Betbk2p.doc

A Cross-Cultural Introduction to

Bioethics

Darryl R.J. Macer, Ph.D. (Editor)

Eubios Ethics Institute 2006

ii A Cross-Cultural Introduction to Bioethics

Eubios Ethics InstituteEubios Ethics InstituteBangkok 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 InstituteAll 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 dataA Cross-Cultural Introduction to Bioethics / editor, Darryl R.J. Macer.Christchurch, N.Z. : Eubios Ethics Institute ©2006.

1 v. xx +280 pp. A4 size. ISBN 0-908897-23-5 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 (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 linksProject site <http://www.unescobkk.org/index.php?id=2508>

Further copies can be obtained from the Eubios Ethics Institute. For teachers involved in the Bioethics Education Project (open to all), this book is free. For others contributions are appreciated by cheque, or bank or postal order, or VISA or MASTERCARD for the following amounts (includes post). Applications from developing countries for free copies should also be addressed as below, and special arrangements for teaching trials.US $20 Euro 15 UK £10 NZ $30 A$33 C$33 ¥ 2000payable to the "Eubios Ethics Institute";

c/o Darryl Macer, Ph.D.,Director, Eubios Ethics Institutec/o UNESCO Bangkok, 920 Sukhumvit Road, Prakanong, Bangkok 10110, THAILAND

Tel: +66-2-391-0577 ext 141Fax: +66-2-664-3772Email: [email protected]

The above address should also be used to send feedback forms from teachers and students!

A Cross-Cultural Introduction to Bioethics iii

Content list

Preface v

Feedback FormsTeacher Feedback Forms viiStudent Feedback Forms xiii

Authorship and Acknowledgments xviii

Authors’ Profiles xviii

A. Bioethics and the Ethics of Science and Technology1. Making Choices, Diversity and Bioethics 12. Ethics in History and Love of Life 63. Moral Agents 184. Ethical limits of Animal Use 225. Ethics and Nanotechnology 27

B. Environmental Ethics1. Ecology and Life 302. Biodiversity and Extinction 363. Ecological Ethics 404. Environmental Science 435. Environmental Economics 516. Sustainable Development 637. Cars and the Ethics of Costs and Benefits 738. Energy Crisis, Resources and Environment 789. Ecotourism 8510. The Earth Charter Initiative 93

C. Genetics1. Genetics, DNA and Mutations 982. Ethics of Genetic Engineering 1023. Genetically Modified Foods 1074. Testing for Cancer Gene Susceptibility 1105. Genetic Privacy and Information 1136. The Human Genome Project 1177. Eugenics 1218. Human Gene Therapy 1229. Universal Declaration on the Human Genome and Human Rights 12910. International Declaration on Human Genetic Data 134

D. Medical Ethics1. Informed Consent and Informed Choice 1452. Telling the Truth about Terminal Cancer 1473. Euthanasia 1534. Brain Death 1585. Organ Donation 1646. Brain Death and Organ Transplant Drama 170

iv A Cross-Cultural Introduction to Bioethics

7. The Heart Transplant 1758. SARS (Severe Acute Respiratory Syndrome) 1769. AIDS and Ethics 17710. Ethical Principles for Medical Research Involving Human Subjects 18311. Bird Flu 18812. Indigenous Medicines and Access to Health 189

E. Reproduction1. Lifestyle and Fertility 1922. Assisted Reproduction 1983. Surrogacy 2044. Choosing Your Children’s Sex and Designer Children 2055. Prenatal Diagnosis of Genetic Disease 2086. Female Infanticide 2117. Human Cloning 2148. United Nations Declaration on Human Cloning 2159. Human Genome Organization (HUGO) Ethics Committee Statement on Stem Cells 222

F. Neurosciences1. Advances in Neuroscience and Neuroethics 224 2. Learning to Remember: The Biological Basis of Memory 2293. The Neuroscience of Pleasure, Reward and Addiction 235

G. Social Ethics1. Revisiting the Body 2412. Child Labour 2513. Peace and Peace-keeping 2534. Human Rights and Responsibilities 269

Movie Guides and Questions (Samples) 277

Note that the Teaching Guides, References, Internet links, are in a separate document that can be downloaded from the Internet site http://www.unescobkk.org/index.php?id=2508 or<http://www2.unescobkk.org/eubios/BetCD/BetbkTR.doc>

Update : 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://www2.unescobkk.org/eubios/udbhr.pdf>

http://www2.unescobkk.org/eubios/udbhr.pdf

http://www.unescobkk.org/index.php?id=2508

A Cross-Cultural Introduction to Bioethics v

Preface

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 title of this book is A Cross-Cultural Introduction to Bioethics, which includes second editions of the chapters in the 2004 textbook Bioethics for Informed Citizens Across Cultures, with a doubling of size due to the presence of more chapters. The chapters can be used at a variety of levels and at different years of teaching. They are combined here in one formulation that has worked in some cultures, but other teachers may wish to use only some of the chapters. Inside a school, the different chapters may fit into the curriculum across several years of education, supplementing existing courses in disciplines such as social studies, ethics, biology, science, history and foreign language classes.

