definitions of bioethics in bioethics education in croatia1

OriginalPaperUDC37:608.1(497.5)ReceivedJuly23rd,2007

Nada GosićDepartmentforSocialSciences,MedicalSchoolinRijeka,BraćeBranchetta20,HR–51000Rijeka

[email protected]

Definitions of Bioethics in Bioethics Education in Croatia1

AbstractWorkpurpose: to present and analyze pedagogical strategies and the communicational ap-proach to definitions of bioethics, a mutual part of the bioethics contents being realized on the university studies of Dentistry, Organization, Planning and Management in Healthcare, and professional studies of Medical Radiology at the Medical School in Rijeka.Methods:themethodofcontentanalysis was used to research and present encyclopaedic and some authorial definitions of bioethics, with special emphasis on definitions of bioeth-ics by authors – bioethicists from Croatia; themethodofpattern1: included the curriculum of Medical Ethics and Bioethics and the Ethics of Healthcare, and researched standpoints of forty-five students educated in studies where bioethics courses are being realized. The pattern is specifically stratified because it: a) included students whose curriculum is being realized in shifts – intensive lectures in a duration of two weeks, and those whose lectures are being realized each week during one semester; b) different year of education (Dentistry – second year students, Organization, Planning and Management in Healthcare and Medi-cal Radiology – first year students). 2. Thescaleofassessment was used to research and obtain standpoints of students on the contents of the curriculum, methods of its perform-ance, and the achieved level of communication among students and communication with the professor.Expected results: the presented method of work and results obtained by the scale of as-sessment should display the acceptability and successfulness of the presented pedagogical-methodological means of work and point out to weaknesses and deficiencies, and finally conclude the extent to which the presented concept, and approaches to the actualization of the definitions of bioethics contribute to the realization of dialogue and communication in which students simultaneously experience the curriculum as necessary, useful, interesting, and one that may motivate them to think, exchange ideas and offer possible solutions. The scale of assessment should point out to different standpoints of students depending on the length of their study (year of study) and commitment to a method of class realization (in shifts and/or weeks throughout the whole semester).

Key wordsbioethics,definitionofbioethics,orientationalknowledge,caseanalysis,moralorientation,workshop

Introduction

Thisworkdemonstratesthemethodicalapproachestodefinitionsofbioethicswhichshouldhelpstudentsofmedicalandhealthcareeducationalprofilesto

1

Thepresentedresultsarosefromthescientificprojecttitled“Bioetikaikultura” (“BioethicsandCulture”),implementedwiththesupport

of the Ministry of Science, Education andSportoftheRepublicofCroatia.

SYNTHESISPHILOSOPHICA48(2/2009)pp.(349–368)

N.Gosić,DefinitionsofBioethics inBio-ethicsEducationinCroatia350

recognizethecontentofbioethicswhichconcernstheirprofessionalorienta-tionandtodeterminenecessaryinformationandknowledgewhichstudentsmustadoptsotheymayorientthemselvesinsolvingbioethicalproblemsre-latedtotheirfutureprofession.Inthepreparationandrealizationofthisworkshop,practicalexperiencerep-resentsaparticularchallengetostudentswhounwillinglyacceptthetermof‘definition’itselfbecauseitassociatesthemwithlearningverbatim,withfearofaloweredgradeiftheydonotknowtorecitethedefinitions.Therefore,theapproachtothistopicisdirectedatagradualanalysisandunderstandingofthedefinitionofbioethics.Thatistosay,theworkdisplayspossibilitiesofdifferentmethodicalapproachesusedtointroducestudentstobioethicsasascientificdiscipline,torecognizeitscontents,pluriperspectivityasamethod-ologicalapproach,andtoevaluatetheimportanceandnecessityofbioethicaleducationinacquiringoforientationalknowledge.

