training is rarely integrated with the requirements of bioscience disciplines. Future scientists and the general society would benefit greatly from the incorporation of ethics and values in the teaching of biology, because it could provide students with a necessary background and framework to make moral decisions of a broad range of issues concerning the human relationship with the nature, the sanctity of human life, and the basic tenets of individual rights. Taking into account the growing significance of bioethics for the biosciences, it is not surprising that it has been included as a core or optional subject in the undergraduate biology and science education in many colleges and universities around the world. In the literature dedicated to teaching in bioethics there have already been presented many successful examples of courses at the undergraduate level both for bioscience student groups (7, 15, 18, 25, 38, 39, 43, 47) and for cross disciplinary groups (3, 49). In addition, there is also a large body of research set within the context of science education, which discusses the ethics of scientific investigations and the assertion that bioscience is not value-free (1, 23).

In this article, we describe our efforts on development of an undergraduate course in bioethics as a part of Biology education in the Faculty of Biology at the Plovdiv University “Paisii Hilendarski”. The main objectives were to describe the designed module, to outline its aims and intended learning outcomes, and to give key details about content, delivery, learning activities and assessment for the course. Our intentions are to provide illustrations that may be helpful to those who are trying to establish a similar module for undergraduate classes in bioethics, and to discuss issues that arise in launching a bioethics course.

Theoretical frameworkThis section presents the theoretical framework on which the course was based. The framework briefly describes what bioethics is and outlines the current state of undergraduate education in bioethics in Bulgaria and abroad, which leads to the specific course details addressed by the present paper.

Defining bioethicsAccording to one definition ‘Bioethics’ is “the systematic study of the moral dimensions – including moral vision, decisions, conduct, and policies – of the life sciences and health care, employing a variety of ethical methodologies in an interdisciplinary setting” (17). Although, when defining the term ‘bioethics’, different writers emphasize diverse aspects, it might be reasonable to regard it as a sub-field of the branch of philosophy called ‘Ethics’, sometimes also named ‘Moral philosophy’. In the opinion of some philosophers ethics should not be thought of as an abstract theory but as a “structure, which together with some degree of empirical fact will yield a decision procedure for moral reasoning”. Ethics seeks to answer the question “What should I do, all things considered?” (45). So, ethics has important practical consequences, as it aims to help people decide what to do in morally puzzling circumstances.

By popular consensus, the word ‘bioethics’ was first used by the American medical scientist Van Rensselaer Potter (1971) in his book Bioethics: Bridge to the Future (40). he originally described bioethics more broadly than the definition given above, as being a new discipline which combines biologic knowledge with knowledge of human value systems, which would build a bridge between the sciences and the humanities, help humanity to survive, and sustain and improve the civilized world (40). Within this book, focused on evolutionary biology, Potter emphasized on the growing human ability to alter the natural world and the human nature, and the consequences of this power for the global future. The author asserted that in order to deal with the increasing human impact on the biosphere people need a new ethical framework that takes into account not only issues in human society, but the environment, and particularly the biosphere. As reviewed in Encyclopedia of Bioethics (17), other life scientists at that time, such as Bentley Glass, Paul Berg, and Paul Ehrlich, were among many that were similarly interested in spurring thought on the biological revolution with regard to eugenics, the engineering of new life forms, and population ethics. Bioethics, then, emerged from biologists who felt obliged to address the moral meaning of the biosphere, and to reflect on the remarkable implications of their discoveries and technological innovations.

Actually, it has been argued that bioethics emerged even earlier as a discipline in its own right. The Nuremberg War Criminal Trials in 1947 were the initiation of forensic investigation of the professional activities of scientists, doctors, lawyers and politicians. As a result, a code of practice for all future research on human subjects was drawn up – the Nuremberg Code. These events are considered by Jonsen (22) as the birth of bioethics. As Bryant and Baggott la Velle noted (7), such usage of the term is nearer to that envisaged by Jonsen than to that proposed by Potter. In the USA for example, bioethics has usually meant medical ethics, including issues such as the allocation of scarce recourses. In Britain, Potter’s term came to be used mainly in relation to medical and later to biomedical issues. Neither the American nor the British uses of the term include the environmental dimension of Potter’s definition, although clearly biological and environmental issues may overlap. Although bioethics was formed as an intellectual movement primarily among life scientists, its initial focus was mainly on medical issues.

