Michelle Chang Science Department Chair Connelly School of the Holy Child 9029 Bradley Boulevard Potomac, MD 20854 (301) 365-0955 mchang@holychild.org

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Genetics, Bioethics, and Biotechnology: Course Outline
Michelle Chang
Science Department Chair
Connelly School of the Holy Child
9029 Bradley Boulevard
Potomac, MD 20854
(301) 365-0955
mchang@holychild.org
COURSE DESCRIPTION:
The primary focus of the course Genetics, Bioethics, and Biotechnology is to discover genetics from
two perspectives: the scientific and ethical approach. We will be alternating between learning the
science behind genetics and biotechnological advances with a philosophical and practical discussion
of the ethics of these technologies. The following scientific units will be covered: Basic
Biology--cells, Mitosis/Meiosis, & Development; Mendelian & Complex Inheritance; DNA;
Biotechnology; Immunity & Cancer. Our study of bioethics will cover the following units: Morality;
the History and Philosophy of Ethics; Principles of Bioethics, and the Tools of the Bioethicist--
Decision making models, Risk Benefit Analysis, Technological Assessment, and Ethics Committees.
We will be using both perspectives to approach various topics of interest: Stem Cells; Cloning;
Genetic Screening and Counseling; Eugenics; Genome Mapping and Patenting; Gene Therapy;
Behavioral Genetics; Right to Privacy and Insurance Issues; Reproductive Technologies; and
Transgenics.
TEXTBOOK: Lewis, R. Human Genetics: Concepts and Applications. 4th Ed. McGraw-Hill. 2001.
I. Scientific Perspectives
a. Basic Biology
i. Cells
ii. Reproduction
iii. Cellular basis of reproduction and inheritance
1. Mitosis and cell cycle
2. Meiosis
iv. Development
b. Transmission Genetics
i. Mendelian genetics
1. Independent assortment, genetic variation
2. Probability and genetic events
ii. Beyond mendel
1. Incomplete and co-dominance, lethal alleles
2. Gene interactions
3. Sex linkage
iii. Extranuclear inheritance
Maternal effects, mitochondrial effects, genomic imprinting
c. DNA and Chromosomes--Molecular biology of the gene
i. DNA, RNA structure
ii. Replication and synthesis
iii. Mutations, repair, transposons
iv. Gene expression
1. Transciption and translation
2. Regulation of gene expression
d. Genetic Technology--DNA biotechnology-techniques, analysis, and applications
i. DNA Manipulation-restriction enzymes
ii. DNA Analysis-Restriction analysis-electrophoresis, Hybridization analysis
iii. DNA Sequencing-- PCR
iv. DNA Typing-Mitocondrial DNA and Genetic Variation
v. Gene Transfer- recombinant DNA and transformation
vi. Human genome project
vii. Genetic screening
viii. Gene therapy
ix. Reproduction technologies
x. Transgenic animals and plants
xi. Stem cell research
II. Ethical Perspectives
a. Ethical Systems and Principles
i. Ethics vs. Morals
ii. Evaluative Language
iii. Moral Development
iv. Moral Relativism
v. Five Ethical Systems
1. Divine Command
2. Social Contract (Moral Relativism)
3. Utilitarian
4. Deonotological
5. Virtue
vi. Major ethical principles
1. Autonomy
2. Nonmaleficence
3. Beneficence
4. Justice
vii. Secondary ethical principles
1. Truth telling
2. Fidelity and promise keeping
3. Confidentiality
4. Principle of proportionality (risk- benefit ratio)
5. Attempt to avoid undesirable exceptions
b. Tools of the Bioethicist
i. Balancing the principles
ii. Decision making models
iii. Risk Benefit Analysis
iv. Technological Assessment
v. Ethics Committees
c. Religious Perspectives on "Playing God" & Personhood Issues
i. Buddhism
ii. Eastern Orthodox Christian
iii. Hinduism
iv. Islam
v. Jainism
vi. Judaism
vii. Native American Religions
viii. Protestantism
ix. Roman Catholicism
x. Sikhism
III. Issues
a. Abortion
b. Agricultural Genetics
c. Assisted Reproductive Technologies
d. Behavioral Genetics
e. Biomedical research
f. Cloning
g. Death and Dying-Euthanasia and Assisted Suicide
h. Eugenics
i. Gene Therapy
j. Genetic Screening and Counseling
k. Genome Mapping and Patenting
l. Organ and Tissue Transplantation
m. Right to Privacy and Insurance Controversies
n. Stem cell research
o. Transgenics
IV. References and Resources
a. Books
i. Beauchamp, T and J. Childress. Principles of Biomedical Ethics. 5th Edition.