The objectives of this book (and on-line resources at UNESCO Bangkok website and the teaching pack on the Eubios CD/DVD) 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.

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://www2.unescobkk.org/eubios/betext.htm>Education listserve <http://groups.yahoo.com/group/Bioethicseducation/>Student listserve <http://groups.yahoo.com/group/ Bioethics_for_students/>

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.

vi A Cross-Cultural Introduction to Bioethics

There has been consensus among those involved that we can measure the success of bioethics education in several ways. Some goals of bioethics 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. We do not need to achieve all three goals to consider education to be successful, and different teachers and institutions put a different amount of emphasis on each goal.

This book has pages for students at many levels of learning, and for teachers. Please access the on-line site for a growing list of chapters and teaching materials and resources in different languages (currently, Korean, Japanese, Spanish, Chinese and Tamil). Chapters as well as whole sections and the textbook can be used in any way the educators wish. It is suggested that teachers select the appropriate length of text (from the introductory styles in the one page versions to the detailed long versions) to give to students to read, but that students can read all the text if they have time and interest. There are also detailed lists of websites and academic references that both teachers and more senior students who wish to spend more time reading about these issues may use. The versions of chapters and materials that are on-line are in colour, but this book is printed for economic reasons in monochrome.

The Eubios Ethics Institute website has about 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.

Short backgrounds of some authors are in the section on Authorship and Acknowledgments. In the case that no author is mentioned on the first page the author was the editor. We also thank the essential financial support of Sasakawa Peace Foundation for the project 2003-2005, and the ongoing support of UNESCO Bangkok. Above all we thank the thousands of students and hundreds of teachers from many countries who have already shared their comments to help improve the materials. That feedback is essential to further improvement of the materials, and the feedback forms follow this.

The limit to this project is only the imagination of those involved.

Darryl Macer, Ph.D.EditorJanuary, 2006

A Cross-Cultural Introduction to Bioethics vii

Teacher Feedback Form – Explanations and Guidelines

The Importance of Completing the Feedback FormConsistent with the purpose of the development of the text book, the purpose of the

feedback forms is to provide good, free and on-line materials and resources for bioethics education which teachers and students can use. The completed evaluation form will be analyzed by specialists in UNESCO and will contribute to the improvement of the textbook. Further research on teaching materials and strategies to provide adequate learning and teaching materials for bioethics helps both students and teachers to better balance ethical principles. Therefore, as much as it is important to learn and teach through using the textbook, by completing the form and returning it to UNESCO for further learning and improvement, we can progress the advancement of education for all. We welcome and appreciate your feedback and comments to Email [email protected] at the Social and Human Science Unit, UNESCO Bangkok. You can also download the form from the website http://www.unescobkk.org/index.php?id=2508 .

The Teacher Chapter and Course Feedback FormThe teacher chapter and course feedback form is developed to improve the textbook

and, thus, student learning on bioethics. By completing this form, teachers can reflect on the discussions and values they shared during the course, and report their opinions on the student reactions to the textbook, the classes, and the course. This will help in planning for the next class or course. Teachers need to fill out the Chapter Feedback Form at the end of the class discussions for each chapter, and the Course Feedback Form at the end of the course. It is essential for the development of quality education for all that teachers collect their chapter and course feedback forms, and students’ chapter and course feedback forms. All of the feedback forms are to be returned to Darryl Macer, UNESCO Bangkok.

The Feedback Form OrganizationThe chapter feedback form is organized into six sections. The first section gathers

basic data about the teachers who are responding. The second section is to see how useful the textbook was to the leaner and the instructor. The key focus of the text book is to provoke meaningful and balanced discussion on bioethics issues so that each individual can be equipped with the ability to think critically for themselves. While answering these questions the students and teachers can reflect on what they have taught throughout the class. Thoughtfully completing the form is crucial for the textbook development, and it will also contribute to development of related materials and methodologies on bioethics. The remaining questions provide useful student feedback on the teacher, other materials, and allow space for other comments.

