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  • 1. Teachers Resources and Notes for A Cross-Cultural Introduction to Bioethics Darryl R.J. Macer, Ph.D. (Editor) (draft version 3, 22 January 2007) Eubios Ethics Institute 2006
  • 2. 2 Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics Eubios Ethics Institute Bangkok Christchurch Tsukuba Science City The Eubios Ethics Institute is a non-profit group that aims to stimulate the discussion of ethical issues, and how we may use new technology in ways consistent with "good life". An important part of this dialogue is to function as an information source for those with similar concerns. Other publications are listed at the end of this book. The views expressed in this book do not necessarily represent the views of the Eubios Ethics Institute or UNESCO. Copyright © 2006 Eubios Ethics Institute All rights reserved. The copyright for the complete publication is held by the Eubios Ethics Institute. No part of this publication may be reproduced except for personal use, and non-profit educational use, without the prior written permission of the Eubios Ethics Institute. Cataloging-in-Publication data Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics / editor, Darryl R.J. Macer. Christchurch, N.Z. : Eubios Ethics Institute ©2006. 1 v. 100 pp. A4 size.ISBN 0-908897-24-3 1. Bioethics. 2. Medical ethics 3. Environmental Ethics 4. Bioethics Education 5. Genetics 6. Neurosciences I. Macer, Darryl R.J. (Darryl Raymund Johnson), 1962- IV. Eubios Ethics Institute. V. Title (Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics). Key Words: Asia, Biodiversity, Bioethics, Bioethics Education, Biotechnology, Body, Cloning, Education for Sustainable Development (ESD), Economics, Energy, Environment, Environmental Ethics, Eugenics, Genetic Engineering, Genetic Screening, Genetic Therapy, Human Genetic Disease, Human Genome Project (Scientific, Ethical, Social and Legal Aspects), Medical Ethics, Medical Genetics (Diagnosis, Treatment and Prevention), Patenting of Life, Peace, Reproductive Technology, Surrogacy, Sustainable Development. On-line version and teachers guides, references, Internet links Project site <http://www.unescobkk.org/index.php?id=2508> On-line version of the textbook / resource book can be downloaded from <http://eubios.info/ccib.htm> On-line version for latest edition of Teacher Resources can be downloaded from <http://eubios.info/BetCD/BetbkTR.doc> Further copies can be obtained from the Eubios Ethics Institute. c/o Darryl Macer, Ph.D., Director, Eubios Ethics Institute c/o UNESCO Bangkok, 920 Sukhumvit Road, Prakanong, Bangkok 10110, THAILAND Tel: +66-2-391-0577 ext 141 Fax: +66-2-664-3772 Email: d.macer@unescobkk.org The above address should also be used to send feedback forms from teachers and students! Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 3. Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics 3 Content list Preface 5 Evaluation and Goals of Bioethics Education 1: Goals of Bioethics 7 2: Evaluation 8 3: Stages in moral development 11 4: Ongoing reassessment and evaluation 14 5: Participatory Methods 16 6: References 17 Explanation of chapters (Page numbers refer to the page in the textbook) A. Bioethics and the Ethics of Science and Technology 1. Making Choices, Diversity and Bioethics 1 2. Ethics in History and Love of Life 6 3. Moral Agents 18 4. Ethical limits of Animal Use 22 5. Ethics and Nanotechnology 27 B. Environmental Ethics 1. Ecology and Life 30 2. Biodiversity and Extinction 36 3. Ecological Ethics 40 4. Environmental Science 43 5. Environmental Economics 51 6. Sustainable Development 63 7. Cars and the Ethics of Costs and Benefits 73 8. Energy Crisis, Resources and Environment 78 9. Ecotourism 85 10. The Earth Charter Initiative 93 C. Genetics 1. Genetics, DNA and Mutations 98 2. Ethics of Genetic Engineering 102 3. Genetically Modified Foods 107 4. Testing for Cancer Gene Susceptibility 110 5. Genetic Privacy and Information 113 6. The Human Genome Project 117 7. Eugenics 121 8. Human Gene Therapy 122 9. Universal Declaration on the Human Genome and Human Rights 129 10. International Declaration on Human Genetic Data 134 D. Medical Ethics 1. Informed Consent and Informed Choice 145 2. Telling the Truth about Terminal Cancer 147 3. Euthanasia 153 4. Brain Death 158 Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 4. 4 Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics 5. Organ Donation 164 6. Brain Death and Organ Transplant Drama 170 7. The Heart Transplant 175 8. SARS (Severe Acute Respiratory Syndrome) 176 9. AIDS and Ethics 177 10. Ethical Principles for Medical Research Involving Human Subjects 183 11. Bird Flu 188 12. Indigenous Medicines and Access to Health 189 E. Reproduction 1. Lifestyle and Fertility 192 2. Assisted Reproduction 198 3. Surrogacy 204 4. Choosing Your Children’s Sex and Designer Children 205 5. Prenatal Diagnosis of Genetic Disease 208 6. Female Infanticide 211 7. Human Cloning 214 8. United Nations Declaration on Human Cloning 215 9. Human Genome Organization (HUGO) Ethics Committee Statement on Stem Cells 222 F. Neurosciences 1. Advances in Neuroscience and Neuroethics 224 2. Learning to Remember: The Biological Basis of Memory 229 3. The Neuroscience of Pleasure, Reward and Addiction 235 G. Social Ethics 1. Revisiting the Body 241 2. Child Labour 251 3. Peace and Peace-keeping 253 4. Human Rights and Responsibilities 269 Movie Guides and Questions (Samples) 277 Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 5. Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics 5 Preface This teacher’s guide is available for use to accompany the textbook, A Cross-Cultural Introduction to Bioethics, which is available in both hard copy or as a soft copy to download without charge from the Internet. The teaching resources and notes include academic references, further reading, Internet sites and other information that supplements the text/resource book. This book may be useful for teachers as they teach bioethics, and for students who wish to write reports and do their own research on the topics in the textbook. The first section is a general introduction to evaluation of bioethics that I have written to help teachers examine what bioethics is. There are many goals of bioethics and they are discussed here. The order of the teaching resources and notes for each chapter follows the same order as in the textbook. This book will be regularly updated on-line. Please refer to the textbook itself for the authors who contributed to the chapters, and who have compiled reference lists for those who wish to examine the background behind the chapters. The student and teacher feedback forms are printed in the textbook, and can be downloaded with the preface of the book. The on-line version of that book can be downloaded from <http://eubios.info/ccib.htm> Bioethics could be defined as the study of ethical issues and decision-making associated with the use of living organisms. Bioethics includes both medical ethics and environmental ethics. Bioethics is learning how to balance different benefits, risks and duties. Concepts of bioethics can be seen in literature, art, music, culture, philosophy, and religion, throughout history. Every culture has developed bioethics, and in this book there is a range of teaching resources that can be used that are written from a cross-cultural perspective by a variety of authors. In order to have a sustainable future, we need to promote bioethical maturity. We could call the bioethical maturity of a society the ability to balance the benefits and risks of applications of biological or medical technology. It is also reflected in the extent to which public views are incorporated into policy-making while respecting the duties of society to ensure individual's informed choice. Awareness of concerns and risks should be maintained, and debated, for it may lessen the possibility of misuse of these technologies. Other important ideals of bioethics such as autonomy and justice need to be protected and included when balancing benefits and risks. Bioethics is not about thinking that we can always find one correct solution to ethical problems. Ethical principles and issues need to be balanced. Many people already attempt to do so unconsciously. The balance varies more between two persons within any one culture than between any two. A mature society is one that has developed some of the social and behavioural tools to balance these bioethical principles, and apply them to new situations raised by technology. The objectives of this guide and the on-line multilingual resources at UNESCO Bangkok website and the teaching pack on the Eubios CD are to provide a free on-line resource teachers and students can use to learn about bioethics, and think more widely about life. A variety of styles are used, and we would like feedback from teachers, students, anyone who wishes to use it. Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 6. 6 Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics List serves function in English for educators and students, and persons from a wide range of countries have tried these resources, and contributed to this project over the past three years. Internet site <http://www.unescobkk.org/index.php?id=2508> Internet site <http://eubios.info/betext.htm> Education listserve <http://groups.yahoo.com/group/Bioethicseducation/> Student listserve <http://groups.yahoo.com/group/ Bioethics_for_students/> Teaching Guides, References, Internet links (this document) <http://eubios.info/BetCD/BetbkTR.doc> This project aims to produce free on-line teaching materials for bioethics education in different countries. The main products will be: 1) Materials for teaching bioethics; 2) A textbook that could be used in school and university classes to teach about bioethical issues; and 3) A network of teachers in different countries. The Eubios Ethics Institute website has over 2000 files available for download, including the UNESCO/IUBS/Eubios Living Bioethics Dictionary, and regular News updates. Further copies of chapters and updates, teaching guides, evaluation sheets, etc. are available upon request. We are also interested in assembling student projects and different teachers' materials in a global site that all can use, and can inform us all. We welcome improvement and additions to this project. The project described herein will continue under the framework of a Bioethics Education Textbook Project of UNESCO Bangkok, continuing to gather more teaching resources in multiple languages from around the world and make them openly available. A network of educators to improve global bioethics education has been developed under the International Bioethics Education Network. The lessons from the project need to be developed in the context of policy and curriculum in a number of countries. Darryl Macer, Ph.D. Editor All suggestions to Darryl Macer, Ph.D., Director, Eubios Ethics Institute c/o UNESCO Bangkok, 920 Sukhumvit Road, Prakanong, Bangkok 10110, THAILAND d.macer@unescobkk.org Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 7. Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics 7 Evaluation and Goals of Bioethics Education 1: Goals of Bioethics There can be several goals of bioethics education, and each could be associated with different measures in evaluation. There does not exist a consensus in the academic literature and teaching community on the most important goals to measure nor on the best criteria to assess whether the education is successful. For more than 60 years it has been recorded that both quantitative and qualitative data are important in social science research, as was said by Merton and Kendall (1946), "Social scientists have come to abandon the spurious choice between qualitative and quantitative data: they are concerned rather with the combination of both which makes use of the most valuable features of each. The problem becomes one of the determining at which points they should adopt the one, and at which the other, approach". Thus an appropriate methodological tool should contain methods to utilize and assess both types of data. The goals of bioethics that were important to measure were found to include: 1) Increasing respect for life; 2) Balancing benefits and risks of Science and Technology; 3) Understanding better the diversity of views of different persons; 4) Understanding the breadth of questions that are posed by advanced science and technology; 5) Being able to integrate the use of scientific facts and ethical principles and argumentation in discussing cases involving moral dilemmas; 6) Being able to take different viewpoints such as biocentric and ecocentric perspectives. We do not need to achieve all goals to consider a class to be successful, and different teachers and schools put a different amount of emphasis on each goal. One important goal of teaching about bioethical issues is to get students to critically evaluate the issues (Conner, 2003). In a Mexican case (Rodriguez, 2005), bioethics classes were used as a way to improve the general behaviour and study aptitude of students. Each institution is likely to put a different amount of emphasis on each goal. Also, different activities are likely to enable some goals to be met and not others (Macer, 2004c). Therefore we do not need to assess all the institutional objectives when evaluating the success of the trials. Instead, case studies of how students and teachers responded were also sought to give a wider descriptive account of various approaches. One of the goals of this project was to examine criteria that could be used to measure the success of bioethics education, and the effectiveness of different forms of education for making mature citizens. There is a consensus among many Western scholars that the balancing of four main bioethical principles, which are Autonomy, Justice, Beneficence and non- maleficence, is central to making better decisions (Beauchamp and Childress, 1994). These principles are introduced in chapter 1 of the text. Autonomy includes ideas such as respect for privacy, respect for personal choice. Justice is to respect the autonomy of others, and to treat persons equally. Beneficence is to try to do good, and non-maleficence is to avoid harm. When solving or trying to reach a consensus about bioethical problems, these four main principles can be a good guide in balancing which ideas should be mostly weighed. One measure of bioethics education could then be whether students are able to use these principles in decision-making, which was examined by presence of these keywords in discourse (oral or written). In the future the use of principles as expressed in the UNESCO Universal Declaration on Bioethics and Human Rights (2005) will also be analyzed to broaden the description of bioethical reasoning. Still, reaching a good decision is often difficult, which also may not be the same if made in different times and situations. Another approach that is common in education is to teach learners to break down ethical dilemmas into manageable problems, for example, the Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 8. 8 Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics separation of action, consequence and motives connected to a moral decision. This separation is reflected on the different bioethical theories, and some of these are introduced in chapter 2. Utilitarianism is an example of a bioethical theory, which looks at the consequences of an action, and is based on the work of Jeremy Bentham and John Stuart Mill. This principle asserts that we ought always to produce the maximal balance of happiness or pleasure over pain, or good over harm, or positive value over disvalue. Utilitarianism can be then broken down into rule utilitarianism, and act utilitarianism. “A rule utilitarian may use moral rules as authoritative instrumental rules, so the morally right action is conformity to a system of rules, and the criterion of the rightness of the rule is the production of as much general happiness as possible (Macer, 1998a)”. Act utilitarians on the other hand, look at the particular act only, and object to moral rules to be only an approximate guides, which could be broken if maximal good is not obtained. Another example of a bioethical theory is rights based theories of Immanuel Kant, and human rights law (Beauchamp and Childress, 1994; Macer, 1998a). The use of utilitarian-style logic and rights arguments were also examined among the discourse. The evaluation tools developed here could be extended to look for presence of other concepts such as virtue ethics for example. Integration of scientific facts is also important in moral reasoning. Science educators discovered during the last few decades that the most efficient way to educate science is to discuss the science together with examples of technology and put the facts into the social context. This method of teaching is generally called the Science, Technology, and Society (STS) approach (Yager, 1990; Ramsey, 1993). Advances in biology and medicine have led to another pressure upon educators, namely how students can be prepared to face the ethical dilemmas that the technology often raises. Many chapters in the text incorporate both teaching of biological facts and ethics. The ethical issues associated with biology are generally grouped under the phrase "bioethics". Bioethics is one part of the approach of STS, and a survey of bioethics teaching is also one method to measure the extent that society issues are included (Macer et al., 1996; Macer, 1999). In general there are less teachers using STS approaches in Asia than in the USA (Kumano, 1991), and Australasia (Macer et al. 1996), but it is growing still. Even within one country, such as the USA, there are a diversity of views on how to effect efficient education of social issues and even the science itself (Waks & Barchi, 1992). In the project in Korea the partner teachers at high school level are a STS network of teachers, and the Chinese school has a STS approach to teaching biology. In some other countries, such as New Zealand, STS approaches are integrated into a broad participatory paradigm of education across all subjects. 2: Evaluation Crucial to the exercise of development of bioethics is a method of evaluation that allows for improvement of materials and meeting better the needs of students in different countries. This project has looked at several methods of evaluation including: development of specific evaluation forms for student and teacher responses to chapters and the textbook or course; ways to analyze the content of student essays and reports; forums where educators and researchers can discuss and improve the content of the textbook and materials, and discuss evaluation; and ways to assess various styles of student feedback from different programs. In the text there are evaluation sheets that were developed as an evaluation tool, and are included in the second edition of the Bioethics Text/Resource book, A Cross-Cultural Introduction to Bioethics (Macer, 2006). The publication of this book and some translations of the chapters in the book in several languages, including Chinese, Japanese, Korean, Tamil and Thai, allows trials of the textbook to be also conducted in local language in selected pilot countries. Comparisons in the way which bioethics dilemmas are used in different countries are Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 9. Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics 9 made, though longer term comparisons will be required. There are also country-by-country update summaries included here. In current assessment of high school students there is a trend from merely making lists of many examples, or listing the positive and negative sides of an argument towards making students exhibit their reasoning as well. One of the common goals of school education is that students can produce a good argument. Stephen Toulmin’s model has become popular in development of students’ argumentation skills (Toulmin et al. 1984). It is summarized in the figure below, that an argument consists of integrating the following: A conclusion or claim – assertions or conclusions about an event or theory Facts – data that is used as evidence to support the assertion Warrants – the statement that explains the link between the data and the claims Backing – underlying assumptions which are often not made explicit Rebuttals – statements that contradict the data, warrant or backing of an argument To create an argument a person needs to state their claim, then support it with facts (data) that are arranged logically. For each fact, they should give the evidence for the fact (warrant), and for each warrant, state the quality of its validity (backing). Then for each warrant and its backing, people should think of an opposing point of view (rebuttal). They then consider further possible warrants and backing for the rebuttals. At the end then they review, having argued the rebuttals, do they need to qualify their original claim? The mental mapping project, or human behaviourome project (Macer, 1992) identified 9 classes of ideas, and attempts to explain the linkages between ideas in the construction of moral choices by different persons (Macer, 2002). The practical applications of that model are yet to reach a stage at which teachers could simply assess the moral development of their students. The Ideas, Evidence and Argument in Science Education (IDEAS) project of Osborne et al. in the UK [http://www.kcl.ac.uk/depsta/education/ideas.html], has as its a goal the assistance of teachers in developing their skills to teach about ideas, evidence and argument in science. The materials they wish to develop include worksheets and video clips to enable teachers to teach children to develop and evidence scientific argument. They suggest teachers should focus on the features of argument shown in the right of the diagram below and suggest that prompt sheets, based around Toulmin’s model of argument are helpful in promoting children's ability to argue. Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 10. 10 Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics The IDEAS project suggests the following criteria can be used in evaluating students’ arguments. Is there a claim? Does the argument have data to support the claim? Does the argument link the data to the claim? Are there further justifications to support the case? Is there any anticipation of a counter argument and how it could be opposed? Ratcliffe and Grace (2003) outline the knowledge, understanding and skills that students studying ethical issues in science acquire and that can be used to design assessment questions. They listed several different levels of knowledge: Conceptual knowledge: Learners can demonstrate understanding of: underpinning science concepts and the nature of scientific endeavour; probability and risk; the scope of the issue – personal, local, national, global, political and societal context; and environmental sustainability. Procedural knowledge: Learners can engage successfully in: processes of opinion forming/decision making using a partial and possibly biased information base; cost-benefit analysis; evidence evaluation including media reporting; and ethical reasoning. Attitudes and beliefs: Learners can: clarify personal and societal values and ideas of responsibility; and recognize how values and beliefs are brought to bear, alongside other factors, in considering socio-scientific issues. As with the above examples of questions that Kohlberg used for the linkage of student arguments to moral stages of development, there are a number of ways that could be developed into evaluation tools for assessment of bioethics education. One of the difficult questions in bioethics education is how to evaluate the usefulness of the materials provided, beyond mere student or teacher satisfaction. One concept that has been used by Macer is whether students demonstrate "bioethical maturity" in some way. “Bioethical maturity assumes a certain level of recognition of weighing up the different arguments that can be used to discuss an issue, the different ethical frameworks that can be used, and comparisons and balancing of the benefits and risks of the dilemmas (Macer, 2002). This process also gives an indication as to how many different ideas people have, and the way they understand the dilemmas, and is ongoing as part of the behaviourome project (Macer, 2002; 2004b). Classroom observations, audio and video tape recordings, and written essays and homework done by the students were collected. This feedback is being continually used to modify the texts and accompanying questions and materials for teachers. Another way to assess the usefulness of the materials for developing ethical principles in making ethical decisions was to look for key words and concepts in the answers students give to oral questions. Evaluation must be done ethically (Alderson & Morrow, 2003), and there are a variety of methods in research which can be applied for evaluation depending on the style of class and Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 11. Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics 11 purpose (Cohen et al., 2003). It is very important to examine the future direction of bioethics education and how this might enable people to question scientific endeavours and what impact their moral decisions will have on them as individuals and upon their societies. The skills that are required to do this involve the ability to identify existing ideas and beliefs, listen to others, be aware of multiple perspectives, find out relevant information and communicate the findings to others. These skills cannot be ‘given’ to students through a didactic approach to teaching, where the teacher imparts the knowledge. Instead, students need to experience situations that will allow them to develop these skills through interacting with the teacher and with each other. This project allows sharing of cases and experience in a range of cultures as well. When bioethics is applied to professional behaviour, such as in medical ethics, methods to evaluate have included the way students conduct a patient examination (http://wings.buffalo.edu/faculty/research/bioethics/eval.html). In Buffalo University Bioethics program (Singer et al., 1993), they applied the technology of the objective structured clinical examination (OSCE) (Cohen et al., 1991) using standardized patients to the evaluation of bioethics. Methods to evaluate the clinical-ethical abilities of medical students, post-graduate trainees, and practising physicians that have been used include multiple-choice and true/false questions (Howe and Jones, 1984), case write-ups (Siegler et al, 1982; Doyal et al., 1987; Redmon, 1989; Hebert et al., 1990), audio-taped interviews with standardized patients (Miles et al., 1990), and instruments based on Kohlberg's cognitive moral development theory (Self et al., 1989). The reliability and validity of these methods have seldom been examined. Auvinen et al. (2004) applied the use of Kohlberg’s stages of moral development to assess ethics teaching in nursing students in Finland, and they found significantly higher ethical maturity when nurses actually had to deal with ethical dilemmas in their practical training in clinics. 3: Stages in moral development In discussions held during project meetings in 2005 there has been a consensus that the theory of moral development developed by Lawrence Kohlberg, and what has come to be called Kohlberg's stages of moral development, does not universally apply when teaching bioethics. The problems are not only with non-Western students, but researchers in Australia and New Zealand have also found that it does not serve as a model. Kohlberg's (1969) theory holds that moral reasoning, which he thought to be the basis for ethical behavior, has developmental stages that are universal. He followed the development of moral judgment beyond the ages originally studied by Jean Piaget looking at moral development thoughout life, and created a model based on six identifiable stages of moral development (Scharf, 1978). Kohlberg's six stages were grouped into three levels: pre-conventional, conventional, and post-conventional. He claimed it is not possible to regress backwards in stages nor to 'jump' stages; each stage provides new perspective and is considered "more comprehensive, differentiated, and integrated than its predecessors." A brief explanation follows. Level 1: Pre-Conventional The pre-conventional level of moral reasoning is especially common in children, and said to be up to the age of 9 in U.S. children he studied, although adults can also exhibit this level of reasoning. Reasoners in the pre-conventional level judge the morality of an action by its direct consequences. The pre-conventional level consists of the first and second stages of moral development, and are purely concerned with the self (egocentric). In stage one (obedience), individuals focus on the direct consequences that their actions will have for themselves. For example, an action is perceived as morally wrong if the person who commits it gets punished. In addition, there is no recognition that others' points of view are any different Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 12. 