Oxford University Press. 2001.
ii. Beauchamp, T. and L. Walters. Ed. Contemporary Issues in Bioethics. 5th
Edition. Wadsworth Publishing. 1999
iii. Bloom, M. et al. Genes, Environment, and Human Behavior. BCSC.2000.
iv. Burley, J. Ed. The Genetic Revolution and Human Rights. Oxford University
Press. 1999.
v. Genetics and Heredity. Institutional Horizons- J. Weston Walsh Publishers.
1989.
vi. Gonick, L and M Wheelis. The Cartoon Guide to Genetics-updated edition.
Harper Perennial. 1983.
vii. Jones, S and B. Van Loon Introducing Genetics, Totem Books. 1993.
viii. Jonsen, A., R. Veatch, L. Walters. Ed. Source Book in Bioethics: A
Documentary History. Georgetown University Press. 1998.
ix. Klug, W and M. Cummings. Essentials of Genetics. 3rd Edition. Prentice Hall.
1999.
x. Kreuzer, H. and A. Massey. Recombinant DNA and Biotechnology. 2nd
Edition. ASM Press. 2001.
xi. Lawler, J. "The Moral World of the Simpson Family: A Kantian Perspective."
The Simpsons and Philosophy: The D'oh of Homer. Eds. Irwin, W, M. Conard.
and A. Skoble. Open Court- Carus Publishing. 2001.
xii. Lewis, R. Human Genetics: Concepts and Applications. 4th Edition. McGraw-
Hill. 2001.
xiii. May, W. Catholic Bioethics and the Gift of Human Life. Our Sunday Visitor.
2000.
xiv. Moore, B. and K. Bruder. Philosophy: The Power of Ideas. 2nd Edition.
Mayfield Publishing. 1993.
xv. Morris, T. Philosophy for Dummies. IDG Books. 1999.
xvi. Post, S. Bioethics for Students: How Do We Know What's Right? Macmillan
Reference USA. 1999.
xvii. Rasmussen, A. and R. Matheson. Ed. A Sourcebook of Biotechnology
Activities. National Association Biology Teachers, North Carolina
Biotechnology Center. 1990.
xviii. Reich, W. Ed. Encyclopedia of Bioethics- Revised Edition. Simon and
Schuster Macmillan. 1995.
xix. Robinson, D. and J. Groves. Introducing Philosophy, Totem Books. 1998.
xx. Robinson, D. and C. Garratt. Introducing Ethics, Totem Books. 1999.
xxi. Shannon, T. An Introduction to Bioethics. 3r Edition. Paulist Press. 1979.
xxii. Walters, L and J. Palmer. The Ethics of Human Gene Therapy. Oxford
University Press. 1997.
b. Vendors
i. Carolina Biological Supply (Sea Urchin Embryology)
ii. Edvotek (DNA electrophoresis, transformation, PCR, bioinformatics )
c. Web sites and Articles on-line
i. The Woodrow Wilson National Leadership Program in Biology-Bioethics
http://www.accessexcellence.org/AE/AEPC/WWC/1992/
(High School Bioethics curriculum)
ii. The Biology Place http://www.biology.com (Overview of Basic Biology:
cells, mitosis/meiosis, genetics, DNAlRNA)
iii. Cytogenics Website http://www.selu.com/~bio/cyto/human (Chromosome maps
and karyotypes)
iv. The Center for Bioethics and Human Dignity http://www.bioethix.org
v. Bioethics.net. The American Journal ofBioethics. http://ajobonline.com/
vi. The Kennedy Institute of Bioethics. http://www.georgetown.edu/research/kie/
vii. Fackelmann, K. Medical Sciences: DNA Dilemmas. The Best of Science
News. http://www.sciencenews.org/sn edpik/ms 2.htm 17 December 1994.
viii. "Right Versus Wrong: Knowing the Difference" Belief, Culture and Learning
Information Gateway. The Institute for Global Ethics. Building Decision Skills.
http://www.becal.net/toolkit/bds/reading.html
ix. Case studies on-line: http://ethics.acusd.edulresources/cases/homeoverview.asp.
