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12/02/2016

Perspectives in learning: Incorporating discussion materials and activities on ethics into science curriculum.

The Presidential Commission for the Study of Bioethical Issues has released over 60 educational resources that can be used as tools to teach students, researchers, clinicians, and other professionals to recognize and address ethical aspects of their work and understand how deliberation can inform ethical decision-making. These resources draw from the Bioethics Commission’s reports, and while all reports produced to date have been topic-specific, bioethics education and improving bioethics literacy has been a constant thread throughout the Bioethics Commission’s work.

The Commission’s most recent report, Bioethics for Every Generation, outlines a variety of models that can be used to teach ethics, and emphasizes that ethics education is about preparing students how to think ethically, rather than what to think. Bioethics for Every Generation also emphasizes that ethical questions and topics can be incorporated into existing courses, such as biology, chemistry, social studies and history courses, among others.

Frank Strona, the Bioethics Commission’s Senior Communications Analyst and Adjunct Faculty with National University’s Department of Health Sciences recently had an opportunity to sit down and interview Steven Kessler, Instructor of Biology and Microbiology at Santa Rosa Junior College in Petaluma, CA and former Visiting Fellow with the Bioethics Commission, discusses how incorporating bioethics into his science curriculum has affected his students and his work as a science educator.

FRANK STRONA: Tell us about how you have used bioethics to enhance traditional science education.

STEVEN KESSLER:  I incorporate bioethical issues into my traditional science classes in a number of ways.  The most satisfying way is to spend an entire class period delving deeply into one or two (if they are related) issues.  The classroom discussion guides on the Commission’s website have served as a great resource for some questions that can be the basis for these class sessions.  My work as a Visiting Fellow during the spring of 2015 involved working with the commission staff to develop these guides.

When I feel that there is less time to devote to a bioethical issue, I will incorporate the questions and themes into my lectures.  Sometimes, I will then instruct the students to have a short discussion in small groups during class time.  Other times, I simply raise the questions during the lecture and perhaps offer a range of possible responses to these questions.  Even if we do not have a formal discussion, I make sure to give the students an opportunity to ask questions or make comments during the lectures.

Regardless of the format that the content is introduced in, the classroom activities and discussions are the basis for essay questions that the students will work on as a take-home assignment or during in-class examinations (although I always give the questions in advance to ensure the students have adequate opportunity to think deeply and clearly about the issues).  For these questions, I make it clear to the students that I do not grade their position on an issue.  Rather, I mention that I am curious about their position and that I will be grading their explanation of and support for their position. My curiosity is sincere and I want all students to feel safe expressing their points of view. I especially want them to learn how to use reason to support it.

In my basic biology courses, I integrate a wide variety of bioethical issues.  A partial list of these issues includes:

  • The quarantine of health care workers during an Ebola (or other infectious disease) crisis
  • The use of a placebo-controlled trial for potential anti-Ebola drugs during an Ebola crisis
  • Providing anti-HIV drugs to the poor
  • Treating multi-drug resistant tuberculosis in prisons
  • The use of antibiotics in farm animals
  • The genetic modification of foods
  • The genetic modification of humans
  • The patenting of biological organisms, tissues, products, and specimens
  • The history of informed consent (e.g. origins of HeLa cells, compulsory sterilization in the U.S., syphilis studies in Tuskegee and Guatemala)
  • Eugenics programs in the U.S.

FRANK STRONA:  Those are important issues. As you know, the Bioethics Commission has educational resources that address many of these issues (for example, an Ethics and Ebola case study on liberty-restricting public health measures and a Classroom Discussion Guide on ethical issues in neuroscience research). These educational resources were developed to support the integration of bioethics education in traditional and nontraditional educational and professional settings.

KESSLERAll of the topics I’ve mentioned are integrated with the basic science. I find that this is an exciting way to learn the science as it places the material in a broader context.  Some students do not need this broader context to become engaged by the material, but for many students the bioethical issues facilitate their engagement.  Additionally, I find my own passion for the material is greatly enhanced by the placement of the science in a broader societal context. I receive a lot of positive feedback from students and colleagues regarding my own passion and behavior in the classroom.

FRANK STRONA: What challenges do science educators face when incorporating bioethics into science curricula? What tips do you have for overcoming these challenges?

KESSLERThe first challenge to incorporating bioethics into the traditional science curriculum is how to balance all the content in order to meet the course and program learning objectives. Typically, a significant portion of the course material that the instructor plans to cover leaves little time for additional topics.  So a faculty could look at the inclusion of a bioethical discussion as an additional category to the course content. However, in my experience, weaving in the bioethical issues as part of the course provides an opportunity for the student to be introduced to a deeper understanding of the chosen topics and can addresses serve as way to model engaged learning.