Procedure and phases of acquiring knowledge

Attheoutset itmustbepointedout that thepresentationof theconceptualdeterminationanddefinitionofbioethics isquiteademandingcourse task.Firstly,thematterinquestionisthetheoreticalcourseunitandthefactthatitdependsonthemethodofpresentingbioethicaldefinitionshowmuchstu-dentswillperceivethebioethicscoursecontentasnecessaryandusefulfortheirfutureprofessionalwork,i.e.howmuchwilltheybemotivatedforacon-tinuedacquiringandadoptionofbioethicalinformationandknowledge.Sec-ondly,ouraimistodemonstratetostudentstheimportanceoftheirfamiliaritywithdefinitionsofbioethicssince theyreveal thecontentdeterminacyandmethodologicalapproacheswhichclearlypointattheconceptualandcontentdifferentiationofmedicalethicsandbioethics,andalreadyonthedefinitionleveldeterminethenecessityforinclusionofdifferentculturalperspectivesintotheobservationandsolutionofbioethicsissues.Theworkisdemandingowingalso to theexpressionof theprofessor’sskill inmotivatingstudentsforanactiveparticipationandrecognitionofissuesrelatingtothedefinitionsofbioethics.Finally,themethodofpresentingdefinitionsofbioethicsshouldinstruct students to recognizeandpresent theactivitieswhich layahead inrealizationofthebioethicscurriculumandbioethicscourse.Werecommendthat theprocedureofacquiringknowledgeisperformedinthreephases:inthefirstofevocation2byuseofbrainstormingstudentshavetheopportunitytoexpressandstateassociationsandinformationonbioethicstheyhavereachedearlier,andattempttooffertheirowndefinitionsofbioeth-ics.Resultsobtainedbythistypeofdiscussionareofmultipleuses.Firstly,inthepresentation,explanationandargumentationofdefinitionsofbioeth-ics,theyserveasaguideforthepresentationofinformationandfactsaboutbioethicsbecausetheypointouttotheknowledgestudentsalreadyhave,andthereforewecanavoid therepetitionofknownfacts.Secondly,comparingdefinitionsgivenbystudentswith thescientificones,wedemonstratehowclose theirdeterminationsare to formaldefinitions, and thirdly, they showhowknowledgeonbioethicsanditsdeterminaciesmaybeadoptedthroughunderstanding,andnotlearningthedefinitionsbyheart.Thesecondphase,followingresearchesoftheForumfortheFreedomofEducation,wedeter-mineasaphaseofunderstanding meanings.3Inthatphasethehistorical-cul-turalperiodthatprecededtheappearanceofbioethicsispresentedfollowedby explanation of reasons why scientific and technological achievementschangedthemeaningofhumanandotherrights,andbynow,inaphaseof



theconceptualproject,demandtheenquiryofattainmentsandtheundertak-ingofresponsibilitiesfortheimaginedandtheundertakenact.Emphasisingthefactthatthedefinitionofbioethicsisachallenginganddemandingsci-entifictask,studentsaresubmittedencyclopaedicandsomeauthorialdefini-tionsofbioethics.Inthethirdphase,accordingtothepreviouslymentionedsource–thephaseofreflection,4studentsinbioethicalworkshops,integratingformerlyacquiredknowledgewiththepresentedknowledgeandinteractivework,approachtotheanalysisofthedefinitionsofbioethics.

Course and content of the first phase of cognition

Studentsquote,andtheprofessornotesassociationsanddefinitionsofbio-ethicstomakethemvisibleandpresentduringtheimplementationoftheen-tireteachingprocedure.Whenallassociationsandpropositionsofdefinitionsareexhausted,theinstructionproceedstothesecondphase.

Course and content of the second phase of cognition

Inthemethodicalsense,thecoursecontentofthisphaseisdraftedaccordingtothehistorical-chronologicalapproach,andisreachedthroughamethodoforalpresentation.Duringaperiodof35minutestheprofessorshouldsustaintheattentionofstudentswiththefollowingcontents:1. Historical-causal reasons for the appearance of bioethics. Theframeof