The rapid advances in biological sciences and in particularly biotechnology in the second half of the 20th century broadened the understanding of bioethics making it closer to Potter’s viewpoints. Now it is widely appreciated that non-medical dimensions of biosciences also raise many ethical concerns such as: should genetically modified (GM) crops be grown in European countries, can they pollute the production of organic farmers and cause them difficulties to maintain the required GM-free status? Is there any risk that the release of GM organisms may affect human health or biodiversity? Does genetic modification take humankind’s ability to alter nature a step too far, thus transgressing boundaries that should never


be crossed? Is there any danger that the use of human genetic information including the output of the Human Genome Project may lead to eugenic practices? etc.

These are only a few examples for the profound ethical issues raised by applications of high-profile biotechnologies. According to Mepham (29), it is deceptive to think that ethics implies only the announcement of some startling headline-grabbing proposal. In fact, bioethics is involved at all stages where facts and values interact. Consequently, the author considers that it would be helpful in the context of defining bioethics, to integrate the insights of different subjects that underpin bioethics, so they could lay the foundations of a new understanding of the ways bioscience and values interrelate. Thus, in line with Potter’s broader definition, bioethics today can be seen as “a relatively recent field of academic enquiry that deals with the ethical, legal, social and cultural implications of the biosciences and their application in biotechnology” (31). Therefore, bioethics is more than just a particular domain of scientific inquiry but works as an intersection between ethics and life sciences, emerging as a new interdisciplinary area of study – connecting medicine, biology, and environmental sciences with social sciences like philosophy, religion, law, and public policies, etc. (8, 30).

Subfields of bioethicsExtension of the application of ethics in life sciences helps to delineate several subfields covered by bioethics: research ethics, biomedical ethics, environmental ethics and ethics of biotechnology” or “ethics of genetic engineering’ (10). All of these areas have become somewhat specialized branches of bioethics, with their own extensive literature in their own right. In short, research ethics is more general in nature and addresses issues of research integrity related to appropriate use of finding, plagiarism, fraud, and bias in the reporting of results (36, 43). Environmental ethics, briefly named ‘eco-ethics’ considers the moral relationship between human beings and the natural environment (28). Biomedical ethics deals with universal moral principles, values and rules which direct and regulate the professional activities of biologists and medics. In addition to long-standing controversies such as abortion and euthanasia, this branch of bioethics studies more recent issues such as genetic screening, stem cell research and cloning (8). Ethics of biotechnology focuses on the study of moral and social implications of techniques resulting from advances in molecular biology, genetics, gene engineering and genomics, but it covers also controversies rising from developments in nanotechnology and cybernetics (8).

Certainly, these sub-fields of bioethics are interconnected which indicates the growing spread of ethics’ application in bioscience. When considering the commercial use of GM crops for example, environmental ethics visibly overlaps with ethics of genetic engineering or when discussing potential benefits and safety of gene therapy, biomedical ethics partly covers with ethics of modern biotechnology. However, certain issues encompassed by all these areas of bioethics are more difficult

and complicated. They could hardly be solved by applying conventional moral philosophy and ethical arguments. Faced with moral dilemmas, some have retreated to using ‘natural’ and ‘unnatural’ as meaning acceptable or unacceptable (7). However, in the early 21st century, much of what is accepted as natural in developed societies is definitely not natural. This applies to almost all medical interventions, many aspects of agriculture and to human interactions with the biosphere. The weakness of the dilemma ‘natural versus unnatural’ as a basis for ethical decision making, at least in the public domain, has been criticized by a number of scholars (7, 8, 24). Some of them have acknowledged that personal revulsion and in particularly reconsidering of underlying human values may be an important factor in determining an individual’s response to biological advancements (7). Nevertheless, in the recent years many authors highlighted that bioethics and especially some training in this scientific field could provide the framework or guidelines, both ethical and legal, to deal with controversial issues caused by developments of biology and biomedical science (3, 4, 12, 39, 42, 48).

The current state of undergraduate bioethics educationEthics is an integral component of medical and nursing degree programs in UK universities, but has not been integrated in the biological education yet. According to Downie’s survey in the University of Glasgow, in 1993 both staff and students recognized the importance of bioethics for undergraduate biology education, but only a few courses at that time included considerable ethics coverage (15). At the first UK seminar on teaching of bioethics in 2002 most of the participants agreed about the need to incorporate ethics into teaching, but they were uncertain of the best way to do it is and whether it would be accepted by their colleagues (16).