12 Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics from one's own view. Stage two is a self-interest orientation, right behavior being defined by what is in one's own best interest. Stage two reasoning shows a limited interest in the needs of others, but only to a point where it might further one's own interests, such as "you scratch my back, and I'll scratch yours." In stage two, concern for others is not based on loyalty or intrinsic respect. Lacking a perspective of society in the pre-conventional level, this should not be confused with stage 5 (social contract) as all actions are performed to serve one's own needs or interests. Level 2: Conventional The conventional level of moral reasoning is typical of adolescents (age 9+ years) and adults. Persons who reason in a conventional way judge the morality of actions by comparing these actions to societal views and expectations. The conventional level consists of the third and fourth stages of moral development. In Stage three, the self enters society by filling social roles. Individuals are receptive of approval or disapproval from other people as it reflects society's accordance with the perceived role. They try to be a good boy or good girl to live up to these expectations, having learned that there is inherent value in doing so. Stage three reasoning may judge the morality of an action by evaluating its consequences in terms of a person's relationships, which now begin to include things like respect, gratitude and the golden rule. Desire to maintain rules and authority exists only to further support these stereotypical social roles. In Stage four, it is important to obey laws and social conventions because of their importance in maintaining a functioning society. Moral reasoning in stage four is thus beyond the need for approval exhibited in stage three, because the individual believes that society must transcend individual needs. If one person violates a law, perhaps everyone would - thus there is an obligation and a duty to uphold laws and rules. As a cultural observation, this is a very common attitude in Asian and Pacific communities. Level 3: Post-Conventional The post-conventional level, also known as the principled level, consists of stages five and six of moral development. Realization that individuals are separate entities from society is important in North American society where Kohlberg developed his theory and so he judged it to be a higher level of morality. In that culture one's own perspective should be viewed before the society's is considered. Interestingly, the post-conventional level, especially stage six, is sometimes mistaken for pre-conventional behaviors. In Stage five, individuals are viewed as holding different opinions and values, all of which should be respected and honoured in order to be impartial. However he considered some issues are not relative like life and choice. Laws are regarded as social contracts rather than dictums, and those that do not promote general social welfare should be changed when necessary to meet the greatest good for the greatest number of people (a utilitarian view). In Stage six, moral reasoning is based on abstract reasoning using universal ethical principles. Decisions are made in an absolute way rather than in a conditional way. In addition, laws are valid only insofar as they are grounded in justice, and that a commitment to justice carries with it an obligation to disobey unjust laws. While Kohlberg insisted that stage six exists, he had difficulty finding participants who use it. Implications After Kohlberg's stage 4, the transition from stage four to stage five, people have become disaffected with the arbitrary nature of law and order reasoning and he said they become moral relativists. This transition stage may result in either progress to stage five or in regression to stage four. As has become clear during the bioethics education project, there is Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 13. Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics 13 such a range of cultural, family and school value systems across the world, that students of one age in one country will most likely be in different stages at different times, even if all persons did follow this progression from stage 1 to stage 6 in moral reasoning, and not revert back to other levels. Stage six would correspond to a person that followed the textbook bioethics of Beauchamp and Childress (1995). Macer (1998) has argued that bioethics is love of life, and that principalism based on following the standard ethical principles alone is not sufficient as an explanation of why people behave the way they do. The role of religious values is also obviously important, as concepts like karma and removal of oneself from the matters of the world do affect the values systems people use when approaching moral dilemmas. Kohlberg used moral dilemmas to determine which stage of moral reasoning a person uses. The dilemmas are short stories that describe situations in which a person has to make a moral decision, yet they provide no solution. The participant is asked what the right course of action is, as well as an explanation why. This style is still commonly used as case-based ethics teaching. There is a need to develop more local cases for dialogues between Asian and Pacific cultures. A dilemma that Kohlberg used in his original research was the druggist's dilemma: Heinz Steals the Drug In Europe. A woman was near death from a special kind of cancer. There was one drug that the doctors thought might save her. It was a form of radium that a druggist in the same town had recently discovered. The drug was expensive to make, but the druggist was charging ten times what the drug cost him to produce. He paid $200 for the radium and charged $2,000 for a small dose of the drug. The sick woman's husband, Heinz, went to everyone he knew to borrow the money, but he could only get together about $ 1,000 which is half of what it cost. He told the druggist that his wife was dying and asked him to sell it cheaper or let him pay later. But the druggist said: "No, I discovered the drug and I'm going to make money from it." So Heinz got desperate and broke into the man's store to steal the drug for his wife (Kohlberg, 1969). Should Heinz break into the laboratory to steal the drug for his wife? Why or why not? Like many cases of bioethics, from a theoretical point of view, it is not important what the participant thinks that Heinz should do. The point of interest is the justification that the participant offers. Below are examples of possible arguments that belong to the six stages. It is important to keep in mind that these arguments are only examples. It is possible that a participant reaches a completely different conclusion using the same stage of reasoning: Stage one (obedience): Heinz should not steal the medicine, because he will consequently be put in prison. Stage two (self-interest): Heinz should steal the medicine, because he will be much happier if he saves his wife, even if he will have to serve a prison sentence. Stage three (conformity): Heinz should steal the medicine, because his wife expects it. Stage four (law-and-order): Heinz should not steal the medicine, because the law prohibits stealing. Stage five (human rights): Heinz should steal the medicine, because everyone has a right to live, regardless of the law. Or: Heinz should not steal the medicine, because the scientist has a right to fair compensation. Stage six (universal human ethics): Heinz should steal the medicine, because saving a human life is a more fundamental value than the property rights of another person. Or: Heinz should not steal the medicine, because that violates the golden rule of honesty and respect. One criticism of Kohlberg's theory is that it emphasizes justice to the exclusion of other values. As a consequence of this, it may not adequately address the arguments of people who value other moral aspects of actions more highly. His theory was the result of empirical Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 14. 14 Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics research using only male participants (aged 10, 13, and 16 in Chicago in the 1960s). Carol Gilligan argued that Kohlberg's theory therefore did not adequately describe the concerns of women. She developed an alternative theory of moral reasoning that is based on the value of care. Among studies of ethics there is a tendency in some studies to find females have higher regard for ethics theories (Ford and Richardson, 1994). Gilligan's theory illustrates that theories on moral development do not need to focus on the value of justice. Other psychologists have challenged the assumption that moral action is primarily reached by formal reasoning. People often make moral judgments without weighing concerns such as fairness, law, human rights and abstract ethical values. If this is true, the arguments that Kohlberg and other rationalist psychologists have analyzed are often no more than post hoc rationalizations of intuitive decisions. This would mean that moral reasoning is less relevant to moral action than it seems (Crain, 1985). 4: Ongoing reassessment and evaluation After pilot trials the set of evaluation sheets that appear in the initial pages of A Cross- Cultural Introduction to Bioethics (Macer, 2006; pp. vii-xvii), were developed. There was a balance in the development of specific evaluation forms for student and teacher responses to chapters and the textbook or course between examination of the way that the thinking progressed and the privacy of the respondents. In the simple questions the respondents were asked to choose from one of: SA (Strongly agree), A (Agree), PA (Partially agree), NA (Not applicable), PD (Partially disagree), D (disagree), SD (Strongly disagree). The results to date show that the students are very positive to the materials and topics. Significant numbers wanted to have longer to discuss the materials and topics, though in these trials the class times varied. In all classes the students felt that they had enjoyed a meaningful discussion, as would be expected given that I had tried to use participatory methods for involving students and long question and answer periods during points in the reading of the written chapters. The teachers were unanimous in strongly disagreeing with Q8, thus judging the materials to be adequate, and strongly agreeing with the chapter’s utility. They also wanted more time for the discussion. The comments given in the response forms are the most useful parts of the form. The open question (Q2) asks students to list keywords, and the students usually wrote a few keywords about the chapter, often the title plus a principle that was emphasized during the lecture. The open comments in Q9 looked at what the students had learned through reading the chapter and in response to this question usually a sentence or two were written. The answers are coded and analyzed, for example as to whether the comment illustrated they had learned about both sides of view. If the questionnaire directly asked whether they had learned about different points of view more would say so, but still most students focused on the facts or keywords of the chapter in their comments. One of the concerns in developing cross-cultural materials is whether some contents are not appropriate in a culture. This concern was also raised in Catholic schools that used the first edition of the textbook, though they judged all the contents to be appropriate. Q10 asked whether there was any content not culturally appropriate. This is a decision teachers must make, and feedback on this is useful as both students and teachers may have different impressions. At the end of the questionnaire (Q19) there was a space for student comments and suggestions. This type of feedback was very useful for the future of the materials and the pilot programs, and for providing feedback to the government Ministries and Boards of Education for the increased coverage of bioethics. As had been called for by teachers for many years (Asada et al. 1996; Macer et al. 1996; Pandian and Macer, 1998; Macer and Ong, 1999), the Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 15. Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics 15 students also request more bioethics classes. Text analysis of student reports for keywords is one of the valuable ways to evaluate students thinking also. Currently we are extending categorization methods that have been developed (e.g. Maekawa & Macer, 2005, 2006). The abbreviations used for some of the general coding categories are below: Both Sides of View (BV): More than one side of an argument or a question being mentioned. Sometimes the views were not clearly stated in individual sentences so the judgment of the report containing a BV or not had to be made after the full evaluation of the report. Personal vs. Other Persons’ Views (PO): The writer’s point of view (e.g., an “I think” statement) plus other people’s point of views being stated regardless of whether they concurred with those of the writer or not. Views/feelings of non-humans were not included in this category. Scientific Facts (SF): A concrete and/or detailed scientific fact more intellectually demanding than common sense or the broad theme of the report. Generally this was not merely the citation of sentences from reference material(s). Quantitative Facts (QF): The use of statistics and/or numbers in a factual manner. Environment and Biocentric Ideas (EB): A statement made mentioning concerns for the environment or ecological concerns, or for example the care or treatment of animals raised as a concern. Generally people tend to reason and write from an anthropocentric viewpoint. Utilitarian Views (UV): A utilitarian view is judging an act as being morally acceptable based on the opinion that the benefits of the action to one group or individual will outweigh the risks or harm produced affecting a larger population. It is also considering the balancing of society versus individuals .will be greater than that for an individuals, not limited to human beings. Principles and Keywords (PK): A keyword denoting an ethical principle or connotation of one regardless of whether being directly stated or not. If only the term “rights” was mentioned, it was marked as R and not PK. Keywords included specific bioethics principles and keywords such as benefit & risk assessment, informed consent, enhancement, public welfare, autonomy, justice, equality of life, animal welfare etc. Rights (R): Clear mention of a right or a connotation of a right. This was limited to the rights of human beings. R is a specialized category of PK. Number of Ideas (NI): An idea is a distinct message unit, statement or concept that may be from the materials or from the writer’s own thinking. Key words and concepts were numbered when going through the reports and the same idea when repeated was not scored twice. Main Idea (MI): The selection of a main idea was based on the main themes of the argument. It is related to the causal relationship between two or more ideas. Often the sentence answering the topic question was chosen as the main idea. Example comments below give some explanation of the coding: "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 (R) which shield us from unjust things. Instead of it, we have to fulfill duties. " (PK) " I don’t agree to give animals legal rights. (R) 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) "I do not want to use animal tests for the safety of cosmetics, but some other people think that it is better to have everything tested on animals." (PO) The first quotation mentions rights, which can vary in other reports such as right to choose, right to information, and right to death, just to mention a few. The second quotation Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 16. 16 Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics mentions utilitarian views. Other utilitarian views include comments such as "If it can cure many people, animal experiments are inevitable" or "For the progress of science there are always some sacrifice". The third quotation is an example of a specific bioethics principle and keyword, "duty". The next example shows both sides of view where this person disagrees to give legal rights to animals, but considers unnecessary killing. Also the importance of environmental protection is mentioned for animals to be able to live in their natural habitat, which is a rare case. The next example shows some scientific background, SF. The last example takes that of the writer versus other persons on animal testing, but the key point is comparing their own opinion with others. Changes in the frequency of keywords and concepts need to be measured against several variables, including internal factors connected to the class such as the wording of the title, the nature of the materials used, the comments given by the teacher, and the comments made during the class. Results are being developed and will appear on the project listserve, preserving student anonymity. 5: Participatory Methods There are various other ways to assess various styles of student feedback from different programs. Some of these are direct participatory class feedback. There are different ways to describe the participation of students, for example, in the largest lecture in India 800 students and 40 teachers listened for 3 hours to a special lecture, whereas in smaller class courses in China 32 students attended a series of 32 90 minute class periods involving 10 teachers. In order to teach bioethics a longer series of sustainable lectures in smaller class groups is a better model, however, still general introductions can stimulate interest in schools for the subject. In the case of large classes there are methods that can be used to improve the participation of students such as talking in pairs while sitting in the class, or working in small groups of three or more persons to discuss particular questions from the text. Participatory methods have been used in science education (Bryce, 2004) and in medical ethics education (Sass, 1999). One participatory method that can be used is to get students to stand in a line to form a continuum line based on their view between two extremes along a moral continuum. After some students give their explanations for why they are standing at that point in the line then students may move to the appropriate point in the moral continuum. Then after a modified question can be used and the students move along the continuum to their new positions. This can include a transition from an abstract question, such as whether they support the use of reproductive human cloning, to a personal question, such as whether they would use reproductive cloning if that was the only way for them to have a genetically related child. Use of donuts (where two circles of people are made and they dialogue for 1 minute each and then the circle shifts around one person so that they repeat the exercise) or fishbowls (where you have 3 circles and the outside person is only recording and making note on the conversations between the other two persons), are two interactive discussion methods that can be used in classes with many persons. Student debates and presentation of reports can allow more in-depth analysis of issues by students, whether as individuals or in small groups, and then the debates can occur within the same class, between different classes, institutions or even countries by the use of video conferencing. 6: References Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 17. Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics 17 The website of the book and teaching resources is http://www.unescobkk.org/index.php?id=2508 Abito, EE. and Ng, MC. (2005) “Bioethics Education Trials at the Ateneo De Manila High School, in the Philippines”, BBRT1 paper. In press. xxx Alderson, Priscilla and Morrow, Virginia. Ethics, social research and consulting with children and young people. Barnardo’s, 2004, 171pp. Asada, Y., Akiyama, S., Tsuzuki, M., Macer, N.Y. & Macer, D.R.J. (1996) "High school teaching of bioethics in New Zealand, Australia, and Japan", Journal of Moral Education 25, 401-420. Asada, Y. & Macer, D.R.J. (1998) “High school bioethics education network in Japan”, pp. 152-166 in Bioethics in Asia, N. Fujiki & D.R.J. Macer, eds. (Eubios Ethics Institute, 1998). Auvinen, J. et al. (2004) “The development of moral judgment during nursing education in Finland”, Nurse Education Today 24: 538-46. Beauchamp, T.L. and Childress, J.F. Principles of Biomedical Ethics. Fourth Edition (New York: Oxford University Press, 1994). Bhardwaj, M. & Macer, D. (1999) “A comparison of bioethics in school textbooks in India and Japan”, Eubios Journal of Asian and International Bioethics 9: 56-9. Bryce, T. (2004) “Tough acts to follow: the challenges to science teachers presented by biotechnological progress”, Int. J. Science Education 26: 717-733. Cohen, Louis, Manion Lawrence and Morrison Keith. Research Methods in Education. 5th Edition. RoutledgeFalmer, 2003. Cohen R, Singer PA, Rothman AI, Robb A. (1991) "Assessing competency to address ethical issues in medicine." Academic Medicine 66: 14-5. Conner, L. (2003). The importance of developing critical thinking in issues education. New Zealand Biotechnology Association Journal, 56, 58-71. Conner, L. (2004). Assessing learning about social and ethical issues in a biology class. School Science Review, 86(315), 45-51. Conner, L. (2005) “The importance of knowledge development in bioethics education”, BBRT1 paper. In press. Crain, W.C. (1985). Theories of Development. New York: Prentice-Hall. Dawson, Vaille and Taylor, Peter, (1997) "The Inclusion of Bioethics Education in Biotechnology Courses", Eubios Journal of Asian and International Bioethics 7 (1997), 171-175. Doyal L, Hurwitz B, Yudkin JS. (1987) "Teaching medical ethics symposium: Medical ethics and the clinical curriculum: a case study." Journal of Medical Ethics 13: 144-149. Ford, RC. & Richardson, WD. (1994) “Ethical decision making: A review of the empirical literature”, J. Business Ethics 13: 205-21. Gilligan, Carol. In A Different Voice: Psychological Theory and Women’s Development. Cambridge, MA.: Harvard, 1993. Hebert P, Meslin EM, Dunn EV, Byrne N, Reid SR. (1990) "Evaluating ethical sensitivity in medical students: using vignettes as an instrument." Journal of Medical Ethics 16: 141-145. Hendrix, J.R. (1993) "The continuum: A teaching strategy for science and society issues", American Biology Teacher 55: 178-81. Jamieson, D. (1995) "Teaching ethics in science and engineering: Animals in research", Science and Engineering Ethics, 1, 185-6. Jarvis, S., Hickford, J. and Conner, L. (1998). Biodecisions. Lincoln: Crop and Food. Kohlberg, L. (1969) Stage and sequence: the cognitive-developmental approach to socialization. Chicago: Rand-McNally. Kumano, Y. (1991) "Why does Japan need STS .... A comparative study of secondary science education between Japan and the U.S. focusing on an STS approach", Bull. Sci. Tech. Soc. Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 18. 18 Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics 11: 322-30. Levinson, R. & Reiss M. J. (Eds). (2003). Key Issues in Bioethics: A guide for Teachers. (Routledge-Falmer, London). Lock, R. & Miles, C. (1993) "Biotechnology and genetic engineering: students' knowledge and attitudes", J. Biological Education 27: 267-72. Longley, Marcus and Iredale, Rachel (2000) “The Human Genome Project, health care and the public in the UK”, pp. 93-106 in D. Macer, ed., Ethical challenges as we approach the end of the Human Genome Project (Eubios Ethics Institute 2000). Macer, Darryl R.J., Bioethics for the People by the People (Christchurch: Eubios Ethics Institute, 1994). Macer, D.R.J., Asada, Y., Tsuzuki, M., Akiyama, S., & Macer, N.Y. Bioethics in high schools in Australia, New Zealand and Japan, (Christchurch: Eubios Ethics Institute, 1996). Macer, D., Obata, H., Levitt, M., Bezar, H. & Daniels, K. (1997) “Biotechnology and young citizens: Biocult in New Zealand and Japan”, Eubios Journal of Asian and International Bioethics 7: 111-114. Macer, Darryl R.J. (1998), Bioethics is Love of Life: An Alternative Textbook (Christchurch: Eubios Ethics Institute, 1998). Macer, D. & Chin Choon Ong, C.C. (1999) “Bioethics education among Singapore high school science teachers”, Eubios Journal of Asian and International Bioethics 9: 138-144 Macer, DRJ. (2002) "The next challenge is to map the human mind", Nature 420: 121. Macer, DRJ., ed., "Bioethics for Informed Citizens Across Cultures" (Eubios Ethics Institute, 2004a). Macer, DRJ., ed. Challenges for Bioethics from Asia (Eubios Ethics Institute 2004b) (specifically pp. 531-645 are on bioethics education and evaluation, results from the ABC5 conference). Macer, D. (2004) Bioethics education for informed citizens across cultures. School Science Review 86 (315), 83-86. Maekawa, F. (2002) Developing an Analytical Method to Evaluate Bioethics Education: Results from Classes Conducted at the University of Tsukuba. M.Sc. Thesis, University of Tsukuba. Maekawa, F. & Macer, DRJ. (2005) "How Japanese students reason about agricultural biotechnology", Science and Engineering Ethics, 10 (4) xxx. Maekawa, F. & Macer, DRJ. (2006) "Bioethics of teaching about reproductive technology and prenatal diagnosis choices in Japan", International Journal of Bioethics In Press. Merton, R.K. and Kendall, P.L. (1946) "The focused interview", American J. Sociology 51: 541-7. Miles SH, Bannick-Mohrland S, Lurie N. (1990) "Advance-treatment planning discussions with nursing home residents: pilot experience with simulated interviews." Journal of Clinical Ethics 2: 108-112. Ministry of Education. (1994). Biology in the New Zealand curriculum. Wellington: Learning Media. Ministry of Education (2005). Educate, Ministry of Education Statement of Intent 2005-2010. Wellington: Ministry of Education. Oka, T. & Macer, DRJ. (2000) Change in high school student attitudes to biotechnology in response to teaching materials, Eubios Journal of Asian and International Bioethics 106: 174-9. Pandian, C. & Macer, DRJ. (1998) "An Investigation in Tamil Nadu with Comparisons to Australia, Japan and New Zealand", pp 390-400 in Azariah J., Azariah H., & Macer DRJ., eds., Bioethics in India (Eubios Ethics Institute 1998). Ramsey, J. (1993) "The science education reform movement: Implications for social Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 19. Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics 19 responsibility", Science Education 77: 235-58. Ratcliffe, Mary and Grace, Marcus. (2003) Science for Citizenship: Teaching Socio-Scientific Issues (Open University Press, Maidenhead). Reiss, M.J. (1999). Teaching ethics in science. Studies in Science Education, 34, 115-140. Rest, J.R. Moral Development: Advances in Research and Theory (New York: Praeger, 1986). Sadler, T. D., & Zeidler, D. L. (2005). Patterns of informal reasoning in the context of socio- scientific decision making. Journal of Research in Science Teaching, 42(1), 112-138. Sass, H.M. (1999) “Educating and sensitizing health professionals on human rights and ethical considerations: The interactive role of ethics and expertise”, International J. Bioethics 10 (1999), 69-81. Self, D., Wolkinsky, F.D. & Baldwin, D.C. (1989) "The effect of teaching medical ethics on medical students' moral reasoning", Academic Medicine 64: 755-9. Scharf, Peter (1978). Moral Education. Davis, CA.: Responsible Action. Siegler M, Rezler AG, Connell KJ. (1982) "Using Simulated Case Studies To Evaluate A Clinical Ethics Course for Junior Students." Journal of Medical Education 57: 380-385. Singer PA, Cohen R, Robb A, Rothman AI. (1993) "The ethics objective structured clinical examination (OSCE)." J Gen Intern Med 8: 23-8. Toulmin, S., Rieke, R. & Janik, A. 1984. An Introduction to Reasoning (second edition). New York: Macmillan. UNESCO (1997) Universal Declaration on the Protection of the Human Genome and Human Rights. UNESCO (2005) Universal Declaration on Bioethics and Human Rights. Van Rooy, W. & Pollard, I. (2002a) Teaching and learning about bioscience ethics with undergraduates, Education and Health 15(3): 381-385. Van Rooy, W. & Pollard, I. (2002b) Stories from the bioscience ethics classroom: Exploring undergraduate students' perceptions of their learning, Eubios Journal of Asian and International Bioethics 12: 26-30. Waks, L.J. & Barchi, B.A. (1992) "STS in U.S. school science: perceptions of selected leaders and their implications for STS education", Science Education 76: 79-90. Yager, R. (1990) "Science/technology/society movement in the United States: Its origin, evolution, and rationale", Social Education 54: 198-201. Zaikowshi, LA. & Garrett, JM. (2004) “A three-tiered approach to enhance undergraduate education in bioethics”, BioScience 54: 942-9. Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 20. 20 Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics Section A. Bioethics and the Ethics of Science and Technology Chapter A1: Making Choices, Diversity and Principles of Bioethics There are numerous books and materials on bioethics, and these are written in many languages. Often newspapers and magazines have discussed these issues, and the cases in those articles can be useful to stimulate students. In these teaching materials there are numerous examples from different topics that can be used to show bioethics in real situations. There are also a number of institutions offering bioethics courses, and some distance learning courses targeted to persons of particular value systems, such as the Jesuit Distance Education Network, Center for Online Bioethics Education [http://www.ajcunet.edu/distanceeducation.aspx?bid=543]. Some of these sites offer their own exclusive bioethics resources, but these are not openly available. One of the new sites on bioethics education that has not adopted an open access approach is the BioEthics Education Project [http://www.beep.ac.uk/content/index.php]. BEEP is funded by the Wellcome Trust and is based at the Graduate School of Education, University of Bristol, UK. The introduction reads well, saying: "It is an interactive website and virtual learning environment for secondary school science teachers and their students. It is a teaching resource developed to highlight the moral, ethical, social, economic, environmental and technological implications and applications of biology." It also is aimed at web-based evaluation, "BEEP is also a research project; we aim to investigate whether online discussion can be used successfully to support school science teachers. Thus use of the website will be evaluated by researchers at the University of Bristol. Data on method of use and user opinion will be collected and documents and presentations may be published concerning the project. However, end user contribution will be anonymised so that no individual or school will be identifiable in such publications." It provides a list of topics and ties these to several UK school curricula. The copyright clause is restrictive however, stating: "Pages on BEEP are protected by copyright. No images, parts of images, or any other part of our website may be permanently copied or reproduced in any form or reproduced on any other website or stored in or transmitted to or from any other electronic or digital form in whole or in part without our prior written permission. In addition you may not alter, manipulate, add to or delete an image or any part of an image. You may access and download the contents of these pages and store a copy of them on a temporary basis for the sole purpose of viewing those pages." Thus for teachers to store, modify the pages to be suitable for their own local needs, use them, and place the pages on their own websites would be breaking this copyright. Download a copy of the UNESCO Universal Declaration on Bioethics and Human Rights, and make an analysis of this framework that was agreed by all member countries of the world in October 2005 for bioethics. <http://eubios.info/udbhr.pdf> Online resources See papers on the Eubios Ethics Institute website, including News in Bioethics and Biotechnology <http://eubios.info/NBB.htm> UNESCO Ethics home page <http://www.unesco.org/ethics> UNESCO Bangkok SHS home page <http://www.unescobkk.org/index.php?id=1313"> There are several internationally agreed declarations on bioethics that are useful for Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 21. Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics 21 background, including: UNESCO Universal Declaration on the Human Genome and Human Rights (1997; Chapter C9) <http://eubios.info/unesco.htm> UNESCO Universal Declaration on Bioethics and Human Rights (19 October, 2005) <http://eubios.info/udbhr.pdf> UNESCO, Establishing Bioethics Committees, 2005 72pp. <http://eubios.info/UNESCO/ebc.pdf> Bergstrom, Philip, ed, Ethics in Asia-Pacific, 2004, 372pp. <http://eubios.info/UNESCO/ethap.pdf> UNESCO, The Precautionary Principle, COMEST Precautionary Principle Expert Group, 2005 <http://eubios.info/UNESCO/precprin.pdf> Report on Nanotechnology, COMEST Nanotechnology and ethics expert group, 2005 <http://eubios.info/UNESCO/nano.pdf> UNESCO International Bioethics Committee, Report of the IBC on the Possibility of Elaborating a Universal Instrument on Bioethics (2003), Giovanni Berlinguer and Leonardo De Castro (Rapporteurs) <http://eubios.info/UNESCO/ibc2003.pdf> UNESCO International Bioethics Committee, Report of the IBC on Pre-implantation Genetic Diagnosis and Germ-line Intervention (2003), Hans Galjaard (Rapporteur) <http://eubios.info/UNESCO/ibc2003ip.pdf> UNESCO International Bioethics Committee, Human Genetic Data: Preliminary Study by the IBC on its Collection, Processing, Storage and Use (2002), Sylvia Rumball and Alexander McCall Smith (Rapporteurs) <http://eubios.info/UNESCO/ibc2002.pdf> UNESCO International Bioethics Committee, Report of the IBC on Ethics, Intellectual Property and Genomics (2002), Justice Michael Kirby (Rapporteur) <http://eubios.info/UNESCO/ibc2002ip.pdf> UNESCO International Bioethics Committee, Report of the IBC on Solidarity and International Co-operation between Developed and Developing Countries concerning the Human Genome (2001), Mehmet Öztürk (Rapporteur) <http://eubios.info/UNESCO/ibc2001.pdf> UNESCO International Bioethics Committee, The Use of Embryonic Stem Cells in Therapeutic Research (2001), Alexander McCall Smith and Michel Revel (Rapporteurs) <http://eubios.info/UNESCO/ibc2001sc.pdf> UNESCO International Bioethics Committee, Report on Confidentiality and Genetic Data (2000), Working Group of the IBC on Confidentiality and Genetic Data <http://eubios.info/UNESCO/ibc2000.pdf> UNESCO International Bioethics Committee, Ethical Considerations Regarding Access to Experimental Treatment and Experimentation on Human Subjects (1996), Harold Edgar and Ricardo Cruz-Coke (Rapporteurs) <http://eubios.info/UNESCO/ibc1996.pdf> UNESCO International Bioethics Committee, Food, Plant Biotechnology and Ethics (1995), Darryl Macer (Rapporteur) <http://eubios.info/UNESCO/ibc1995pg.pdf> UNESCO International Bioethics Committee, Bioethics and Human Population Genetics Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 22. 22 Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics Research (1995), Chee Heng Leng, Laila El-Hamamsy, John Fleming, Norio Fujiki, Genoveva Keyeux, Bartha Maria Knoppers and Darryl Macer <http://eubios.info/UNESCO/ibc1995pg.pdf> UNESCO International Bioethics Committee, Genetic Counselling (1995), Michel Revel (Rapporteur) <http://eubios.info/UNESCO/ibc1995gc.pdf> UNESCO International Bioethics Committee, Ethics and Neurosciences (1995), Mr Jean- Didier Vincent (Rapporteur) <http://eubios.info/UNESCO/ibc1995ns.pdf> UNESCO International Bioethics Committee, Report on Human Gene Therapy (1994), Mr Harold Edgar and Mr Thomas Tursz (Rapporteurs) <http://eubios.info/UNESCO/ibc1994.pdf> UNESCO International Bioethics Committee, Report on Genetic Screening and Testing (1994), Mr David Shapiro (Rapporteur) <http://eubios.info/UNESCO/ibc1994gs.pdf> UNESCO International Bioethics Committee, Advice of the IBC on the Patentability of the Human Genome, 2001. <http://eubios.info/UNESCO/ibcpatent.pdf> See links < http://eubios.info/Info.htm> Site: Joint Centre for Bioethics (University of Toronto) WWW: http://www.utoronto.ca/jcb/Resources/resources.html Site: Council of Europe Home Page WWW: http://www.coe.fr/oviedo/edito-e.htm Site: National Consultative Ethics Committee for Health and Life Sciences (France) WWW: http://www.ccne-ethique.org/home.htm Site: Library of Bioethics and Medical Humanities Texts and Documents WWW: http://wings.buffalo.edu/faculty/research/bioethics/texts.html Site: National Bioethics Advisory Commission (Former one, USA) WWW: http://bioethics.gov Site: Nuffield Council on Bioethics WWW: http://www.nuffield.org/bioethics/ Site: Online Ethics Center for Engineering and Science (Case Western Reserve University) WWW: http://onlineethics.org/index.html Site: Distance Learning Programs of Study (Medical College of Wisconsin) WWW: http://www.mcw.edu/bioethics/depage.html Site: Ethics Updates (University of San Diego Values Institute) WWW: http://ethics.acusd.edu Site: Syllabus Exchange Catalog (Kennedy Institute of Ethics) WWW: http://www.georgetown.edu/research/nrcbl/syllabus/ Site: Kennedy Institute of Ethics, High School Bioethics Project WWW: http://bioethics.georgetown.edu/hsbioethics/ Site: The University of Pennsylvania High School Bioethics Project WWW: http://bioethics.net/hsbioethics/ Site: National Health Museum, Access Excellence: Issues and Bioethics WWW: http://www.accessexcellence.org/AB/IE/ Site: McGraw Hill General and Human Biology: Bioethics Case Studies WWW:http://www.mhhe.com/biosci/genbio/olc_linkedcontent/bioethics_cases/index.html Site: Howard Hughes Medical Institute Bulletin Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 23. Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics 23 WWW: http://www.hhmi.org/bulletin/mar2002/ethics/highschool.html Further reading Tom Beauchamp and James Childress (2001) Principles of Biomedical Ethics. Fifth Edition. Oxford University Press, Oxford. Chapter A2: Ethics in history and love of life Background This chapter is designed to give students a more theoretical background to different theories of ethics. It is written at a higher level than chapter A1, to give some references to ethics theories especially for students who have not had a detailed background in ethical theories. Further reading Darryl Macer (1998) Bioethics is Love of Life. Eubios Ethics Institute. Available on-line in English and Japanese translation. <http://eubios.info/bll.htm> Chapter A3: Moral agents Background This chapter is designed to introduce ways to distinguish between different living organisms, and other beings, in terms of their moral status. The concept of moral status is central to whether a being can be ascribed intrinsic moral values in ethical debates. The chapter opens the way for teachers to examine more controversial issues in bioethics, then those described in the textbook, for example, the moral status of the human embryo. It is best to consider chapter A3 before doing A4. Perhaps the most important lesson to learn is that life is not so easy, and neither is bioethics. To make an ethical decision means balancing alternatives, and benefits and risks of harm. One way to do this is to think about the factors that are involved on each side before making decisions. Different people may do this a little differently; perhaps the final question of animal rights is how much right do people have to choose different answers. Further reading Darryl Macer (1998) Bioethics is Love of Life. Eubios Ethics Institute. Available on-line in English and Japanese translation. <http://eubios.info/bll.htm> Chapter A4: Ethical Limits of Animal Use Background In a survey of bioethical issues conducted in Australia, New Zealand and Japan in 1993, there was much division over whether animal experiments were necessary or not. Some teachers took strong positions on either side of the question whether some animal experiments are Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 24. 24 Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics necessary to teach biology in high school. There are also many types of experiment, for example, observation in nature, in the class, dissection, and some experiments were described that caused painful death to vertebrates. The purpose of this summary is not to take sides, but we should ask the question what type of experiment is necessary, and how much is learnt. One key lesson for students is moderation and balancing. Rather than having extreme views being argued in the class this issue allows students to imagine what it is like to be another animal. It is not likely that anyone will actually go on to do experiments on chimpanzees in their life. However, it is extremely likely that everyone will eat fish, swat a fly, cook a steak, use products or drugs developed with animal experiments, and at least use the money supported by exports of animal products for your education. If you are studying biology, you probably want to understand how animals can live, and sometimes you need to see animal experiments, whether in life, or on video, or in a book. The impressions from each example can be different. The data being obtained from animal experiments does have implications for all thinking beings about our place in the world, so the issue can be related to many topics. Absolutes are often difficult, but it is ethically important to make balanced choices. It is ethically consistent to try to use lower organisms, cells, or computer models for animal experiments; but at some stage of testing, both animal and human trials are necessary. What is a scientific question? Bioethics must have a basis from all data, including reasoning, philosophy and biological knowledge. Bioethics considers both biological data and values. There are many non-scientific questions, like ‘What is the value of life?’, ‘What is the value of love?’, and ‘What is the meaning of existence?’. Scientific questions are those we can disprove by experiment; whereas, there are many issues in bioethics that we cannot test in the laboratory. A scientific question would be to examine how similar the DNA of humans, chimpanzees and mice are. The complete genome sequence of mice and humans is known, and available on the Internet. Comparisons of chimpanzee genome and humans reveal 99% similarity, and that there may be few different genes between these two species. Up to 75% of the 30,000 genes that both chimpanzees and humans have may be involved in determining our behaviour. Further information There are numerous books and materials on animal experiments and animal rights, and these are written in many languages. Often they are written from the extreme support or extreme protest against animal use. Often newspapers and magazines have discussed these issues, and the cases in those articles can be useful to stimulate students. In these teaching materials there are numerous examples from different topics that can be used to show bioethics in real situations. Online resources See papers on the Eubios Ethics Institute website, including News in Bioethics and Biotechnology < http://eubios.info/NBB.htm > See links < http://eubios.info/Info.htm > Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 25. Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics 25 There are many resources on the use of animals, and it is interesting to compare materials produced by organisations on the extremes of this debate with each other. Videos may be available from many animal rights or medical research supporting organisations in your local country. Chapter A5: Ethics and Nanotechnology Background Nanotechnology is a new area of science and technology that is being widely supported. The application of the precautionary principle to consider this is one of the emerging trends in new areas of science and technology. Further reading Air Force Science and Technology Board (2002) Implications of Emerging Micro and Nanotechnology. National Academies Press. Baum, Rudy, ed. (2003) Point – Counterpoint: Nanotechnology: Drexler and Smalley Make the Case For and Against ‘Molecular Assemblers’. Chemical and Engineering News 81:48 pp.37-42 Bergstrom, Philip, ed, Ethics in Asia-Pacific, 2004, 372pp. <http://eubios.info/UNESCO/ethap.pdf> BioThailand (2005) The International Conference in BioNanotechnology. In: BioThailand 2005 Book of Abstracts. National Center for Genetic Engineering and Biotechnology, National Science and Technology Development Agency, and Ministry of Science and Technology. Bangkok. p.1-42 COMEST Report on Nanotechnology, COMEST Nanotechnology and ethics expert group, 2005 <http://eubios.info/UNESCO/nano.pdf> Drexler, K. Eric (1986) Engines of Creation: The Coming Era of Nanotechnology. Anchor Books, Doubleday, NY/London/Toronto/Sydney/Auckland. 299pp. Drexler, K. Eric (1992) Nanosystems: Molecular Machinery, Manufacturing and Computation. Wiley Interscience. 576pp. Freitas, Robert A. Jr. (1999) Nanomedicine: Volume I - Basic Capabilities. Landes Bioscience, Georgetown, Texas. See full text at www.nanomedicine.com/NMI.htm Feynman, Richard P. (1960) There’s Plenty of Room at the Bottom. Engineering and Science Volume 23, No.5. See text at www.zyvex.com/nanotech/feynman.html Joy, Bill (2000) Why the Future Doesn’t Need Us. Wired 8.04: 238-263 and see online: www.wired.com/wired/archive/8.04/joy.html Kelly, Kevin (1994) Out of Control: The New Biology of Machines. Fourth Estate, London and Addison Wesley, USA. 666 pp. Nalwa, Hari Singh, ed. (2004) Encyclopedia of Nanoscience and Nanotechnology. American Scientific Publishers. 10 volumes, ~10,000 pp. National Academy of Engineering (2004) The Engineer of 2020: Visions of Engineering in the New Century. National Academies Press. National Academy of Sciences (2004) Emerging Technologies and Ethical Issues in Engineering: Papers from a Workshop, October 14-15, 2003. National Academies Press. National Nanotechnology Initiative (2002) Small Wonders, Endless Frontiers: A Review of the Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 26. 26 Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics National Nanotechnology Initiative. National Academies Press. See www.nano.gov National Academy of Engineering (2005) Tenth Annual Symposium on Frontiers of Engineering. Rob Phillips, ed., National Academies Press. Regis, Ed (1995) Nano! Bantam Books, Toronto, New York, London & Sydney. 307pp. Scientific American (2001) Nanotechnology Special Issue. Scientific American September 2001, 94pp. See www.sciam.com/nanotech Smalley, Richard (2002) Oral Testimony given before the US House of Representatives Subcommittee on Science on Future Directions of the DOE Office of Science. 1-4. See also the Smalley Group – Rice University website: http://smalley.rice.edu UNESCO, The Precautionary Principle, COMEST Precautionary Principle Expert Group, 2005 <http://eubios.info/UNESCO/precprin.pdf> Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 27. Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics 27 Section B. Environmental Ethics Chapter B1: Ecology and Life Sample answer to Student Activity Basic network diagram showing flows of energy and matter through a simple ecosystem (extra marks for additional features; for example cycles of respiratory and photosynthetic gases, or even the role of the caterpillar in pollination after metamorphosis). Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 28. 28 Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics Further reading Begon, Michael, Harper, John L. and Townsend, Colin R. (1986) Ecology: Individuals, Populations and Communities. Blackwell Scientific Publications, Oxford. 876pp. Bentley, Peter J. (2001) Digital Biology. Headline Book Publishing, London. 277pp. Capra, Fritjov (1997) The Web of Life: A New Synthesis of Mind and Matter. Flamingo, HarperCollins, London. 320pp. Carson. Rachel (1962) Silent Spring. Penguin Books, London. 317pp. Cohen, Jack and Stewart, Ian (1994) The Collapse of Chaos: Discovering Simplicity in a Complex World. Penguin Books, London. 495pp. Cousteau, Jacques (1953) The Silent World. Penguin Books, London. 156pp. Croall, Stephen and Rankin, William (1981) Ecology for Beginners. Pantheon Books, New York. 175pp. Darwin, Charles R. (1859) On The Origin of Species by Means of Natural Selection. John Murray, London. Dawkins, Richard (1989) The Selfish Gene. New Edition. Oxford University Press, Oxford. 352pp. (first published 1976) Deutsch, David (1997) The Fabric of Reality. Penguin Books, London. 390pp. Dyson, George (1997) Darwin Among the Machines. Penguin Books, London. 286pp. Gould, Stephen Jay (1989) Wonderful Life: The Burgess Shale and the Nature of History. W.W. Norton, New York. Johnson, Steven (2001) Emergence: The Connected Lives of Ants, Brains, Cities and Software. Penguin Books, London. 288pp. Keeton, William T. and Gould, James L. (1986) Biological Science. Fourth Edition. Norton International Student Edition, W.W. Norton, New York. 1175pp. Lewin, Roger (1993) Complexity: Life at the Edge of Chaos. Phoenix Paperbacks, London. 234pp. Margulis, Lynn and Sagan, Dorion (1995) What Is Life? Weidenfeld and Nicolson, London. 207pp. O'Connor, Joseph and McDermott, Ian (1997) The Art of Systems Thinking. Thorson's, HarperCollins, London. 265pp. Ridley, Matt (1996) The Origins of Virtue. Viking, London. Weber, Walter J. Jr. (2001) Environmental Systems and Processes: Principles, Modeling and Design. Wiley-Interscience, John Wiley & Sons, New York. 556pp. Wilson, Edward O. (1992) The Diversity of Life. Penguin Books, London. 406pp. Chapter B2: Biodiversity and Extinction Further reading Briggs, John C. (1994) Mass Extinctions: Fact or Fallacy? In: Glen, William, ed. Mass Extinction Debates: How Science Works in a Crisis. Stanford University Press. p.230-236 Caughley, Graeme (1994) Review: Directions in Conservation Biology. J. Animal Ecology 63: 215-244 Frankham, Richard, Ballou, Jonathan D. and Briscoe, David A. (2002) Introduction to Conservation Genetics. Cambridge University Press, Cambridge. 617pp. Gould, Stephen J. and Eldridge, Niles. (1993) Punctuated Equilibrium Comes of Age. Nature 366: 223-227 Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 29. Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics 29 Hoegh-Guldberg, Hans, and Hoegh-Guldberg, Ove (2004) The Implications of Climate Change for Australia's Great Barrier Reef. WWF Australia and Qld Tourism Industry Council. I.U.C.N. (World Conservation Union) (1994) IUCN Red List Categories (As Approved by the 40th Meeting of the IUCN Council). Species Survival Commission, I.U.C.N., Gland, Switzerland. 21pp. Jeffries, Michael J. (1997) Biodiversity and Conservation. Routledge Introductions to Environment Series, London & NY. 208pp. Leakey, Richard and Lewin, Roger (1996) The Sixth Extinction: Biodiversity and its Survival. Phoenix, Orion Books, London. 271pp. Mollison, Bill (1988) Permaculture: A Designers’ Manual. Tagari Publications, Tyalgum NSW. 576pp. Raven, P.H (1990) The Politics of Preserving Biodiversity. BioScience 40: 769-74 Rees, Martin (2003) Our Final Century. Will Civilization Survive the Twenty-First Century? Arrow Books, Random House, London. 228pp. Shiva, Vandana (1991) Ecology and the Politics of Survival. UN University Press, New Delhi. Van Valen, Leigh (1994) Concepts and the Nature of Selection by Extinction: Is Generalization Possible? In: Glen, William, ed. Mass Extinction Debates: How Science Works in a Crisis. Stanford University Press. p.200-216. Ward, Peter (1995) The End of Evolution: Dinosaurs, Mass Extinction and Biodiversity. Weidenfeld & Nicholson, Orion Publishing Group, London. 302pp. Wilson, Edward O. (1992) The Diversity of Life. Penguin Books, London. 406pp. Wilson, Edward O. (2002) The Future of Life. Little Brown/Abacus, London. 232pp. Chapter B3: Ecological Ethics Further reading Chief Seattle, Chief of the Dwamish (1854) Response upon Surrendering His Land to Governor Isaac Stevens in 1854. Cocks, Doug (2003) Deep Futures - Our Prospects for Survival. University of New South Wales Press, Sydney, & McGill-Queens University Press, Montreal. 332pp Cooper, N.S. and Carling, R.C.J., eds. (1996) Ecologists and Ethical Judgements. Chapman & Hall, London. Eckersley, Richard, ed. (1998) Measuring Progress: Is Life Getting Better? C.S.I.R.O. Publishing, Collingwood, Vic., Australia. 382pp. Harding, Ronnie, ed. (1998) Environmental Decision-Making: The Roles of Scientists, Engineers and the Public. The Federation Press, Leichhardt, NSW. 366pp. Hayward, Tim (1994) Ecological Thought: An Introduction. Polity Press, Blackwell, Cambridge. Hertsgaard, Mark (1999) Earth Odyssey: Around the World in Search of Our Environmental Future. Abacus, London. 372pp. Light, Andrew and Rolston, Holmes III, eds. (2003) Environmental Ethics: An Anthology. Blackwell Philosophy Anthologies, Blackwell, Malden, Oxford, Melbourne & Berlin. 526pp.+index Lovelock, James (1979) Gaia: A New Look at Life On Earth. Oxford University Press, Oxford. 157pp. Macer, Darryl (1998) Bioethics Is Love of Life: An Alternative Textbook. Eubios Ethics Institute, Christchurch & Tsukuba.160pp. Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 30. 30 Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics Myers, Norman, ed. (1984) Gaia: An Atlas of Planet Management. Gaia Books, Anchor, Doubleday, New York. 272pp. Pollard, Irina (2002) Life, Love and Children: A Practical Introduction to Bioscience Ethics and Bioethics. Kluwer Academic Publishers, Boston. 269pp. Roszak, Theodore (1992) The Voice of the Earth. Touchstone, Simon & Schuster, New York. 367pp. Seuss, Dr. (1971) The Lorax. Random House, New York. Singer, Peter (1975) Animal Liberation. New York Review/Random House, New York. Suzuki, David and McConnell, Amanda (1997) The Sacred Balance: Rediscovering Our Place in Nature. Allen & Unwin, St. Leonards, NSW. 261pp. Chapter B4: Environmental Science Online resources A.C.F. (Australian Conservation Foundation) web site: www.peg.apc.org/~acfenv/ American Library Association Task Force on the Environment: www.ala.org/alaorg/rtables/srrt/tfoe/ Australian Coastal Atlas web site: www.environment.gov.au/marine/coastal_atlas Australian Geographer: www.tandf.co.uk/journals Australian National Trust: www.austnattrust.com.au Bat Conservation International: www.batcon.org/ Best Environmental Directories (for over 600 environmental subjects): www.ulb.ac.be/ceese/ meta/cds.html Biodiversity (Australian govt.): www.biodiversity.environment.gov.au/plants /threaten/action_plans/ BioOne: www.BioOne.org Center for International Earth Science Information Network (CIESIN): www.ciesin.org/ CogniScope (global systems analysis method): www.cwaltd.com/index1.htm Columbia Earthscape: www.earthscape.org Community Biodiversity Network (Earth Alive!): www.cbn.org.au Data Libraries & Archives Online: www.datalib.ubc.ca/datalib/gen/data_libr.html Destination Earth Program (NASA): www.earth.nasa.gov/ Earth Day Network: www.earthday.net Earth Garden Books: www.earthlink.com.au/earthgarden Earth Network: www.ecouncil.ac.cr Earth Observing System (NASA): http://eos.nasa.gov/imswelcome Earth Viewer: www.fourmilab.ch/earthview/vplanet.html Earthquake Information: www.civeng.carleton.ca/cgi-bin/quakes/ Earthwatch: http://gaia.earthwatch.org/ and www.earthwatch.org/ Ecology Action Centre: www.cfn.cs.dal.ca/Environment/EAC?EAC-Home.html Ecotourism Society web site: www.ecotourism.org Eco-Village Information Service: www.gaia.org/ EnviroLink: http://envirolink.org and www.envirolink.org:/start_web.html EnviroNet (E.R.I.N. Australia): www.erin.gov.au/net/neid.html and www.erin.gov.au/net.environet.html Environment Australia (Australian Government): www.environment.gov.au Environment Education Resource Directory (Australia): www.environment.gov.au/net/aeen.html Environment Canada: www.atlenv.bed.ns.doe.ca/ Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 31. Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics 31 Environmental Defense: www.environmentaldefense.org Environmental Journals & Serials Online: http://155.187.10.12/library/serials.html Environmental Law Alliance Worldwide: www.igc.org/elaw/ Environmental Network Room (environmental scepticism links): http://environmental.networkroom.com/directorybytopic/myths/ Environmental Organisation Directory and Search Engine: www.webdirectory.com Environmental Weeds Home Page (Australia): http://weeds.merriweb.com.au The Environmentalist (journal): www.wkap.nl/journals/environmentalist E.P.A. (Environmental Protection Agency, U.S.): www.epa.gov/ E.R.I.N. (Environmental Resources Information Network, Australia) Environment Portfolio: www.erin.gov.au/portfolio/environment/env_port.html Gaia Forest Conservation Archives: http://forests.org/gaia.html Geological Society of America (GSA): www.geosociety.org Global Change Data and Research Program: www.gcdis.usgcrp.gov and www.usgcrp.gov Global Change Research Information Office: www.gcrio.org/ Global Change Master Directory (NASA): http://gcmd.gsfc.nasa.gov/ and http://gcmd.nasa.gov/ Gould League: www.schnet.edu.au/ Green Cross International: www.gci.ch Green Net (green charities): www.green.net.au Green Net (UK/European Focus): www.gn.apc.org Green Page: www.vcomm.net/enviro/greenpg.html Greenpeace International web site: www.greenpeace.org Journal of Bioeconomics: www.wkap.nl/journals/journal.bioeconomics Journal of Environmental Planning & Management: www.tandf.co.uk/online.html Journal of Risk and Uncertainty: www.wkap.nl/journals/jru N.A.S.A. (U.S. National Aeronautics & Space Administration): www.nasa.gov National Parks & Wildlife Service (N.S.W. Plans of Management): www.npws.nsw.gov.au/news/exhibition/POM/index.html Natural Resources Management Project: www.nrm.or.id N.S.W. Environmental Impact Assessments: www.duap.nsw.gov.au/eis~2.htm Planet Ark (Reuters environmental news): www.planetark.org Planet Earth Home Page: www.planetearth.net/info.html and www.nosc.mil/ planet_earth/info.html Rainforest Action Network: www.ran.org Remotely Sensed Land Data: http://ghrc.msfc.nasa.gov/ Science (journal): www.sciencemag.org Society of Environmental Journalists: www.sej.org Space Calendar: www.jpl.nasa.gov/calendar/ State of the Environment & Indicators Technical Papers: www.erin.gov.au/environment/epcg/soe.html State of the Environment Report (Australia): www.environment.gov.au/epcg/soe/soe96/soe96.html Urban Ecosystems: www.wkap.nl/journals/urban_ecosystems Water Quality and Ecosystem Modeling: www.wkap.nl/journals/waterqual World Conservation Monitoring Centre: www.wcmc.org.uk/ World Data Center-A for Remotely Sensed Land Data: http://ghrc.msfc.nasa.gov/ World Wide Web Resources - Environment (directory): www.uky.edu/Subject/environment.htm#a11 Worldwatch Institute: www.worldwatch.org Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 32. 32 Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics Further reading Barrow, John D. (1998) Impossibility: The Limits of Science and the Science of Limits. Vintage, Random House, London. 279pp. Barrow, C. J. (2000) Social Impact Assessment: An Introduction. Arnold Publishers & Oxford University Press, London/New York. 222pp.+index Buchanan, Mark (2000) Ubiquity: The Science of History. Phoenix, London. 230pp. Chalmers, A.F. (1999) What is this thing called Science? Third Edition. University of Queensland Press, St Lucia. 266pp. first published 1976 Clark, John R. (1996) Coastal Zone Management Handbook. Lewis Publishers, CRC Press, Boca Raton, Fl. 694pp. Cocks, Doug (2003) Deep Futures - Our Prospects for Survival. University of New South Wales Press, Sydney, & McGill-Queens University Press, Montreal. 332pp Dodge, Martin and Kitchin, Rob (2001) Mapping Cyberspace Routledge, London 260pp Eckersley, Richard, ed. (1998) Measuring Progress: Is Life Getting Better? C.S.I.R.O. Publishing, Collingwood, Vic., Australia. 382pp. Fairweather, Peter G. (1989) Environmental Impact Assessment: Where is the Science in EIA? Search 20(5): 141-144 Falconer, Allan and Foresman, Joyce (2002) A System for Survival: GIS and Sustainable Development. ESRI Press, Redlands, California. 116pp. Glasson, John, Therivel, Riki and Chadwick, Andrew (1994) Introduction to Environmental Impact Assessment: Principles and Procedures, Process, Practice and Prospects. UCL Press, University College, London. Hall, Stephen S. (1992) Mapping the Next Millennium: How Computer-Driven Cartography is Revolutionizing the Face of Science. Vintage, Random House, New York. 477pp. Harding, Ronnie, ed. (1998) Environmental Decision-Making: The Roles of Scientists, Engineers and the Public. The Federation Press, Leichhardt, NSW. 366pp. Hilborn, Ray and Walters, Carl J. (1981) Pitfalls of Environmental Baseline and Process Studies. EIA Review 2/3: 265-278 Horn, Robert V. (1993) Statistical Indicators for the Economic and Social Sciences. Cambridge University Press, Cambridge. 227pp. Huggett, Richard J. (1993) Modelling the Human Impact on Nature: Systems Analysis of Environmental Problems. Oxford University Press, Oxford. 202pp. I.P.C.C. (Intergovernmental Panel on Climate Change) (1990) Climate Change: The I.P.C.C. Scientific Assessment. Houghton, J.T., Jenkins, G.J. and Ephraums, J.J. (eds.) World Meteorological Organization & United Nations Environment Programme. Cambridge University Press, Cambridge. 