thiscontentisconstitutedbythepresentationofthescientific-technologi-calprogressandachievementsinmedicine.Thebirthoflife,sustainingoflife,anddeathanddyingarethreelevelsoftheproblemwhich,owingtonumerousdiscoveriesandachievementsofmedicaltechnology,begantoshedalightonmedicineinanewmanner.Namely,theunderstandingofmedicineasascienceandactivityinwhicheverythingisdoneforthewel-fareofthepatient,wasopposedbyeventsthatconfrontedmedicineanditsprofessionalswithissuestowhich,inthenameofhumandignityandthereturnoftrustinmedicine,answershadtobefound.Thoseanswerswould,inthenameoftheformer,enlightenandexplaincausesforthenewlyrisensituation,andinthenameofthelatter,outlineanewviewonmedicalper-sonnelasprofessionalswhotreatillpeoplewithexpertise,responsibilityandhumanness.Duetoanincreasedtestingoftheimplementationofthe Hippocratic Oath provisions–intermsoflegalizedabortion,circulationanduseofthecontraceptivepill,attemptstoexperimentwithtechniquesofassistedinsemination,possibilitiesoftransplantation,inthesituationofthefirstbabybornbyuseoftheartificialinseminationtechnique,defini-tionofthedeathofaperson,achievementsofthepharmaceuticalindustry–itbecamemoreclearlynotjustOath’slimitationscausedbytheflowoftime,butalsobytheraiseofvoicesandresistanceofthosewhoseunques-tionableobedienceOathinitselfimplied.Confronted ontheonehandwithtechnicalpowerandachievementsandontheotherwithvoiceswarningofinhumanityandcrueltyofmedicalprofessionals,medicinecouldnotre-spondtothenewlyrisenchallenges.Thesituationisalsoexplainedbythe

2

Moreextensivelyin:Vidović,V.V.,Kletzien,Sh.B.,Bekavac,M.C.(2002):Aktivno učenje i ERR okvir za poučavanje, Aktivno učenje i kritičko mišljenje u visokoškolskoj nastavi, Priručnikzanastavnike,1.dio,Forumzaslo-boduodgoja,Zagreb,pp.26–27.

3

Ibid.,pp.27–28.

4

Ibid.,pp.28–29.



factthatthevoiceforhumandignity,carefortheillperson,righttomakeadecision, changeof traditional standpointson thenatureandachieve-mentsofmedicine,wasgivenandpresented,preciselyfortheseissues,bycompetentprofessionals.Casesthathavegivenprooftoargumentsontheinabilityofmedicinetogiveautonomousanswersforproblemsleftbehindbythescientific-technologicalprogress,andsituationsinwhichpatientsandmembersof their families soughtprotection incourtsof justice forthebreachoftheirdignityandhumanity,andpubliclyspokeofwhattheyhadendured,becamecontentsofanalysisandsubjectofscientificdiscus-sion.Itshouldbepointedoutthatpurelythecharacterofthecaseandthenatureofrelationshipswithinitdeterminedtheparticipantsanddiscourseonpossiblesolutions.Theninitiatedasadiscourseonadifferent, todayhasoutgrownintoaninterdisciplinarydialogueinwhichaconsensusonadecisionandsolutionmustbeunavoidablyachieved.Thispathofout-growthmaybefollowedthroughattemptsinfindinganddefiningethicalstandardsinmedicineandhealthcareandthroughcultural-valuechangesandtothemrelevantsocialperspectivesonwhatitmeanstohaveaqualita-tiveanddignifiedlife.

2. Reasons that lead Van Rensselaer Potter to create the term ‘bioethics’. Hiswarningsdeserveaspecialattention.AccordingtoPotter,iftheextentofscientific-technologicalprogressisnotbroughtintoquestion,manwill,with his knowledge and abilities, endanger himself, other lives and theenvironmentinwhichheworksandlivesin.Inanarticletitled“Biocy-berneticsandSurvival”(1970)Pottersaidforbioethicsthatitis“anewdisciplinepromotedtounitebiologicalknowledgewiththeknowledgeonhumanvaluesystems”.5Inthathistoricalmomenthepointedouttothene-cessityofanethicalenquiryandevaluationofproductsandconsequencesofthescientific-technologicalprogressand,equallyimportant,directedtoaspecificsciencewhichtreatsvaluesbythenatureofitsscientificorienta-tion–tophilosophy.6

3. Bytakingintoconsiderationpoints1and2,thebirthofbioethicsbecomesclearer,7aswellasthedeterminationofthetermandreasonswhichinashortperiodoftimeledtovariousencyclopaedicandauthorialdefinitions.Thisisfollowedbythepresentationofencyclopaedicandauthorialdefini-tionsofbioethics.Inadditiontotwo,letuscallthem–officialdefinitionsfromencyclopaediceditionsissuedin1978and1995–weholdthatitisuseful toanalyzeadditionalsourceswhich,according tostudents’state-ments,arequicklyandeasilyaccessible.Withoutdoubt, thesubjectun-derdiscussionistheInternet.Forthispurpose,definitionsfromInterneteditionsofthe Encyclopaedia Britannica8 andWikipedia9 arealsoimple-mentedintothepresentationandanalysis.