The incorporation of ethics in teaching was very strongly recommended in the Biosciences Benchmark published by the Quality Assurance Agency in the UK (41): one of the seven generic standards expected of all bioscience honors graduates is that they “be able to construct reasoned arguments to support their position on the ethical and social impact of advances in the biosciences” and some of the intellectual skills expected are “recognizing the moral and ethical issues of investigations and appreciating the need for ethical standards and professional codes of conduct” and “ undertake field and/or laboratory investigations of living systems in a responsible, safe and ethical manner”. In 2004 already about 70% of the undergraduate programs included an ethical component (47).

Today, a number of universities in the UK offer undergraduate courses in bioethics for biology and science education students (7, 12, 16, 39, 47). Some of these modules are established as a part of the core program for students taking the B.Sc. education and as an option for undergraduates studying biological sciences (B.Sc.). Often bioethics is taught in the second year of undergraduate biology degrees but in about one-third of UK universities it is mainly taught in the final year. It is considered that teaching bioethics in the final year of


a degree has some advantages such as greater understanding of biology acquired by students than earlier in their training. Also, the wider range of students’ transferable skills developed during their previous degrees allows bioethics to be taught at a deeper level (39, 47).

Even though bioethics provision is probably more embedded in UK education than anywhere else in the northern hemisphere, the heritage is actually longest in New Zealand, where social and ethical issues have been part of the core curriculum since 1993 (13, 48). As Willmot and Willis pointed out (48), given the prominent involvement of the American philosopher Van Rensselaer Potter in the development of bioethics as a discipline, it might be expected that schools in the USA would also have bioethics as a compulsory subject. This is counteracted, however, by the absence of a national curriculum; content is therefore determined at the state and local district levels and may or may not include ethical issues. A systematic review of bioethics education in the USA has not been undertaken, but the results of a survey by J. Bryant and C. Morgan (published in 2007) concluded that very few American universities offer some specific courses on ethics/bioethics for Bioscience students (6). The majority of them were provided by philosophers, ethicists, social scientists or theologians and could be taken as options by Bioscience students.

However, as discussed by Zaikowski and Garrett (49), biology majors are not routinely exposed to the implications of science for society, including environmental, genetic, and medical ethics, because most programs focus solely on mastery of laboratory skills and on knowledge of facts, principles, theories, and equations (4, 18, 43). Nor are future scientists and teachers systematically introduced to important issues in the professional practice of science and technology, such as scientific integrity, research ethics, dissemination of information, and research on animal and human subjects, etc. (49). In response to the lack of exposure to ethics in science programs, there have been efforts to enhance the significance of ethics in bioscience degree programs and promote faculty development such as the introduction by the National Science Foundation (NSF) of their Ethics Education in Science and Engineering program (EESE). This is seen by Bryant and Morgan (6) as an expression of the perceived need that students choosing to undertake further study in Biology should have some training in ethics. The programme provides grants for projects that “focus on improving ethics education for graduate students and on ethical issues that arise in research or graduate research education, particularly in interdisciplinary or inter-institutional contexts” (37). But this statement is not equivalent to requiring that ethics must be part of post-graduate education. For example, a study conducted by Bryant and Morgan (6) has shown that there was no specific ethics component in Masters degree programs for Bioscience students in many USA universities although some bioethical issues may be discussed into individual courses at this level (28). In addition, it should be noted that many universities in North America offer formal graduate degrees in bioethics, but

within most of them graduate education in bioethics is pursued through established disciplines such as philosophy, religious studies, law and experimental medicine (14).

UNESCO has developed an Ethics Education Program aimed toward promoting and supporting teaching in different aspects of ethics, including bioethics and professional standards. As it can be seen in the UNESCO’s Universal Declaration on Bioethics and Human Rights: “in order to promote the principles set out in this Declaration and to achieve a better understanding of the ethical implications of scientific and technological developments, in particular for young people, States should endeavor to foster bioethics education and training at all levels as well as to encourage information and knowledge dissemination programmes about bioethics” (44).

At present, most faculties of life sciences at the Bulgarian universities do not include an explicit bioethics component in the curriculum for undergraduate students. As the review of different degree programs indicated, at present only the Faulty of Biology at Sofia University “St. Kliment Ohridski” offers a course in bioethics as an optional subject for the undergraduates studying Biomanagement and Sustainable Development at B.Sc. level. Currently, a teaching in bioethics is mainly pursued through disciplines such as philosophy, sociology and theology which are studied in the faculties of philosophy and history of our universities. Furthermore, these undergraduate courses in bioethics are not established as a part of the core programme but only as an option for students taking B.Sc. or M.Sc. degrees in fields such as philosophy, sociology and religious studies.