The course feedback form focuses more on personal background questions regarding bioethics. This information helps us see how well the students were informed about bioethics and related issues before using the textbook. As bioethics is closely connected to values and beliefs, the questions in the course feedback form ask questions beyond the course and the textbook, intended to collect information useful for teaching of ethical issues. Issues regarding ethics and values can be different in different cultures, but the underlying principles of respect for human rights and dignity, and environmental protection, are universal throughout the world. The collected information will form a crucial database for further research on bioethics adapted to each country’s cultural values. All information will be kept anonymous and privacy will be protected.


mailto:[email protected]

viii A Cross-Cultural Introduction to Bioethics

Teacher Course Feedback Form A Cross Cultural Introduction to Bioethics

Title of the Chapter and/or Material: Name Date of evaluation:

( )d( )m( )yNative language Nationality AgeClassroom language Gender M / FDept. and School Evaluation Instructions

Email (Please write your email if you have any.) ∙ Use pen. ∙ Write/check clearly. ∙ Completed form should be returned to the teacher or sent to the email below.

Name of the course Class hours( )hrs/week

Student information Grade level Size of the class Male:Total: Female:

∙ Please write any comments you wish to make about the textbook, teacher and course in the comments and suggestion box.∙ Should you have any suggestion about the feedback form, please email to Darryl Macer, [email protected]

Teacher1 What is your academic background? (e.g. name of the school/institution and program/major/department,

the name of the city, degree, title, etc.)

2 What are the classes do you usually teach at your school/institute? What grade levels do you usually teach?

3 Have you taken any Bioethics or Ethics class before? (Circle the class if YES) / NOIf yes, when (your age and school year), where (name of the school or institution and the city), and by whom (name of the teacher or program)? If you do not remember clearly, please provide as much information as possible.

4 What is your religious, cultural and/or ethnic background?

5 Give us the names of historical/popular figures whom you think practiced higher ethical values throughout their life.

6 Have you ever discussed these persons in class? Yes / NoIf yes, in what chapter of the textbook or topic did you refer to them?

7 Do you think elders play a positive role when forming the ethical values of their children? Yes/No


A Cross-Cultural Introduction to Bioethics ix

8 Other than direct family or relatives, who or what do you think has an influential role when forming the ethical and/or moral values of children?

9 In your opinion, which ethical values are important for young people to learn?

10 Why do you think it is meaningful to learn about bioethics?

The text book11 How long was the course ? Which chapters of the textbook did you use?

12 Which key words were used throughout the course among students?

13 Which of the chapters were difficult for your students to understand, and why?

14 Which of the topics were not covered during the course and why?

15 Did you modify any of the textbook and activities to make them more suitable for your own context?

16 What were the useful guiding questions (from the text book, your own questions, and/or student questions) that helped to have good classroom activities and discussions?

17 Which of the chapters were not appropriate for your cultural values and norms? Were there any contents and questions that were not easily understood by your students? Please describe briefly what they are and why. (Should you need more space, please continue in the comment box below.)

** Please indicate your agreement or disagreement using this seven point scale:SA(Strongly agree), A (Agree), PA (Partially agree),NA (Not applicable), PD (Partially disagree), D (disagree), SD (Strongly disagree) **

18 The textbook is very useful. SA A PA NA PD D SD

19 The suggestions for classroom activities were helpful. SA A PA NA PD D SD

20 The textbook was helpful in provoking meaningful discussion in class. SA A PA NA PD D SD

21 The textbook was well organized and contains meaningful information. SA A PA NA PD D SD

22 The questions in the textbook are helpful in guiding meaningful thinking and further study/research on the topic.

SA A PA NA PD D SD

x A Cross-Cultural Introduction to Bioethics

23 What have you learned through the textbook and the interaction with students during the course?

24 Are there any questions in this evaluation that you do not like? Yes / No Why not?

The students and classroom activity** Please indicate your agreement or disagreement using this seven point scale:

SA(Strongly agree), A (Agree), PA (Partially agree),NA (Not applicable), PD (Partially disagree), D (disagree), SD (Strongly disagree) **

25 The students were interested in the textbook topics. SA A PA NA PD D SD

26 The students were interested because of classroom activities SA A PA NA PD D SD

27 The students made good use of examples and illustrations. SA A PA NA PD D SD

28 All students had equal chance to answer and comment. SA A PA NA PD D SD

29 The students were active in discussions. SA A PA NA PD D SD

30 The students’ questions were answered/responded to their questions and comments clearly and concisely.

SA A PA NA PD D SD

Technology integration31 What types of educational aids in addition to the text did you use in the classroom activities? Please

circle all those used in the class: charts, role-play, video, flash cards, computer, projector, OHP, cassette, CD, DVD, guest speaker, field trip and others ( ) (Please list the names and titles of educational materials that were used when integrating educational technology, such as name of the video tape, DVD title etc.)