In the first edition of theEncyclopaedia ofBioethics (1978) ‘bioethics’ isdefinedasfollowing:

“Bioethicsisasystematicinvestigationofhumanbehaviourinthefieldofsciencesconcerninglifeandhealthcaresofarasthisbehaviourisconsideredinthecontextofmoralvaluesandprinciples.”10

Inthesecondedition(1995)itiswritten:

“Bioethics is a systematic study of themoraldimensions–includingmoral vision, decisions,conductandpolicies–ofthelifesciencesandhealthcare,employingavarietyofethicalmetho-dologiesinaninterdisciplinarysetting.”11



IntheEncyclopaedia Britannicaundertheheadword‘bioethics’wefindthefollowingdefinition:

“…branchofappliedethicsthatstudiesthephilosophical,social,andlegal issuesarisinginmedicineandthelifesciences.Itischieflyconcernedwithhumanlifeandwell-being,thoughitsometimesalsotreatsethicalquestionsrelatingtothenonhumanbiologicalenvironment.”12

Definitionof‘bioethics’fromWikipedia:

“Bioethics is concernedwith the ethical questions that arise in the relationships among lifesciences,biotechnology,medicine,politics,law,philosophy,andtheology.Disagreementexistsabouttheproperscopefortheapplicationofethicalevaluationtoquestionsinvolvingbiology.Somebioethicistswouldnarrowethicalevaluationonlytothemoralityofmedicaltreatmentsor technological innovations, and the timingofmedical treatmentof humans.Otherswouldbroadenthescopeofethicalevaluationtoincludethemoralityofallactionsthatmighthelporharmorganismscapableoffeelingfearandpain.Thusbioethicshasacomprehensivescope,includinghumanhealth,humanlife,animalandvegetablelife;inotherwords,allissuesrelatedtolife.”13

In presenting authorial definitions of bioethics emphasismust be given tothepraiseworthystudyofCroatianbioethicistHrvojeJurić.14Tosummarize,theauthordrawsadistinctionbetween twostandpoints indefiningbioeth-ics.Firstisrepresentedbyauthorswholinkbioethicswithclinicalpractice,healthcare,biological,biomedicalandpharmaceuticalresearches.Thereforewecould,accordingtoJurić’sunderstanding,callthatstandpointnarrower, humane and humanely biomedical.15 Thesecondoneinsistuponamorecom-plexdefinitionofbioethicswhichcomprehensivelyinclude,sidebysidewith

5

Matulić, T. (2001): Bioetika, Glas koncila,Zagreb,p.39.

6

StudentsoftheMedicalSchoolinRijekamayinform on a work ofVan Rensselaer Potterandhiscontributiontotheroleofphilosophyin discussing bioethical problems by study-inghisbookBioethics – Bridge to theFuture(Croatian translation was published by De-partment forSocialSciencesof theMedicalSchoolinRijeka,CroatianSocietyforClini-cal Bioethics, Croatian Bioethical SocietyandtheInternationalAssociationforClinicalBioethics(ISCB),in2007).

7

AlbertR.Jonsen,historianofmedicalethicsandbioethics,publishedabookThe Birth of Bioethics (Oxford University Press, 1998)inwhich he investigates the reasons for theemergenceofbioethics.

8

“Bioethics”, Encyclopaedia Britannica,2007, http//www.britannica.com/eb/article-9079252.Access:April23rd,2007.

9

“Bioethics”,www.wikipedia.org/wiki/Category.

10

Šegota,I.(1999):“Novadefinicijabioetike”,Bioetički svesci, Rijeka,Medicinski fakultetKatedradruštvenihznanosti,pp.1,11.

11

Ibid.,p.26.

12

“Bioethics”, Encyclopaedia Britannica, 2007,http//www.britannica.com/eb/article-9079252.Access:April23rd,2007.

13

“Bioethics”,www.wikipedia.org/wiki/Category.