Course descriptionObjectives and learning outcomesThe literature discussed above clearly illustrates the increasing needs of bioethics courses for the students in the field of biosciences. Therefore we launched an undergraduate module in bioethics at the Faculty of Biology in Plovdiv University “Paisii Hilendarski”. The module was established as a compulsory subject in the curriculum for all B.Sc. students studying biological sciences and remained an optional for B.Sc. students studying Bioinformatics and Science teachers. The course was designed to be introduced in the third or fourth year of study for most of the degrees during the academic year 2012-2013, because we desire to give students the opportunity to first complete the courses in molecular biology, molecular genetics and genetic engineering. Only then will they be aware of the main biotechnological approaches and procedures that may raise bioethical questions (e.g., gene cloning, gene therapy, genetic diseases, and genetic modification of existing organisms). The only exception was with the B.Sc. students in Ecology and Environmental Conservation, where the first bioethics course was taught during the second year of study and started in the fall term of the academic year 2011-2012.

The major objective of the bioethics course is to provide a syllabus mainly for the students in biology and other


biosciences, which have a good background in biotechnology but less knowledge in moral philosophy and ethical theory. The lack of experience in the latter two fields may cause considerable discomfiture for students when ethical decision-making is needed, especially when they want to know “the correct way” to solve moral dilemmas and “the right answer” to moral issues raised by applications of modern bioscience. The problems with a discussion of ethical dilemmas in science can be further complicated by the fact that each person brings to the ethical decision making process their personal background of cultural and often religious values that they have developed during their earlier life experience without questioning other sides of these dilemmas.

Taking into account these considerations, our intention was to give students philosophical and ethical grounding that may ensure deeper understanding of the social and moral issues arising from the advances in biosciences. It is clear that the study of ethical theories could not provide students with either the perfect solution method or the concrete answer to every ethical conflict. But it is assumed that, the knowledge and understanding of a range of philosophical positions may help undergraduates to become engaged in reasoned and informed ethical decision making (7, 36). Therefore, we have planned to start the course by looking at the general features of major ethical theories and at moral decision-making, including a framework for analyzing bioethical issues. After this introduction to ethics, the next module continues with more specific themes, starting with environmental ethics as an issue with global implications and then continuing with ethical controversies in areas of biotechnology, gene engineering and biomedical science. The course finishes by presenting some issues of research integrity that are essential to the conduct of authentic scientific research in the biosciences.

Some scholars consider that the aim of bioethics teaching should not be to make students behave in a particular way, because such approach would require indoctrination, which is a process inimical to the ethos of higher education (16). Moreover, the complexity of the issues that bioethics seeks to address seems to defeat all attempts to come up with a single, all-inclusive, but widely acceptable, theory or position (32).

Therefore, the main objectives of our course are focused on: i) developing a profound understanding of current bioethical issues; ii) exposing alternative and sometimes competing ethical viewpoints to undergraduates and encouraging, but not determining, students’ moral decision-making; iii) enabling them to argue and counter-argue in order to contribute to informed discussion and debate.

These objectives can be specified in the form of intended learning outcomes. By the end of the course students should be able to:a Demonstrate understanding of the terms ‘ethics’ and

‘bioethics’;a Demonstrate understanding of the biosciences and

ethical considerations associated with a current advance

in biotechnology, modern biomedicine, agriculture and in the utilization of natural resources;

a Apply knowledge and understanding of different philosophical theories and ethical principles in analysis of the way in which humankind deals with the natural world;

a Integrate the use of scientific facts and ethical principles and argumentation in discussing cases involving moral dilemmas;

a Use and critically evaluate information gathered from a variety of sources;

a Recognize the diversity of informed ethical opinions regarding the development of current advancements in biology and biomedicine;

a Take different viewpoints to ethical and social issues of biosciences including both biocentric and ecocentric worldviews rather than only anthropomorphic perspectives;

a Develop their own viewpoint and make a choice between different ethical positions in discussing moral issues involved in biosciences;

a Develop scientific attitudes, reflective processes and decision making skills;

a Develop a sense of moral obligation and responsibility both in their relationship with nature and in their future professional activity.

From this list of learning outcomes there are three main goals of the bioethics module grouped into knowledge, transferable skills and moral development of biology students. In the first place we intend to deepen the students’ understanding of the science and ethical considerations associated with the current progress in biology, biotechnology and biomedicine. Secondly, we address a number of transferable skills, including the ability to make informed ethical decisions and the ability to critically reflect on one’s own viewpoint and beliefs. Thirdly, there is striving for the development of students’ moral sensitivity and holistic appraisal while they seek out alternatives to resolve ethical and social issues.

