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Bioethics was born to be a new discipline in biology eduaction that serves a forum for discussion about ethics and values with regard to problems that emerge from biological advances. In UIN Sunan Kalijaga, bioethics has been delivered since 2007 to equip students of Biology and Biology Education Study Program with skills and knowledge on how to solve ethical problems related to biological and biotechnological issues. Since 2007, Bioethics in UIN Sunan Kalijaga has been designed to accomodate biological issue and Islamic values, and not too focus on medical issues. This paper reflects to the process of designing the course and the course in action. It also serves as a reflection and evaluation to bioethics education. In this reflection, a small survey was conducted to understand students' perspectives and understanding of what bioethics course should be.
Keywords: bioethics, bioethics education, State Islamic University Sunan Kalijaga
Abstrak: Bioetika muncul sebagai sebuah ilmu baru dalam pendidikan biologi yang berfungsi sebagai sebuah forum diskusi mengenai nilai etika dan moral berkaitan dengan masalah-masalah yang muncul akibat perkembangan ilmu biologi. Di UIN Sunan Kalijaga, bioetik diajarkan sejak 2007 untuk membekali mahasiswa dari Program Studi Biologi dan Pendidikan Biologi dengan keterampilan dan ilmu pengetahuan tentang bagaimana memecahkan secara etis persoalan dan isu-isu yang muncul di bidang biologi dan bioteknologi. Sejak 2007, bioetik di UIN Sunan Kalijaga telah didesain untuk mengakomodasi isu biologi yang dikaitkan dengan nilai-nilai keislaman, dan tidak terlalu fokus pada isu-isu kedokteran. Artikel ini melakukan refleksi terhadap bagaimana mata kuliah bioetik di desain dan bagaimana mata kuliah ini diberikan kepada mahasiswa. Artikel ini bertujuan untuk memberikan refleksi dan evaluasi terhadap mata kuliah bioetik di UIN Sunan Kalijaga. Pada refleksi ini, sebuah survey kecil juga dilakukan untuk memahami pandangan dan pemahaman mahasiswa mengenai bagaimana mata kuliah bioetika seharusnya diberikan.
Kata kunci: bioetika, pendidikan bioetika, UIN Sunan Kalijaga
Dynamic revolution in the field of biology has brought human beings to be the most powerful species on earth. Biotechnology has made it possible for human beings to manipulate other species and their environment. The finding of the DNA structure by the most efficient collaboration -Watson and Crick- has opened the secret of life.
With biotechnology, biologists can now manipulate plants and animals' DNA and creates new life forms that have never been existed. For example, the insertion of glowing genes from a jelly fish into zebra fish's DNA has made the zebra fish glowing. This biotechnical product was created by Korean scientists, and had been given a name; glofish. On the one hand, such a finding provides benefits for the biologists as well as the community. The glofish, for example, does not only bear artistic values, but it also has biological significances as a bio-pollutant indicator. However, concern and skepticism occur from those who oppose this biotechnical invention. Those people would argue that the glofish will have negative influences on the nature. If the fish coincidentally escapes to the wild environment, it will destroy the entire ecosystem. If the ecosystem is destroyed, then: who will be responsible for the destruction? From this illustration, undoubtedly, science is a double-edged sword. While scientific and technological developments can be argued to contribute to human beings' health, wealth and comfort, they also generate problems in their wake and become a source of concern. Thus, the problem is not only about science but also about the ethics behind the science. As Margaret Sommerville puts it:
....advances in science can have a paradoxical effect: they may solve some existing ethical problems, but in doing so, open up different or new ones. (Somerville, 2000, p.29)
According to its terminology bioethics comes from two Latin words bio (life) and ethics, hence, roughly means "life ethics". The term "bioethics" was officially coined by Van Renssealer Potter (1971) in a book Bioethics: Bridge to the Future (Bryant & Baggott la Velle 2003, Newby 1984, Pellegrino 1999). In Cambridge Dictionary of Advanced Learner (2003), bioethics means the study and consideration of what is right and wrong in biological advances and activities such as genetic engineering and the transplantation of organs.
Cahill (2003) explains four standpoints of bioethics. First, bioethics theories in justice and fairness must be related to the reality of global economic, moral, and political agency. Second, bioethics must fulfill the need of "global counterparts at the global level" (p. 42). Third, the ethical grounds for ideal justice and government may come from cultural differences and pluralism in a social construct. Fourth, bioethics in social context must "validate a constructive and reformist stance" (p. 42). Based on Cahill's standpoint of bioethics, one may conclude that bioethics is promising disciplines for the future segregation between science and humanity. Ethics in bioethics frames will work in a "real world" rather than imaginer. In turn, bioethics will emerge as a fruitful discipline among the boundaries of science.