32 Please specify for which parts of the textbook you used what types of educational aid.

33 Do your students have regular access to a computer and the internet? At where?

34 Did any classroom activity involve searching further materials on the internet? How often did this happen and what websites were suggested? Did students mention websites they found themselves?

Overall ratings Excellent Poor

35 Rate this chapter using the following scale. ⑤ ④ ③ ② ①

36 Would you like to recommend this chapter to other teachers? SA A PA NA PD D SD

Comments and Suggestions (You can write more on additional sheets, and please send copies of your student reports)

A Cross-Cultural Introduction to Bioethics xi

Teacher Chapter Feedback Form A Cross Cultural Introduction to Bioethics

Title of the Chapter and/or Material:

Name Date of evaluation:




Student information Grade level Size of the class Male:Total: Female:

∙ Please write any comments you wish to make about the textbook, teacher and course in the comments and suggestion box.∙ Should you have any suggestion about the feedback form, please email to Darryl Macer, [email protected]∙** Please indicate your agreement or disagreement using this seven point scale: SA(Strongly agree), A (Agree), PA (Partially agree),

NA (Not applicable), PD (Partially disagree), D (disagree), SD (Strongly disagree) **The text book

1 How much of the total class time was used for the chapter?

2 What key words were repeated throughout the discussion among the students?

3 Do you think this chapter provides good learning experience for students? Yes/No

4 What were the guiding questions that helped the discussion?

** Please indicate your agreement or disagreement using this seven point scale: SA(Strongly agree), A (Agree), PA (Partially agree),NA (Not applicable), PD (Partially disagree), D (disagree), SD (Strongly disagree) **

5 I am very interested in this chapter. SA A PA NA PD D SD

6 The allocated time was adequate for the chapter and the topic. SA A PA NA PD D SD

7 The chapter was helpful in provoking meaningful discussion in the class. SA A PA NA PD D SD

8 The chapter was well organized and contains meaningful information. SA A PA NA PD D SD

9 The questions in the chapter are helpful to guide meaningful thinking and further study/research on the topic.

SA A PA NA PD D SD

10 The examples and contents were not adequate to address the issue in the chapter.

SA A PA NA PD D SD

11 I recommend this chapter to other teachers. SA A PA NA PD D SD

12 Was there any content and/or questions that are not appropriate for your cultural values and norms? Or was there any content and/or questions that were not easily understood by the students? Please describe briefly what they are and why. (Should you need more space, please continue in the comment box below.)

13 What have you learned through the chapter and the interaction with students during the class?


xii A Cross-Cultural Introduction to Bioethics

The students and classroom activity** Please indicate your agreement or disagreement using the seven point scale **

14 The students were interested in the topic. SA A PA NA PD D SD

15 The students made good use of examples and illustrations. SA A PA NA PD D SD

16 All students had opportunities to answer and comment. SA A PA NA PD D SD

17 The students were active in discussion. SA A PA NA PD D SD

18 The students’ questions were answered/responded to clearly and concisely. SA A PA NA PD D SD

Technology integration19 What types of educational aids did you use? Please circle all those used in the class: charts, role-play,

video, flash cards, computer, projector, OHP, cassette, CD, DVD, guest speaker, field trip and others ( ) Please list the names and titles of educational materials that were used when integrating educational technology, such as name of the video tape, DVD title etc.

20 Please specify what types of educational aid you used for each part of the chapter that you used.

21 How interested were students when you integrated educational aids into the classroom activities?

22 Do students normally use the internet, and from where?

23 If there is an on-line interactive bioethics course or CD textbook, how is your school’s facility if you were to use the website or electronic textbook for your class?