ContentThe module is divided into five general topic areas selected from various sources which are designed to serve the university training in bioethics for students in the biosciences (8, 19, 20, 21, 24, 36). The first topic introduces students to the nature of ethics and bioethics, and the other four are devoted to current issues in the sub-fields covered by bioethics – environmental ethics, ethics of biotechnology, biomedical ethics and research ethics. The main topics included each of these areas are listed in Box 1.

It should be stressed that some of the offered topic areas might be flexible and the focus could easily be changed according to the main requirements of the biology degrees. For instance, the course for the students taking the degree of


Molecular Biology may emphasize on the current issues in ethics of biotechnology and on more recent fields of biomedical controversy such as gene therapy or cloning. Despite the different priorities posed by various biology degrees, it is required that the introduction to bioethics be the first topic in line of study as it provides students with an adequate ethical background in dealing with other subject areas.

Box 1. Topic areas included in the bioethics course1. Theoretical background to bioethics: Two lectures devoted to the nature of bioethics (defining bioethics, history and philosophy, modern science, a new history of biology, the scientific method, bioscience and biotechnology, importance of bioethics for the biosciences); theories of ethics (introduction to ethics, ethics and morality, moral reasoning and major ethical theories – utilitarianism, deontology and virtue theory); a framework for ethical analysis (common morality, ethical principles, making ethical decisions, the ethical matrix or map, using the ethical matrix to facilitate professional and personal decision-making).2. Environmental ethics: Eight lectures focused on interactions of humans with the natural world (the place of humans in nature, environmental values, origin and emergence of environmental ethics, ideas of stewardship and Gaia); current themes in environmental ethics (anthropogenic impact on the biosphere and precautionary principles, environmental sustainability); current issues in environmental ethics (terrestrial and aquatic pollution, global climate change, environmental degradation and loss of biodiversity, ecotourism and ethics); humans and non-humans animals (animal welfare and animal rights, human use of non-human animals, ethics of animal research, legislation for, and alternatives to animal experimentation).3. Ethics of biotechnology: eight lectures concerning genetic modification (general ethical issues related to genetic modification, application of genetic modification – pharmaceuticals, GM food and crops, genetic modification of animals, research use of genetic modification, GM and less-developed countries; GM microorganisms as bacteriological warfare; conception of risk, assessment, management, communication and standards of risk; interpreting the precautionary principles); the Human Genome Project (use of human genetic information – genetic testing, screening and profiling, biobanks; genetic enhancement and eugenics); wider current issues associated with the application of gene engineering (crop GM technology, world trade and global justice; genotyping in developing countries, intellectual rights and gene patenting, genetic piracy).4. Biomedical ethics: Eight lectures about cloning and stem cells (ethics of human cloning, reproductive cloning and therapeutic cloning, embryonic stem cells and the status of the early human embryo, experiments on embryonic stem cells, legislation and therapeutic cloning); ethical aspects of the assisted reproductive technologies (artificial insemination and donor insemination, in vitro fertilization, surrogate mothering, designer babies), reproductive choices (prenatal screening, prenatal and pre-implantation genetic diagnosis, sex selection, and selective abortion); current issues in therapies for genetic and multifactorial diseases (clinical trials, legislation and ethics of somatic gene therapy and of germ-line therapy; ethical issues in manipulating human germ line, trials in developing countries, the germ-line therapy as positive eugenics; xenotransplantation).5. Research ethics: Two lectures concerning research integrity (truthfulness, diligence, objectivity, circumspection and collegiality); respect for the subject of study (respect and responsibility for human subjects and for non-human subjects as well); professional duties of the bioscientists (responsibilities to preserve professional standards in their research and educational activity; social responsibility to present a specialized scientific knowledge to society, ethics consultation as moral engagement).