Some scientists argue that bioethics is the same as medical ethics, because this term has been used vastly to refer to the study of ethics in human treatment in medical setting. Yet Bryant and Baggot la Velle (2003) says that bioethics is a bridge between science and humanities. The debate in bioethics is not merely about medical consideration but also in respect with human to human interaction, human use of animal experimentation, and exploitation of ecosystem. Thus, the boundary of bioethics is larger than medical ethics. Moreover, Thornthon et al (1993) mentions the participants of bioethics conversation include researchers, physicians, philosophers, theologians, social workers, policy makers, etc. In accordance with Bryant and Baggot la Velle (2003), I believe that bioethics is a compulsory subject in bridging natural sciences and humanities. Therefore, conducting bioethics courses for biology students is as important as medical ethics for medical students. I tend to see that bioethics is broader than medical ethics. In other word, medical ethics is under the bioethics heading. If we only have medical ethics in our curriculum, we might fail in addressing dilemmatic issues in biology, for instance, animal experimentation, genetic modified foods, etc. To decide which course is more important for biology student, consider the following question: who are most responsible for cloning or genetic engineering; biologists/bio-scientists or medical practitioners?
In Islamic University Sunan Kalijaga Yogyakarta, ethics is vastly taught to accomodates the science and the religious values (in this regard is Islam). Accordingly, in the Biologi Study Program (one of the programs offered in the university), a bioethics course has been developed. Actually, bioethics is not a new subject for Potter (1971) had coined the term 'bioethics' since 1970s. Bioethics has received its status in the setting of medical education since the time of Hippocrates, and has been described as "an area of special study concerned with the comportment of [ethics] and philosophical implications of certain biological and medicosurgical procedures, technologies, bioengineering, surgical procedures, and medical treatments." (Ficarra, 2002, p. 5). On modern days, definition of bioethics is usually very broad. It covers both the ethics of biology and the ethics of medical science. Such a definition was formulated by Warren Thomas Reich (The editor in chief of Encyclopedia of Bioethics) as "the systematic study of the moral dimensions-including moral vision, decisions, conduct, and policies-of the life sciences and health care, employing a variety of ethical methodologies in an interdisciplinary setting." (Reich et al., 2004).
Bioethics definition today refers to an already established subject called biomedical ethics. In fact, In Indonesia, bioethics is an important course especially for medical students, and yet it has a little place in biology education. The main aim for having bioethics so far is to create this course as meaningful as biomedical ethics for medical students and clinicians. This is a reason why developing and delivering bioethics in our university becomes a challenging task for both the lecturer and the university managers.
The bioethics that has been developed in the State Islamic University Sunan Kalijaga is slightly different from Potter's. As the teaching occurs in an Islamic environment, our bioethics course tries to accommodate the science (biology), the ethics, and the religion (Islam). In accomodating religion, the curriculum and discourse have been designed to build a bridge between Islamic studies, natural sciences and technology, and social sciences.It was not an easy task, but it can be a prototype subject that serves as a bridge between science, ethics, and religion.
Bioethics in our university has been delivered since 2007. Within almost 5 years, bioethics has emerged as a compulsory course in the curriculum. And this paper will explore our reflection of the subject. It reflects the design of the curriculum and the delivery of the course. To enrich our view, we conducted a small survey to understand our former students' perspective and thoughts about the subject. Overall, this article aims at providing an evalution tool for the improvement of the subject itself in the future.
FORMULATING A BIOETHICS COURSE CURRICULUM CONTAINING ISLAMIC VALUES
For biology teachers, like us, it is easier and comfortable if we can discuss bioethics from an objective view of point. However, bioethics by nature is a messy one (Solberg, 2005); it does not need our objectivity. Indeed, we don't have objective tools or formulas in exercising and making ethical decision of biological cases. We will constantly be bounded with our subjectivity, moral values, and -perhaps- religious values that we believed.