A Cross-Cultural Introduction to Bioethics xiii

Student Feedback Form - Explanations and Guidelines

The Importance of Completing the Feedback FormConsistent with the purpose of the development of the text book, the purpose of the

feedback forms is to provide good, free and on-line materials and resources for bioethics which teachers and students can use. The completed evaluation form will be analyzed by specialists in UNESCO and will contribute to the improvement of the textbook. Further research on teaching materials and strategies to provide adequate learning and teaching materials for bioethics helps both students and teachers to better balance ethical principles. Therefore, as much as it is important to learn and teach through using the textbook, by completing the form and returning it to UNESCO for further learning and improvement, we can progress the advancement of education for all. We welcome and appreciate your feedback and comments to email address [email protected] at the Social and Human Science Unit, UNESCO Bangkok. You can also download the form from the website http://www.unescobkk.org/index.php?id=2508 .

The Student Chapter and Course Feedback FormThe student chapter and course feedback form is developed to improve textbook and

student learning on bioethics. By completing the forms, students can reflect on the discussions and values they shared during the course. This will help to further strengthen the lessons. As students are the most active player throughout the course and the major stakeholder in the textbook design, it is important for them to fill out the form at the end of each chapter and course. All the completed forms and other information should be returned to the teacher.

The Feedback Form OrganizationThe Chapter Feedback Form is organized into six sections. The first section tells us

basic data about the students who are responding. The second section is to see how useful the textbook was to the learner and the instructor. The key focus of the text book is to provoke meaningful and balanced discussion on bioethics issues so that each individual can be equipped with the ability to critically think for themselves. While answering these questions the students and teachers can reflect on what they have learned or taught throughout the course. Thoughtfully completing the form will be crucial for textbook development, and it will also contribute to the development of related materials and methodologies on bioethics. The remaining questions provide useful student feedback on the teacher, other materials, and allow space for other comments.

The Course Feedback Form features more on personal background questions regarding bioethics. This information helps us see how well the students were informed about bioethics and related issues before using the textbook. As bioethics is closely connected to values and beliefs, the questions in the course feedback form ask for information beyond the course and the textbook. Issues regarding ethics and values can be different in different cultures, but the underlying principles of respect for human rights and dignity, and protection of the environment are universal throughout the world. The collected information will form a crucial data base for further research on bioethics adapted to each country’s cultural values. All information will be kept anonymous and privacy will be protected.



xiv A Cross-Cultural Introduction to Bioethics

Student Course Feedback Form A Cross Cultural Introduction to Bioethics

Title of the Chapter and/or Material: Name (If you do not wish, you do not have to write your name.) Date of evaluation:

( )d( )m( )y

Languages for class discussion

Nationality AgeGender M / F

Dept. and School Evaluation Instructions


Name of the course and teacher


NA (Not applicable), PD (Partially disagree), D (disagree), SD (Strongly disagree) **Student

1 Have you taken any Bioethics class before? Yes / No If yes, when (your age and school year), where (name of the school or institution and the city), and by whom (name of the teacher or program)?

2 If yes, how long was the course and what were the textbooks?

3 Were there other books and materials (movies, story books, slides, documentary, field trip etc.) for the class? Yes / NoIf yes, what were they?

4 Have you taken a general ethics class before? Yes / No

5 What is your religion, and cultural/ethnic background? Do you think it affects your ethical values?

6 If you happened to find a wallet with $100 and the person’s ID card on a street, and there is no one around, would you return the money and the wallet to the police? Yes / NoWould you act differently if there is no ID card? Yes / No

7 Do you think the answers to the previous questions tell us a person’s morality? Yes/NoPlease share with us why you think so.

8 How would you describe the meaning of learning “bioethics”?

9 In your view, what is ethical thinking and action? Is it the same as moral thinking?


A Cross-Cultural Introduction to Bioethics xv

The Textbook10 What topics and which chapters were covered?

11 What do you think the key words from this course are?


12 The textbook is very interesting. SA A PA NA PD D SD

13 The allocated time was adequate for the course and the topic-bioethics. SA A PA NA PD D SD

14 The textbook was helpful in provoking meaningful discussion in class. SA A PA NA PD D SD

15 The course and the textbook were well organized and contained meaningful information concerning bioethics.

SA A PA NA PD D SD

16 The questions in the textbook are helpful in guiding meaningful thinking and further study/research on the topics.

SA A PA NA PD D SD

17 List three important things that you learned through this course.

18 Were any of the chapters not appropriate given your cultural values and norms? Please describe briefly why. (Should you need more space, please continue in the comment box below.)