365pp. I.U.C.N. (World Conservation Union) (1994) Guidelines for Protected Area Management Categories. Commission on National Parks and Protected Areas and World Conservation Monitoring Centre for the I.U.C.N., Gland, Switzerland. 261pp. Jackson, K.F. (1975) The Art of Solving Problems. Hodder & Stoughton, London. 244pp. Jacobson, Harold K. and Price, Martin F. (1990) A Framework for Research on the Human Dimensions of Global Environmental Change. ISSC/UNESCO Series 3, International Social Science Council with UNESCO. 71pp. Kuhn, Thomas (1970) The Structure of Scientific Revolutions. Second edition. University of Chicago Press, Chicago. (First edition published 1962). Leopold, Luna B., Clarke, Frank, Hanshaw, Bruce and Balsley, James (1971) A Procedure for Evaluating Environmental Impact. U.S. Dept of the Interior, Geological Survey Circular 645: 1-13 Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 33. Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics 33 Lomborg, Bjørn (2001) The Skeptical Environmentalist -Measuring the Real State of the World. Cambridge University Press. 515pp. (originally published 1998 in Danish). See also links at: Jim Norton, ed. Correcting Myths from Bjørn Lomborg, http://info- pollution.com/lomborg.htm and Anti-Lomborg.com links at: http://www.mylinkspage.com/lomborg.html Maltby, Edward (1997) Ecosystem Management: The Concept and the Strategy. World Conservation 3/97: 3-4 Mayer, Richard E. (1992) Thinking, Problem Solving, Cognition. Second Edition. W.H. Freeman & Company, New York. 560pp. McNeill, John (2000) Something New Under the Sun: an Environmental History of the Twentieth Century. Penguin Books, London. 421pp. Milner-Gulland, E.J. and Mace, R., eds. (1998) Conservation of Biological Resources. Blackwell Science Ltd, Oxford. National Research Council (1996) Linking Science and Technology to Society’s Environmental Goals: National Forum on Science and Technology Goals. National Research Council Policy Division, Washington DC. 520pp. See fulltext link at: www.nap.edu/readingroom/records/EV.html Orians, Gordon H. (1986) The Place of Science in Environmental Problem Solving. Environment 28(9): 12-41 Peine, John D., ed. (1999) Ecosystem Management for Sustainability: Principles and Practices Illustrated by a Regional Biosphere Reserve Cooperative. C.R.C Press L.L.C./Lewis Publishers, Boca Raton, Fl. Pollard, Morgan (2004) The Modeling of Sustainable Development and its Relevance to a Human Ideas Map for Bioethics. In: Macer, Darryl, ed. Challenges for Bioethics from Asia. Eubios Ethics Institute, Christchurch & Tsukuba. p.151-169 Saunders, D.A, Margules, C.R. and Hill, B. (1998) Environmental Indicators for National State of the Environment Reporting - Biodiversity. Australia: State of the Environment (Environmental Indicator Reports). Environment Australia, Department of the Environment, Canberra. 69pp. Turban, E. and Aronsen, J.E. (1998) Decision Support Systems and Intelligent Systems. 5th Edition. Prentice-Hall International, Upper Saddle River, New Jersey. 890pp. Union of Concerned Scientists (1992) World Scientists’ Warning to Humanity. Published on Internet at: www.ucsusa.org/ucs/about/page.cfm?pageID=1009 Wakeford, Tom and Walters, Martin, eds. (1995) Science for the Earth: Can Science Make the World a Better Place? John Wiley & Sons, Chichester. 370pp. Wathern, Peter, ed. (1988) Environmental Impact Assessment: Theory and Practice. Unwin & Hyman, London. Wolpert, Lewis (1992) The Unnatural Nature of Science. Faber & Faber, London.188pp. Wood, C., Dipper, B. and Jones, C. (2000) Auditing the Assessment of the Environmental Impacts of Planning Projects. J. Environ. Planning & Mgmt 43(1): 23-47 Chapter B5: Environmental Economics Teachers notes for a suggested Student Activity: Distribute to each student transparencies or photocopies of the two tables ‘Progressive Evolution of Ecological Ethics’ (Bioethics of Biodiversity chapter) and ‘Progressive Evolution of Environmental Ethics’ (Environmental Economics chapter). The tables show the progress of thought in ecological and environmental ethics from current conservative human behaviour Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 34. 34 Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics (generally somewhere on the left side of the tables) through to more ecologically progressive philosophies required for a brighter environmental future (towards the right side). Each student can identify and fill in boundaries (or ranges, in different colours) on their copies of the tables (i.e. wavy boundary lines from top to bottom), which represent their own estimates of general progress across the tables for: a) observed current human behaviours worldwide b) desired future human behaviours (ideal or preferred range of viewpoints) if it were possible for future global society From the overlay of these two ranges on top of each other, the important region of ‘unrecognised hopes for the future’ can be identified (as in the simplified sample answer). Combine all the student estimates into average ranges for the class, and determine whether their observations of current progress coincide with their wishes for future human progress. In students today, is there a significant gap between the status quo and their hopes for progress in ecological and environmental ethics? Remember there are no strictly right or wrong answers in philosophical issues. Further Reading Ayres, Robert (1996) Statistical Measures of Unsustainability. Ecological Economics 16: 239-255 Bartelmus, Peter (1994) Environment, Growth and Development: The Concepts and Strategies of Sustainability. Routledge, London & New York. 163pp. Bentham, Jeremy (1781) An Introduction to the Principles of Morals and Legislation. Bircham, Emma and Charlton, John, eds. (2001) Anti-Capitalism: A Guide to the Movement. Bookmarks Publications Ltd, London & Sydney. 409pp. Boulding, Kenneth (1966) The Economics of the Coming Spaceship Earth. In: H. Jarrett, ed., Environmental Quality in a Growing Economy. Johns Hopkins University Press, Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 35. Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics 35 Baltimore. Boyden, Stephen, Dovers, Stephen and Shirlow, Megan (1990) Our Biosphere Under Threat: Ecological Realities and Australia’s Opportunities. Oxford University Press, Oxford. 347pp. Brennan, Andrew (1996) Ethics, Ecology and Economics. In: Cooper, N.S. and Carling, R.C.J., eds. Ecologists and Ethical Judgements. Chapman & Hall, London. 13-26 Brown, Paul and Cameron, Linda (2000) What Can be Done to Reduce Overconsumption? Ecological Economics 32: 27-41 Cavanagh, John, and Mander, Jerry, eds. (2004) Alternatives to Economic Globalization: A Better World is Possible. Second edition. A Report of the International Forum on Globalization. Berrett-Koehler Publishers, San Francisco. 408pp. Cocks, Doug (1999) Future Makers, Future Takers - Life in Australia 2050. University of New South Wales Press, Sydney. 332pp. Cocks, Doug (2003) Deep Futures - Our Prospects for Survival. University of NSW Press, Sydney, and McGill-Queens University Press, Montreal. 332pp. Cohen, Joel E. (1995) How Many People can the Earth Support? Norton Paperbacks, New York & London. 507pp.+index Colby, M.E. (1991) Environmental Management in Development: The Evolution of Paradigms. Ecological Economics 3: 193-213 Common, Mick (1995) What Is Ecological Economics? In: Australia & N.Z. Society for Ecological Economics/Centre for Agricultural & Resource Economics, Ecological Economics Conference Papers, Coffs Harbour, NSW. 1-16 Common, Michael (1988) Environmental and Resource Economics: An Introduction. Longman Group UK Ltd, Harlow, Essex. 316pp.+index Cowell, Richard (1997) Stretching the Limits: Environmental Compensation, Habitat Creation and Sustainable Development. Trans. Inst. Br. Geogr. 22: 292-306 Croall, Stephen and Rankin, William (1981) Ecology For Beginners. Pantheon Books, New York. 175pp. Daly, H. (1977) Steady State Economics. Freeman, San Francisco. Second Edition (1991) Island Press, New York. Davenport, Thomas H. (1997) Information Ecology: Mastering the Information and Knowledge Environment. Oxford University Press, Oxford. 255pp. Davies, John K. and Kelly, Michael P., eds. (1993) Healthy Cities: Research and Practice. Routledge, London & New York. 188pp. Eckersley, Richard, (1998) Perspectives on Progress: Economic Growth, Quality of Life and Ecological Sustainability. In: Eckersley, Richard, ed. Measuring Progress: Is Life Getting Better? C.S.I.R.O. Publishing, Collingwood, Victoria. 3-34; 382pp. Ehrlich, Paul and Ehrlich, Ann (1968) The Population Bomb. Ballantine Books, New York, and also (1990) The Population Explosion. Hutchinson, London. 320pp. Ellwood, Wayne (2000) Redesigning the Global Economy New Internationalist 320:7-10 George, Susan (1988) A Fate Worse than Debt: A Radical New Analysis of the Third World Debt Crisis. Penguin Books, London. 300pp. Goudzwaard, Bob and de Lange, Harry (1995) Beyond Poverty and Affluence: Toward an Economy of Care. William Eerdmans, Michigan, and World Council of Churches, Geneva.165pp. First published in Dutch 1986 Hamilton, Clive (1994) The Mystic Economist. Willow Park Press, Fyshwick, ACT. Hamilton, Clive (1998) Measuring Changes in Economic Welfare: The Genuine Progress Indicator for Australia. In: Eckersley, Richard, ed. Measuring Progress: Is Life Getting Better? C.S.I.R.O. Publishing, Collingwood, VIC. 69-92 Hamilton, Clive (2004) Growth Fetish. Allen & Unwin, Crows Nest, NSW. 262pp. Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 36. 36 Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics Handy, Charles (1989) The Age of Unreason. Arrow, Random House, London. 217pp. Handy, Charles (1998) The Hungry Spirit: Beyond Capitalism - A Quest for Purpose in the Modern World. Arrow Books, Random House, London. 272pp. Hardin, Garrett (1968) The Tragedy of the Commons. Science 162: 1243-1248 Hawken, Paul (1993) The Ecology of Commerce: A Declaration of Sustainability. Harper Business, New York. 250pp. Hawken, Paul, Lovins, Amory B. and Lovins, L. Hunter (2000) Natural Capitalism: The Next Industrial Revolution. Earthscan Publications, London. 397pp. Heilbroner, Robert (1953) The Worldly Philosophers: The Lives, Times and Ideas of the Great Economic Thinkers. Seventh Edition (2000) Penguin, London. 365pp. I.U.C.N. (World Conservation Union) (1995) Economic Assessment of Protected Areas: Guidelines for Their Assessment. Economic Benefits of Protected Areas Taskforce, Commission for National Parks & Protected Areas and Australian Nature Conservation Agency, on behalf of I.U.C.N., Gland, Switzerland. 142pp. LeGrain, Philippe (2002) Open World: The Truth about Globalisation. Abacus, London. Lowe, Ian (1998) Reporting on the State of Our Environment. In: Eckersley, Richard, ed. Measuring Progress: Is Life Getting Better? C.S.I.R.O. Publishing, Collingwood, VIC. 287-298 Malthus, Thomas Robert (1798) Essay on the Principle of Population. Marx, Karl (1867) Capital and also Marx and Engels (1848) The Communist Manifesto. McLuhan, Marshall and Powers, Bruce (1989) The Global Village: Transformations in World Life and Media in the 21st Century. Oxford University Press, Oxford & New York. 220pp. Meadows, Donella, Meadows, Dennis, Randers, Jorgen and Behrens, William III (1972) The Limits to Growth: A Report for the Club of Rome’s Project on the Predicament of Mankind. Newgate Press/Potomac Associates/Pan Books, London. 205pp. Meadows, Donella, Meadows, Dennis and Randers, Jorgen (1992) Beyond the Limits: Global Collapse or a Sustainable Future. Earthscan, London. 300pp. Meadows et al. (2005) The Limits to Growth: 30 Year Update. Mill, John Stuart (1857) Principles of Political Economy and also (1863) Utilitarianism. Monbiot, George (2003) The Age of Consent: A Manifesto for a New World Order. Flamingo, and Harper Perennial, London. 274pp Peet, John (1995) Energy and the Contributions of Georgescu-Roegen. In: Australia & N.Z. Society for Ecological Economics/Centre for Agricultural & Resource Economics, Ecological Economics Conference Papers, Coffs Harbour. 27-38 Rawls, John (1971) A Theory of Justice. Harvard University Press, Cambridge, Mass. Ricardo, D. (1817) Principles of Political Economy and Taxation. Roodman, David Malin (1998) The Natural Wealth of Nations: Harnessing the Market for the Environment. Worldwatch Environmental Alert Series, W.W. Norton, New York & London. 304pp. Sachs, Jeffrey, with foreword by Bono (2005) The End of Poverty: How We Can Make it Happen in Our Lifetime. Penguin Books, London. 397pp. Saul, John Ralston (1997) The Unconscious Civilization. CBC Massey Lectures Series, Penguin Books, Ringwood, VIC. 205pp. Saul, John Ralston (2005) The Collapse of Globalism and the Reinvention of the World. Viking, Penguin Group, Camberwell, Vic. 309pp. Saunders, D.A., Hobbs, R.J. and Margules, C.R. (1991) Biological Consequences of Ecosystem Fragmentation: A Review. Conservation Biology 5(1): 18-32 Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 37. Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics 37 Schumacher, E.F. (1973) Small Is Beautiful: A Study of Economics as if People Mattered. Abacus, Sphere Books, London. 255pp. Singer, Peter (2002) One World: The Ethics of Globalisation. Yale University Press, US, & Text Publishing Company, Melbourne. 255pp. Smith, Adam (1776) An Inquiry Into the Nature and the Wealth of Nations. Stiglitz, Joseph (2002) Globalization and its Discontents. Penguin Books. 288pp. Suzuki, David and Dressel, Holly (2002) Good News For a Change: How Everyday People are Helping the Planet. Stoddart Publishing, Toronto, and Allen & Unwin, Crows Nest, NSW. 400pp. Trainer, Ted (1995) The Conserver Society: Alternatives for Sustainability. Zed Books, London. 246pp. Trudgill, S.T. (1990) Barriers to a Better Environment. Belhaven Press (Pinter Publishers), London. 151pp. Turner, R.K., Pierce, D. and Bateman, I. (1994) Environmental Economics: An Elementary Introduction. Harvester Wheatsheaf, Simon & Schuster International Group, Hertfordshire. 318pp.+index Unger, Peter (1996) Living High and Letting Die. Oxford University Press, Oxford & New York Veenhoven, R. (1996) Happy Life Expectancy: A Comprehensive Measure of Quality-of-Life in Nations. Social Indicators Research 39: 1-58 Waters, Malcolm (2001) Globalization. Second Edition. Routledge, London & New York. 247pp. First published in 1995. Weizsacker, Ernst von, Lovins, Amory B. and Lovins, L. Hunter (1998) Factor Four: Doubling Wealth, Halving Resource Use. The New Report to the Club of Rome. Earthscan Publications, London. 322pp. Welford, Richard (1997) Hijacking Environmentalism: Corporate Responses to Sustainable Development. Earthscan Publications, London. 251pp. Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 38. 38 Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics Chapter B6: Sustainable Development Extra activity using the Chair A new activity from the sustainable development chapter was devised by Lindsey Conner to involve persons in something active. The book includes a chair with different legs of sustainable development (Ecological Leg; Social Leg; Cultural Leg; Economic Leg, p. 68), and a number of items. The items in that list in the book were extended (see below) and stuck onto polystyrene foam blocks (about 4cm cubes), and then each person in the room takes a block and they have to assign the blocks to different legs. People were then thinking about how they could use blocks in other ways but they thought it visually showed how sustainability is a balancing act. The power of the activity is that some of the concepts (ideas) on the blocks can go on several legs and the discussion and reasoning behind putting them on a particular leg is deemed important. People have to explain their original category and the new one if they had to achieve a balanced chair. The block names include (for ideas…): Biodiversity Ecosystems Habitats Endangered Species Mountains Sewage Old Batteries Kakapo Teachers Schools Rivers Physical Processes Smog Garbage Natural Resources Social welfare Culture Freedoms Counselling services Health & Medical United Nations Desires Politics Democracy Human Resources Greenpeace Police Religion Ethics & Behaviour Legal System Military Industries Entertainment Rights Responsibilities Family Values Television Media Ginseng Horse racing Economies of scale Common resources Rugby Goods Services Employment Product diversity Car pools Quality of Life Production efficiency Fair Trade Discount travel Consumerism User pays Online resources Academic Information: www.academicinfo.net Alternative Technology Association: www.ata.org.au Australian Ethical Investments: www.austethical.com.au Australian Marine Environment: www.environment.gov.au/marine/ Bioscience-Bioethics Friendship Co-operative: www.bioscience-bioethics.org Centre for Social and Environmental Accounting Research: www.dundee.ac.uk/accountancy/ csear C.I.E.S.I.N. (Earth Science Information Network): www.ciesin.org/ Clock of the Long Now (10,000-year clock and library): www.longnow.org C.O.M.E.S.T (World Commission on the Ethics of Scientific Knowledge and Technology, in association with UNESCO): www.most.go.th/comest/index.htm Coral Reef Hotspots: http://manati.wwb.noaa.gov/orad C.S.I.R.O. (Commonwealth Scientific & Industrial Research Organisation, Australia): www.csiro.au/csiro/csirores.htm and www.publish.csiro.au Environment, Development and Sustainability (journal): www.wkap.nl/journals/eds Environmental and Resource Economics (journal): www.wkap.nl/journals/ere Environmental Journals & Serials Online: http://155.187.10.12/library/serials.html Eubios Ethics Institute: www.biol.tsukuba.ac.jp/~macer/Info.html Fair Trade Foundation: www.fairtrade.org.uk F.A.O. (Food and Agriculture Organization): www.fao.org/ Foresight Institute: www.foresight.org Global Change Research Information Office: www.gcrio.org/ Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 39. Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics 39 G.B.R.M.P.A (Great Barrier Reef Marine Park Authority): www.gbrmpa.gov.au Guidelines for Assessing the Sustainability of Australian Fisheries: www.environment.gov.au/ marine/fisheries/assessment/main.html Institute for Global Ethics: www.globalethics.org/ Institute for Local Self Reliance: www.ilsr.org Institute for Policy Studies: www.ips.dc.org Institute of Development Studies (Devline): www.ids.ac.uk International Council for Science: www.icsu.org/ International Geosphere-Biosphere Program: www.igbp.kva.se/ International Institute for Environment & Development (I.I.E.D.): www.iied.org International Institute for Sustainable Development (I.I.S.D.): www.iisd.ca/ International Journal of Sustainable Development and World Ecology: www.parthpub.com/susdev/home.html International Movement for a Just World: www.jaring.my/just/ International Society for Environmental Ethics: www.cep.unt.edu/ISEE.html I.P.C.C. (Intergovernmental Panel on Climate Change): www.ipcc.ch/index.htm I.U.C.N. (World Conservation Union): http://iucn.org Journal of Risk and Uncertainty: www.wkap.nl/journals/jru Medline (U.S. National Library of Medicine): www.bewell.com/MEDLINE/ Mitigation and Adaptation Strategies for Global Change (journal): www.wkap.nl /journals/mitigadap Multinational Monitor: www.essential.org/monitor/ National Academy Press (full texts online): www.nap.edu National Science Foundation (U.S.): www.nsf.gov/geo/egch/ N.O.A.A. (National Oceanic and Atmospheric Administration, U.S.): www.noaa.gov Nobel Prize Archive: www.almaz.com/nobel Notable Citizens of Planet Earth (biographical dictionary): www.tiac.net/users/parallax/ One World (sustainability news and business directory): www.oneworld.com Permaculture Research Institute: www.permaculture.org.au Political Resources: www.politicalresources.com Project Gutenburg (books library): http://promo.net/pg/ Religion Studies: www.academicinfo.net/religindex.html Science Applications International: www.saic.com Socially Responsible Investment: www.wiso.gwdg.de/ifbg/sri.html Socio-Economic Data Application Center: http://sedac.ciesin.org SustainAbility Ltd: www.sustainability.co.uk Sustainability WebRing (directory): http://n.webring.com/hub?ring=sustainability United Nations web site: www.un.org U.N.D.P. (United Nations Development Program): www.undp.org U.N.E.P. (United Nations Environment Program): www.unep.org U.N.E.S.C.O. (United Nations Educational, Scientific & Cultural Organisation): www.unesco.org UNESCO/IUBS/EUBIOS Living Dictionary of Bioethics: www.biol.tsukuba.ac.jp/~macer/biodict.htm U.N.F.P.A. (United Nations Population Fund): www.unfpa.org U.N.I.C.E.F (United Nations Children’s Fund): www.unicef.org University Corporation for Atmospheric Research: www.ucar.edu/ White House Fact Sheet: Policy Declaration on Environment and Trade: http://sunsite.utk.edu/FINS/Sustainable_Development/Fins-SD-20.txt World Data Center-A for Human Interactions in the Environment: www.ciesin.org /home- Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 40. 40 Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics page/WDC.html Workers Rights Consortium: www.workersrights.org World Bank: www.worldbank.org World Database of Happiness: www.eur.nl/fsw/research/happiness/ World Development Movement: www.wdm.org.uk World Intellectual Property Organisation: www.wipo.org/eng/main.htm World Resources Institute: www.wri.org/meb World Trade Organisation (W.T.O.): www.wto.org/wto Worldwatch Institute: www.worldwatch.org Further reading Caldwell, L.K. (1994) Sustainable Development: Viable Concept and Attainable Goal? Environmental Conservation 21(3): 193-195 Carley, Michael and Christie, Ian (1992) Managing Sustainable Development. Earthscan Publications, London. 303pp. Carpenter, Richard A. (1994) Can Sustainability be Measured? Ecology International Bulletin 21: 27-36 Clark, Mary E. (1989) Ariadne’s Thread: The Search for New Modes of Thinking. Scholarly and Reference Division, St. Martin’s Press, New York. Cohen, Joel E. (1995) How Many People can the Earth Support? Norton Paperbacks, Norton & Co. New York/London 506pp.+index Commonwealth of Australia (1992) National Strategy for Ecologically Sustainable Development. Department of Environment, Sport and Territories. Australian Government Publishing Service, Canberra. 128pp. Commonwealth of Australia (1996) Report on the Implementation of the National Strategy for Ecologically Sustainable Development (1993-1995). Inter-governmental Committee for Ecologically Sustainable Development for the Commonwealth Dept. of Environment, Sport and Territories, Canberra. 206pp. de Graaf, H.J., Musters, C.J.M. and ter Keurs, W.J. (1996) Sustainable Development: Looking for New Strategies. Ecological Economics 16: 205-216 Deville, Adrian and Harding, Ronnie (1997) Applying the Precautionary Principle. Federation Press Pty Ltd, Sydney. 79pp. di Castri, Francesco (1995) The Chair of Sustainable Development. Nature & Resources 31(3): 2-7 Dovers, Stephen and Handmer, John (1995) Ignorance, The Precautionary Principle, and Sustainability. Ambio 24(2): 92-97 Dovers, S.R., Norton, T.W. and Handmer, J.W. (1996) Uncertainty, Ecology, Sustainability and Policy. Biodiversity and Conservation 5: 1143-1167 Dunphy, Dexter, Benveniste, Jodie, Griffiths, Andrew and Sutton, Philip, eds. (2000) Sustainability: The Corporate Challenge of the 21st Century. Allen & Unwin, St Leonards, NSW. 282pp. Eckersley, Richard, ed. (1998) Measuring Progress: Is Life Getting Better? C.S.I.R.O. Publishing, Collingwood, Vic., Australia. 382pp. Ekins, Paul (1992) A New World Order: Grassroots Movements for Global Change. Routledge, London & New York. 248pp. Frazier, J.G. (1997) Sustainable Development: Modern Elixir or Sack Dress? Environmental Conservation 24(2): 182-193 Fricker, Ally (1991) Towards a Sustainable Society: The Fallacies of the Prophets of Doom or Ostrich-Like Optimism. In: Bierbaum, Nena, ed. Towards Ecological Sustainability. Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 41. Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics 41 Centre for the Environment and Sustainable Development, Flinders University, SA.193-198 Gatto, M. (1995) Sustainability: Is it a Well-Defined Concept? Ecological Applications 5(4): 1181-1183 Haller, Stephen (2002) Apocalypse Soon? Wagering on Warnings of Global Catastrophe. McGill Queens University Press, Montreal.185pp. Hancock, D.A., Smith, D.C., Grant, A. and Beumer, J.P., eds. (1997) Developing and Sustaining World Fisheries Resources: The State of Science and Management. 2nd World Fisheries Congress. C.S.I.R.O., Collingwood, Victoria. Harding, Ronnie, ed. (1998) Table 2.1: The Objectives and Principles of Ecologically Sustainable Development (ESD). In: Environmental Decision-Making: The Roles of Scientists, Engineers and the Public. The Federation Press, Leichhardt, NSW. 27-29; 366pp. I.U.C.N. (World Conservation Union) (1980) World Conservation Strategy: Living Resources Conservation for Sustainable Development. I.U.C.N., Gland, Switzerland. King, Alexander & Schneider, Bertrand (1991) The First Global Revolution: A Report by the Council of the Club of Rome. Simon & Schuster, London. 234pp. Laszlo, Ervin, ed. (1997) Third Millennium: The Challenge and the Vision. The Club of Budapest Report on Creative Paths of Human Evolution. Gaia Books Ltd, London.156pp. Levin, S.A. (1993) Perspectives on Sustainability. Ecological Applications 3: 545-589 Light, Andrew and Rolston, Holmes III, eds. (2003) Environmental Ethics: An Anthology. Blackwell Philosophy Anthologies, Blackwell Publishers Ltd, Malden, Oxford, Melbourne & Berlin. 526pp.+index Ludwig, Donald (1993) Environmental Sustainability: Magic, Science and Religion in Natural Resource Management. Ecological Applications 3(4): 555-558 Ludwig, D., Hilborn, G. and Walters, C. (1993) Uncertainty, Resource Exploitation and Conservation: Lessons from History. Science 260: 17-36 Martin, Hans-Peter and Schumann, Harald (1997) The Global Trap: Globalization and the Assault on Democracy and Prosperity. Pluto Press, Annandale, NSW. 269pp. (originally published 1996 in German). McCormick, Frank J. (1999) Principles of Ecosystem Management and Sustainable Development. In: Ecosystem Management for Sustainability: Principles and Practices Illustrated by a Regional Biosphere Reserve Cooperative. C.R.C Press L.L.C., Boca Raton, FL. 3-21 Meadows, Donella, Meadows, Dennis, Randers, Jorgen and Behrens, William III (1972) The Limits to Growth: A Report for the Club of Rome’s Project on the Predicament of Mankind. Newgate/Potomac/Pan Books, London. 205pp. Mies, Maria and Bennholdt-Thomsen, Veronika (1999) The Subsistence Perspective: Beyond the Globalised Economy. Zed Books, London & N.Y., and Spinifex Press, Aust. & N.Z. 246pp. (originally published 1997 in German) Milbrath, Lester W. (1989) Envisioning a Sustainable Society: Learning Our Way Out. State University of New York Press. 403pp. Moir, W.H. and Mowrer, H.T. (1995) Unsustainability. Forest Ecology & Management 73: 239-248 Moldan, Bedrich, Billharz, Suzanne and Matravers, Robyn (1997) Sustainability Indicators: A Report on the Project on Indicators of Sustainable Development. John Wiley & Sons, Chichester. 415pp. Myers, Norman (1993) Biodiversity and the Precautionary Principle. Ambio 22(2-3): 74-79 Pearce, D.W. ed. (1991) BluePrint 2: Greening the Global Economy. Earthscan, London. Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 42. 42 Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics Pearce, D.W. ed. (1994) BluePrint 3: Measuring Sustainable Development. Earthscan, London. 224pp. Pearce, D.W., Markandya, A. and Barbier, E.B., eds. (1989) Blueprint for a Green Economy (BluePrint 1). Earthscan, London. Peine, John D., ed. (1999) Ecosystem Management for Sustainability: Principles and Practices Illustrated by a Regional Biosphere Reserve Cooperative. C.R.C Press L.L.C./Lewis Publishers, Boca Raton, FL. Pitcher, Tony and Pauly, Daniel (1998) Rebuilding Ecosystems, not Sustainability, as the Proper Goal of Fishery Management. In: T. Pitcher, P. Hart & D. Pauly, eds. Reinventing Fisheries Management. Chapman & Hall, London. 311-329 Pugh, Cedric (1996) Sustainability and Sustainable Cities. In: Pugh, Cedric, ed. Sustainability, the Environment and Urbanisation. Earthscan Publications, London. 250pp; 135-177 Real World Coalition (2001) From Here to Sustainability: Politics in the Real World. Earthscan, London & Sterling, VA. 223pp. Rees, Martin (2003) Our Final Century. Will Civilization Survive the Twenty-First Century? Arrow Books, Random House, London. 228pp. Reid, David (1995) Sustainable Development: An Introductory Guide. Earthscan, London. 261pp. Rheingold, Howard, ed. (1994) The Millennium Whole Earth Catalog: Access to Tools and Ideas for the Twenty-First Century. HarperCollins Publishers, San Francisco. 384pp. Rheingold’s web site: www.minds.com Robertson, Geoffrey (1999) Crimes Against Humanity: The Struggle for Global Justice. Penguin Books (2000), Ringwood, VIC. 554pp. Roddick, Anita, ed. (2001) Take It Personally: How to Make Conscious Choices to Change the World - A Globalization Survivor’s Guide. Thorsons/HarperCollins Publishers Ltd, London. 257pp. Roy, Arundhati (1999) The Cost of Living: ‘The Greater Common Good’ and ‘The End of Imagination’. Flamingo, HarperCollins Publ., London. 162pp. Saul, John Ralston (2001) On Equilibrium. Penguin Books. 370pp. Schalit, Joel ed. (2002) The Anti-Capitalism Reader: Imagining a Geography of Opposition. Akashic Books, New York. 349pp. Siebenhuner, Bernd (2000) Homo sustinens - Towards a New Conception of Humans for the Science of Sustainability. Ecological Economics 32: 15-25 Sivakumar, M. and Messer, J., eds. (1995) Protecting The Future: E.S.D. in Action - Proceedings of the National Conference on Successful Strategies for Ecologically Sustainable Development, University of Wollongong, 5-7 Dec. 1994. Futureworld: National Centre for Appropriate Technology Inc., Wollongong, NSW. 492pp. Tilbury, Daniella and Wortman, David (2004) Engaging People in Sustainability. Commission on Education and Communication, I.U.C.N. (World Conservation Union), Gland, Switzerland & Cambridge, U.K. 137pp. Trainer, Ted (1995) The Conserver Society: Alternatives for Sustainability. Zed Books Ltd, London. 