Our first struggle in designing a curriculum for a bioethics course started when we were challenged by the word 'Islamic bioethics'. It comes into a lot of questions (and confusions): Can we really be able to formulate 'Islamic bioethics' while Islamic value itself is so broad? Which Islamic tradition is that we have to include in the curriculum, despite the fact that we have many 'genres' in Islam (Sunni, Syiah, etc)? Is it possible to have such a bioethics course with an Islamic nuance when most of handbooks and materials are written in the context of Western culture?
The struggle has brought us to create a different framework of bioethics course. Our bioethics course weighs 2 credits, consists of 12 to 14 meetings, and covers many issues; ranging from the history of bioethics to Islamic bioethics and discussing many cases such as genetically modified organisms, surrogate motherhood, xenotransplantation, neuroethics, environmental ethics, and the like. To accommodate the course curriculum we have included some elements, i.e.:
Setting theoretical basis for learning ethics
Bioethics is a composition of two major disciplines: biology and ethics. Therefore, setting a theoretical basis is important approach if we want our biology students understand the philosophy of biology. Nonetheless, it may deepen our reflection and ripen our ethical decision. For the purpose of the course, both ethical theories from Western philosophers and Moslems are presented. The students study Kant, Mills, and Bentham as much as they learn ethical propositions derived from Moslem philosophers.
Using a model in exercising ethical problems
There are many models can be used to exercise with moral or ethical problems, such as RESOLVEDD strategy and ABCDE model  (Johansen & Haris, 2000). Such a model simplifies the complexity of a bioethics case and enables students to think systematically before making an ethical judgment. In the teaching instruction, Daniel Maguire's routes to moral reality and ABCDE are used as models for ethical exercises for our students (Maguire & Fargnoli, 1991 ; Johansen & Haris, 2000).
Discussion and class debate as the implementation of active-learning
Most of the time, case studies are used to draw students' attention. After a presentation of a case, the class is followed by a discussion or a class debate. During the discussion, instructors always encourage our students to state their opinion as Moslems. Therefore, it is not rare that our students are discussing a case while citing the Quran and Hadith as resources.
Using a model of moral games that is provided by Darryl Macer (2005), we exercise ethical problems in fun and free-risk environment. We practice 'donuts'. In the game, students were asked to state their opinion from strongly agree to strongly disagree by arranging themselves in a circe (Macer, 2005). Students were also asked to express their concerns and arguments to a bioethical issue through artistic representations. The class was asked to draw a picture and create a poster in response to a particular issue.
Most of bioethics references are written by Western scholars. Therefore, we designed the curriculum which is accessible towards Islamic bioethics by including some references from Moslems authors, such as Sajoo and Anees, Zainal Abidin Bagir, etc. Our references, however, contain much limitation including language limitation. Most of our materials are written in English, which sometimes lead to problems to some of our students. In overcome this situatation, some local materials and translated materials were used.
Some materials used in this course are:
The Hastings Center (www.thehastingscenter.org).
A websites that links to online library, periodical journals, research and teaching materials, as well as a calendar listing conferences, courses, and events. In addition to this, the Hasting Centre has long been known as the most influential bioethics center in North America. Founded by Daniel Callahan, this center has carried out a lot of research and publication in the field of bioethics.
This site provides information on the social and ethical issues related to genetics and technology. It also links to news and sources that can be used as references in bioethics education.
The National Academies (www.nationalacademies.org)
This site provides extensive publications, projects, news, and sources on ethics. The publication can be assessed online for free. This can also become a good resource to find relevant and current topics in bioethics.
Bioethics Education Project (BEEP)
This is interactive website is intended to help teachers (especially secondary teachers) to find bioethics resources. Funded by Welcome Trust in the University of Bristol, the BEEP is also intended to be a place for conducting an online discussion on bioethical issues. This website contributes to useful materials for teachers and students who are enrolled in bioethics courses. The materials are, for example, articles, case studies, short, animated movies, lesson plans, and links to other journals and resources.
High School Bioethics Curriculum Project (HSBCP), the Kennedy Institute of Ethics http://www3.georgetown.edu/research/nrcbl/hsbioethics/index.html
The HSBCP is a project of the Kennedy Institute of Ethics, Georgetown University, Washington. The goal of this project is to provide high school teachers with materials, resources, and lesson plans that are useful for teaching bioethics.
The American Journal of Bioethics (www.ajobonline.com)
This website publishes the American Journal of Bioethics online along with the latest news, announcements, and comprehensive sources on bioethics. It can be very useful for students and educators who are looking for materials as well as job opportunities in the field. We can find a blog (www.bioethics.net) that is dedicated to discussing issues in the development of science and technology and its implication on ethics.