The teacher and the classroom activity ** Please indicate your agreement or disagreement using this seven point scale:

SA(Strongly agree), A (Agree), PA (Partially agree),NA (Not applicable), PD (Partially disagree), D (disagree), SD (Strongly disagree) **19 The teacher helped students get interested in the topic. SA A PA NA PD D SD

20 The teacher made good use of examples and illustrations. SA A PA NA PD D SD

21 The teacher welcomed questions/comments. SA A PA NA PD D SD

22 The teacher answered/responded to questions and comments clearly and concisely.

SA A PA NA PD D SD

23 The ethical concepts were learned through a series of discussions more than the teacher’s lecture.

SA A PA NA PD D SD

Technology integration24 Do you have access to a computer? Yes / No If yes, how often do you use the internet and where?

25 Did the classroom activity involve searching for further materials on the internet? If yes, how often did you search the internet in and out of class? What websites did you use?


26 Rate this chapter using the following scale. ⑤ ④ ③ ② ①27 Would you recommend this textbook to your friends? SA A PA NA PD D SD


xvi A Cross-Cultural Introduction to Bioethics

Student Chapter Feedback Form A Cross Cultural Introduction to Bioethics

Title of the Chapter and/or Material:

Name Date of evaluation:





NA (Not applicable), PD (Partially disagree), D (disagree), SD (Strongly disagree) **The text book

1 How much of the total class time was used for the chapter?

2 What key words were repeated throughout the discussion?


3 The chapter is very interesting. SA A PA NA PD D SD

4 The allocated time was adequate for the chapter and the topic. SA A PA NA PD D SD

5 The chapter was helpful in provoking meaningful discussion in the class. SA A PA NA PD D SD

6 The chapter was well organized and contains meaningful information. SA A PA NA PD D SD

7 The questions in the chapter are helpful to guide meaningful thinking and further study/research on the topic.

SA A PA NA PD D SD

8 The examples and contents were not adequate to address the issues in the chapter.

SA A PA NA PD D SD

9 What have you learned through reading the chapter?


A Cross-Cultural Introduction to Bioethics xvii

10 Were there any contents and/or questions that are not appropriate for your cultural values and norms? Or were there any contents and questions that were not easily understood by the students? Please describe briefly what they are and why. (Should you need more space, please continue in the comment box below.)

The teacher and the classroom activity ** Please indicate your agreement or disagreement using this seven point scale:

SA(Strongly agree), A (Agree), PA (Partially agree,)NA (Not applicable), PD (Partially disagree), D (disagree), SD (Strongly disagree) **11 The teacher helped students get interested in the topic. SA A PA NA PD D SD

12 The teacher made good use of examples and illustrations. SA A PA NA PD D SD

13 The teacher welcomed questions/comments. SA A PA NA PD D SD

14 The teacher answered/responded to questions and comments clearly and concisely.

SA A PA NA PD D SD

15 The ethical concepts were learned through a series of discussions more than the teacher’s lecture.

SA A PA NA PD D SD

Technology integration16 If the classroom activity involved educational aids, please circle all those used in the class:

video/ computer/projector/OHP/cassette/CD/DVD/and others ( ) (Please list the names and titles of educational materials that were used when integrating educational technology, such as name of the video tape, DVD title etc.)

17 Did any classroom activity involve searching further materials on the internet? How often and what are the websites?




xviii A Cross-Cultural Introduction to Bioethics

Authorship and Acknowledgments

The chapters in this book have been written by a team of persons including the editor, with other authors from a range of countries and backgrounds. Additional thanks for editing goes to many persons including Mary Ann Chen Ng, Morgan Pollard, and many colleagues and teachers in different countries. Thanks also to Nobuko Macer, Fumi Maekawa, Mihaela Serbulea, Hyunjoo Youn and Catherine van Zeeland for essential help with the ongoing project.

The textbook/resource book compiled here also owes appreciation to those who attended many pilot meetings in different countries, and the working meetings 12-16th February 2004 at the time of the Ninth Tsukuba International Bioethics Roundtable (TRT9) and the Fifth Asian Bioethics Conference (ABC5), which saw the formation of the International Bioethics Education Network. Also to many who gathered for meetings on the project at the First UNESCO Bangkok Bioethics Roundtable, 11-16 September, 2005 in Thailand. The human network is another product of the project, essential for implementation and expansion of bioethics education. The papers and visual aids of those meetings are available on the Eubios Ethics Institute Internet site and Eubios CD.