246pp. U.N.C.E.D. (United Nations Conference on Environment and Development) (1992) Agenda 21: A Blueprint for Survival Into the 21st Century. U.N.C.E.D., United Nations Environment Program, Rio de Janeiro. U.N.E.S.C.O. AND C.O.M.E.S.T. (2005) The Precautionary Principle. United Nations Educational, Scientific and Cultural Organisation and World Commission on the Ethics of Scientific Knowledge and Technology, Paris. 54pp. <http://eubios.info/UNESCO/precprin.pdf> Venning, Jackie and Higgins, John (2001) Towards Sustainability: Emerging Systems for Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 43. Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics 43 Informing Sustainable Development. U.N.S.W. Press, Sydney. 239 pp. W.C.E.D. (World Commission on Environment and Development) (1987) Our Common Future. Brundtland, Gro Harlem, (ed.) Oxford University Press, Oxford. 400pp. Also known as ‘The Brundtland Report’. Wilson, Edward O. (1998) Consilience: The Unity of Knowledge. Abacus, Little Brown & Co., London. 374pp. Yencken, David and Wilkinson, Debra (2000) Resetting the Compass: Australia’s Journey Towards Sustainability. C.S.I.R.O., Collingwood, Victoria. 400pp. Sustainability Crossword solutions (See p.72 of the textbook for the crossword) The sustainability crossword includes concepts not just from this chapter, but also from the range of previous chapters in this Section B “Environmental Ethics”. It is not necessarily easy to complete, and can potentially be used for marking purposes as a homework assignment. Please discourage students from writing in the textbook by distributing photocopies or downloading the crossword from the website at eubios.info/BET/Betcwd.doc Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 44. 44 Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics ACROSS: DOWN: 1. Positive 3. Responsibilities 2. Us 11. Support 4. Eg 15. Progress 5. Process 20. Maps 6. Net 22. Democracy 7. Bioethics 25. Emergent 8. Intra 26. Recycle 9. Inter 28. Utopia 10. Sustainability 29. Next 12. Uncertainty 30. Uni 13. Poly 31. Happiness 14. Time 33. Rights 15. Pre 34. Ethics 16. Respect 36. Sustainable 17. Strategic 38. Wilderness 18. Precautionary 40. Intrinsic 19. Complexity 42. Economics 21. Subsist 45. Indicator 23. Renew 47. Demo 24. Restrict 49. Sun 27. Clever 51. Long 28. UN 52. Yes 30. United 53. Ism 32. Sustain 55. Air 35. Hunger 58. Valuation 37. Limits 60. Free 39. GMO 61. Yin 41. Contents 63. EIA 42. Ecology 64. Technology 43. Organic 65. Gaia 44. Systems 67. Trees 46. Reality 68. Nest 48. Models 69. Conserve 49. Space 70. Sufficiency 50. Bio 54. Rate 56. Fair 57. Roof 59. Now 60. Fun 62. NGO 66. We Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 45. Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics 45 Chapter B7: Cars and the Ethics of Costs and Benefits Cars are an integral part of the fabric of every modern society; so, most students will approach the issue of personal car use with strong predetermined ideas. The quantitative analysis is a good starting point to encourage rational and objective analysis and dispassionate reflection. The project in this chapter to calculate costs and benefits could be presented in two sessions. In the first session, the issue can be presented and the analysis explained and demonstrated. Students, either individually or in groups, should be assigned the task of performing the analysis for homework. In the second session, students should present the results of their analysis to the class and be encouraged to discuss some of the many questions raised in the chapter. Some students or their parents may be uncomfortable sharing some of the data needed for the quantitative analysis, for example household income and hours worked. If so, then teachers may provide some typical values for the local community. Other data might be difficult to obtain; again, teachers might help by providing some reference values for students to use. It might also be interesting to ask different students or groups of students to perform the exercise with different types of vehicles, for example very small cars or sport utility vehicles. Also please share the results of your class analysis with the international bioethics textbook team; perhaps we can include a comparison table in a future edition. The topic touches many areas. The basic analysis is simple, but if it is of interest to the teacher and students, additional projects could be assigned to investigate some of the issues raised in the chapter after the quantitative analysis. Since one of the goals is broad thinking, the classroom discussion can be allowed to depart from the topics explicitly mentioned in the chapter. Depending on your student's access to Internet, and the way you want to teach, you could give them the page of useful links. Please let us know whether they were given the links before or after class reports. References 1) Otsuka, Yoshimasa (ed.). 2002. Asahi Shimbun Japan Almanac 2003. Tokyo. 2) Federal Highway Administration, U.S. Department of Transportation. October 2001. Vehicle travel for selected countries. http://www.fhwa.dot.gov/ohim/hs00/pdf/in4.pdf 3) Kondo, Yoshinori, et al. 2002. Analysis of the influence of vehicle travel activity at actual driving condition on fuel economy and exhaust emission, paper No.99-02: 13-16, presented to the 2002 annual meeting of the Japan Society of Automotive Engineers, 24-26 Nov. 2002, Kyoto. Online resources International Road Federation http://www.irfnet.org/ Publishes World Road Statistics (but expensive) Victoria Transport Policy Institute http://www.vtpi.org/ Directory of Transportation Libraries and Information Centers http://ntl.bts.gov/tldir Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 46. 46 Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics OECD Environmentally Sustainable Transport http://www.oecd.org/topic/0,2686,en_2649_34363_44954_1_1_1_37433,00.html Centre for Sustainable Transportation http://www.cstctd.org/CSThomepage.htm Carfree Times http://www.carfree.com/cft/index.html NEMO http://nemo.uconn.edu/ Union of Concerned Scientists Clean Vehicles Program http://www.ucsusa.org/clean_vehicles/index.cfm Sustainable Transportation http://www.sustainable.doe.gov/transprt/trintro.shtml National Highway Traffic Safety Administration http://www.nhtsa.dot.gov/ Transportation Research and Injury Prevention Programme (TRIPP) www.iitd.ac.in/tripp Insurance Institute for Highway Safety and the Highway Loss Data Institute http://www.carsafety.org/ Royal Society for the Prevention of Accidents http://www.rospa.co.uk/cms/ Center For Livable Communities http://www.lgc.org/center/ International Council for Local Environmental Initiatives www.iclei.org Institute for Sustainability and Technology Policy http://wwwistp.murdoch.edu.au/ Health Benefits of Cycling http://www.lcc.org.uk/campaigns/cyclist_safety_health/health_benefits_of_cycling.asp Chapter B8: The Energy Crisis and the Environment Background This chapter introduces issues of energy production and natural resources. The issues are found in many existing textbooks in many school curricula. Chapter B9: Ecotourism Background This chapter introduces issues of ecotourism using some interesting and simple case studies and activities. This chapter could also be the basis for some field work and visits to communities involved in ecotourism projects. Further reading Boo, E. (1990) Ecotourism: the Potentials and Pitfalls. W.W.F., Washington D.C. Bottrill, C.G. and Pearce, D.G. (1995) Ecotourism: Towards a Key Elements Approach to Operationalising the Concept. J. Sustainable Tourism 3(1): 45-54 Commonwealth Department of Tourism (1994) National Ecotourism Strategy. Australian Government Publishing Service, Canberra. 68pp. Goodwin, H. (1996) In Pursuit of Ecotourism. Biodiversity and Conservation 5: 277-291 Honey, M. (1999) Ecotourism and Sustainable Development: Who Owns Paradise? Island Press: U.S.A., 1999. International Ecotourism Society web site: www.ecotourism.org Moore, S. and Carter, B. (1993) Ecotourism in the 21st Century. Tourism Management, April 1993: 123-130 Ng, M.A. (2003) The Ethics and Attitudes towards Ecotourism in the Philippines in Bioethics in Asia in the 21st Century. Eubios Ethics Institute. Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 47. Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics 47 Chapter B10: The Earth Charter Background This document may be interesting for understanding commonly agreed issues relating to the environment. Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 48. 48 Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics Section C. Genetics Chapter C1: Genetics, DNA and Mutation There are several topics on medical genetics in these online materials including breast cancer screening (chapter C4), genetic privacy and information (chapter C5), eugenics (chapter C7), and gene therapy (chapter C8). Also the movie guide for GATTACA is recommended as a film directly relevant to genetic privacy and discrimination. Online resources See papers on the Eubios Ethics Institute website, including News in Bioethics and Biotechnology WWW: http://eubios.info/NBB.htm Universal Declaration on the Human Genome and Human Rights, UNESCO WWW: http://www.unesco.org/ibc/en/genome/projet/ Site: HumGen (University of Montreal, references of laws) WWW: www.humgen.umontreal.ca Site: DNA Learning Center (Cold Spring Harbor Laboratory) WWW: http://vector.cshl.org Site: Heredity, Health and Humanity WWW: http://www.beloit.edu/~biology/genethics/ethics.homepage.html Site: Human Genome Project Education Resources WWW: http://www.ornl.gov/hgmis/education/education.html Site: National Information Resource on Ethics and Human Genetics WWW: http://bioethics.georgetown.edu/nirehg.html Site: Council for Responsible Genetics (CRG) WWW: http://www.gene-watch.org Site: GeneWatch UK Links WWW: http://www.genewatch.org/links.htm Site: Bioethics Resources (Genetics and Ethics) WWW: http://www.utoronto.ca/jcb/Resources/resources.html Site: Genethics Literature WWW: http://www.ethics.ubc.ca/brynw/genlit.html Site: Genomic and Genetic Resources on the World Wide Web (National Human Genome Research Institute, National Institutes of Health) WWW: http://www.nhgri.nih.gov/Data/ Site: DOE Information Bridge WWW: http://www.osti.gov/bridge/ Site: Genetics and Biotechnology Journals WWW: http://www.sciencekomm.at/journals/genetics.html Site: Ethics and Genetics BA Global Conversation (University of Pennsylvania) WWW: http://www.bioethics.net Further Reading Munson, Ronald (Ed.) (2000) Intervention and Reflection: Basic Issues in Medical Ethics. Sixth Edition, printed in the United States of America, (Chapter 8. Genetics: Intervention, Control, and Research. pp. 558-645.) Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 49. Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics 49 Marteau, T. and Richards, M., (Eds.) (1996) The Troubled Helix: Social and Psychological Implications of the New Human Genetics. Cambridge University Press. Local material from hospitals, national genetics societies and companies offering genetic testing are available. Chapter C2: Ethics of Genetic Engineering Background The objective of this chapter is to give a brief description to students about Genetic Engineering, and a balanced view of the ethical concerns raised by the use of new technologies. Also, class debates can be organised among students on benefits and risks; especially focusing on their ethical concerns. The groups may debate twice, the second time on the opposite side of the debate to previously, to encourage better understanding of the issues. There are many existing resources on the subject, and biology teachers often introduce some of these issues when explaining the technology. Online resources See papers on the Eubios Ethics Institute website, including News in Bioethics and Biotechnology < http://eubios.info/NBB.htm> UNESCO, The Precautionary Principle, COMEST Precautionary Principle Expert Group, 2005 <http://eubios.info/UNESCO/precprin.pdf> UNESCO International Bioethics Committee, Food, Plant Biotechnology and Ethics (1995), Darryl Macer (Rapporteur) <http://eubios.info/UNESCO/ibc1995pg.pdf> There is a vast amount of Internet material, some is unreliable and extreme on both sides of the issues. Care is needed. Some useful links include: http://biosafety.ihe.be/ http://www.fao.org http://www.cfsan.fda.gov/~lrd/biotechm.html#reg http://www.srtp.org.uk/whatisrt.shtml http://reason.com/bi/bi-gmf.shtml Chapter C3: Genetically modified foods Background This issue is hotly debated in the media, on the web, and in each country. In case the students wish to look at the international regulations, the Codex Alimentarius has adopted codes for international use on the risk assessment and procedures for use of GM food. National committees usually have websites with explanation of guidelines. A debate on these topics using the opposing materials available about the issue can be interesting, and is relevant to the diets of most persons. Chapter C4: Testing for Cancer Gene Susceptibility Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 50. 50 Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics See also chapters C5 “Genetic Privacy and Information” and D2 “Telling the Truth about Terminal Cancer. The Trash and Treasure note-taking activity is from Big Six Lesson Plans - http://ericir.syr.edu/big6/bigsix.html Jansen, B bjansen@tenet.edu This procedure can be used as a discriminatory strategy with any text. It explains to students that a researcher must dig to find words to help answer the questions (treasure) and toss aside unnecessary sentences, phrases, words, ideas as trash because they do not answer the questions and therefore are unimportant in this context. The idea is to help students use a focusing question to search the text. Teacher Instructions 1. Demonstrate the method using an OHP and transparency of a paragraph of information on the topic. 2. Choose a question. Write it on the board to demonstrate what the students should do. 3. Read the text on the overhead transparency sentence by sentence to the students. Ask “Does this sentence answer the question?” 4. If the answer is no, tell the students that that sentence is trash. Go on to the next sentence. 5. If the answer is yes, read that phrase word by word. They are treasure words and are written as notes. Underline the words and phrases that answer the question on the transparency. 6. Keep reading the paragraph sentence by sentence until the text is finished. Students are impressed when they see how little they have to write. Some limitations and risks of genetic testing Limitations 1. The current range of tests does not look for and cannot detect all disease-causing mutations or susceptibilities to genetic disorders. 2. There are no cures or treatments currently available for some diseases that can be diagnosed or predicted by genetic testing. 3. Even if the mutation known to be associated with some diseases is absent, the disease may still develop. 4. There is the possibility that test results are not correct (human error). 5. Some mutations are very variable. Many changes in the same gene can result in a disorder e.g. cystic fibrosis. Several different mutations can lead to the same disorder. Risks 1. People may experience psychological anxiety when they are told they have susceptibility to a genetic disorder. 2. There is a huge risk of misunderstanding and anxiety when people who have been tested do not get skilled counseling. There is a need to train health professionals in how to do this. 3. The results of testing can strain family relationships, especially if the family members do not want to know the implications for them. Family members may withhold information that could have implications for the rest of the family. 4. Genetic information about individuals is very sensitive. Failure to protect this information could have far-reaching effects on their well-being. For example it could lead to social and economic discrimination. Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 51. Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics 51 Resources UNESCO International Bioethics Committee, Report of the IBC on Pre-implantation Genetic Diagnosis and Germ-line Intervention (2003), Hans Galjaard (Rapporteur) <http://eubios.info/UNESCO/ibc2003ip.pdf> UNESCO International Bioethics Committee, Human Genetic Data: Preliminary Study by the IBC on its Collection, Processing, Storage and Use (2002), Sylvia Rumball and Alexander McCall Smith (Rapporteurs) <http://eubios.info/UNESCO/ibc2002.pdf> UNESCO International Bioethics Committee, Report on Confidentiality and Genetic Data (2000), Working Group of the IBC on Confidentiality and Genetic Data <http://eubios.info/UNESCO/ibc2000.pdf> UNESCO International Bioethics Committee, Genetic Counselling (1995), Michel Revel (Rapporteur) <http://eubios.info/UNESCO/ibc1995gc.pdf> UNESCO International Bioethics Committee, Report on Genetic Screening and Testing (1994), Mr David Shapiro (Rapporteur) <http://eubios.info/UNESCO/ibc1994gs.pdf> Chapter C5: Genetic Privacy and Information The use of genetic information in employment and insurance has raised a number of ethical and social considerations. The ethical principle of justice would support promotion of equal opportunity for persons, and the ethical principle of avoiding harm would try to protect health and safety. In insurance, respecting individual decision not to undergo genetic testing can be an injustice to others who may need to pay a higher premium. We wish to promote individual’s autonomy in the society, however the interests of others should also be taken into consideration. The completion of the first mapping of the human genome has provided huge potential for research into the ways in which genes relates to people’s lives. There is enthusiastic public support for promises of better medical diagnosis and treatments. However, there is also fear about new advances in biotechnology, genetic screening, stem cell research, leading to the lack of privacy, and the increased possibilities of genetic discrimination. The issue of informed consent is fundamental in conducting genetic research and protection of individual privacy. We have yet to make an adequate effort to resolve the ethical and social issues involved in genetic testing. A father's discovery that he carries the gene for Huntington’s disease would also mean learning that his children will have a 50% chance of developing the same disease. This crucial disclosure of information has particular implications for individuals as members of families. While individuals may be ambivalent about knowing their own genetic predisposition, concern for the interests of others requires us to respect their autonomy, that is, their right to know or not to know. It is very important that this privacy is respected, because this information can also lead to genetic discrimination. Biological samples such as blood, saliva, or amniotic fluid (from which fetal cells are obtained) can be used for testing. The techniques used in your local area could be investigated by contacting local hospitals. Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 52. 52 Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics Resources See chapters C9 and C10 for International Declarations on the subject. Also the statements of the Human Genome Organization Ethics Committee. <http://eubios.info/index.htm> UNESCO International Bioethics Committee, Report of the IBC on Pre-implantation Genetic Diagnosis and Germ-line Intervention (2003), Hans Galjaard (Rapporteur) <http://eubios.info/UNESCO/ibc2003ip.pdf> UNESCO International Bioethics Committee, Human Genetic Data: Preliminary Study by the IBC on its Collection, Processing, Storage and Use (2002), Sylvia Rumball and Alexander McCall Smith (Rapporteurs) <http://eubios.info/UNESCO/ibc2002.pdf> UNESCO International Bioethics Committee, Report on Confidentiality and Genetic Data (2000), Working Group of the IBC on Confidentiality and Genetic Data <http://eubios.info/UNESCO/ibc2000.pdf> UNESCO International Bioethics Committee, Genetic Counselling (1995), Michel Revel (Rapporteur) <http://eubios.info/UNESCO/ibc1995gc.pdf> UNESCO International Bioethics Committee, Report on Genetic Screening and Testing (1994), Mr David Shapiro (Rapporteur) <http://eubios.info/UNESCO/ibc1994gs.pdf> Chapter C6: The Human Genome Project Resources UNESCO International Bioethics Committee, Human Genetic Data: Preliminary Study by the IBC on its Collection, Processing, Storage and Use (2002), Sylvia Rumball and Alexander McCall Smith (Rapporteurs) <http://eubios.info/UNESCO/ibc2002.pdf> UNESCO International Bioethics Committee, Report of the IBC on Ethics, Intellectual Property and Genomics (2002), Justice Michael Kirby (Rapporteur) <http://eubios.info/UNESCO/ibc2002ip.pdf> UNESCO International Bioethics Committee, Report of the IBC on Solidarity and International Co-operation between Developed and Developing Countries concerning the Human Genome (2001), Mehmet Öztürk (Rapporteur) <http://eubios.info/UNESCO/ibc2001.pdf> UNESCO International Bioethics Committee, Bioethics and Human Population Genetics Research (1995), Chee Heng Leng, Laila El-Hamamsy, John Fleming, Norio Fujiki, Genoveva Keyeux, Bartha Maria Knoppers and Darryl Macer <http://eubios.info/UNESCO/ibc1995pg.pdf> UNESCO International Bioethics Committee, Advice of the IBC on the Patentability of the Human Genome, 2001. <http://eubios.info/UNESCO/ibcpatent.pdf> Chapter C7: Eugenics Resources Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 53. Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics 53 UNESCO International Bioethics Committee, Bioethics and Human Population Genetics Research (1995), Chee Heng Leng, Laila El-Hamamsy, John Fleming, Norio Fujiki, Genoveva Keyeux, Bartha Maria Knoppers and Darryl Macer <http://eubios.info/UNESCO/ibc1995pg.pdf> Chapter C8: Human Gene Therapy Gene therapy was unusual as science because many ethical issues were discussed for years before it was actually done. It has not led to a real therapy for most patients. There may be some parallel to the way that stem cell therapy is being discussed with much hype as a miracle cure nowadays, and the way gene therapy was discussed in the 1980s. Online resources See papers on the Eubios Ethics Institute website, including News in Bioethics and Biotechnology < http://eubios.info/NBB.htm> US NIH Guidelines for Research Involving Recombinant DNA Molecules http://www4.od.nih.gov/oba/rac/guidelines/guidelines.html ClinicalTrials.gov gives information about all US clinical trials of drugs and therapies including the purpose of the trials, who may participate, locations, and phone numbers for more details. http://www.clinicaltrials.gov/ UNESCO International Bioethics Committee, Report of the IBC on Pre-implantation Genetic Diagnosis and Germ-line Intervention (2003), Hans Galjaard (Rapporteur) <http://eubios.info/UNESCO/ibc2003ip.pdf> UNESCO International Bioethics Committee, Ethical Considerations Regarding Access to Experimental Treatment and Experimentation on Human Subjects (1996), Harold Edgar and Ricardo Cruz-Coke (Rapporteurs) <http://eubios.info/UNESCO/ibc1996.pdf> UNESCO International Bioethics Committee, Report on Human Gene Therapy (1994), Mr Harold Edgar and Mr Thomas Tursz (Rapporteurs) <http://eubios.info/UNESCO/ibc1994.pdf> Chapter C9: Universal Declaration on the Human Genome and Human Rights Background The declaration provides a summary of internationally accepted principles on these issues and is available in multiple languages from the UNESCO websites. It can be interesting for debates. Chapter C10: International Declaration on Human Genetic Data Background The declaration provides a summary of internationally accepted principles on these issues and Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 54. 54 Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics is available in multiple languages from the UNESCO websites. It can be interesting for debates. Section D. Medical Ethics Chapter D1: Informed Consent and Informed Choice Background The issue of informed consent has been widely discussed in medical ethics, and can apply to the visits that students make to health care professionals. Resources The internationally agreed declaration on bioethics is useful for background: UNESCO Universal Declaration on Bioethics and Human Rights (19 October, 2005) <http://eubios.info/udbhr.pdf> UNESCO, Establishing Bioethics Committees, 2005 72pp. <http://eubios.info/UNESCO/ebc.pdf> Bergstrom, Philip, ed, Ethics in Asia-Pacific, 2004, 372pp. <http://eubios.info/UNESCO/ethap.pdf> UNESCO International Bioethics Committee, Report of the IBC on the Possibility of Elaborating a Universal Instrument on Bioethics (2003), Giovanni Berlinguer and Leonardo De Castro (Rapporteurs) <http://eubios.info/UNESCO/ibc2003.pdf> UNESCO International Bioethics Committee, Ethical Considerations Regarding Access to Experimental Treatment and Experimentation on Human Subjects (1996), Harold Edgar and Ricardo Cruz-Coke (Rapporteurs) <http://eubios.info/UNESCO/ibc1996.pdf> Chapter D2: Telling the Truth about Terminal Cancer See also Chapter D3 “Euthanasia”. Usually there is information available from local hospitals and oncology departments that may be useful for students. The four contexts of dying awareness of life-threatening illness were described by Glaser & Strauss (1965). The emotions of shock, denial, anger, bargaining and depression experienced by Mr. G were first published by Kubler-Ross in her book On Death and Dying (1969). In the case described in this chapter, Mr. G is protected from the shock of hearing about his terminal condition. According to his background (age and generation), it is assumed that he most probably would have had no intention to actively participate in his treatment. And that he would have preferred to depend on his children and medical authorities to make appropriate decisions on his behalf. Based on his culture, it is often presumed that keeping the cruel truth of an impending death outweighs the benefits of knowing. However, based on studies done in many countries, dying people become more devastated when they eventually learn that they were deliberately prevented from knowing the truth about the seriousness of their illness. What is the attitude in your country? A discussion on cultural differences could be a good way to get students to become passionate about this topic. After all, in the end, all people die. Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 55. Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics 55 References The Eubios CD or website provides a news section on euthanasia, with a number of papers discussing the topic. Glaser and Strauss (1965) Awareness of Dying. Aldine, Chicago. Kubler-Ross, E. On Death and Dying. (1969) The Macmillan Company, New York. Seale, C., Addington-Hall, J. and McCarthy, M. (1997) "Awareness of Dying: Prevalence, Causes and Consequences." Soc. Sci. Med. 45: 477-84. Chapter D3: Euthanasia Please see also the related Chapter D2 "Telling the Truth about Terminal Cancer", but note the difference between hospice care and supporting people's choices to limit medical treatment at the end of life (passive), and active euthanasia which is largely the topic of this chapter. Many medical professionals today have taken the Hippocratic Oath (4th Century BC). The Hippocratic Oath includes prohibitions against active euthanasia and deals with the duties of the physician, such as confidentiality, resistance to injustice, and moral respect for each patient. However, euthanasia has a very long history. In fact, in the Stoic tradition (ca. 300 BC), active assistance with suicide of the physically or mentally impaired was allowed. The term euthanasia here referred to the ideal of a quick, gentle and honourable death. These Dutch guidelines are based on the criteria set out in court decisions relating to when a doctor can successfully invoke the defence of necessity. This form of defence is valid when a conflict of responsibilities occurs between preserving the patient's life on the one hand and alleviating suffering on the other. The conflict must be resolved on the basis of the doctor's responsible medical opinion measured by the prevailing standards of medical ethics. The euthanasia law is intended to respect the wish of the patient, thereby recognising the need for defining Patients' Rights. In 1994, 'Amendments under the Burial Act' incorporated the definition of patient's rights, making the Netherlands the first country in Europe to pass a law defining the responsibilities of doctors to their patients. Physicians must provide clear information, written down if requested, before they obtain consent for any operation. These developments are reflected in the court decisions made with regards to euthanasia since the 19th century. According to the Supreme Court in 1891, respect for human life has to be balanced against the loss of personal dignity, unbearable suffering and the impossibility to die in a dignified manner. The appeal to force majeure in a euthanasia case, therefore, was and still is recognised when a physician was confronted with a conflict of duties and acted in accordance with the medical-ethical demands of careful practice. This general exception is laid down virtually unchanged in the new law in a special justification for physicians. Critics say that euthanasia and assisted suicide are not private acts, but involve one person facilitating the death of another, and a human environment that shapes its conditions. In this view, euthanasia is a matter of public concern since it can lead to abuse, exploitation and erosion of care for the most vulnerable people in society. Respect for the person of the patient and concern for the family requires the optimal personal and public use of resources in end-of- Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 56. 