14

H.Jurićpresented resultsofhis researchonthedeterminantsanddefinitionsofbioethicsatthesymposiumtitled“Filozofijaiplurali-zam” (“Philosophy and Pluralism”), whichwasheldinZagrebonthe24thand25thNo-vember2005.Jurić,H.(2005):“Multi-,pluri-,trans-,ubioetici iokonje”,www.h-alter.org(Access:October3rd,2006).

15

Tothegroupofauthorswhichdefinebioeth-icsinthatmannerbelongTomBeauchampiJamesChildresswiththeirworkThe Princi-ples of Biomedical Ethics, and Peter SingerandHelgaKuhse,editorsofthecollectedpa-persBioethics: An Anthology andManual of Bioethics.Moreextensivelyon this inJurić,H.(2005).



clinical-medicalissues,numerousotherissuesthatmaybecharacterizedasglobal-ecological.To illustrate the referred arguments, Jurić takes into ac-countalargenumberofauthorsandtheirdefinitions.Fromhistextwetakethefollowing:

– OtfriedHöffeintheLexicon of Ethics, amongotherthings, pointsout:

“Bioethicsisbeingunderstoodasaninterdisciplinarybasedscienceonsurvival,whoseprimarywishistobuildbridgesbetweenspiritualandnaturalsciences.Directedatthemereinstrumen-talrelationshiptonature,bioethicsdealswitheconomical,social,political,aswellasculturalpresuppositionsofthehumanrelationshiptonature…inthefieldofbiomedicalethics,bioethicsconsidersmoralissuesofbirth,lifeanddeath…”;16

– LudwigSiepdefinesbioethicsas:

“… the areaof ethics dealingwith theproper relationshipofman to life or thenature as awhole”;17

TothisresearchwealsoadddefinitionsofCroatianbioethicists:

– InthebookBioetikaTončiMatulićsaysthat

“…thenotionofbioethicsisacompound-wordinwhich,fromperspectivesofpresentcogni-tionsandinterpretationsthepartbioleadstothebio-medicalscienceswiththeiraccompanyingbiotechnologies,whiletheotherpartethics leadsfirstlytothephilosophicaldisciplineofethicswhichisconcernedwiththegivenfoundationsofproperhumanbehaviour,andsubsequentlywiththesystem of moral ethical-values itselfwhichitdefines,elaborates,explainsandpresu-pposesasatheoreticalconditionforthedefinitionofframesforproperpracticalhumanacti-on”;18

– AnteČović:

“…bioethicsisanarea,relational-philosophicalandpluriperspectiveethics”;19

– HrvojeJurić:

“Bioethicsisanopenareaofencountersanddialoguesofdifferentsciencesandactivities,anddifferent approaches andviews to theworld,whichgather to articulate, discuss and resolveethicalissuesrelatedtolife,tolifeinitsentiretyandeachpartofthisentirety,tolifeinallitsforms,stages,phasesandmanifestations.”20

Aftertheaccountofthesedefinitionsofbioethicsitisimportanttoemphasizethefollowing:eachoftheabovementioneddeservesitsplaceinthecurricu-lumofbioethicsandotherbioethicscourses,andeachprofessorshould,forthepurposeofanalysisandunderstandingoftheessenceofbioethics,choosethosedefinitionswhichspeakthemostaboutthecontentandteachingmate-rial that shouldbe realizedandadopted.On thatnote, for the introductorylessonsinbioethicsandthelecturesincoursesofMedicalEthics21andEth-icsofHealthcare,22inourpractisewedecidedfortheanalysisofdefinitionsfromtheEncyclopaedia of Bioethicsandtwoauthorialdefinitions,whileforthe lectures in courses Bioethics,23 Bioethics and theCulture ofDialogueinMedicine,24andOnHealthDifferently,25fortheanalysisandunderstand-ingofthecharacterofbioethicswealsointroducedotherquoteddefinitions.Equally,wediscussedonactualityofthehighlighteddefinitionsandrefertotheminotherteachingunits.