I also thank the staff and students of schools in many countries, especially in Tamil Nadu India, Ateneo de Manila High School in Manila, The Middle School attached to Beijing Normal University, and University of Tsukuba, Japan, for special enthusiasm in the first years of trials of this project, as well as all other schools and universities in which trials were conducted. Thanks especially to the country and regional coordinators which are Australia (Irina Pollard), China (Jinhua Fu and Jing Zhao), India (Jayapaul Azariah, M. Jothi Rajan, Arokiam Thaddeus), Japan (Darryl Macer), Malaysia (Maude Phipps), Mexico (Marcela Rodriguez), New Zealand (Lindsey Conner, Darryl Macer), the Philippines (MaryAnn Chen Ng, Ester Abito, Milarosa Librea), South Korea (Ivo Kwon), Taiwan (Dena Hsin), Thailand (Darryl Macer). Their enthusiasm has also inspired the project to expand to more countries.

I also thank the essential financial support of Sasakawa Peace Foundation for the project 2003-2005, and the staff including program officer Tetsuya Ishizuka help in developing the project. For the follow-up of the project I thank the support of UNESCO Bangkok and the Division of Ethics and Science and Technology, UNESCO, which is mapping and developing methods for teaching ethics. We welcome more authors, contributors and partners to this project. The teachers guide, movie guide, updates, translated versions, and other files are placed on the Internet site to download as files for all to share and improve.

Darryl Macer

Authors’ ProfilesDarryl R.J. Macer, Ph.D., New [email protected]

Darryl is Regional Advisor on Social and Human Sciences in Asia and the Pacific, in RUSHSAP, UNESCO Bangkok, Thailand, and Affiliated Professor in Bioethics at United Nations University Institute of Advanced Studies since 2002. He is also Director, Eubios Ethics Institute, Japan, New Zealand and Thailand. He taught bioethics at the University of Tsukuba, Japan from 1990-2005, and in many countries. He has a B.Sc (Hons) in Biochemistry from Lincoln College, University of Canterbury, 1983; Ph.D. in Biochemistry at the MRC Laboratory of Molecular Biology, and Trinity College, University of Cambridge, U.K., 1987.

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Morgan Pollard, [email protected]

Morgan is a postgraduate student in the environmental sciences, currently working on a PhD project on the modelling of sustainable development through Southern Cross University’s School of Environmental Science and Management in Lismore, New South Wales, Australia. He has completed a BSc double major in ecology and environmental geography at the University of Sydney, with an Honours thesis in marine biology. He has travelled widely in lesser developed countries, and these travels and studies have led him to his current interests in fostering a sustainable world.

Minakshi Bhardwaj, Ph.D., U.K./[email protected]

Mina has training in biology and bioethics, and specialises in ethics and international governance and regulation of biotechnology, including biomedicine and use of genetic technologies. At ESRC Centre for Economic and Social Aspects of Genomics (CESAGen), Lancaster University, UK (http://www.cesagen.lancs.ac.uk/staff/bhardwaj.htm) she is responsible for a flagship project on Genetic Databases and also partner in three other international projects including, LEMLife coordinated by Chulalongkorn University, Thailand, and PropEur coordinated by University of Birmingham, UK. She is editorial board member of EJAIB and referee’s for Electronic Journal of Biotechnology ( EJB) and Journal of Human Mutation ( HuMu). She did her PhD in Biological Sciences/bioethics from University of Tsukuba, Japan as a Monbu-ka-gakusho scholar and also worked as a volunteer researcher for UN Food and Agriculture Organisation (FAO) for a few months. She has published several papers in both science and social science journals.



Susannah Tye, [email protected]

Susannah is a postgraduate student in the Department of Biological Sciences at Macquarie University, Sydney, Australia. Her research investigates the effects of stress hormones on neurotransmission in the mesolimbic dopamine system, an important pathway in the brain involved in drug addiction, and assesses the role of stress hormones in drug addiction and relapse. This work seeks to provide insights into the biological and behavioural links between lifestyle stresses and drug addiction. Susannah is also involved in a Sydney wide survey of youth health awareness investigating the health-related educational needs of Sydney’s high school students for the development of useful teaching resources. She enjoys teaching at both Macquarie University and local Sydney high schools.


xx A Cross-Cultural Introduction to Bioethics

Irina Pollard, Ph.D. , [email protected]

Irina is a biologist, Associate Professor in the Department of Biology at Macquarie University, Sydney, Australia. She is co-founder of the new ethical discourse ‘bioscience ethics’ and her friendship portal at http://www.bioscience-bioethics.org provides free entry to educational material in disciplines connected to stress physiology, reproduction, developmental toxicology and the environment. Access to other sites carrying items of interest to bioscience-bioethics is also available. Her major research/teaching impacts are in lifestyle stresses and their transgenerational effects. These studies have led to a deep concern for social justice and to the publication of two comprehensive, interdisciplinary texts in the area of human reproduction and bioscience ethics. Pollard enjoys life, work, travel and a good anecdote.