56 Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics life decisions that promote the value of humane life. On a personal level, a dying patient needs care. A patient is not merely a biological unit but a cultural being with a conscience, a social existence and family ties. On a public level, legal measures are taken to protect the rights of patients and physicians, and financial budgets are put together to provide the public with 'good treatment'. Criticism of the euthanasia law expresses uncertainty about the ways in which this 'good treatment' takes shape in society, especially in the long-term. One concrete step in the direction of dealing with the slippery-slope argument is the clarification of the complex conceptual apparatus adopted in official legal and health care institutions. According to the critics, a worrying entrance in the statistics is the category of 'intentional life-terminating acts without explicit request'. This entrance is regarded as a separate category and constituted approximately 0,7 per cent of all death in the Netherlands in 1995. These cases concern mostly patients who no longer can express their will, and suffer the last phase of a terminal disease such as cancer and neurological diseases. In the majority of cases morphine is administered, not only to relieve the patient from pain, but also with the purpose of hastening death. Though there is a relatively clear definition of euthanasia, there is a lack of a clear legal framework for these other occurring cases in which the patient does not have a clear say. Discussion Suggestions • Does decriminalisation of euthanasia have the same effect in wealthy countries as in poor countries? • How important are different cultural and religious notions of death to the definition of euthanasia? • Are the arguments for decriminalising euthanasia the same in a democracy as under a authoritarian regime? Online Resources See papers on the Eubios Ethics Institute website, including News in Bioethics and Biotechnology http://eubios.info/NBB.htm Dutch Ministry of Foreign Affairs on euthanasia: http://www.minbuza.nl/english/homepage.asp. For web sites that oppose the legalisation and decriminalisation of euthanasia and assisted suicide, see: The Euthanasia Prevention Coalition: http://www.epc.bc.ca/ and a radical opponent of euthanasia at: http://www.prolifeinfo.org/euthanasia.html Background literature on euthanasia and suicide in the Netherlands Griffith, John & Alex Bood & Heleen Weyers (1998) Euthanasia & Law in the Netherlands, Amsterdam: Amsterdam University Press. Hendin, H., C. Ruthenfrans, and Z. Zylics (1997) 'Physician-assisted suicide and euthanasia in the Netherlands' Journal of the American Medical Association 277: 1720-22. Keown, Damien (1995) 'Euthanasia in the Netherlands: sliding down the slippery slope?' in Keown (ed.) Euthanasia Examined. Ethical, Clinical and Legal Perspectives. Cambridge: Cambridge University Press. Kimsma G, Leeuwen (1993) E. Dutch Euthanasia: Background, Practice, and Present Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 57. Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics 57 Justifications. Cambridge Quarterly of Healthcare Ethics. Shneidm, Edwin S. (1990) 'Preventing Suicide'. In John Donelly Suicide. Right or Wrong? Buffelo, New York: Promotheus Books Wijsbek, Henry (2001) Taking Lives Seriously. Philosophical Issues in the Dutch Euthanasia Debate, Amsterdam: Dissertation Vrije Universiteit Van der Maas, P.Jp., J.J.M. van Delden, L. Pijnenborg, C.W.N. Looman (1991) 'Euthanasia and other medical decisions concerning the end of life', Lancet 1991 (338): 669-674. Chapter D4: Brain Death Materials on brain death are available in some countries from the organ donation networks, and these may be a good source of teaching material. Certain countries, like Japan, have debated the issue for many years and have abundant literature. There is confusion about the issue in materials so use reliable sources. There is background material below on brain death, and a technical description. Japanese language notes are also available. Several pictures of the brain are available. You could white out some areas and ask students to fill in the regions if you wish. The story continues in Chapter D5 “Organ Donation”. There is a play script available as well, in Chapter D6 “Brain Death and Organ Transplant Drama”. See also Chapter D3 “Euthanasia”. What is brain death? Brain death is defined as the irreversible loss of all functions of the brain. Although diagnosis of this condition varies country to country in general it can be determined in several ways. First - no electrical activity in the brain; this is determined by an EEG. Second - no blood flow to the brain; this is determined by blood flow studies. Third - absence of function of all parts of the brain - as determined by clinical assessment (no movement, no response to stimulation, no breathing, no brain reflexes.) The criteria may be legally applied in some conditions, with exclusions for persons who are very young, in drug overdose, or whose bodies are very cold, because of the reliability of the criteria. There are also other conditions, like locked in syndrome, persistent vegetative state or coma, which are distinct from brain death, because the persons in those states are alive. Sometimes writers and the media get confused. A persons' heart can still be beating because of the ventilator and medications helping to keep the blood pressure normal. In most countries of the world a person who is declared brain dead is legally dead. Japan is one exception, and leaves the decision up to the person’s prior expression on the organ donor card, with their family's agreement. Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 58. 58 Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics Chapter D5: Organ Donation Materials on organ transplants are available in some countries from the organ donation networks, and these may be a good source of teaching material. The story continues from Chapter D4 “Brain Death”. There is a play script available also in Chapter D6 “Brain Death and Organ Transplant Drama”. Online resources Japan Organ Transplantation Network, available at http://www.jotnw.or.jp/news/news.html. Management Centre for Transplantation and Special Diseases, Iran, http://www.Irantransplant.org Philippines “Organ Donation Act of 1991”, Republic Act No. 7170, http//:www.chanrobles.com/republicactno7170.htm Saudi Organ Transplantation, Available at Saudi Center for Organ Transplantation: http://www.scot.org.sa/eng-index.html Singapore Human Organ Transplant Act, (HOTA), http://www.moh.gov.sg/corp/systems/organ/hota.do Chapter D6: Brain Death and Organ Transplant Drama Background This chapter is a drama version of chapters D4 and D5, see references for those chapters. Chapter D7: The Heart Transplant Background This chapter is a single page topic on organ transplants, see references for chapter D5. Chapter D8: SARS (Severe Acute Respiratory Syndrome) Background This chapter introduces some of the ethical issues associated with a recent outbreak of an infectious disease with the issues of quarantine and medical responsibility. Chapter D9: AIDS and Ethics This topic about AIDS is very straightforward on one hand, and very culture-oriented and complex on another. In some countries it may be more difficult to discuss about sexual behavior than in other countries. It is desirable therefore to acquire information according to the needs of every country where the class is taught. There have been a number of films made involving AIDS, for example "Philadelphia". In some countries patients can openly say they have AIDS, or HIV carriers will talk about how they feel. In others it is a secret. Online resources Eubios AIDS news: http://eubios.info/NBB/NBBAIDS.html UNAIDS: http://www.unaids.org/index.html WHO health topics on HIV: http://www.who.int/health_topics/hiv_infections/en/ Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 59. Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics 59 [Japanese pages] http://www.hokenkai.or.jp/ http://www.jfap.or.jp/ (AIDS prevention information network) http://www.cai.presen.to/ http://www.page.sannet.ne.jp/uchida/ http://www.internetacademy.co.jp/~s1201102/ (Little Angel) http://l-gff.gender.ne.jp/2001/qdp/aids.html Chapter D10: Ethical Principles for Medical Research Involving Human Subjects Background This chapter is the so-called Helsinki Declaration, which is a basic international standard for guidance for experimental medical research. It is not without controversy. Resources UNESCO International Bioethics Committee, Ethical Considerations Regarding Access to Experimental Treatment and Experimentation on Human Subjects (1996), Harold Edgar and Ricardo Cruz-Coke (Rapporteurs) <http://eubios.info/UNESCO/ibc1996.pdf> Chapter D11: Bird flu Background This chapter introduces some of the ethical issues associated with a recent outbreak of an infectious disease with the issues of quarantine and medical responsibility. Chapter D12: Indigenous Medicines and Access to Health Background This chapter introduces some of the ethical issues associated with the choices made in the use of medicines in health care systems. It would be interesting to see how many students and families use traditional medicines. Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 60. 60 Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics Section E. Reproduction Chapter E1: Lifestyle and Fertility Chapters E1 and E2 are linked to each other in discussing fertility and assisted reproductive technologies, intended to be taught over consecutive study periods. There are many issues that could be discussed, so the chapters are long and you may want to split them into more class times or selectively use specific sections. There are also photographs in the CD or on the website that can be downloaded. Chapters E1 and E2 have four specific aims: 1. To fully discuss the divide between fertility and infertility. 2. To outline the influences of lifestyle, environment and social development on personal empowerment and reproductive health. 3. To describe the assisted reproductive technologies. 4. To highlight major bioscience-bioethical concerns. By the end of chapter E1 students should be able to describe: a) Fertility health indicators b) The relationship of lifestyle factors to fertility c) Major contributors to reproductive health across the course of the life cycle. Summary To achieve the goal of a healthy, live child it helps for parents to learn as much as possible about the biology of fertility, pregnancy and childbirth and about the factors that promote or compromise fertility and reproductive health of the mother and her fetus. This lesson attempts to raise general awareness about ways social/lifestyle stresses during conception and pregnancy may impair growth and development resulting in long-term, even permanent, abnormalities in the child. Teacher to emphasize that when reproduction is considered a privilege, not a right, the chances of a good outcome is elevated significantly. Reproductive health care, education and support: general background analysis People’s sense of right and wrong behavior comes from many sources – not least from ethical instincts inherited from our evolutionary past. For the full development of reproductive health, humans depend upon the satisfaction of basic needs such as contact, intimacy, emotional expression, pleasure, tenderness and love. In order to maximally develop a person’s genetic potential personal, interpersonal and societal wellbeing is significant. It follows that since health is a fundamental human right, so must reproductive health be a basic right extended into future generations. When a couple plans to reproduce, they can take many practical steps to safeguard their own fertility and reproductive capacity, thereby safeguarding their children’s health well before conception and birth. These steps include seeking out prenatal care, ensuring good nutrition, avoiding harmful substances and learning about exercise and sex during pregnancy. Numerous studies have shown that prenatal care benefits almost every aspect of pregnancy as it decreases the likelihood of early miscarriage, fetal or neonatal death, fetal prematurity and low birth weight. Even before a woman becomes pregnant she can and be tested for her immunity to Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 61. Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics 61 German measles (rubella). If she’s not immune to this disease and contracts it during pregnancy, her fetus can suffer serious developmental defects; such as deafness and mental disability. This is a good reason for a non-immune woman to be vaccinated when planning to have a child. She can also be tested for HIV. This is another important reason since the virus can infect the fetus during pregnancy or at birth, and antiretroviral therapy can diminish the risk that this will happen. Fathers also transmit debilitating effects to their offspring. Because sperm cells are particularly vulnerable to genetic damage, birth defects in children appear to be more often linked with paternal than with maternal DNA damage. Planning to have a baby entails unique responsibilities from both parents and some understanding of biological systems is helpful in reducing problem pregnancies. We all know that prevention is preferable to ‘cure’ and when reproduction is considered a privilege, not a right, the chances of a good outcome is elevated significantly. The Box summarizes several possible approaches to the biological understanding of human fertility. Box: Approaches to the Understanding of Fertility Physical and functional basis of fertility The neural control mechanisms that mediate fertility and good reproductive potential The genetics underlying the reproductive capacity and potentials of its maximization The hormonal system that provides the capacity to nurture the fetus The pathological and microbiological causes of infertility The mental aspects governing fertility and how the brain generates mental states The interpersonal relationships that maintain high quality fertility References Macer, Darryl (editor) ‘UNESCO/IUBS/EUBIOS Living Dictionary of Bioethics’. http://eubios.info/biodict.htm Pollard, Irina (2002). ‘Life, Love and Children: A Practical Introduction to Bioscience Ethics and Bioethics’. Kluwer Academic, Boston. Pollard, Irina (1994). ‘A Guide to Reproduction Social Issues and Human Concerns’. Cambridge University Press, Cambridge. Chapter E2: Assisted Reproduction Chapters E2 and E1 are linked to each other in discussing fertility and assisted reproductive technologies. There are many issues that could be discussed, so the chapters are long and you may want to split them into more class times, or selectively use specific sections. There are also photographs in the CD or on the website that can be downloaded. Photos illustrating sperm forms, ICSI and cross-cultural family members are available. Chapters E2 and E1 have four specific aims: 1. To fully discuss the divide between fertility and infertility. 2. To outline the influences of lifestyle, environment and social development on personal empowerment and reproductive health. Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 62. 62 Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics 3. To describe the assisted reproductive technologies. 4. To highlight major bioscience-bioethical concerns. Further possible discussion questions: 1. Clinicians have to be vigilant not to repeat the same mistakes and so, in order to benefit their patients, have to learn from each other’s experiences. What are the major spheres of knowledge central to our understanding of human fertility and reproductive success? 2. A man was found to have around 12 million sperm per milliliter of semen. In all probability will he be able to father children in the normal way? 3. During hysterectomy a woman has her uterus removed. What effect will this have on her producing eggs? 4. If the technique of reproductive cloning were perfected and adopted, would that affect people’s ethical views about reproductive behavior? Compare and contrast what in your opinion is right or wrong in the reproduction domain. 5. Explain how your views have changed following this bioethics module. 6. For both sperm and oocyte donations, there is a market for donors who are perceived to be genetically superior, and higher fees may be paid in such cases especially for oocytes. Discuss the bioethical ramifications of this. 7. What in your mind are the ‘correctness’ issues raised in the case of a rich couple using a poor woman’s body to surrogate their child? 8. Discuss the pros and cons of paying high prices for ‘genetically favored’ gametes. Will the couple love their child as much or will they be resentful if their dream of a ‘superior’ child does not come true? 9. Scientific discoveries build on previous scientific discoveries and the outcome of scientific experiments cannot be known in advance. Discuss. 10. What are the perceived, including culturally-specific, barriers to seeking and utilizing ART assistance and other reproductive care services? 11. How can we, as potential parents, best benefit from the insights gained by scientists since the birth of the first IVF baby in 1978? 12. Discover culturally-dependent fertility beliefs and practices. Male infertility Sperm fertilizability tests investigate sperm fertilizing capacity and have become a valuable adjunct to the classical semen analysis. Sperm function tests may indicate whether conventional methods of assisted reproduction should first be applied or whether the couple should immediately be included into a micro-manipulation program such as ICSI (see section on ICSI). Various steps can be taken to achieve pregnancy in patients with poor sperm quality. Intrauterine insemination is often successful because placing the prepared semen high up in the uterus, allows sperm to bypass the cervix and its mucus that can contain anti-sperm antibodies. Partner insemination is usually called artificial insemination by the husband (AIH) and has been useful in cases of paraplegia (sperm is collected by electroejaculation), obstructed vas deferens or epididymis (sperm is aspirated from the epididymis) and forced separation of couples (prisoners on long-term sentences). Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 63. Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics 63 Donor insemination may also be used in combination with other ART technologies, including sperm separation for sex preselection and for other ‘designer’ characteristics. The latter application raises serious concerns from the ethical, legal and biological points of view. Male infertility treatment has advanced rapidly since the early 1990s. Men with sperm abnormalities sufficient to prevent in vitro fertilization can now father children through the techniques of sperm micromanipulation or assisted fertilization. It is easy to see that the outcome of ICSI is not related to any of the normal biological sperm selection processes described in the Teachers Notes for chapter 8. Female infertility A woman may stop menstruating (called secondary amenorrhea) or menstruate irregularly (called oligomenorrhea) or just fail to ovulate but menstruate normally. Many fertility problems can be reversed by lifestyle changes, psychotherapy (if the cause is depression or an eating disorder, for example), or failing the above, by drug treatment such as clomiphene or its generic versions. Clomiphene is an estrogen antagonist which by several feedback mechanisms promotes the maturation of ovarian follicles restoring fertility; sometimes too effectively as 5-10% of clomiphene-induced pregnancies are twins (compared with about 1% of normal pregnancies). IVF In IVF only a small number of sperm are needed because no long-distance migration is involved. Various IVF adaptions are discussed below. You may want to use these for class if students are competent enough. Gamete Intra-Fallopian Transfer (GIFT) Technology In an alternative procedure, oocytes are harvested from the woman as for IVF, but they are placed directly into her fallopian tubes, along with sperm from the partner. Fertilization then takes place in the fallopian tubes. This procedure is called gamete intra-fallopian transfer or GIFT and was developed to simulate the natural fertilization process more closely. The Ovarian Hyperstimulation Syndrome The ovarian hyperstimulation syndrome is a serious and potentially life-threatening physiologic complication encountered in a small percentage of patients undergoing the standard IVF hormone stimulation cycles in preparation for oocyte collection. Numerous ovarian follicles develop which drastically elevate estradiol secretion which, in turn, causes fluid shifts, nausea, vomiting and acute physiological distress. Serious health consequences resulting from medical treatments or diagnostic procedures are referred to as iatrogenic. Cytoplasmic Transfer Technology A more recent technological breakthrough is transfer of cytoplasm from a younger donor oocyte to a recipient oocyte belonging to an older woman facing the risk of repeated IVF failure. By the ‘rejuvenation’ procedure the older woman is, in some instances, enabled to bear her own genetic infant. Cytoplasmic donation widens the options (childlessness, adoption, or donor oocyte programs) available to a growing population of couples who face a high risk of Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 64. 64 Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics failure with traditional IVF. As with ICSI, the preference provided by cytoplasmic transfer is a child genetically related to the mother. Early reports have shown, however, that cytoplasm manipulation may heighten the risk of chromosomal abnormality (see Assisted Reproduction: Risks and Uncertainties’). Spare embryos donated to research are used to improve on existing technology or advance the development of new treatments. For example, donated embryos are a source of embryonic stem cells, which are believed to have many potential therapeutic uses. Counseling Most of us understand counseling to be a therapeutic technique providing advice and guidance to a patient and significant others. Therefore, counseling is an important part of any fertility treatment and applies both to the doctor, who maybe motivated by a too enthusiastic desire to help the infertile couple, and the couple who maybe blinded to consider valid alternatives by their desperate desire for a child. When it comes to infertility treatment protocols, all known potential risks must be carefully explained and received. Accredited IVF clinics require couples to sign a general consent form acknowledging that they have understood and accepted the information provided. This information typically clarifies the various assisted reproductive technologies planned, includes a warning that there may be associated short, medium and long term health risks, that there is no guarantee of a successful pregnancy and that they have been given fair opportunities to become better informed. The advantages of this practice to the couple are immeasurable from the point of view of increased understanding and in establishing mutual respect for each other and their unborn children. Assisted reproduction: risks and uncertainties Over the past few years, evidence has begun to emerge that suggests that babies born as a result of IVF and related procedures have an increased risk of low birth weight, genetic disorders, neurological abnormalities and maybe even cancer. In the meantime, fears about the safety of reproductive technologies should be kept in perspective because in most cases the studies done were based on small samples size, while other studies on children conceived by assisted reproduction have found no evidence of any serious problems. Evidently more research is needed to assess the risks and care should be taken to refine as much as possible the ART techniques in order to reduce these risks. New technologies for treating male- mediated infertility, for example, have been developing rapidly but their long-term effects on the offspring are still uncertain. Some researches are now questioning the safety of ICSI and other invasive techniques, claiming that they maybe linked to increased rates of birth defects and rare genetic imprinting disorders. An increasingly important biological and ethical issue concerns the application of assisted reproduction in all cases of infertility regardless of etiology. About one-third of all patients referred for fertility treatment have a significant history of drug exposure, reinforcing the view that drug exposure is an important consideration in all at-risk groups (Part A is devoted to the relationship of lifestyle and fertility). ART has certainly offered hope to those whose fertility has been compromised by the excessive use of recreational drugs, although the technology itself may, in some cases, further compromise the reproductive outcome. Poor IVF prognosis in the offspring may well be a contributing factor in a sub-population suffering from drug-induced infertility rather than the infertile population at large. Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 65. Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics 65 References Macer, Darryl (editor) ‘UNESCO/IUBS/EUBIOS Living Dictionary of Bioethics’. http://eubios.info/biodict.htm Pollard, Irina (2002). ‘Life, Love and Children: A Practical Introduction to Bioscience Ethics and Bioethics’. Kluwer Academic, Boston. Pollard, Irina (1994). ‘A Guide to Reproduction Social Issues and Human Concerns’. Cambridge University Press, Cambridge. UNESCO International Bioethics Committee, Report of the IBC on Pre-implantation Genetic Diagnosis and Germ-line Intervention (2003), Hans Galjaard (Rapporteur) <http://eubios.info/UNESCO/ibc2003ip.pdf> UNESCO International Bioethics Committee, The Use of Embryonic Stem Cells in Therapeutic Research (2001), Alexander McCall Smith and Michel Revel (Rapporteurs) <http://eubios.info/UNESCO/ibc2001sc.pdf> Chapter E3: Surrogacy Surrogacy If a woman cannot sustain pregnancy at all because, for example, her uterus is malformed or absent, or because her general medical condition makes pregnancy inadvisable, or she is unwilling to reproduce naturally because of inheritable genetic disease, an option is to use a surrogate mother. In a further twist of gestational surrogacy, the oocytes used for IVF may be taken from neither the woman nor the surrogate, but from a third woman whose genes are considered preferable to those of the surrogate. Adoption Adoption is a low-tech but often very successful way for infertile couples, or couples who have chosen against reproduction, to have children. A major problem with adoption from the perspective of would-be parents living in societies such as the United States of America or Australia, is the acute shortage of suitable adoptees; that is, healthy infants of the same ethnicity as themselves. Older or ‘special-needs’ children; that is, children with disabilities or other medical or psychological problems, are much more readily available and so are sets of siblings who want to be adopted together. For this reason and for a variety of other personal preferences, many couples nowadays choose to adopt infants from abroad even though this involves 1-3 years waiting periods and considerable expense. Cross-cultural family relationships have revealed them to be especially rewarding in that they generate wider understanding and respect for difference and challenge conventional mores about family and social conduct. Chapter E4: Choosing Your Children’s Sex and Designer Children Sex selection For example, they may have one or more children of one sex and now want to balance Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 66. 66 Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics the family with a child of the other sex, or perhaps think that it’s good for a brother to have a sister, or vice versa. More troubling, however, is the general social preference for boys seen in a variety of Asian and African cultures. Boys are preferred because traditionally they help with the farm work, bring money into the family and their children will carry on the family name. Girls are less favored because marrying them off requires heavy bridal payments and they leave their birth family after marriage. A particular abhorrent practice of the past was infanticide or abandoning newborn children of the unwanted sex. Nowadays, with amniocentesis and chorionic villus sampling it is possible to determine the sex of a fetus before birth. The introduction of obstetric ultrasonography has made it also possible to visualize a fetus’s genitals and to determine its sex. This can be done with reasonable accuracy by 12-14 weeks post-conception. As a consequence, sex-selective abortion is now a realistic option. Studies have exposed that the practice of aborting female fetuses is prevalent in India and China where the sex ratio of newborn children has become noticeably skewed toward males. In China, for example, about 119 male births are registered for every 100 female births, and in some parts of India the ratio is 126:100. The natural sex ratio at birth is about 105:100, at least for Western populations. Might not the present be an opportune time to reconsider abandoning gender discriminatory practices and return to women their due value and proper recognition? Considerable high-tech research has gone into developing techniques for selecting a child’s sex before fertilization. Because the fetus’s sex is determined by whether the oocyte is fertilized by an X-bearing or a Y-bearing sperm, researches have developed sperm separation techniques by focusing on the sperm’s total DNA content (X-bearing sperm contain about 2.9% more DNA that Y-bearing sperm). This difference is detected by a technique called flow cytometry. X- or Y-enriched fractions of sperm may then be selected to inseminate women who desire a girl or a boy, respectively. The researchers claim over 90% success with girls; results with boys are only slightly better than chance. A more complex, but more reliable method of selecting a child’s sex is by preimplantation genetic screening where only embryos of the preferred sex are transferred for implantation. Although this technique is mostly done to avoid sex-linked disease, some fertility clinics are said to offer this service for the purpose of family planning. Designer children A market for ‘superior’ sperm has long existed but the demand seems to be geared to donors with high intellectual attainment. For example, the Repository for Germinal Choice in Escondido, California, is a nonprofit organization founded in 1980 by Robert Graham. It distributed sperm from Nobel Prize winners, and other high achievers. The Repository has since gone out of business, but another organization Heredity Choice continues to offer semen from prominent scientists and others. Resources UNESCO International Bioethics Committee, Report on Human Gene Therapy (1994), Mr Harold Edgar and Mr Thomas Tursz (Rapporteurs) <http://eubios.info/UNESCO/ibc1994.pdf> UNESCO International Bioethics Committee, Report of the IBC on Pre-implantation Genetic Diagnosis and Germ-line Intervention (2003), Hans Galjaard (Rapporteur) <http://eubios.info/UNESCO/ibc2003ip.pdf> Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 67. Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics 67 Chapter E5: Prenatal diagnosis of genetic disease Background This chapter introduces a difficult moral issue that is hotly debated in countries that oppose abortion. It is also linked to the eugenic issue, discussed in chapter C7, and genetic privacy discussed in chapter C5. It is important to understand the different points of view in this issue. Resources UNESCO International Bioethics Committee, Report on Genetic Screening and Testing (1994), Mr David Shapiro (Rapporteur) <http://eubios.info/UNESCO/ibc1994gs.pdf> UNESCO International Bioethics Committee, Report of the IBC on Pre-implantation Genetic Diagnosis and Germ-line Intervention (2003), Hans Galjaard (Rapporteur) <http://eubios.info/UNESCO/ibc2003ip.pdf> UNESCO International Bioethics Committee, Genetic Counselling (1995), Michel Revel (Rapporteur) <http://eubios.info/UNESCO/ibc1995gc.pdf> UNESCO International Bioethics Committee, Report of the IBC on Pre-implantation Genetic Diagnosis and Germ-line Intervention (2003), Hans Galjaard (Rapporteur) <http://eubios.info/UNESCO/ibc2003ip.pdf> Chapter E6: Female Infanticide Background This chapter introduces a crime that still occurs in some parts of the world, and some of the social issues behind it. It is related to chapter E4. Chapter E7: Human cloning Background This chapter introduces a controversial topic that has been widely debated internationally. Further documentation is provided in Chapters E8 and E9. Resources UNESCO Universal Declaration on the Human Genome And Human Rights (1997; Chapter C9) <http://eubios.info/unesco.htm> UNESCO International Bioethics Committee, The Use of Embryonic Stem Cells in Therapeutic Research (2001), Alexander McCall Smith and Michel Revel (Rapporteurs) <http://eubios.info/UNESCO/ibc2001sc.pdf> UNESCO International Bioethics Committee, Report on Confidentiality and Genetic Data (2000), Working Group of the IBC on Confidentiality and Genetic Data <http://eubios.info/UNESCO/ibc2000.pdf> UNESCO International Bioethics Committee, Ethical Considerations Regarding Access to Experimental Treatment and Experimentation on Human Subjects (1996), Harold Edgar and Ricardo Cruz-Coke (Rapporteurs) <http://eubios.info/UNESCO/ibc1996.pdf> Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 68. 68 Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics Chapter E8: United Nations Declaration on Human Cloning Background This provides the text of a United Nations Declaration, and allows students to see where their countries voted in this debate. Chapter E9: Human Genome Organization Declaration on Stem Cell Research Background This is an example of a statement from a professional scientific association on a key issue of popular debate. Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 69. Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics 69 Section F. Neurosciences Chapters F1, F2 and F3 are linked to each other as they communicate progressive topics in neuroscience and neuroethics. The present chapter is introductory and describes basic principles together with interesting applications taken from modern neuroscience and neuroethics (see ‘Summary’ below). Chapter F2 focuses on the fundamentals of learning and memory. The final chapter of this trilogy explains the neuroscience of addiction. Lifestyle factors and socially relevant examples are provided throughout. Summary The brain has always fascinated psychologists and with the advent of new technologies, it has become possible to investigate the brain more methodically. Neuroscience includes the study of brain development, sensation and perception, learning and memory, movement, sleep, stress, aging as well as neurological and psychiatric disorders. It also investigates the molecules, genes and cells responsible for nervous system functioning. Neurons are the elements responsible for information-processing and information-transmitting within the nervous system and throughout the whole bodily system. Since the nervous system consists of all the essential functioning processes bridging cell anatomy and cell activity, it is also the basis of all human behavior. Its cellular organization leads to the complexity of neural networks that, in turn, are responsible for sensory functions such as sight, smell, touch and hearing. Modern neuroscience research has enabled scientists to describe human brain function fundamental in driving human consciousness and behavior. Present and future research has/is developing ways to cure, or prevent, neurological and psychiatric disorders. The present chapter aims to provide the preliminary tools to provoke student reflection and debate about modern insights into neuroscience and neuroethics. For instance, the module selects Parkinson’s disease in order to introduce intra-cerebral grafting of fetal tissue, which may provide a cure but is also the subject of vigorous debate. I am hoping that discussion of the above procedure together with its relevant ethics, will lead the way to more discussion about medical research in general. Students need to be included in ethical debates involving medical research in order to gain an understanding of the difficulties of forming ethical guidelines in a society with different social and cultural values. Resources UNESCO International Bioethics Committee, Ethics and Neurosciences (1995), Mr Jean- Didier Vincent (Rapporteur) <http://eubios.info/UNESCO/ibc1995ns.pdf> Chapter F1: Advances in Neuroscience and Neuroethics Body or Mind – Where is the Difference? (Question 1) Ethical codes have evolved over hundreds of thousand of years through the interplay of biology and culture. Through neuroscience, we have now discovered that human emotions and the ability to make rational decisions can be attributed to different parts of the brain. Ethical choice depends on the capacity to foresee the results of actions and includes the acceptance of individual responsibility – the ability to recognize and weigh decisions. The human brain – the cortex in particular – is more than an instrument for shaping the environment. In addition to receiving and linking heard, seen, smelled and felt sensations, parts of the cortex’s frontal lobe Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 70. 70 Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics interpret what is received incorporating it into the development of judgment, volition and consciousness of self and others. It is possible to connect the evolution of ethics with the evolution of these various parts of the brain. Over time the development of the frontal lobes allowed for more creativity and ability to make rational decisions. The ability to communicate with others increased the complexities of social relationships improving the human’s perception of self and others. At that point in evolution, humans began to understand the moral and ethical consequences of their actions by recognizing the effects their actions had on the behavior of others. This offered the opportunity for the development of a collective awareness, or ethics. Ethical behaviors have survival value where humans acting in the interest of others are favored in the struggle for existence and are more likely to survive. Neuroethics (Questions 2 – 7) Judicial systems around the world punish criminals who are responsible for committing an unlawful act. But how could one be convicted of committing a crime if he/she could not control themselves as a result of brain malfunction? To determine if a person is insane, the court of law applies a series of tests, which differ between countries. The basic principles of all such tests are to examine cognition: whether the offender had the ability to understand wrong from right during the criminal act and volition or choice of whether or not the offender was able to control themselves when they committed the criminal act. The insanity defense states that a person cannot be guilty of committing a criminal act if they are unable to acknowledge that the act was wrong or could not control their actions because of a mental illness. Neuroscience research has examined the cause of behavior that permits people to commit criminal acts. It suggests that some criminal actions are due to damage or related illnesses/diseases to the prefrontal cortex region. Interestingly, when the prefrontal cortexes of rats are damaged they regularly make the more impulsive choices, suggesting that the prefrontal cortex regulates impulsive behavior. Modern brain imaging began in the 1970s with computed axial tomography (CAT) scans and many advances have since been made. In the earlier days of neuroimaging, studies focused on structure-function relationships in the brain and now organization of the primary sensors and motor regions of the brain is particularly well understood. Today studies probe at our deepest thoughts, define our complex cognitive behaviors and judge our rational decision- making and consciousness. Neuroimaging reveals the structure of the living brain through technologies such as computer-assisted tomography (CAT) scans or magnetic resonance imaging (MRI). Brain function is revealed through positron emission tomography (PET) scans, single photon emission tomography (SPECT) scans, or functional magnetic resonance imaging (fMRI). Future developments in functional brain imaging may provide sufficient information to potentially breach the privacy of a person’s own thoughts. Privacy is therefore high on the list of ethical issues raised by the new brain scanning technologies. Despite apprehension on expert ability to measure mental or neural processing meaningfully, there is an aura around ‘high tech’ visual images which may lead judges and juries to put more weight on evidence from functional neuroimaging than is warranted. A better public understanding of the limitations of imaging is necessary to prevent an over-reliance on this source of information. Since modern neuroimaging faces the common bioethical considerations of privacy, confidentiality and the misuse of this information, the ethical considerations are very similar to those associated with the human genome debate. That is, the social implications of the availability of personal information, particularly relating to future behaviour, to the wider community. Neuroimaging can currently interpret personality, desires and may even ‘see’ a Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 71. Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics 71 state of mind (e.g. racial attitude) of which one is unaware. The implications this would hold for our health, legal, employment, immigration, education and not to mention insurance systems are phenomenal. It isn’t always in the person’s best interest to have that information available to others. Radiologists, using predictive testing, are faced with long-standing ethical issues, particularly those relating to psychopathology. In summary: Before brain fingerprinting becomes established as a forensic tool, its accuracy needs to be assessed. Brain fingerprinting techniques are being rated that can reveal an individuals’ knowledge of an event. If a truly accurate lie detector could be developed current privacy guarantees might not provide enough protection against scanning requests from courts, the government, the military or employers. Physiological measures, especially brain- based measures, possess illusory accuracy and objectivity as perceived by the general public. Finger Printing – Can Machines Read Your Mind? (Questions 8, 9) Advances in neuroscience may well improve our ability to make predictions about an individual’s future. This seems particularly likely through neuroimaging, as patterns of brain images taken under varying circumstances, are correlated with different future behaviors or conditions. Neuroscience might predict, or reveal, mental illness, behavioral traits, or cognitive abilities, among other things. For example, neuroimages might lead to predictions, with greater or lesser accuracy, of a variety of neurodegenerative diseases. As identified above, this raises some rather serious concerns that the technology could be abused. Further, such imaging tests may be inaccurate, may present information patients find difficult to evaluate, and may provide information of dubious value and some harm. Society may wish to regulate such tests along the lines proposed for genetic tests where establishing guidelines for the testing procedure would involve the following: ● Establishing the accuracy of the test for detecting a particular condition. ● Assessment of the competency of those performing the test. ● Ensure informed consent has been obtained to ensure the individual being tested is fully aware of the possible outcomes and limitations of the test. ● Post-test counseling to ensure that the tested individual understands fully the consequences of the results. Another important policy question would be whether such tests should be regulated through government action or by professional self-regulation. Intra-cerebral Grafting of Fetal Stem cells for Parkinson’s Disease (Questions 10, 11) The ethical debate surrounding stem cell research is centered on the use of embryonic stem cells. Specifically, on the deliberate production and destruction of human life. The embryo, which is manipulated technologically in an artificial environment, will never reach the uterus where nature intended it to be. Religion can be considered the most influential aspect driving the stem cell debate. But there is diversity of thought as not all religions are categorically against all stem cell research. For example, Buddhism believes in rebirth and the transformation of the deceased karma into the embryo; thus, life is ‘ensouled’ at conception. However, Buddhism also teaches the virtues of knowledge and compassion and has a long tradition of practicing medicines, which promote the alleviation of suffering. Based on this reasoning, Buddhism accepts adult and embryonic Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 72. 72 Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics stem cell research to an extent. This sentiment equally applies to other religious groups. Contemporary life has profoundly modified Christianity even in the official circles of the Church, including the Roman Church, where there are many scholars who find no difficulty in maintaining communion while accepting the modern scientific view of the world. And so it is with the stem cell debate which covers a wide variety of perspectives from qualified acceptance to total disclaimer. References Check, E. (2005). Brain Scan Ethics Come Under the Spotlight. Nature 433:185. DeCamp, M. and Sugarman, J. (2004). Ethics in Behavioral Genetics Research. Accountability in Research 11:24-47. Farah, M. and Wolpe, P. (2004). Monitoring and Manipulating Brain Function: New Neuroscience Technologies and their Ethical Implications. Hastings Center Report 43:35-45. Goodenough, O. (2004). Responsibility and Punishment: Whose Mind? A Response. Philosophical Transactions for the Royal Society of London B 359:1805-1809. Lovegren, S. (2005). Thought-Controlled Machines May Be One Step Closer. National Geographic News, April 2005. http://news.nationalgeographic.com/news Sapolsky, R. (2004). The Frontal Cortex and the Criminal Justice System. Philosophical Transactions for the Royal Society of London B 359:1787-96. Van de Klundert, M. (2005). Parkinson’s Disease: Recent Insights in the Disease Mechanism and a Proposal for a New Line of Drug Development. Nature Neuroscience 3:537-544. Chapter F2: Learning to Remember: The Biological Basis of Memory Learning to Remember (Question 1) Memories of an event can be modified to include information that never actually occurred. Such memories are known as ‘false memories’. False memories become modified through external suggestions or through the process of imagination, and this can occur so that a person’s memory of an event supports a belief that they hold, or fits with information that others later provide. As the person then relives a memory in their mind, they can unintentionally alter its contents so that it is more meaningful to them. In experimental conditions, some brain areas, for example the posterior medial temporal lobe, respond differently to true memories and false memories and this can be visualized using brain-imaging techniques. Functional magnetic resonance imaging (fMRI) measures brain blood flow while a person is partaking in some activity, say recalling a memory, and can be used to detect which areas of the brain are being activated. When an eyewitness is called to testify in a criminal case it is important that their recollection of the event is supported by other evidence to ensure that it is a true memory. Such evidence can be provided by forensic tests, such as fingerprint or DNA evidence, or through the support of other witnesses. In situations where a memory recalled by an eyewitness is critical to the case, fMRI evidence could be utilised to support its validity. It is important to remember however, that such fMRI evidence can only support, but not prove, the validity of the memory, in the same way that a lie detector test supports a person's statement, but does not prove its truthfulness. Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 73. Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics 73 Learning to Remember (Question 2) Since imagination is a proven modifier of memories it is a technique that should be used with the utmost caution in therapeutic settings. Surveys of clinical psychologists, psychiatrists and other therapists reveal that imagination is often utilised as a therapeutic tool as patients are advised to imagine an event in the hope that it will stimulate buried or repressed memories. This is particularly dangerous if used in treating cases of trauma, such as sexual abuse, where imagining the abuse could enhance and exaggerate the memory in the patients mind and increases their confidence that it occurred. “Imagination inflation" is an established psychological phenomenon, whereby the act of imagination makes the event seem more familiar and that familiarity in turn, can mistakenly be attributed to childhood memories rather than to the act of imagination. Such confusion, when a person does not remember the source of information, can be especially acute for the distant experiences of childhood and the potential negative consequence of this technique for both the patient and their families is of significant ethical concern. Making Memories (Question 3) The experimental animals that were genetically engineered to perform well on memory tasks have helped neuroscientists understand the brain mechanisms involved in learning and memory, but the use of this information to design individuals with 'super memories' poses many ethical concerns. Not only do we need to consider the potential health consequences, but also our right (or lack thereof) to design a person's characteristics based on our personal values. While learning and memory are undoubtedly valuable traits, the ability to retain information, as opposed to constructively evaluating it, is perhaps overemphasized due to the social value placed on intellectual performance and the ability to recall facts. The ability to remember information and recall it in academic settings, i.e. during school exams, does not necessarily make an individual successful in life. Such traits must be balanced with other abilities, including emotional qualities such as compassion and empathy, mental skills such as creativity, and physical skills such as co-ordination, to name but a few. Flexibility in both thinking and behaviour are the cornerstones of survival as animals (including humans) must constantly adapt to an ever changing environment. The ability to retain information that is associated with intelligence does not necessarily breed successful or happy individuals, instead emotional intelligence is proving to be a more important characteristic. Qualities associated with emotional intelligence include self-awareness, impulse control, empathy and social dexterity, and it is these traits that are associated with success in life, rather than the ability to store and recall information. With the incidence of emotional disorders such as depression occurring at increasing rates throughout the globe, it is important that we remain mindful of the balance that must be maintained between intellectual and emotional abilities. Fading Memory: Alzheimer's Disease (Question 4) Those suffering from neurodegenerative disorders such as Alzheimer's disease require full time care and often their needs are above and beyond what family members can meet. Therefore, it is imperative that adequate treatment facilities be established within communities to accommodate the growing need for caring for those who are physically healthy, but whose mental capacities are deteriorating. Governments need to devote adequate funding to the Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 74. 74 Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics treatment of such diseases, in both establishing adequate facilities and properly training professional staff and caregivers. It is imperative with an aging population that sufficient facilities are established in time to meet the growing demand that will be placed on them. Without such facilities significant burden will be placed on the family members of those who are suffering from Alzheimer's. Children will be forced to care for physically healthy, but demented parents who are no longer able to care for themselves. Often Alzheimer's patients require around the clock attention, forcing adult children to forfeit their own lives in order to provide full-time care for their elderly parents. In addition to this, governments need to invest in research investigating neurodegenerative disease prevention and cure, to ultimately relieve this form of human suffering and the burden that it places on health care systems and families. Fading Memory: Alzheimer's Disease (Question 5) Genetic tests can provide valuable information about a person's susceptibility to a particular disease. Such testing, however, must be supported by informative briefings, with individuals providing their informed consent to participate in the procedure, to ensure that they are fully aware of all the facts and options available to them. Parents who utilize prenatal screening procedures for a degenerative disorder such as Alzheimer's disease have the right to be advised of the potential to treat the disease in the future, particularly given the fast paced nature of medical developments in today's world. While parents' choices of whether to continue with a pregnancy or not are highly personal and influenced by many factors including their faith or religious beliefs, their economic circumstances or their own health concerns, it is important that they are fully informed about the current research in the area and provided with supportive counsel to discuss each of their concerns in a respectful atmosphere. Genetic testing can be particularly beneficial in circumstances where preventative medicine is available, or under development, because it provides individuals with an opportunity to treat the disease before it develops. Individuals informed that they are at risk of developing a degenerative disease are also more motivated to partake in healthy habits that are likely to enhance their outcome, such as eating a diet high in antioxidants, known to have preventative medicinal properties for diseases such as Alzheimer's or Parkinson's disease, or can avoid unhealthy habits that can accelerate the onset of each disease. Fading Memory: Alzheimer's Disease (Question 6) Issues surrounding privacy of information are particularly important in circumstances where genetic screening is utilised to identify disease risk. Individuals have a right to protect their information, however insurance companies also argue that they have a right to be fully informed of the health status of their clients, including any knowledge they may have of their risk for future disease if this has been confirmed through genetic testing. Positive genetic test results for a degenerative disease that would occur sometime in the future would likely result in the insurance company charging higher premiums to that individual today in order to cover their expenses in the future. This could in turn, discourage people from partaking in potentially beneficial screening programs for the fear that it will incur greater cost to them if they do not have the right to protect their information. Memory Enhancement Therapies (Question 7) The majority of our memories are ‘negative memories’ whereby our nervous system actively filters out unimportant information and inhibits the formation of memory traces in the Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 75. Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics 75 brain. A pill that acts to enhance the consolidation of memories may be of benefit to an individual in some circumstances, for example, while studying for an exam, but is likely to incur significant side effects if taken while a person's brain is still developing, or if taken over a long period of time. It is unlikely that a ‘memory enhancing pill’ could allow a person to selectively store memories of their choosing (such as class notes), without also storing unrelated or insignificant information, or perhaps even modifying memories more easily. The excess storage of information could, in turn, put unnecessary pressure on the storage and retrieval systems of the brain over time, which may incur negative consequences that are as yet unknown. Social pressure to succeed in school and business will likely provide the motivational drive for individuals to consume memory enhancing drugs, to the point where the negative side effects may not be of significant interest to them. Yet the developing mind is particularly fragile, and we must proceed with caution when administering drugs to young individuals, when the effects on neuronal systems are not well established. In addition to this, long-term consumption may have disastrous consequences on established neuronal systems, given the neuronal mechanisms involved in memory storage, if pushed to the extreme, may lead to the destruction of neuronal cells. Social pressure to succeed in either school or business can place undue pressure on individuals to modify their mental abilities with a memory-enhancing drug. The development and availability of such drugs will inevitably provide unfair advantage for those who consume them in learning and memory tasks and will place pressure on those who do not take the drug to consume it also. This advantage is likely to be associated with higher socioeconomic status, that is, those who can afford the treatment will potentially benefit from enhanced memory, while those who cannot, may be disadvantaged. In a competitive school or work environment, this advantage may be likened to chemicals such as anabolic steroids that enhance physical performance in sporting activities, and regulations to prevent unfair advantage may need to be introduced. References Farah M.J., Illes J, Cook-Deegan R, Gardner H, Kandel E, King P, Parens E, Sahakian B, Wolpe PR. (2004). Neurocognitive enhancement: what can we do and what should we do? Nat Rev Neuroscience 5:421-425. Goleman, D. (2003). Destructive emotions and how we can overcome them a dialogue with the Dalai Lama, Mind and Life Institute, Great Britain Kalat, J.W. (2001). Biological psychology 7th Ed., Wadsworth Thomson Learning, USA Loftus E.F. (2005). Searching for the neurobiology of the misinformation effect, Learning and Memory 12:1-2. Chapter F3: The Neuroscience of Pleasure, Reward and Addiction What is Addiction? (Question 1) This question can readily be adapted to suit a class activity where some students portray the point of view of the rat while others trace their thoughts and feelings in human terms. For example, does drug addiction surrender the right of personal freedom of thought and Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 76. 