http://www.medwebplus.com/subiectlBioethics/Case studies
http://nova. bsuvc.bsu.edu/~d000tadl/
x. Gardiner, L. Fostering Students' Moral Development, Rutgers University.
http://www.ucet.ufl.edu/ProgramService/essay8.htm
d. Audiovisual
i. Jurassic Park-scene at dinner table-genetic power-Dr. Ian Malcom
ii. 6th day-scenes about repet -cloning-commercials on DVD
iii. GATTACA -genetic discrimination, reproductive screening and technology
iv. Lorenzo's Oil- alternative medicine
v. Blade Runner (genetic engineering)
vi. Being John Malkovich (personhood)
vii. Standard Deviant's Amazing World of Biology (cells, mitosis/meiosis,
DNA/RNA)
BIOLOGY BASICS
GENETICS, BIOETHICS, & BIOTECHNOLOGY
MS. CHANG
SEPT. 6
Intro & Handouts
Jurassic Park
Discussion
Complete Safety
Contract, Start
writing Assignment
#1, Skim Chapter 1
& Start SG (1-9).
7
Cells & Organelles
Safety Contract due
Read Ch. 2 (18-28),
Work on SG (10-15),
& Study for Quiz
10
Quiz: Cell &
organelles
Cell Reproduction-
Mitosis
Writing
Assignment #1
due
Read Ch. 2 (29-33)
& Do SG (16-18)
11
Cell Cycle Control
Finish Ch. 2 (34-38)
& Do SG (19-21)
12
SCHOOL
CANCELLED
13
NO CLASS
14
NO SCHOOL
17
Cell to cell
Interactions
Stem cells Viruses
& Prions
Finish Ch. 2
(34-38) &
Do SG (19-21)
18
Mitosis vs. Meiosis
Sperm & Egg
Production
Start Ch. 3 (42-52) &
Work on SG (22-27)
Study for Quiz
19
Quiz: Mitosis &
Meiosis
Start Development
Work on SG
20
NO CLASS
21
Development
Read Ch. 3 (52-57)&
Work on SG (28-30)
Start studying for
Test
24
Development
Lab
Finish Lab & SG
25
Birth Defects &
Aging
Development Lab
due
Read Ch. 3 (58-61,
64), Do SG (31) , &
study for Test
26
Cloning
Read Ch. 3 (62-63),
Do Writing
Assignment #2, &
Study for Test
27
NO CLASS
28
Stem Cells
Writing Assignment
#2 due
Read Handout, Do
Writing Assignment
#3, & Study for Test
OCT. 1
Review
Writing
Assignment #3
due
Study for Test
2
Test
Study Guide due
ETHICAL SYSTEMS AND PRINCIPLES
GENETICS, BIOETHICS, & BIOTECHNOLOGY
MS. CHANG
OCT 3
What is good?
Evaluative Language
Finish Writing
Assignment #3,
Review notes of
What is Good?
4
NO CLASS

5
Ethical Systems
Writing Assignment
#3 due
Work on Worksheets
8
Holiday
Columbus Day
9
Ethical Systems
Study Ethical
Systems, Finish
Worksheets
10
Sea Urchin
Development Lab
Worksheets Due
11
No Class
12
Simpsons Discussion
and Deontology
Read Simpsons
Article & prepare for
discussion
15
Moral Development
and Moral Relativism
16
No School
11 PSATS
th
12 College Day
th
17
Intro to Projects
Autonomy and
Nonmaleficence
18
No Class
19
Beneficence and
Justice
22
Secondary Principles
Decision Making
Models
Study for Quiz
23
Meet in US
Computer Lab
Quiz on Ethical
Systems and
Principles
Case Studies
Work on Project
24
Case Studies Work
Time
Work on Project
25
No Class
Work on Project
26
Case Studies Work
Time
Project Due at end of
Class
29
Holiday
30
Project Presentations
31
Field Trip
1
No class
2
12:00 PM Dismissal
End of Quarter
NAME ___________________________ DATE _____________ BLOCK_____
DUMBFOUNDING DILEMMAS
Decision Making Model Project
Experts say that in sorting through ethical dilemmas, they rely on certain principles:
Autonomy, Nonmaleficence, Beneficence, Justice are the primary principles. Truth telling,
Fidelity, Promise keeping, Confidentiality, Cost-Benefit analysis, and Avoidance of Exceptions
are among the secondary principles. These principles are based on fundamental values
associated with respect for human dignity, a universal idea which most people agree is important.