DeliveryAccording to the undergraduate biology curriculum, updated throughout the year 2010, two to four credits are provided for the compulsory bioethics module offered to the B.Sc. degrees: 2 credits for the degree of Molecular Biology, 3 credits for the degree of Biology, and 4 credits for the degree of Ecology and Environmental Conservation. Two credits are allocated for the degrees of Bioinformatics, Biology and Chemistry, and Biology and Physics where bioethics is an option module. The material covered both in the compulsory and optional course is devised to be delivered by lectures (30 × 2 h) and seminars (15 × 1 h).

the lectures discuss and explain ethical theories, principles, facts and ideas and link them to details of major issues included in the above listed topics. The aim of the lectures is often to expose students to predetermined viewpoints but in a way that gives students time to perceive, dispute, and clarify points. This could be particularly useful in helping students to become aware of basic ideas of bioethics. Although lecture courses contribute to the understanding of essential ethical conceptions and recent controversies in life sciences, they are unable to deliver outcomes such as enabling students to appreciate critically information about moral issues of bioscience, to make a choice between different ethical positions when discussing these issues or to reflect upon their own ethical decisions and values.

The complexity and difficulties when making moral decisions could be overcome through the seminars designed to accomplish the training in bioethics. The purpose of the seminars is to give students an opportunity to develop and practice their knowledge, understanding and reasoning ability by discussing example issues and also by writing reasoned answers to bioethical questions. The sequence of seminars comprises topics of lecture material and moves from broad to narrow scope. In order to be effective, the seminars require the exercise of transferable skills related to analysis, argumentation, problem solving, reflective reasoning, moral judgment, self-regulation and team work.

In order to conduct successfully the overall course in bioethics and therefore to achieve the expected learning outcomes, we propose a teaching approach named reflective approach. In the context of undergraduate bioethics education, the reflective approach can be described as a student-centered approach that focuses attention on development and self-development of the students as active, self-regulated and autonomous persons able to take well-informed and morally justified decisions about socio-ethical issues in biosciences. The core of this approach has been presented by the psychic phenomenon reflection that is conceived such as an internal examination of one’s own knowledge and cognitive processes in order to lead to a new understanding and appreciation (5). The personal and professional importance of reflection in undergraduates’ learning and particularly in making decisions of controversial issues is highlighted by a vast number of authors, and shall not be reviewed in this paper. Rather, the


general features of the reflective approach will be outlined in the forms of educational guidelines aiming at effective training on bioethics. These guidelines, drawn from areas of philosophy, developmental psychology, sociology, and pedagogy, can be summarized as follows:

• Providing opportunity for students to engage in dialogic interaction and collaborative learning so that they may be able to participate in argumentative discourse, pose questions to each other, reflect and understand more deeply multiple viewpoints in resolving a specific issue;

• Encouragement of students’ moral development with an emphasis on strengthening their moral sensitivity (awareness of the moral dimensions of situations) and moral reasoning (determining which alternative line of action is morally justified);

• Development of both students’ meta-cognitive knowledge (knowledge about one’s own learning strategies, person and task characteristics) and meta-cognitive skills (reflection, monitoring and self-regulation of thinking, behavior and experience) which are essential components in making judgments and decisions of socio-scientific issues;

• Increasing the pragmatic and authentic context of students’ learning with a focus on applying of thinking strategies in problem-solving situations closely related to the real practice.

Box 2. Example case study from the topic “ethics of biotechnology”. From Bryant et. al. (11)Ä “You are a young adult, newly diagnosed with insulin dependent diabetes. After a range of tests your daily regimen of insulin injections is established and you are doing well on it. However, after some weeks you realize after reading the label on one of your batches of insulin that you have been prescribed recombinant human insulin. Because of your particular view of the natural world you have an intrinsic objection to all GM techniques, in whatever context.You ask your doctor to prescribe pig insulin instead. She refuses, stating first that it is not in your best interests to have pig insulin and second the very scarce supplies of pig insulin are kept only for those who actually need it because they experience problems with human insulin”.Ä How should you proceed?

Given the principle standings of the reflective approach and based on the literature discussing how to best teach ethics of modern bioscience, we plan a series of activities to conduct the training in bioethics. Examples of learning activities embedded mainly in the seminars, are as follows:

• Case studies – making decisions of complex, open-ended and ill-structured issues like the socio-ethical issues of biology may most effectively be learned through in-depth study of real-life scenarios. All topic areas enclosed in the lecture course could be selected to compose various authentic cases. An illustration is shown in Box 2. Team work and small group discussions have been suggested as a means of helping

students explore multiple ethical perspectives, examine them critically and move toward to more justified and balanced solutions. All groups (ideally of five students each) tackle the same bioethical case. Students are required to present a poster illustrating the solution and ethical justification of the position taken by the group’s members.