76 Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics behaviour? Does providing the state with powers to order addiction rehabilitation violate or defend the right of freedom of choice? Dopamine: The Courier of Addiction (Question 2) There has been a long-standing debate between the medical and the moral models of addiction. The moral interpretation deems addiction as a voluntary behaviour, whereby an individual chooses at free will to engage in using an abusive drug without assuming responsibility for his or her actions. The medical interpretation differs from the moral one and states that an individual forms an addiction based on brain processes. As described in the text, recent research has provided increased understanding of the biological-behavioural features of addiction. These differing interpretations have fuelled fiery controversy; not least because the medical model describes drug abuse as a form of brain disease resulting from chronic behavioural abuse by the individual. In the final analysis, however, it’s probably wise to assume that the truth lies somewhere in between the two models of addiction. Dopamine: The Courier of Addiction (Question 3) One of the reasons neuroscientists study drugs is to better understand how synapses and neurons function within the brain in order to more fully understand the ways the brain operates, channels thinking and modulates behaviour. Some neuroscientists are particularly interested in how and why people become addicted to drugs of abuse because understanding this will allow physicians to better treat addiction and prevent/ameliorate the traumatic cravings in those who have become addicted. Moreover compassionate understanding of physiological systems has the added quality of accelerating community pressure for reform in areas of social injustice which underlie and perpetuate drug consumption risking addiction (see notes for question 6). Research effort is also directed at developing drugs that inhibit the drive to consume the drug of abuse by blocking key receptor sites in the dopamine reward circuit. Research efforts are also directed at developing better medications for the treatment of disorders such as anxiety, depression or schizophrenia, or for the treatment of degenerative diseases such as multiple sclerosis, Parkinson's disease or Alzheimer's disease. Finally, another related area of research is directed at the development of drugs that enhance normal brain functions such as cognition and memory (see notes for question 7 and Chapter F2, section 4). Dopamine: The Courier of Addiction (Question 4) The primary difference between 'good drugs' and 'bad drugs' relates to the amount taken and the motivation for taking it. If we think for a moment we will soon realize that many drugs that we consider dangerous; including cocaine, morphine and amphetamines, have useful medical applications. The reason that drugs of abuse are labeled as 'bad' is because the individual who consumes them in excess may become addicted to the point where the motivation to consume said drug overwhelms almost, if not all, aspects of their life. In extreme cases, life’s normal pleasures and motivations such as eating, socializing, thinking and working are completely inhibited. There is also the risk that addicted individuals, especially those who have become sensitized to their drug (i.e., require higher doses to receive a previously satisfying 'high') may misjudge a 'safe' dose level risking hospitalization or death. In the absence of quality controls, keeping track of ‘safe’ dose levels of black market substances, especially of narcotics such as heroin, is made extremely complicated and wide fluctuations in Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 77. Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics 77 purity and strength become the norm rather than the exception. Alternatively, a drug is considered 'good' if it helps to restore a malfunctioning physiological system to its original, or adequate, level of performance. ‘Good’ drug consumption must be controlled in order to minimize the risk of addiction and this is where informed consent by the patient is crucially important. The Biology of Drug Addiction (Question 5) Our brain has evolved a mechanism whereby it encourages us to repeat behaviours that are conducive to our own survival, as well the survival of the species as a whole. The mesolimbic dopamine system is critically involved in mediating incentive-motivation laden behaviours such as eating, drinking or sexual activity. Each of these activities lead to the activation of dopamine cells in the ventral tegmental area which release dopamine in the nucleus accumbens. This neuronal signal is referred to as a reward signal and serves to reinforce these behaviours, motivating an animal to repeat them in the future. In this way, we (and other animals) will naturally repeat behaviours that are conducive to our own survival (eating and drinking) and the propagation of the species (reproduction). Animals with these survival enhancing mechanisms are in turn, more likely to pass on their genes to future generations, and in turn propagate the species. Unfortunately these basic mechanisms which, in the natural setting, are beneficial to survival are ‘hijacked’ by chemical mechanisms upon exposure to drugs of abuse such that the maladaptive drug consumption is reinforced as a behaviour. Lifestyle, Stress and Addiction (Question 6) Modern functional imaging technology has generated a dramatic increase in our understanding of the neural mechanisms underlying cognition, behaviour and moods. Mood is the consistent extension of emotion in time, while emotion is typically transient and responsive to the thoughts, activities, and social situations of the day. It is our mood – the state of our emotional balance – that powerfully influences the way we perceive the world and interact within our environment. Emotion corresponds to an ancient signalling system that evolved millions of years ago in all mammalian species living in social groups. From the very first the newborn makes use of emotional signals of joy, sadness, anger and disgust in order to stimulate the parents to protect its basic needs. The free expression of these primary emotions, and their recognition, interact to shape the quality of the bonds that develop between family members and is fundamental to the brain’s further development. Later, as the infant’s brain develops, personalized configurations of brain connections expand to construct the mind – the individual’s unique personality. Pure emotion becomes tempered with individual memories, experiences and cultural/private meanings. Significantly, attachment and emotional expression between parent and offspring go hand in hand with the development of the emotional self. The development of the secondary emotions; such as shame, pride, guilt, rely upon the ability to make intelligent judgments against an acquired set of ethical standards. As mature adults the secondary emotions dominate our social behaviour, the stability of our relationships and our personal ethical consciousness. Insufficient emotional stimulation and/or an excessive amount of negative simulation in the early stages of life is likely to result in a higher risk of mental health troubles down the Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 78. 78 Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics track. On the positive side, however, the brain remains functionally plastic throughout the prenatal-neonatal periods and infancy, allowing it to adjust neuro-physiologically and psychologically and, increasingly, to adapt to the prevailing environment. For example, the outcome of children raised in dysfunctional families is not completely negative. Recent studies have indicated that such children are much more resilient than supposed. Importantly, for the child suffering extreme deprivation the chances for recovery in an improved environment are far better than previously predicted. Nevertheless, in circumstances of heightened, prolonged stress and weakened means of defense, the sufferer may seek the escape that mind-altering, psychoactive substances can provide. Simply expressed, those who become dependent on alcohol or drugs may be using these substances as a medication to calm feelings of anxiety, anger or depression. It is important to note, however, that the self-medication theory of stress alleviation may not follow a direct relationship in every case. That is, the harmful effects from recreational drugs are invisible and cumulative and those participating in casual drug consumption for recreational purposes may risk compensatory deregulation of key neurochemical pathways that in turn can result in states of anxiety or depression in formerly healthy individuals with no other inherent risk factors. For example, there is increasing evidence that regular cannabis (marijuana) use and depression are associated. There are varying reasons why cannabis use and depression might be associated – cannabis use may precipitate depression or depressed individuals may seek cannabis to improve their mood. From the perspective of the individual addict, however, this may not be very helpful as it calls to mind the fruitless chicken-and-egg argument. We may wonder then why the majority of young people are able to experiment with drugs and alcohol without becoming addicted; while others become dependent almost from the start. It should be kept in mind that poverty itself delivers emotional blows to children: poorer children at age 5 are already more fearful, anxious and sad than their better-off peers. The stress of poverty corrodes family life resulting in fewer expressions of parental warmth, more depression in mothers (who are often single and jobless) and a greater reliance on harsh punishments, perpetuating social inequalities in health and wellbeing. Scientist can only draw attention to the biological needs that have to be satisfied and possible pathological consequences if they are not – society has to take responsibility. A commitment to the right of humans to express their full genetic potential free from preventable harm is fundamental to the mature society and this is where bioscience-bioethics can assist. Lifestyle, Stress and Addiction (Question 7) As described in section F2.4, another emerging ethical issue in neuroscience concerns the use of drugs that enhance normal function including mood enhancement and focus enhancement. Drugs used to treat conditions such as depression and attention deficit hyperactive disorder (ADHD), for example, are readily available as more people with less severe symptoms are being prescribed these medications. One reason for this is that doctors are not trained neuroscientists or psychologists and misdiagnosis cannot be ruled out. If healthy people are prescribed anti-depressants there is a reduction of negative emotions and they become less fearful, hostile and do better in social situations. Equally, if healthy people take Ritalin, a drug used to treat ADHD, this improves their vigilance, problem solving and planning abilities. So what is the problem with healthy people receiving beneficial effects from these drugs? Possible discussion points may incorporate the following: Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 79. Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics 79 ● Parents who may press pediatricians for Ritalin in order to give their child an extra edge at school. ● School and university students using Ritalin (bought of individuals prescribed the medication) during their exam period. ● Can illegally bought drugs be taken unsafely risking the potential for overdosing? ● Is it right to risk addiction or other changes in neuronal functioning? ● Is it right to be cheerful and focused only because of drugs? Could the long-term health and social effects be serious? ● If mood enhancement were to become accepted and widespread, would it be evenly distributed? Would people from low socio-economic backgrounds, or those who didn’t use enhancement drugs, be disadvantaged? ● May parents be indirectly coerced to put their children on Ritalin because they cannot perform as well as the drug-enhanced children? ● If widespread enhancement raises the standard of normalcy, are we overriding important biological imperatives? Drugs can also be used to treat people who have committed a serious sex-offense or violent crime. At the moment treatment and rehabilitation through the use of drugs, which alter body chemistry and nervous system function, is voluntary. But what if the court requires offenders to undergo compulsory treatment rather than relying on the more traditional methods; such as anger management classes? Is compulsory treatment a human rights issue? Note that traditional treatment keeps intact a person’s natural thought processes, while drug treatment causes changed cognitive patterns. Other important issues may include the technology itself. How safe are the technologies? Who should decide whether they are safe or not? When promising new treatments are discovered, who should receive them? Is a rich person more deserving than a poor one or a young person more deserving than an old one? References Anderson, K., Anderson, L. and Glanze, W. Editors (1998). Mosby’s Medical, Nursing & Allied Health Dictionary 5th Ed. St. Louis, Missouri: Mosby. Bioscience-Bioethics Friendship Co-operative at www.bioscience-bioethics.org Castle, D. and Murray, R (2004). Marijuana and Madness: Psychiatry and Neurobiology. Cambridge UK: Cambridge University Press. Kalat, J.W. (2001). Biological Psychology 7th Ed. Wadsworth Thomson Learning, USA. Pollard, Irina (2005). Bioscience-Bioethics and Life Factors Affecting Reproduction with Special Reference to the Indigenous Australian Population: Review. Reproduction 129:391-402. Pollard, Irina (2004). Meditation and Brain Function: A Review. Eubios Journal of Asian and International Bioethics 14:28-33. Pollard, Irina (2003). From Happiness to Depression. Today’s Life Science 15:22-26. Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 80. 80 Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics Section G. Social Ethics Chapter G1: Revisiting the Body Background The topic of obesity, dieting and body shape is very relevant for teenagers, and this chapter makes students think about assumptions that they make. It challenges the media preoccupation with body shape. References 1. Chris Shilling, The Body and Social Theory, Sage Publications, London/Newbury Park/New Delhi, 2003. 2. Charles Taylor, The Ethics of Authenticity, Harvard University Press, Cambridge, Massachussetts, 1991. 3. Thomas Mautner ed., The Penguin Dictionary of Philosophy, Penguin Books Ltd., England, 2000. 4. Erik Parens, “Authenticity and Ambivalence: Toward Understanding the Enhancement Debate,” Hastings Center Report 35, no.3, 2005, pp. 34-41. 5. Richard Titmuss, The Gift Relationship: From Altruism to Commerce, Pantheon, New York, 1971. 6. US House of Representatives, HCON 124 1H, 109th congress, 6 April 2005. 7. Donna Dickenson, “Commodification of Human Tissue: Implications for Feminist and Development Ethics” Developing World Bioethics, 2 (1), 2002, pp. 55-63. 8. Moore vs. The Regents of the University of California, 51 Cal.3d 120, 1990. 9. The President’s Council on Bioethics, Staff Background Paper - Organ Transplantation: Ethical Dilemmas and Policy Choices, Washington D.C., January 2003. 10. Leonardo de Castro, “Commodification and Exploitation: Arguments in Favour of Compensated Organ Donation” Journal of Medical Ethics, 29, 2003, pp. 142-46. 11. D. Dickenson, Commodification, pp.55-63. 12. Carol Gilligan cited in “Whose Body Is This? Feminism, Medicine, and the Conceptualization of Eating Disorders” pp.45-70, Susan Bordo, Unbearable Weight: Feminism, Western Culture, and the Body, 10th Anniversary edition, University of California Press, Berkeley and Los Angeles, 2003. 13. S. Bordo, Unbearable Weight, p. 67. 14. Ibid, p.68. 15. Elizabeth Frazer, Jennifer Hornsby, and Sabina Lovibond, eds., Ethics: A Feminist Reader, Blackwell Publications, England, 1992. 16. Susan Bordo, “Are Mothers Persons: Reproductive Rights and the Politics of Subject- ivity”, pp.71-98, Unbearable Weight : Feminism, Western Culture, and the Body, 10th anniversary edition, University of California Press, Berkeley and Los Angeles, 2003. 17. Ibid, p. 76. 18. Ibid, p. 77. 19. Ibid, p. 95. 20. Arthur Greil, “ Infertile Bodies: Medicalization, Metaphor, and Agency” in Marcia C. Inhorn and Frank Van Balen eds., Infertility Around the Globe: New Thinking on Childlessness, Gender, and Reproductive Technologies, University of California Press, Berkeley and Los Angeles, 2002, pp.101-118. 21. Ibid, p.106. 22. Ibid, p.110. Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 81. Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics 81 23. American Society of Plastic Surgeons website 24. 25. Erik Parens, “Is Better Always Good? The Enhancement Project,” in Erik Parens ed, Enhancing Human Traits: Ethical and Social Implications, Georgetown University Press, Washington D.C., 1998, pp. 1-28. 26. “Dermatologists Bend Ethical Standards to Sell their wares”, Boston Globe, 23 August 2005. 27. Norman Daniels “The Genome Project, Individual Differences, and Just Health Care,” in Justice and the Human Genome Project, ed. Timoty F. Murphy and Marc A. Lappe, University of California Press, Berkeley, 1994 pp.110-32, at 122, cited in E. Parens Is Better Always Good? p.3. 28. James E. Sabin and Norman Daniels, “Determining ‘Medical Necessity’ in Mental Health Practice,” Hastings Center Report 24, no.6 (1994): 5-13, at 5 cited in E. Parens, Is Better Always Good? p.3. 29. Eric T. Juengst, “What Does Enhancement Mean?” in Erik Parens ed, Enhancing Human Traits: Ethical and Social Implications, Georgetown University Press, Washington D.C., 1998, pp. 29-49. Chapter G3: Peace and Peacekeeping Background Peace is one of the objectives of ethical dialogue and this chapter introduces topics which may be interesting for class debates of senior high school students. Further reading Adams, James (1998) The Next World War. Arrow Books, London, and Random House, Sydney. 438pp. Air Force Science and Technology Board (2002) Implications of Emerging Micro and Nanotechnology. National Academies Press. Ananthaswamy, Anil (2003) March of the Motes. New Scientist 23 August 2003: 26-31 Barker, Jonathan (no date) The No-Nonsense Guide to Terrorism. New Internationalist Publications, Oxford, and Verso, London. 144pp. Barnaby, Frank ed.(1988) The Gaia Peace Atlas: Survival Into the Third Millennium. Gaia Books, Pan, London 271pp. Baylis, John and Smith, Steve (2001) The Globalization of World Politics: An Introduction to International Relations. Oxford University Press, Oxford. 690pp. Board of Army Science and Technology (2001) Opportunities in Biotechnology for Future Army Applications. National Academies Press. Boutwell, Jeffrey and Klare, Michael (2000) A Scourge of Small Arms. Scientific American June 2000: 30-35 Bremer, Stuart and Cusack, Thomas, eds. (1995) The Process of War: Advancing the Scientific Study of War. Gordon & Breach Scientific Publishers, Amsterdam. Brogan, Patrick (1998) World Conflicts. Bloomsbury, London. 682pp. first edition 1989. Burton, John W. (1996) Conflict Resolution: Its Language and Processes. The Scarecrow Press, London. 87pp. Carroll, John (2002) Terror: A Meditation on the Meaning of September 11. Scribe Publications, Carlton North, Victoria. 105pp. Chomsky, Noam (1989) Necessary Illusions: Thought Control in Democratic Societies. Pluto Press, London. 422pp. Chomsky, Noam (2001) September 11. Seven Stories Press & Allen & Unwin. 137pp. Chomsky, Noam (2003) Hegemony or Survival: America’s Quest for Global Dominance. Allen & Unwin, Crows Nest, NSW. 279pp. Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 82. 82 Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics Chua, Amy (2003) World on Fire: How Exporting Free-market Democracy Breeds Ethnic Hatred and Global Instability. Random House, Sydney, and William Heinemann, London. Clements, Kevin and Ward, Robin, eds. (1994) Building International Community: Cooperating for Peace Studies. Peace Research Centre, Canberra and Allen & Unwin, St Leonards NSW. 354pp. Drexler, K. Eric (1986) Engines of Creation: The Coming Era of Nanotechnology. Anchor Books, Doubleday, NY/London/Toronto/Sydney/Auckland. 299pp. Dyson, Freeman J. (1984) Weapons and Hope. Harper Colophon, New York. 341pp. Evans, Gareth (1993) Cooperating for Peace. Allen & Unwin, St. Leonards, NSW. 224pp Feynman, Richard P. (1960) There’s Plenty of Room at the Bottom. Engineering and Science Vol. 23 No.5 Gaubatz, Kurt Taylor (1991) Election Cycles and War. Journal of Conflict Resolution 35: 212-224 Geller, D.S. and Singer, J.D. (1998) Nations at War: A Scientific Study of International Conflict. Cambridge University Press, Cambridge. 242pp. Genest, Marc A. ed. (1996) Conflict and Cooperation: Evolving Theories of International Relations. Harcourt Brace College Publ., Fort Worth. 583pp. Gladwell, Malcolm (2000) The Tipping Point: How Little Things can make a Big Difference. Abacus, London. 279pp. Goleman, Daniel (1996) Emotional Intelligence: Why it can matter more than I.Q. Bloomsbury Publ., London. 352pp. Grayling, A.C. (2003) What is Good? The Search for the Best Way to Live. Phoenix, Orion Books, London. 274pp. Guevara, Ernesto ‘Che’, anthology edited by Deutschmann, David (1997) Che Guevara Reader: Writings on Guerilla Strategy, Politics and Revolution. Ocean Press, Melbourne & New York. 400pp. Hall, Lavinia ed. (1993) Negotiation: Strategies for Mutual Gain. The Basic Seminar of the Program on Negotiation at Harvard Law School. Sage Publications, Newbury Park, London & New Delhi. 212pp. Haller, Stephen (2002) Apocalypse Soon? Wagering on Warnings of Global Catastrophe. McGill Queens University Press, Montreal.185pp. Hartung, William O. (2003) How Much are you Making from the War, Daddy? Bantam Books, Sydney, and Nation Books, Avalon Publishing Group, New York Hunt, Scott (2002) The Future of Peace – On the Front Lines with the World’s Great Peacemakers. HarperCollins, San Francisco, 372pp. Huntington, Samuel (1996) The Clash of Civilisations and the Remaking of World Order. Touchstone Books, Simon & Schuster, London & New York. 368pp. Joy, Bill (2000) Why the Future Doesn’t Need Us. Wired 8.04: 238-263 and see online: www.wired.com/wired/archive/8.04/joy.html Kelly, Kevin (1994) Out of Control: The New Biology of Machines. Fourth Estate, London and Addison Wesley, USA. 666ppp Kirk, Andrew (2004) Words that Changed the World: Civil Disobedience. Ivy Press, East Sussex. 128pp. Kuhn, Thomas (1970) The Structure of Scientific Revolutions. Second edition. University of Chicago Press, Chicago. (First edition published 1962). Leaman, Oliver, ed. (2000) Eastern Philosophy: Key Readings. Routledge Key Guides, London & New York, 305pp. Macer, Darryl (1998) Bioethics is Love of Life: An Alternative Textbook. Eubios Ethics Institute, Christchurch and Tsukuba. 160pp. Milburn, Gerard (1996) Quantum Technology. Frontiers of Science Series, Allen & Unwin, St Leonards, NSW. 188pp. Morris, Julian ed. (2000) Rethinking Risk and The Precautionary Principle. Butterworth Heinemann, Oxford. 294pp. Murty, Danuse (2003) Buddhist Studies for Secondary Students. Buddhist Council of NSW, Sydney, and Buddha Educational Foundation, Taipei. 119pp. National Academy of Sciences (2004) Emerging Technologies and Ethical Issues in Engineering: Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 83. Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics 83 Papers from a Workshop, October 14-15, 2003. National Academies Press. National Academy of Sciences (2004) Biotechnology Research in an Age of Terrorism: Confronting the ‘Dual Use’ Dilemma. National Academies Press. National Academy of Engineering (2004) The Engineer of 2020: Visions of Engineering in the New Century. National Academies Press. National Academy of Engineering (2005) Tenth Annual Symposium on Frontiers of Engineering. Rob Phillips, ed., National Academies Press. National Research Council (1996) Linking Science and Technology to Society’s Environmental Goals: National Forum on Science and Technology Goals. National Research Council Policy Division, Washington DC. 520pp. Naval Studies Board (2003) An Assessment of Non-Lethal Weapons Science and Technology. National Academies Press. Neiman, Susan (2002) Evil in Modern Thought: An Alternative History of Philosophy. Princeton University Press, Princeton, N.J. 358pp. Norman, Richard (1995) Ethics, Killing and War. Cambridge University Press, Cambridge. 256pp. Pilger, John (2002) The New Rulers of the World. Verso, New Left Books, London & New York. 254pp. Pollard, Irina (1999) Warfare: Fitness Enhancement or Losing Strategy? A Bioscience Ethics Perspective. Eubios Journal of Asian and International Bioethics 9: 50-54 Ransom, David, ed. (2000) Globocops. New Internationalist 330: 9-28 Rees, Martin (2003) Our Final Century. Will Civilization Survive the Twenty-First Century? Arrow Books, Random House, London. 228pp. Robertson, Geoffrey (1999) Crimes Against Humanity: The Struggle for Global Justice. Penguin Books (2000), Ringwood, VIC. 554pp. Robertson, George, Mash, Melinda, Tickner, lisa, Bird, Jon, Curtis, Barry and Putnam, Tim, eds. (1996) FutureNatural. Routledge, London & New York. 310pp. Rolland, Romain (2000) Mahatma Gandhi: The Man who Became One with the Universal Being. Srishti Publications, London. 145pp. First published 1924 Russel, Bertrand (1938) Power. Reprinted 1992 by Routledge, New York. 207pp. Scientific American (2001) Nanotechnology Special Issue. Scientific American September 2001, 94pp. Shawcross, William (2000) Deliver Us From Evil: Warlords and Peacekeepers in a World of Endless Conflict. Bloomsbury, London. 420pp. Soros, George (2004) The Bubble of American Supremacy: Correcting the Misuse of American Power. Allen & Unwin, Crows Nest NSW, and PublicAffairs, Perseus Books Group, USA. 207 pp. Taber, Robert (1965) The War of the Flea: Guerrilla Warfare Theory and Practice. Paladin, Frogmore, St Albans, Herts. 160pp. Toffler, Alvin & Toffler, Heidi (1993) War and Anti-War: Making Sense of Today’s Global Chaos. Little, brown & Co., London. 368pp. Vincent, Kevin (1995) Modern Political Ideologies. Second Edition. Blackwell, Oxford, UK and Cambridge USA. 361pp. Watson, Lyall (1995) Dark Nature: A Natural History of Evil. HarperCollins, New York. 318pp. White, Michael (2002) Rivals: Conflict as the Fuel of Science. Vintage, Random house, London. 417pp. Woodcock, Alexander and Davis, Monte (1978) Catastrophe Theory. Penguin, 171pp. Worcester, Kenton, Bermanzohn, Sally and Ungar, Mark, eds. (2002) Violence and Politics: Globalization’s Paradox. Routledge, New York & London. 256pp. Wrong, Dennis (1979) Power: Its Forms, Bases and Uses. Key Concepts in the Social Sciences, Basil Blackwell, Oxford. 326pp. Zakaria, Fareed (2003) Why America Scares the World: The Arrogant Empire. Newsweek March 24, 2003: 12-28 Zinn, Howard (2002) Terrorism and War. Seven Stories Press, U.S., and Allen & Unwin, Crows Nest, NSW. 156pp. Chapter G4: Human Rights and Responsibilities Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 84. 84 Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics Background Human rights are already included in many curricula. This chapter introduces some issues which may be interesting for class debates of high school students. Further reading Gorlin, Rena A., ed. (1999) Codes of Professional Responsibility: Ethics Standards in Business, Health and Law. Fourth Edition. Bureau of National Affairs, Washington DC. 1149pp. Grayling, A.C. (2003) What is Good? The Search for the Best Way to Live. Phoenix, Orion Books, London. 274pp. Laszlo, Ervin, ed. (1997) Third Millennium: The Challenge and the Vision. The Club of Budapest Report on Creative Paths of Human Evolution. Gaia Books Ltd, London.156pp. Levin, Leah (1998) Human Rights: Questions and Answers. ‘Human Rights in Perspective’ Series, UNESCO, Paris. Macer, Darryl (1994) Bioethics for the People by the People. Eubios Ethics Institute, Christchurch and Tsukuba. 458pp. Macer, Darryl (1998) Bioethics is Love of Life: An Alternative Textbook. Eubios Ethics Institute, Christchurch and Tsukuba. 160pp. Makinson, David and Symonides, Janusz, eds. (1998) Human Rights: 50th Anniversary of the Universal Declaration. International Social Science Journal December 1998. p.465-590 Martin, Hans-Peter and Schumann, Harald (1997) The Global Trap: Globalization and the Assault on Democracy and Prosperity. Pluto Press, Annandale, NSW. 269pp. (originally published 1996 in German). Monbiot, George (2003) The Age of Consent: A Manifesto for a New World Order. Flamingo, and Harper Perennial, London. 274pp Muntarbhorn, Vitit (2002) Dimensions of Human Rights in the Asia Pacific Region. Office of the National Human Rights Commission of Thailand, Bangkok. 327pp. Rawls, John (1971) A Theory of Justice. Harvard University Press, Cambridge, Mass. Robertson, Geoffrey (1999) Crimes Against Humanity: The Struggle for Global Justice. Penguin Books (2000), Ringwood, VIC. 554pp. Sachs, Jeffrey, with foreword by Bono (2005) The End of Poverty: How We Can Make it Happen in Our Lifetime. Penguin Books, London. 397pp. Singer, Peter (2002) One World: The Ethics of Globalisation. Yale University Press, US, & Text Publishing Company, Melbourne. 255pp. Symonides, Janusz and Volodin, Vladimir, eds. (1999) UNESCO and Human Rights: Standard-Setting Instruments, Major Meetings, Publications. Second Edition. UNESCO, Paris. 537pp. Theis, Joachim (2004) Promoting Rights-Based Approaches: Experiences and Ideas from Asia and the Pacific. Save the Children, Sweden. 147pp. United Nations Educational, Scientific and Cultural Organisation (1998) World Directory of Human Rights Research and Training Institutions. Fourth Edition. UNESCO, Paris. 285pp. United Nations Educational, Scientific and Cultural Organisation (1999) Birth of the Universal Declaration on the Human Genome and Human Rights. Division of the Ethics of Science and Technology of UNESCO. 166pp. United Nations Educational, Scientific and Cultural Organisation (2003) Human Rights in the Constitutions of UNESCO’s Member States in the Asia and Pacific Region. UNESCO Regional Unit for Social and Human Sciences in Asia and the Pacific, Bangkok. 420pp. United Nations High Commissioner for Refugees (2000) The Status of the World’s Refugees: Fifty years of Humanitarian Action. UNHCR and Oxford University Press, Oxford. United Nations (1948) Universal Declaration of Human Rights. Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>
  • 85. Teaching Resources and Notes: A Cross-Cultural Introduction to Bioethics 85 United Nations (1993) World Conference on Human Rights: The Vienna Declaration and Programme of Action, June 1993. United Nations, New York. United Nations High Commissioner for Human Rights, and Centre for Human Rights (1997) Human Rights and Law Enforcement: A Manual on Human Rights Training for the Police. Professional Training Series No. 5. United Nations, Geneva. 211pp. Unger, Peter (1996) Living High and Letting Die. Oxford University Press, Oxford & New York Venturelli, Shalini, ed. (1998) Human Rights (special double issue) Journal of International Communication Vol. 5: No’s 1 & 2. Weiss, Thomas G., Forsythe, David P. and Coate, Roger A. (2001) The United Nations and Changing World Politics. Third Edition. Westview Press, Perseus Books Group, Boulder (US) and Oxford (UK). 362pp. Darryl Macer, ed., Teaching Resources and Notes for A Cross-Cultural Introduction to Bioethics © Eubios Ethics Institute 2006 < http://www.unescobkk.org/index.php?id=2508>