Different Approaches to Ethics Teaching


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This presentation was given at the Federation of European Biochemical Societies (FEBS) Congress in Prague during July 2009. It offers some reflections on both the why and how to for introducing an ethics component into bioscience courses. Particular emphasis is placed on the use of case studies, including scenarios posed in video clips (for copyright reasons the latter are not included here).
Presentation (c) Chris Willmott, 2009

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Different Approaches to Ethics Teaching

  1. 1. FEBS, Prague, July 2009 Different Approaches to Ethics Teaching Dr Chris Willmott Dept of Biochemistry University of Leicester cjrw2@le.ac.uk University of Leicester THE University of the Year 2008
  2. 2. Why teach ethics to bioscientists? • Explosion of new issues “Modern Science has placed in our hands capabilities that have aggravated long-standing ethical problems as well as introducing new quandaries”. Stanley Grenz (moral philosopher)
  3. 3. Why teach ethics to bioscientists? • Explosion of new issues • Equipping students to explain key issues to friends 1999 Eurobarometer survey: “Ordinary tomatoes do not contain genes while genetically-modified tomatoes do” 35% agreed with the statement 30% “do not know”
  4. 4. Why teach ethics to bioscientists? • Explosion of new issues • Equipping students to explain key issues to friends • Relevance to future careers - research? - teaching? - medicine? - science communication?
  5. 5. Why teach ethics to bioscientists? • Explosion of new issues • Equipping students to explain key issues to friends • Relevance to future careers • It’s interesting
  6. 6. Why teach ethics to bioscientists? • Explosion of new issues • Equipping students to explain key issues to friends • Relevance to future careers • It’s interesting • In the UK, the QAA says we should Quality Assurance Agency “Benchmarking statements” - first edition, 2002 - second edition, 2007 http://tinyurl.com/QAAbioscience07
  7. 7. QAA Benchmarking for Bioscience “Students should expect to be confronted by some of the scientific, moral and ethical questions raised by their study discipline, to consider viewpoints other than their own, and to engage in critical assessment and intellectual argument” “Recognising the moral and ethical issues of investigations and appreciating the need for ethical standards and professional codes of conduct”
  8. 8. QAA Benchmarking for Bioscience All students should: “Have some understanding of ethical issues and the impact on society of advances in the biosciences” Good students should: “Be able to construct reasoned arguments to support their position on the ethical and social impact of advances in the biosciences”
  9. 9. Ethical issues for Bioscientists Can consider issues in three categories: 1. Research integrity 2. Biomedical ethics 3. Environmental bioethics
  10. 10. Approaches • Case studies/ scenarios • Debate and role-play • Newspapers • Book extracts • TV programmes/Films/News • Clips to convey information • Clips as discussion starters • Student-generated videos
  11. 11. Bioethics = Bio- and ethics • Science – could it be done? • Ethics – should it be done? Important that both are being considered: Science without ethics may be immoral Ethics without science may be impossible
  12. 12. Case studies & scenarios • Case studies allow real-world framing of otherwise abstract ideas • Can have a key role in opening up complex issues for students • May be genuine or fictional (though latter work best when as close to real as possible)
  13. 13. Case study (1) – Carl and Julie Carl is a twenty-one year old builder. He is engaged to Julie, and she has recently discovered that she is expecting their first child. In 2001, Carl’s maternal grandfather died from Huntington’s disease (HD), a late-onset degenerative disease of the nervous system. HD is inherited in a dominant fashion; if you do have HD, you have a 50% chance of passing it on to your children. Carl’s mum has decided not to take the test to find out if she got the faulty copy from her father, but now that he is expecting to be a father himself, Carl is keen to find out if there is any risk that he has passed on the condition. What are some of the issues at stake for Carl and Julie? What are the consequences of taking the test, or deciding not to? If you were Carl, what would you do?