You and a partner will choose an ethical dilemma. (See Attached Case Studies)
You must analyze your dilemma using the decision making model we talked about in class.
FOLLOW THE MODEL CAREFULLY AND THOROUGHLY.
You must prepare the following:
#an outline of each of the thirteen steps that you took
#a boxed diagram
#a prose argument
!at least 3 pages long (double spaced, 12 point font)
!written in MLA form (See Writer's Inc) with cover page
!include Parenthetical References and Works Cited page
!include at least three resources in your Works Cited
Use the attached Grading Rubric for thorough explanation of the grading criteria.
You will have three days in the computer lab to work on this project: Tuesday October 23,
Wednesday October 24, and Friday October 26.
Your project is due and will be presented on Tuesday, October 30, 2001.
My partner's name _______________________________________________
My Case _______________________________________________________
Case 1: The Case of the Mighty Midgets. Shelly and Simon met at the University of Maryland while participating in a genetic study on
Achondroplasia, an inherited form of dwarfism. Shelly and Simon are both dwarfs and have this rare genetic condition, yet they lead full, active, happy,
and what they feel are fully-functioning lives. They found they had a lot more in common, dated, and eventually got married. They've been together for
five years and now desire to have a child, specifically a dwarf child. They have sought the help of a genetic counselor to help them in their pursuit of a
dwarf child. They would consider aborting a fetus destined to grow to normal height.
Case 2: Who's the Father? Alice is the 6-year old daughter of James and Carol H. Alice was diagnosed with cystic fibrosis (CF) at age 2. Alice has a
moderately severe case of CF and receives postural drainage from her mother three times a day. In addition, she is on a regimen of vitamins and enzymes
that requires her to take about 25 pills each day. Carol spends much of her day caring for Alice. At least twice each year, Alice requires hospitalization to
fight respiratory tract infections. James and Carol have been talking about having another child. Alice is cared for at a public clinic associated with a
medical school that has a research project on CF. The clinic physicians suggest that James and Carol undergo screening for the CF gene as part of the
project When the results come back to the clinic, Alice's physician is quite surprised to leam that Carol, but not James, carries the CF gene. Since James
is not a carrier, it is virtually impossible for him to be Alice's biological father.
Case 3: Big Brother-Boss. Angela is a healthy 32- year old certified public accountant who is married with no children. She has been working for 8
years in a small accounting firm. She has decided that she would like to move to a nearby large city and work for a major accounting firm. Five years
ago, Angela's mother was diagnosed with Huntington's disease (HD) an autosomal dominant disease. Angela's mother is in a nursing home. Angela's job
interviews go well, and she is offered an excellent position that she readily accepts. However, as Angela is filling out the required paperwork in the
personnel office, she notices that she must sign a consent form for a physical that includes a genetic screening test of her DNA. When Angela questions
whether she must have such as test done, she is told it is required by the company.
Case 4: The Dirty Little Secret. Jenny is a 3D-year old woman with familial adenomatous polyposis, an inherited disorder that carries an extremely
high risk of colon cancer. She was just recently diagnosed with this mutant gene while can cause fatalities at a very early age. Jenny is married and has
two children. She has several siblings who live in a neighboring town. Her children and siblings may also have this deleterious gene. Jenny wants to keep
her diagnosis to herself and refuses to tell her family or allow her children to be tested.
Case 5: Caring Grannie Annie. Anne is two months pregnant She is healthy-but her family has a history of fragile X syndrome, an inherited form of
mental retardation-and is a carrier of the disorder. She knows that any child she could have would be healthy, but there is a chance her baby might be a
carrier. Anne is concerned that her child might be a carrier like herself and pass the defective gene to the next generation. She goes to a counselor and
intends to abort the fetus if it is a carrier of the trait
Case 6: Cloning Newspaper headlines screamed it, everyone was talking about it-A SHEEP WAS CLONED! Scientists created an exact duplicate of a
sheep from a body cell. For some time no one could duplicate the work done in the Scottish lab. Then a mouse was cloned, and now a number of mice
clones have been produced. In the sheep and mouse cloning, a body cell was removed and its nucleus placed into another animal's egg cell. Then, an
electrical current was sent through the cell, and it started dividing. A physicist in Chicago has announced that he is setting up a laboratory to do human
cloning. If laws are passed against it, he says; he will move his lab to another country. Anthony Luning was
more than curious about cloning. Starting with one apartment building, he now owned enough land to make him the richest man in Charlotte, North
Carolina. Being rich, however, doesn't keep tragedy from happening to you. One day his five-year-old daughter, Lucy, was crossing the street and was hit
by a drunk driver. By the time the ambulance came, she had suffered serious brain damage. In the emergency room, doctors put her on a respirator, and
her heart was beating normally. Mr. Luning was told, however, that she probably would never regain consciousness. He was devastated. In Charlotte, a
group of scientists were working on cloning a cow from the body cell of a cow that was a high milk producer.