Islam Online (http://www.islamonline.net/english/index.shtml).
This is a website that provides online fatwas on ethical issues concerning the development of science and technology. The ulamas that give these fatwas are Islamic scholars from all around the world. One of the ulamas is Dr. Yusuf Qardawi, who is well known as a contemporary and moderate Moslem scholar. Bioethics educators from Islamic institution can benefit from this website by getting Islamic perspectives on the issues.
Komisi Bioetika Nasional (The National Commission on Bioethics). http://www.biotek.lipi.go.id/komisi-bioetika/index.php?option=frontpage&Itemid=22. The National Commission on Bioethics was built by the Lembaga Ilmu Pengetahuan Indonesia. One of the main duties of this commission is to provide the government and Indonesian society with adequate information related to the progress of science and its implication on ethics.
Jurassic Park (film, 1993)
This is a science fiction movie that depicts the development of cloning technology to clone extinct animals; in this case, dinosaurs. In this film, biologists have learnt how to clone dinosaurs from the DNA found in mosquitoes trapped in amber. By doing so, they have recreated dinosaurs and placed them in a special park, namely Jurassic Park. Based on the novel written by Michael Crichton, this Steven Spielberg film can be a useful resource in teaching bioethics in the Biology Program. This film touches upon a range of issues concerning animal cloning and cloning technology.
Grocery Store Wars (a short animation, 2005)
This film is produced by Free Range Studios for the Organic Trade Association, and directed by Louis Fox. This is a short film that can be downloaded online from http://www.storewars.org/flash/index.html. Teachers can use this resource to begin a discussion about Genetically Modified Foods and its effects on farming and organic products.
DNA Interactive (an interactive animation, 2003)
Dedicated to genetics teaching, this DVD provides an interactive approach to learn the "science" behind genetic manipulation. This can be a good source for teachers who want to encourage the students to build their arguments behind scientific facts and processes. This film was made in 2003 by DNA Learning Center, Cold Spring Harbor Laboratory. Teachers and students can also access this film online from http://www.dnai.org/index.htm.
Bioethics is an interdisciplinary subject; therefore, we use team teaching as a delivering strategy. Each year, we invited teachers from various educational backgrounds. We had a teacher from the Faculty of Islamic Education (tarbiyah), who delivered a topic about the history of science in Islam. And we had a teacher from Chemistry Education who assisted students during the class debate. Recently, we have a teacher with a major background of interreligious studies to provide our students with knowledge on how ethics is positioned within religious values.
THE COURSE IN ACTION
During the Course
For almost 5 years, we have been implementing bioethics in our curriculum. The curriculum we created gained a full and positive response from our students. In average, we have more than 80 students every year.
Using the routes to moral reality and ABCDE, we gained a substantial success on teaching bioethics. We concluded that our students need a model which helps them to solve practical problems in ethics. In our analysis, a model resembles a formula in science. Since our students have been very familiar with formulas, they do not find it difficult to use a model. In fact, a model makes their work easier.
However, most of our students feel that they have not gained a full perspective of Islamic ethics because there were only two teachers in the team. If we had more teachers (guest teachers), then a real interdisciplinary atmosphere would be achieved. This is what we intend to do in the future. We agree that interdisciplinary atmosphere should be a key point in teaching bioethics. In doing so, Yukiko & Miho's statement resounds to us:
Bioethics in our view should remain interdisciplinary, and is not the teaching of information but the teaching of thinking, reasoning and decision making, which involves balancing of the issues (Yukiko & Miho, 1996)
Self-Evaluation and Portfolios as Evaluation Tools
Self-evaluation and portfolios are used as evaluation tools because each class is unique. Moreover, bioethics is relatively different from other courses. Using self-evaluation, students can freely argue whether the course has been useful or not. This is important for the improvement of the course in the future. Portfolios enable us to understand the process behind students' learning and what the obstacles that they had been through.
SURVEY TO STUDENTS' UNDERSTANDING
As a complementary activity in our reflection, we had conducted a small survey to understand what the students think about bioethics course. The survey was administered to 58 students who had taken bioethics. The questionnare adopted questions admininistered in research, titled High school teaching of bioethics in New Zealand, Australia and Japan (Yukiko & Miho, 1996). The participants were randonmly chosen.