It must be stressed that the function of the case study here is to get the students to consider the ways of making value-based decisions rather than determine a particular position. For some questions there is no single correct answer, while for others no answer has yet been found. In seeking for an appropriate vehicle for expression of the full range of ethical viewpoints, we recommend using Ben Mepham’s ethical framework called an “ethical matrix” (36) for analyzing controversial cases in the biosciences and biotechnology (see an example in Box 3). This framework has been designed to facilitate a coherent, transparent and explicit process of ethical decision-making by clarifying the principles involved (well-being, autonomy and fairness) that gives due attention both to objective facts and to human values (33). Details of the ethical matrix and how it might be applied in negotiating of moral issues in biology are given to students early in the course, during the first seminar.

Box 3. Example of ethical matrix specifying respect for three principles (well-being, autonomy and fairness) in the use of genetic modification applied to animals (e.g. in the case of GM fish designed to grow more rapidly through supplementing of the growth hormone genes). From Mepham (34)

Respect for: Well-being Autonomy FairnessConsumer/Patient

Acceptability/health choice Rights/

Affordability

Treated animals Welfare Behavioralfreedom Intrinsic values

Biota Conservation Biodiversity Sustainability

Society Social harmony Democratic choice

Fair allocation of resources

Note: The matrix can be used to help identify the extent to which each of the specified principles might be respected, and to facilitate deliberation on how positive and negative impacts should be weighed.

• Role plays – since many ethical issues posed by advancement of the biosciences are perplexed and have several more often contradictious standpoints, they may be presented as role playing. This should allow students to take risk-free positions in a “safe” environment by acting out characters in hypothetical situations, to help them better clarify the range of concerns, values, and reason patterns held by other people, as well to see a problem from a different perspective. Students, who may not agree with a given position, have the opportunity to justify their own point of view. For the first time it may be useful for the lecturer to write a situation beforehand including brief details of the roles and situation for students to act out, so that they can


develop the ideas themselves. If the class has been subdivided then the subgroups can compare their experiences together, e.g. those who played the same role in the different role plays can discuss with each other their opinions and feelings as they played out the roles. An example of role plays adapted for the topic area of environmental ethics is shown in Box 4.

Box 4. Example role play in the discussion on the gene patenting from the topic “ethics of biotechnology”. From Bryant et. al. (9), adapted by usÄ Introduction to debate:“A biotechnology company established in a small less developed country has discovered a gene that encodes a protein in the network of resistance to oxidative stress in plants. Laboratory experiments have shown that when the gene is transferred by genetic modification techniques to crop species, the crop plants show an enhanced capacity to grow and produce yield under conditions where water supply is limiting. The company has not published its data because it is filling a patent on the gene. If the patent is granted, the company plans to license it to a major trans-national agrichemical company”.Ä Should the patent be granted? We can characterize the different positions in the debate about whether the patent of the gene should be granted. Several stakeholders’ opinions follow, by representatives of the following: ü The biotechnology company;ü The government of the country;ü The United Nations Commission on Sustainable Development (CSD);ü The indigenous farmers who are dealing only with organic farming;ü The indigenous ranchers who do not reject GMO;ü The trans-national agrichemical company.

• Reflective questionnaires – these questionnaires are designed to encourage students’ ability in writing to explicitly express the basis of their thoughts, beliefs and moral judgments evoked by topics, experiences or opposing viewpoints being discussed. As an option of self-questioning, the written reflective questions can be a great tool for internal control and monitoring on one’s own thinking strategies in reasoned ethical decision-making. The questionnaires will be useful if they are administered before analyzing a specific case or before discussing a particular topic in class. The students are then invited to re-visit their answers to see whether the presentation of the issue has changed their view, thinking or values in any way. Questions such as “How did you come to hold that point of view?; “What do you base this position on?”; “Could you ever say which one was the better position in the discussion?”; or “Did you change your standpoint after the issue was dealt with? If yes, in what way”, may facilitate students’ reflective judgment and moral reasoning that are increasingly more robust, but developmentally appropriate in the teaching of bioethics (42).

• Writing essays – we offer essays as a form of expressive writing for which students are asked to reflect on a

particular issue (which may either be well or loosely defined) or a directed question (2). Writing an essay is not like knowledge telling or science reporting because it requires the learner to analyze his/her personal position and critique his/her conceptual understanding of an authentic issue/dilemma selected from the course content. We are interested in how students supported and justified their claims – how they integrated evidence from both their personal and academic ‘‘funds of bioethics’ knowledge’’, and also how they interpreted the multiple positions from ethical perspectives. Topics of the essays should be related to the course material from the syllabus. Students may compose their writings on a topic of their choice, preferably not previously addressed in the course, although the lecturer can be proposed example essay topics as well. Students are required to submit briefly their written products on a poster or PowerPoint presentation and then discuss them with the whole class.