They used Mr. Luning's property for their herd, and he had been following their progress. As a businessman, he saw the potential for the process. Now, as
a parent, he had another idea. Dr. Irene Smith was the head scientist on the project Mr. Luning called her several weeks after the accident He told her he
was willing to spend every cent he had to bring his daughter back. He wanted her to clone his daughter from one of her body cells. If the doctor in
Chicago could do it, so could she.
Case 7: Heart Transplant
The hospital ethics committee was discussing an important and urgent case. A donor heart had become available, but an extremely rare thing had
happened. Two heart-transplant candidates in the hospital were both matches for the donor heart. One patient was known to the committee as Mr. X, the
other as Ms. Y. For someone with heart failure, Mr. X had been on the transplant waiting list a long time. He had been waiting one year and was near
death. Ms. Y had just been placed on the list and could be sustained with medication for quite some time, possibly until another heart became available.
The answer seemed obvious-give the heart to Mr. X. A number of the members of the committee did not agree with this answer. They argued that time on
the transplant list should be only one factor considered. They saw a problem in Mr. X's medical record. Mr. X was 64 years old and had suffered from a
heart condition for years. He had had two angioplasties and two bypass operations to correct a blockage of the heart's blood vessels. The problem seen by
some committee members was that Mr. X still smoked, ate fatty foods, and was very overweight After each procedure, doctors had warned Mr. X that he
must change his life-style, and that if he didn't, his condition would worsen. He never stopped smoking, however, and never changed his diet He said it
was too hard. Research has proven that smoking and high cholesterol are risk factors for heart problems. Blockage of the coronary arteries is directly
attributed to these two factors. Treatments such as angioplasty (opening the blood vessels by passing a tube into the arteries) and bypass surgery
(connecting new blood vessels that go around the clogged ones) can correct the problem, but they are not a total cure. To avoid further problems, patients
must control their diet, stop smoking, and alleviate stress. This, of course, is not easy. Mr. X appeared not even to try. The heart was about to be airlifted
to the hospital. The committee had to make their decision very soon.
Case 8: Hormones and Multiple Births
Dr. Marshall Marino talks to couples every day at the fertility clinic where he works. All of his patients are there because they have infertility
problems, which are usually due to one of three things: not enough sperm, not enough eggs, or problems holding the embryo in the uterus. Both
partners are tested for infertility problems. Today, Dr. Marino is speaking to the Hernandezes. They have been trying to get pregnant for four
years, but are still young, in their thirties. The doctor explains that Maria's ovaries are not producing eggs on a regular schedule. He suggests they
begin hormone treatments as soon as possible. The hormones will stimulate the ovaries to make eggs. Mark and Maria Hernandez have done
their homework, though. They read about the McCaughey septuplets born in Iowa and wonder if that might happen to them. Dr. Marino wants to
be honest with all of his patients, so he explains the side effects of taking the hormone treatments. Often the ovary responds to the hormone by
giving off a number of eggs at one time. If these eggs are all fertilized, the result is a multiple birth. Years ago, doctors thought they could control
the dosage of the hormone and, therefore, keep the ovulation under control. This has proven not to be true. There is a chance of what are called
"supertwins," that is, triplets and more. Maria thinks a multiple birth would be good. With their problems, who knows if she will ever get
pregnant again? But Mark has read that the more embryos in the uterus, the more danger there is of premature birth, brain damage, and possibly
death. This frightens him.