  14. 14. Genetic screening Carl can know his status and prepare accordingly But his mum has made a conscious decision not to know, hence potential harm to her Other consequences: - Carl’s relationship with Julie? - Carl’s relationship with baby? - Implications for Carl’s work? - Insurance implications, etc (Developed from episode of “Bitter Inheritance”)
  15. 15. Case study (2) – Wendy & Paul Wendy and Paul Carter have been married for twelve years. They would love to have children. Unfortunately, Wendy had breast cancer when she was 28 and although the chemotherapy has brought total remission from the disease it also caused damage to her ovaries that has made her infertile. Paul and Wendy have been on the waiting list at their local IVF clinic for a number of months awaiting donated eggs to try and have a baby. At present, however, there are 200 potential mothers seeking each donated egg and the couple know that realistically they may never receive a donated egg via the normal channels. Researchers at the hospital attached to the IVF clinic have recently gained permission to carry out experimental procedures using eggs harvested from aborted foetuses. The technique is controversial, but for Paul and Wendy it may represent their only chance to receive a donated egg.
  16. 16. Case study (2) – Wendy & Paul What are the issues involved in this case? - Feel free to include aspects of the case that are likely to be issues for other people, your contributions need not be limited to your own opinions.
  17. 17. Case study (2) – Wendy & Paul • This case - content is fictional but based on real ideas and statistics - used in Session 1 of 6 in bioethics series - used as vehicle to introduce more philosophical aspects
  18. 18. Case study (2) – example comments Deontological (first principles, rights, duties) • Does a foetus have any rights? • Does the “mother” have any rights or say in the upbringing of their “grandchild”? • Should people be allowed to manipulate nature for their own gain? Consequentialist (outcomes) • What would be the psychological effects on the child? • If the child turns out to be “defective” then who is culpable? • What is the likelihood of success?
  19. 19. Vehicle for introducing philosophy Deontological (first principles, duties) Consequentialist (outcomes) Virtue ethics (importance of character) Principlism
  20. 20. Making ethical decisions Principles of Biomedical Ethics (Beauchamp & Childress) propose 4 principles: • Non-maleficence Don’t do harm • Beneficience Do good, act in the best interests of others • Autonomy Maximise freedom for individual or community • Justice Treat equal cases equally and unequal cases differently Principlism
  21. 21. Genetic screening Carl can know his status and prepare accordingly (Autonomy, Beneficience) But his mum has made a conscious decision not to know, hence potential harm to her Other consequences: - Carl’s relationship with Julie? - Carl’s relationship with baby? - Implications for Carl’s work? - Insurance implications, etc (Adapted from episode from series “Bitter Inheritance”)
  22. 22. TV footage – why? • Familiar visual medium • Can be used to: - convey information - as discussion starters • Clips save time over full programme
  23. 23. What sort of programmes? • Documentaries, e.g. - A Child Against All Odds (2006) - DNA – The Promise & The Price (2008) - The World’s First Face Transplant (2006) • Drama e.g. - Holby City (various, esp 2006) - The Island (2005) - Million Dollar Baby (2004) • News clips - topical - pithy summary - online?
  24. 24. Clips to raise issues – GATTACA GATTACA (Dir: Andrew Niccol, 1997) is set “in the not too distant future”. Having watched the clip, consider the following questions: • How realistic is the genetic screening process shown in the film? Which aspects can already be done? Which are likely to be more difficult? • Screening of this type would be controversial. What are some of the potential benefits, and what are some of the potential problems? • Consider your answers to Q2. What form of ethical thinking does each represent? • Does this film offer any insights into current development in genetic screening?
  25. 25. GATTACA – Science issues Technology shown could offer selection, but not enhancement – gene can only be included if mum or dad had it! Current PGD? Future PGD? Genetic determinism? How much of us as individuals is down to our genes and how much down to other factors (food intake, trauma, etc)?
  26. 26. GATTACA – Ethical issues Genetic discrimination – ‘Valids’ v ‘In-valids’? A ‘made- man’ v a ‘faith-birth’? A ‘vitro’ v a ‘utero’? Insurance moratorium in UK (until 2011). Risk and social exclusion? What would it be suitable to check for? Diseases? Gender? Physical features? Character traits? What costs to the individual and to society are worth paying in order to select-out diseases? What do such attitudes say about people with disabilities now? Role of genetics in forensics?