Students’ assessmentA number of bioethics courses delivered during the second year of biology degrees in several universities use in-course assessment as the main form of assessment (7, 15, 43, 47). Some of the bioethics modules taught in the final year of bioscience degrees, prefer to apply an examination based mainly on questions that entail students to consider and describe arguments presented from more than one perspective when solving a specific ethical case of biology (39).

In evaluation of students’ learning in our bioethics course, we have tended to use in-course assessment that is based on a combination of various components – a group poster produced during the case study, an oral presentation of different standpoints in the role plays and individual written essay. These three components clearly fit well the need to present various viewpoints and evidence, and then arrive at a balanced conclusion in resolving of ethical controversies. Twenty percent of the grade shall come from participation in the group work and an oral presentation in playing structured roles. The weight of these presentations in the final grade may be kept low to allow students to express themselves freely, without being concerned about the impact of their statements on their mark. Thirty percent of the grade shall result from a group poster which should be presented and discussed in the class after the particular case has been studied. For the group poster, all participants in the group gain the same mark, which counts for 30% of an individual’s total mark. Another component of the course grade (50%) shall come from individual essays written by students on a topic of their choice (or offered by the teacher), preferably not previously addressed in the course. For these essays, students are required to research additional references, books, or Web sites to document their study and support their conclusions. It is important to emphasize that in assessing both the presentations and posters and essay writing, we do not look for a particular ethical standpoint but understanding of socio-ethical issues covered by topics from


the syllabus and reasoning skills used in making a morally justified decision. In their writings, students are asked not only to express their opinions but also to objectively address both sides of controversial issues. They are expected to identify positive aspects of all perspectives, even if they disagree with one particular viewpoint. We consider that this structure of students’ evaluation combines the need for self-motivation and study and allows for individual student assessment, yet at the same time fosters team work and group participation.

ConclusionsAlthough universities have autonomy to design and examine their own programs, more academic committees and organizations in the world such as QAA in the UK, AAAC (American Association for the Advancement of Science), UNESCO and others recommend that undergraduate’s curricula in the bioscience should include an ethics component. The incorporation of ethics not only enriches the content of biology as students become aware of the relevance that biological knowledge has for many issues of importance to society, it also enables students to become more proficient professionals who understand how to apply principles of ethical decision making in their practice. Moreover, integrating of bioethics in the bioscience education may equip students with strong competencies and transferable skills needed for their real life as members of society, who realize the complexity of ethical issues in biology, who can ask the right questions of policymakers, and who recognize their own contribution to impacts on the environment.

The described module of bioethics for undergraduates in biology degrees is an attempt towards better synchronization of Bulgarian higher education with the global trends of instructional practice in the biosciences. We think that training in bioethics may play a crucial role in undergraduates’ biology education. On the one hand, bioethics is necessary to uphold the relationship between the life sciences and values that are essential to society, and, on the other hand, it is fundamental in the current context of the expanding applications of modern biotechnology and exigencies related both to human wellbeing and environment. Consequently, the proposed course introduces some of the bioethical issues students will most likely face in their future practice and daily life, and the ways of thinking on those issues in a rational and constructive manner. In doing so, it shall challenge the scientism that undoubtedly persists within some topics of the subject matter. Here, we concur with B. Mepham’s position that those, who wish to use science and technology ethically need to be able to provide sound reasons for their views (35).

Overall, we believe that the course material provides an excellent environment for applying of a reflective approach that could stimulate new ways of thinking about socio-ethical dimensions of the life sciences and biotechnology .This approach may help our students, as a new generation of scientists, to learn how to reach decisions on the ethical implications of scientific matters because many of the

biosciences that cause ethical dilemmas are both constantly changing from a technical perspective and are attached to deep-seated cultural and moral values. However, teaching in bioethics based on a reflective approach in the auditoriums might provide future professionals with a considerable background to recognize ethical issues of biology and might train them to learn skills to act in morally and socially responsible ways.

AcknowledgementsThis study was partially funded by grant № BG051PO001-3.3.03-0025 (/31). The authors are thankful to the research group in the Biotechnological Information Centre at the Agrobioinstitute for their assistance.

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article doi: 10.5504/bbeq.2011.0089 education & basic ......certainly, students may learn ethics...

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