Case 9: Transplant
After her gall bladder surgery, Ruth Sparrow had a serious problem. The problem was not her health. The surgery was successful, and she was
recuperating well. The problem was money. Her bill was close to $20,000, but she had no insurance and no savings to fall back on. Then she
thought of a creative way of solving her problem. She offered one of her kidneys to the hospital. "I will give you a kidney, if you'll mark my bill
paid in full," she told hospital administrators at Bayfront Medical Center in St. Petersburg, Florida. The hospital turned her down. Ruth had
anotheridea, though. She placed an ad in a local newspaper: "Kidney runs good. Taking offers. $30,000 or best offer." While some of the
responses were crank calls, several people took her ad seriously and called to ask her blood type. Before the ad had run its three-day span,
however, it was pulled by the newspaper, who explained that only duly licensed agencies can run ads for organ donations. In addition, it is illegal
to sell your organs, and in Florida it is a felony. Federal and state laws prohibit buying or selling of a human organ or tissue. Recently a quiet
campaign has arisen to convince the public to rethink the issue. With thousands of people on waiting lists for organ transplants, there are not
enough donations to go around. Some advocates offmancial reimbursement believe that more Americans would donate their organs if there were
some incentive to do so. Lloyd Cohen, of George Mason University, has pointed out that a great deal of money is made on transplant operations.
Hospitals, doctors, and drug companies all benefit-why not the donor? How might this be done? Healthy people might contract to have their
organs sold after death, with the money going to their family. Funeral or hospital expenses could be covered by donation of an organ after death.
Ruth Sparrow thought that if people could advertise the use of their eggs or sperm for a price, or even the use of their uteruses (surrogacy), she
should be able to do the same with her kidney. "I have an organ here that could save a life," she said. "I've got two kidneys, one I could do
without"
Case 10: Development
It wasn't a simple divorce case. The Davises, Junior and Mary Sue, were asking the court to make a judgment in a kind of case no other court had
looked at before. Earlier in their marriage, because of infertility problems, the couple had visited a clinic and undergone a procedure called in
vitro fertilization. In this procedure, her eggs and his sperm were fertilized in the laboratory and nine embryos were produced. Two were placed
in Mary!Sue's uterus, and seven were frozen. The two embryos placed in her body did not grow to a pregnancy. Although the Davises had
planned to return and use the other seven, they found the situation of the marriage unbearable-perhaps partly because of the procedure itself,
which is expensive and stressful. They decided to divorce, and now each was asking for the embryos. Junior wanted the embryos to destroy
them, whereas Mary Sue wanted to implant the embryos. Mary Sue's attorney argued for Mary Sue's right to proceed with the implantation on the
basis that the embryos were potential human life, not typical property. She argued further that even if the embryos were ruled to be property,
Mary Sue should have a say in their disposition, under the divorce laws of Tennessee. She also entered a counterclaim that Junior be ordered to
pay child support in the event that Mary Sue bore a child. For his part, Junior's attorney argued that an "embryo" is not a person and, therefore,
should not be considered a child. He also said that it was Junior's right under the Constitution to not be "forced" to become a parent The court
needed to decide if the embryos were property or children, or neither. Ifruled to be property, the embryos would be divided between the Davises.
If ruled to be children, custody would have to be awarded. The trial court, the first court, decided the embryos were "children in embryo,"
awarding custody of them to Mary Sue and directing that she be allowed to implant them. Junior appealed the ruling to the Tennessee Court of
Appeals. The court of appeals reversed the trial court and gave the embryos to Junior. Again, it was appealed, now to the state supreme court.
Case 11: Frozen Embyros
Acorn Fertility Clinic has a space problem. Its director, Franklin Pearce, just presented Acorn's Board of Directions with the problem, and now a
vigorous discussion was going on. Pearce left the room to think. The problem is partly a result of the clinic's success. Since its inception ten
years earlier, the clinic has almost tripled its number of patients, and its success in achieving pregnancies in infertile couples is equal to the
national average. The clinic's greatest success has been in the use of in vitro fertilization. This procedure involves fertilizing the egg outside the
body and then placing the zygote in the uterus of the patient Usually up to 15 zygotes are produced, but only a few are placed back in the
woman. The rest are frozen and held in liquid nitrogen. Infertility specialists have been freezing embryos since 1984, with much success. The
length of time an embryo can be held in a frozen state and "thawed out" successfully is not known. With better and better freezing techniques, the
time is increasing. Recently a baby was born from an embryo that had been frozen for eight years. Acorn Fertility has been freezing embryos
since its inception. It has a large number of such embryos-thousands, in fact-some frozen for ten years. The parents of many of these embryos are
present or past patients who have no need for them. With its patient base increasing, Acorn needs the space for new embryos. The problem is not
Acorn's alone. Ten thousand embryos are frozen each year in the United States, and the numbers are increasing. Many of these are sitting in
liquid nitrogen in fertility clinics like Acorn. Now sitting in his office, Dr. Pearce wondered what the Board of Directions would decide to do
with the embryos that aren't being used.