  27. 27. News clip – structured activity Therapeutic Cloning Yo a g ingtos ea3m u re o e w n une th 0 4 inutevid ofro FiveNe so J 16 2 0 , e m dis us inga a c s n pplic tio b ate mo s ie tsa Ne c s Unive ity fo a n y a f c ntis t w a tle rs r pe is io toc rry o “ ra uticc ning . Re dthro h the eq s ns rm s n a ut the pe lo ” a ug s ue tio be reyo s ethec s yo kno wha tolo k o fo fo u e lip, o u w t o ut r. From the video Expla ho the pe in w ra uticc ningw uldwo lo o rk Wha isthes urc o thee g tobeus din thisre e rc t o e f gs e s a h? Wha isthes te a o there e rc t ta d im f s a h? Thinking deeper In thec P fe s r Murdo h s ys lip, ro s o c a : “Imagine a child, say a ten year old child, now who is diabetic who’s cells that normally produce insulin are not working properly, so that child will have to take insulin injections for the rest of their life. Possibly, in five or ten years time, we could be in a situation where we could take a tiny piece of skin fromthat child, do some work within the laboratory to tell that skin cell to forget that it was ever a skin cell, to learn to become a stem cell, which means that it has no background information about what it is going to be, and then teach that stemcell to become an insulin secreting cell so that cell can be planted back into the child and then the diabetes theoretically would be cured.” Co pa thisw thee m re ith xpla tio o ho the pe na n f w ra uticc ningw uldwo lo o rk; - in w t wa w sit d re a ha ys a iffe nt, nd - in w t wa w sit thes m ? ha ys a a e Wha o je tio tos mc ll re e rc a m ntio din thevide ? t b c ns te e s a h re e ne o Wha o r re s ns(no m ntio d) m y c us pe pletoo c tothe pe t the a o t e ne a a e o bje t ra uticc ning lo ? Wha te hnic l diffic t c a ultie m ht m kethiswo diffic toa hie ? s ig a rk ult c ve
  28. 28. Using News stories in Bioscience • Think of as many ways as possible that you might link one or more of the following news stories to your teaching of: (a) basic bioscience and/or (b) bioethics? Face transplant Cognitive GFP Marmosets enhancement? Images from http://news.bbc.co.uk/
  29. 29. GFP Marmosets Science of transgenics Ethical questions What is GFP? Is it OK to alter How was the gene monkeys in this way? transferred in? Does the fact that Why was it transferred in? alteration was inherited make any difference? What is the basis for animal rights? Wider debate about animals Do animals have rights? Abolitionists Sentiency? Welfarists Justice? 3Rs (refine, reduce, replace) Utility? Image from http://web.princeton.edu/sites/ehs/biosafety/animalworker/pics/marmoset.jpg
  30. 30. Face transplants Ethical Technical Risks v Benefits Availability of donor face? Motivation? Functionality of transplant? Plan B if rejected? Lifestyle issues Psychological Media intervention? Cancer risk? For patient? For potential patients? For wider society? Immunological Face and identity? Rejection rates? (30-50% over first 2-5 yrs) Harmful effects of immunosuppressive drugs? Image from http://news.bbc.co.uk/
  31. 31. Cognitive enhancing drugs? Science of Arguments in favour enhancement Autonomy What drugs are people “if it’s ok for kids it’s ok for taking? me” What is the basis of Others get advantage from their effect? genes or wealth Legal = know medicine is what it claims to be Better productivity = Therapy v economic benefit Enhancement Can a case be made that Arguments against moving someone from poor to normal is different from Safety: esp long term use normal to superior? Fairness: will others need to take enhancers to compete Image from http://freedocere.files.wordpress.com/2009/05/ritalin-sr-20mg-full1.jpg
  32. 32. Helpful websites e.g. www.bioethicsbytes.wordpress.com
  33. 33. Helpful websites e.g. www.bioscience.heacademy.ac.uk/resources/ethicsbrief.htm Bioethics Briefings Six titles and others to follow
  34. 34. Helpful websites e.g. www.beep.ac.uk
  35. 35. Helpful websites e.g. www.at-bristol.org.uk/cz/Default.htm