Dena Hsin-Chen Hsin, Ph.D., Taiwan [email protected]

Dena is a lecturer at the nursing department, China Medical University in Taichung, Taiwan. She got her PhD in Bioethics at the University of Tsukuba, Japan. Her MSN from the University of Dubuque in USA and has taught nursing for more than ten years. She also has experience of working in the cancer center of Taipei as oncology nurse specialist for four years. She initiated the curriculum of Nursing Ethics in her department eight years ago and had been invited to be editor and writer of medical ethics textbook projects sponsored by the Ministry of Education Taiwan.

Lindsey Conner, Ph.D., New [email protected]

Lindsey is Principal Lecturer, Research Coordinator School of Secondary Teacher Education, Christchurch College of Education, New Zealand. Her PhD in Education from Monash University in Australia was in bioethics education. She works in Teacher Education, Teaching and learning methods, Biology Education, Science Education, Issues Education, Reflective Learning, Assessment Development and Evaluation. She has taught in university and schools.



Alireza Bagheri, M.D., Ph.D., [email protected]

Ali is a medical doctor from Iran. Ali received his Ph.D. on medical ethics from the University of Tsukuba, Japan. His past three years work has focused on ethical and legal issues in brain death and organ transplantation. In his most recent contribution he examined a cross-cultural comparative study on organ transplantation laws especially in Asian countries. Ali is currently working on Medical Futility at the Kyoto University in Japan.



A Cross-Cultural Introduction to Bioethics xxi



Michael Anjello Jothi Rajan, Ph.D., [email protected]

Jothi is FDP Research Scholar, School of Physics, Madurai Kamaraj University, Madurai, India. He is also a lecturer at Arul Anandar College, Karumathur, Tamil Nadu. His specialty is nanotechnology research.His wife who also contributed to some chapters, Arockiam Thaddeus, is a biology lecturer in Jayaraj Annapackiam College for Women, Periyakulam, Theni District, Tamil Nadu, India.

Mary Ann Chen Ng, the Philippines/[email protected]

Mary Ann is finishing her PhD in the Graduate School of Life and Environmental Sciences, University of Tsukuba, Japan. Her dissertation is on environmentalism and ecotourism in the Philippines. Her M.Sc. was in bioethics from the University of Tsukuba. She has taught at the Ateneo de Manila University, University of the Philippines and Tsukuba Institute of Science and Technology. Her research interests include environmental ethics, feminist and cross-cultural bioethics. She currently resides in Southern California.



Richard S. J. Weisburd, Ph.D., U.S.A./Japan [email protected] is an Associate Professor in the Graduate School of Life and Environmental Sciences, University of Tsukuba, Japan, where he teaches biology, oceanography, and scientific writing to both graduate and undergraduate students. Though Rick was born in New York and has made his home in Japan since 1990, he is a citizen of the Earth’s Quaternary biota. Rick is the editor-in-chief of ELSS, a scientific editing and translation company. His recent research has been conducted in Japan and China and is focused on environmental policy and ethics, especially related to biodiversity.

Margaret Sleeboom-Faulkner, Ph.D., the Netherlands [email protected] is research fellow at the International Institute for Asian Studies (IIAS) and the Amsterdam School for Social Science Research (ASSR), and lectures in the fields of Asian studies and cultural anthropology at the University of Amsterdam. Her work focuses on nationalism and processes of nation-state building in China and Japan and on biotechnology and society in Asia. She currently directs the Socio-genetic Marginalization in Asia Programme (SMAP) in co-operation with the Netherlands Science Organisation (NWO), the IIAS and the ASSR (2004 -2009).

M. Selvanayagam, Ph.D., India [email protected]

Professor and Head, Dept. of Zoology, Loyola College, Chennai, India. Director of the LIFE Institute, Loyola Institute of Frontier Energy. Specializes in environmental sciences and zoology.

Gursatej Gandhi, M.D., Ph.D., India [email protected]

Reader, Department of Human Genetics, Guru Nanak Dev University, Amritsar, India. Specializes in human genetics research, teaching and clinical practice.


xxii A Cross-Cultural Introduction to Bioethics

Note that some authors did not provide their profile for distribution in which case only names are included under the chapters they contributed to.

A Cross-Cultural Introduction to Bioethics xxiii

Life is something we are all in together.

This book is intended to make people think, respect, love, and question.

We hope that this book will help readers develop their own bioethics.

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