Case 12: Artificial Womb
In Japan, an artificial womb has been created that incubates goat fetuses. The scientists who developed it say they are working on a model that
can be used for human fetuses, but that the technology is ten or more years away. The womb is a plastic box filled with anmiotic fluid and
attached to a number of devices that monitor vital functions. Researchers remove the fetus from the mother at 17 weeks of development A pump
replaces the placenta by supplying oxygen and food that goes directly into the fetus's blood. The fetus lies submerged in the fluid, and its blood
supply is cleaned and oxygenated by a dialysis machine through the umbilical cord. Currently a goat fetus can stay in the womb a maximum of
three weeks, but scientists are working to extend this time and to solve the problems when the goat fetuses are removed from the artificial womb.
Some have lived for a few days, others for much longer. Unfortunately, the media has sensationalized the research and distorted the device's use.
They have speculated that women might want this technology because it would free them from the pain of childbirth. Scientists, however,
envision how the artificial womb would benefit women with frequent miscarriages or problems with pregnancy and/or infertility.
Case 13: Treatment of Critically 01 Newborns
Art and Julia Inskeep's new baby, Joshua, was born premature at 24 weeks of pregnancy. When they went to see him in the neonatal intensive
care unit, they were not allowed to touch him. He was so small. His feet weren't even as big as a fingertip. The doctors don't know what caused
Julia to go into premature labor. But when Joshua was born, they told the Inskeeps that there had been successes in saving 24-week-old babies.
With the newest machinery and techniques, the doctors said, the baby had a good chance of surviving. Neonatologists, who study newborns, are
concerned with outcomes. The more premature a baby, the worse its outcomes. A normal pregnancy length is 36 weeks, but babies have survived
after being born as early as 23 weeks. The biggest problem is the lack of a substance called surfactant. This fatty substance coats the inner surface
of the lungs and keeps them from collapsing. During its time in the uterus, the baby breathes fluid, and its oxygen comes from the mother's blood.
A number of advances are helping younger and younger babies survive. One is the development of a surfactant taken from calf fetuses. Another
is a respirator called an oscillator. Instead of delivering the normal respiration rate of 30 breaths per minute, the oscillator gives 900 tiny puffs per
minute. This keeps the baby's lungs constantly inflated, and oxygen seems to enter the bloodstream more efficiently. The procedure, however,
can be dangerous. The technology is usually used with babies who are at least 25 weeks developed; the less developed the baby, the more likely
the occurrence of a brain bleed, which would cause brain damage and have other serious consequences. The doctors have asked the Inskeeps to
decide whether or not to have Joshua connected to the oscillator. Art and Julia have never had a more difficult decision.
Case 14: DNA Dragnet
Mark Silano lived in a small town that rarely had serious problems. Recently, however, there had been a particularly brutal crime. A young girl
had been found murdered in one of the town's parks. It had been almost three months and the police didn't seem to be getting anywhere. As he
was skimming his local newspaper, Mark came across an advertisement with a large black border. He read it carefully:
All males between the ages of 18 and 25 are asked to come in voluntarily to help in the investigation of the Anna P. murder case. One vial of
blood will be drawn from each volunteer for the purpose of DNA testing.
At first Mark didn't understand the implications of the ad. Then he remembered a show he had seen on television, which told about DNA
fingerprinting and how criminals could be identified from tissue samples found at a crime scene. Mark was 22 and so fell into the category asked
for in the ad. He thought he should volunteer, but he was really frightened of needles. He didn't want to give blood. The first investigation to use
DNA forensics took place in the United Kingdom in 1983. All the men in a town where a murder had occurred were asked to give blood samples
for DNA testing. Colin Pitchfork, who was the murderer, tried to pay a number of people to give blood for him. When one man did, but then
realized what this meant, Pitchfork was arrested. DNA dragnets, as they are often called, are now used allover the United Kingdom, and are
increasingly used in the United States.