The questionnaire was divided into 3 sections. First section was about the identity of the participant. Although we asked about their identities, such as name, gender, age, etc; we actually kept the information confidential. There is no ethics committee in our university that monitors or sets up guidelines for research involving human participants. However, as we thought that ethical issues in research in important, we developed an ethical guideline exclusively for our research. The guideline includes:
1. Protecting the participants by giving them pseudonyms
2. Providing a letter to the participants explaining our research and our statement to protect participants' confidentiality. Also, the document states that participatory in the reserach is fully voluntarily that respondents could withdraw from the research without any penalities.
3. Preparing consent forms that were signed by both the participants and the researchers.
In the survey, we asked 9 questions to understand students' perception about bioethics course. We asked them to define bioethics as they understood after taking the course (Q1).
Question 1 surprisingly was given various responses. At least, 3 definitions of bioethics emerged from the survey. First 55.17 % of the respondents define bioethics as a matter of norms and values attached to biological science, biotechnology, medical science, and biological experimentation. Secondly, 41,38 % of them conclude that bioethics is a bridge between scientific advancement with values and norms that applies in the society. Not only it is deal with human species, bioethics according to this definition protects all living things on earth. Surprisingly, only 3,45% of the respondents see bioethics is close to religious ethics and values. From this result, we infer that the delivered bioethics in our study program lacks of references regarding Islamic bioethics. This difficulty arises due to a lack of our understanding to Moslem scholars that concern with bioethics. Mostly, the theories of western ethics philosophers, such as Bentham and Mills, were brought to the class. This result, however, provides us a sharp reflection of what is lacking in the course.
Question #2 asked about the respondents' response whether bioethics course is necessary for them. Almost 100% of them answered that bioethics is clearly needed for biology/biology education students. Only 5.17% were abstains. This result gives us a positive feedback that our students actually need bioethics in their course and that we can continue delivering bioethics in the upcoming years.
Question #2 to question #6 were asked to see respondents' response as to whether they are familiar to the following bioethical issues: eugenic, in-vitro fertilization, genetic modifications, and research ethics. The result shows that only 6% of our students believe that they are familiar with eugenic. Although eugenic is one of the issues presented in the class, this issue has only been viewed at a glance. With regard to genetic modifications, almost 83% of the respondents say that they understand the issue relatively well. Some issues within genetic modifications such as gene theraphy was only understood by less than 50% of the respondents.
In terms of research ethics/ethics in experimentation, 81% of respondents state that they know the issue very well. However, some aspects of ethics in research only apply in theory. In practice, many research involving human and non-human subjects carried out in the university do not have a specific ethical guideline. In fact, an ethics committee is yet to be developed. With this situation in mind, we asked the respondents about their views about animal experimentation (question #7 to question no #9).
In question #7, it was asked whether the participants are familiar with the issue of animal experimentation. 77% of the participants state that they know some aspects of animal experimentations. The rest 23 % feel that they do not familiar with the issue.
Question #8 explored respondents' views about the use of a protocol in executing research using animal. 22% of the respondents strongly agree if a protocol is developed and is used accordingly. Other 78% do not know that such a protocol is available.
The last question about animal experimentation (question #9) asked whether the teaching of bioethics they have taken shapes their views about animal experimentation. 67% of the students believed that bioethics education at the State Islamic Univesity (UIN) Sunan Kalijaga Yogyakarta had shaped their understanding of animal experimentation issues. However, it was not clear whether bioethics principles were applied when students conducted their experiments or research for their final paper.
While bioethics as a subject is readily absorbed to biomedical ethics, the attempt to frame Islamic bioethics as a course for biology/biology education's students is worth taking. Our reflection concludes that bioethics course in Islamic universities needs to accommodate the element of science (biology), the ethics, and the religion (Islam). The curriculum design should at least include: ethical theories as a philosophical basis (both from Western and Islamic perspective), biological concept (drawn from both modern knowledge and scriptures -Quran and Hadith-), a model to analyze ethical problems, accessible references from Western and Moslem scholars, and availability of team teaching. Our finding concludes that although we tried to incorporate Islamic perspective in our materials, students still feel that it was not enough to convey the message of Islamic bioethics.
There should be research into how bioethics is being best taught, the suitable issues , and the effective methods to help students understand the issues. More research are also needed to understand the effectiveness of bioethics evaluation and how it could be improved. Since bioethics needs to remain interdisciplinary, therefore it is important to incorporate the knowledge and values of various disciplines. In doing this, it may need more experts enter the class and share their values and views.