Facilitated discussions – online or in-person – are perhaps the best way to use class time to allow the students to gain this deeper understanding. Not only does it offer the student an opportunity to use analytical skills and critical thinking, it also exposes them to other students’ ideas and points of view in a controlled and safe learning environment.  However, when time is the biggest obstacle to addressing bioethical issues, I feel comfortable simply naming some questions, concerns, and controversies during a lecture.  The students can then be provided with additional resources to gain a deeper perspective that tie in to an assigned essays for homework or as exam questions so that they can probe the issues carefully outside of class time.

A second challenge is that basic science instructors do not typically have training in or feel comfortable guiding a discussion about ethical issues.  In my case, I do not always structure the material or course time as a formal philosophical ethics-based discussion, as I am not a professionally trained ethicist either.  Instead, I navigate the topic so it begins with a discussion of the background terminology or information that all participants should share. Then, I ask the students to form small groups and brainstorm the pros and cons of the issue.

I set up several “guidelines” during the small group sessions; I encourage students to avoid assigning any value to the pros and cons at this point. I might suggest to them that they list all the pros and/or cons, even those that seem ridiculous to them at first. I find that an exhaustive list here is helpful in acknowledging as many points of view as possible and allows for a better-reasoned conclusion.  As each group reports back the findings, I do a quick review, after making sure the list seems thorough enough, and depending on how much time we need, I then ask them to start weighing the pros and cons on the list – of course, this naturally occurs during the brainstorming as well – so, that we can move towards a conclusion or recommendation.  I think the approach to a discussion of bioethical issues described here provides an accessible format, and I also expect that many types of instructors could be comfortable with it since this is largely an exercise in reasoning and logic.

FRANK STRONA: What would you say to science educators or others concerned that bioethics might distract from science education?

KESSLERThat is what I consider the third challenge of incorporating bioethics content in the classroom, and that is overcoming the skepticism that exists from other science instructors.  This is something I have experienced.  This skepticism is expressed as criticism of my choice to spend time on bioethics at the expense of an already dense list of material that is required in the course.  (I make sure that I am also addressing all required material as well.)  Another type of criticism I have received is more theoretical.  A colleague has voiced to me a concern that attention to ethical issues muddies the students’ understanding of the science.

Firstly, I consider an avoidance of the ethical issues may convey a set of implied values the instructor may hold or it could leave the students confused.  For instance, if the topic is the genetic engineering of human embryos and the instructor only covers the technical aspects of this (possible future) technology, the students might get the impression that the teacher is promoting the technology, provided that the teacher does not have a cynical tone when presenting the material.  Alternatively, taking even a few moments to acknowledge concerns with the technology provides the students with some assurance that it is acceptable to think more deeply and critically about the technology and rounds out the understanding that there is multiple ways of thinking on the topic.

Secondly, by actively addressing the ethics angle, there is a possibility that the instructor will engage and inspire more students in their overall pursuit of a deep and meaningful education.  I hold that this is the opposite effect of any colleague concerned with distracting the students by addressing ethical issues.

Thirdly, some ethical discussions involve a direct examination of the science. If the discussion revolves around the safety of a technology, then a solid understanding of the science is an important part of assessing the safety. Considering safety then can direct the students to more deeply consider the technical aspects. Additionally, when I bring in the discussion associated with Ethics & Ebola, I am gratified by the attention to the scientific method and clinical trial design that happens as a part of weighing the reliance on placebo-controlled trials.

FRANK STRONA: Incorporating bioethics into science curriculum can be exciting, challenging, and engaging. The Bioethics Commission has developed educational resources for students and professionals including topic-based modules, deliberative scenarioswebinars, and empirical research resources, that address a variety of ethical issues related to public health emergencies, whole genome sequencinghuman subjects research, and more.

As students move into graduate and professional programs, their ethical training becomes more specialized, and can continue to build upon the ethical skills students have learned throughout their life. Developing the skills needed to make difficult ethical decisions does not happen overnight, and like any other skill, requires time and practice.

Incorporating bioethics into science curriculum can enhance a student’s learning experience and encourage further exploration into bioethics through professional or extracurricular activities. All of the Commission’s reports emphasize the importance of incorporating ethics education at all levels of education, because everyone, regardless of their background, will encounter a bioethical challenge at some point in their life.

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