Case 15: AIDS Vaccine
Since the AIDS epidemic began, researchers have been working to develop a vaccine to immunize people against a disease that affiicts 30 million
people worldwide. Dr. Donald Francis, the first to warn of the epidemic in the 1980s, has been one of the most determined scientists. After many
years of work in a priyate company, he has developed a vaccine that is aimed at two of the most common strains of the virus. The Federal Drug
Administration (FDA) has recently allowed a large-scale testing ofDr. Francis's vaccine for AIDS. The vaccine, called Aidsvax, works by
generating antibodies that would allow the immune system to fight the AIDS virus. It may not work, however, and such a large test will expose
many people to the virus. For years Frank Irving read about AIDS. Ever since his younger brother, Philip, died of the disease two years ago he
wished he could do something to help. He had no real scientific training or education, however, and felt useless. Then, after reading about the
new trials for the vaccine developed by Dr. Francis, he had an idea. He would volunteer to try the vaccine. He was healthy, had none of the risk
factors for the disease, and had been tested every six months since his brother died. Frank read all the articles he could get his hands on. In one
article a very famous scientist, David Baltimore, said he had reservations about the trials. He felt they were a long shot, and that having such a
huge trial, 5,000 people in the United States and 2,500 in Thailand, was premature and might reduce the number of people willing to participate
in future trials. Other researchers believe that a traditional vaccine, such as Francis's vaccine, cannot protect against HIV, since this virus
constantly mutates and a combination of drugs is necessary to combat it. Frank didn't care-he wanted to help. He knew that only healthy men and
women could volunteer to test a vaccine, those unaffected by the HIV virus. He wanted to be one.
ADDITIONAL WEBSlTES THAT HAVE CASE STUDIES
http:/ /ethics.acusd. edu/resources/cases/HomeOverview.asp
http://www.medwebplus.com/subject/Bioethics/Case_studies
http:/ /nova bsuvc.bsu.edu/~d000tadl/
http://www.sciencenews.org/sn edpik/ms 2.htm
http://www.mhhe.com/biosci/genbio/casestudies/
GRADING RUBRIC
DUMBFOUNDING DILEMMAS: DECISION MAKING MODEL PROJECT
Criteria Points
Outline:
Includes all relevant thirteen steps, does not have to be in complete sentences, parenthetical and
reference information included
5 PTS
Step I: IDENTIFY THE QUESTION
Thorough generation of ETHICAL questions raised by the case
At least three questions
Identification of the specific question that you address
5 PTS
Step II: IDENTIFY THE ISSUE
Name the issue that you are addressing
2 PTS
Step III: STATE THE FACTS OF THE CASE
Avoidance of inferences
Concise, true, and sufficient statement of the facts surrounding the case.
5 PTS
Step IV: IDENTIFY THE STAKEHOLDERS
Thorough inclusion of all the stakeholders involved
5 PTS
Step V: LIST THE POSSIBLE DECISIONS
Creative and Exhaustive list of possible solutions.
Thoroughly reasoned explanation of decision.
Thoughtful analysis, discussion, and analysis of each of the solutions which include possible impacts
on stakeholders.
10 PTS
Step VI: GATHER NEEDED BACKGROUND FACTS.
In-depth research of legal, scientific, medical, social consequences and information related to the
case. Use of at least three resources.
10 PTS
Step VII: MAKE A DECISION
Complete reflection and explanation of the option you have chosen. Valid reasoning behind choice.
Comprehensive description of affects on stakeholders.
5 PTS
Step VIII: IDENTIFY THE GUIDING PRINCIPLE
Detailed logical explanation of which principle supports your decision.
Valid justification of the use of that principle and why you are willing to breach other principles.
5 PTS
Step IX: CITE A SUPPORTING AUTHORITY
Identification of an authority that supports your decision. Comprehensive research of supporting
authority.
5 PTS
Step X: FORMULATE A REBUTTAL
Creative and realistic ideas that would cause you to abandon your claim. Clarity of reasoning and
logic in explanations.
5 PTS
Step XI: STATE YOUR LEVEL OF CONFIDENCE
Inclusion of 1-3 word statement
2 PTS
Step XII: BOX UP THE CASE FOR REPORTING
Neatness and presentation
Includes all parts and connections
10 PTS
Step XIII: PREPARATION OF PROSE ARGUMENT
Grammar, spelling, neatness, sentence structure, length–at least 3 pages
Format–MLA Style, title page, 1-inch margins, 12-pt font, page numbering.
Use of parenthetical references in Body of Text and inclusion of Works Cited in proper form
21 PTS
___/(7)
___/(7)
___/(7)
PRESENTATION
Clarity and proper volume of speech
Familiarity with case
Ability to answer questions
Demonstration of in-depth knowledge, reasoning, and logic involved with details of the case
5 PTS
TOTAL ____/100