Workshops

Workshop I: Analysis of the contents of encyclopaedic and authorial definitions of bioethics

Aim:todiscussfundamentaldefinitionsofbioethicsfrom1978and1995;torecognizesimilarities; toconsiderhowmuch theauthorialdefinitionscon-tributetotheunderstandingofencyclopaedicdefinitionsofbioethics;tocon-cludewhatmustbe,accordingtothefirstandtheseconddefinition,masteredinbioethicseducation;toconsiderhowmuchtheauthorialdefinitionscon-tributetotheunderstandingofencyclopaedicdefinitionsandhowmuchdotheyhelpinthedefinitionofthecharacterofbioethicalcontents.

Procedure of learning:– Workonthetext;– Pointingouttaskstobeachievedthroughtextanalysis.

Material:paper,pencils,feltpens,flipchart,workingmaterialforeachgroup:textofthedefinition,issuesthatmustbediscussedandanswered.

Introductory activity: to inform students about tasks thatmust be realizedandmethodsofworkthatwillhelpthemmastertheirtasksmoreeasilyandquickly.Studentsareaskedtoformfoursmallgroupssothatineachgroupparticipate3–4students.Teacherintroducesstudentswithtaskseachgroupovertakes.Thefirstgroupreceivesthetextwiththedefinitionofbioethicsfrom1978withthetasktohighlightthecontentsthisdefinitioncovers,toindicatewithinthedefinitionthosecontentswhicharefamiliar tothemandthosetheyalreadyhaveide-asabout, then tofind thoseunknowntogroupmembersand, finally, thoseonwhichtheyshouldinformthemselvesmoreandlearnaboutonbioethicscourses.Thesecondgroupreceivesthetextwiththedefinitionofbioethicsfromtheyears1978and1995.The task is to findmutualcontents inbothdefinitionsandhighlightwhatisdifferentinthesedefinitions.Basedonthedefinition byTončiMatulić, the third group answers the question ofwhatthisdefinitiondirectsatandwhatknowledgeisnecessaryaccordingtothis

16

Widerin:Jurić,H.(2005),cit.ed.

17

Ibid.

18

Matulić,T.(2001),cit.ed.

19

Čović,A.(2004):Etika i bioetika,Pergame-na,Zagreb,p.28.

20

Jurić,H.(2005),cit.ed.

21

ThecourseoflecturesisbeingrealizedontheMedical School inRijeka for the Integratedpre-graduateandgraduateuniversitystudyofDentistryandprofessionalstudyofMedical-laboratoryDiagnostics.

22

Thecourseoflecturesisdraftedforthestu-dentsoftheprofessionalstudyofMedicalRa-diologyattheMedicalSchoolinRijeka.

23

The course of lectures is performed on twouniversity studies at the Medical School inRijeka: pre-graduate university study ofOrganization, Planning andManagement inHealthcare andpre-graduateuniversitystudyofSanitaryEngineering.

24

ThecourseoflecturesisbeingrealizedontheIntegratedpre-graduateandgraduateuniver-sitystudyofMedicine.

25

ThecourseoflecturesisrealizedontheUni-versitystudyofmedicine, andfromacademicyear 2007/08 it is also realized on the pre-graduate university study of Organization,PlanningandManagementinHealthcare.



definition.The fourthgroup,comparingdefinitionsbyAnteČovićand theencyclopaedicdefinitionfrom1995,mustfindananswertothequestionoftheirsimilaritiesanddifferences.

Central activity:analysisofdefinitionsandanswerstoquestionsasked.Teacher motivates students to seek answers to questions because of theirimportanceforconceptualizationofthefollowingteachingmaterial.He/sheremindsstudentsthatsuchmethodsofworkmakethemresponsiblefordi-rectingbioethicalcontentsandadoptingnecessarycourseinformation.Fol-lowingworkinsmallgroups,he/shehelpsstudentstosolveproblemswhichcreateddifficultiesforthemingroupwork.Afterthegroupworkisfinished,representativesofeachgroupgiveanswerstoquestions,andteacherwritesthemdownontheflipchart.Activityiscontinuedinafrontalformofworksothatallstudentsmayexpresstheirthoughtsandcommentsontheanswersreceived.

Final activity: planning and programming future tasks on courses in bio-ethics.Basedontheobtainedanswers,students,togetherwiththeirteacher,concludewhich contentsmust be adopted andwhich knowledge completed in theirfuturecoursework.26

Workshop II: Complexity and pluriperspectivity – outset basis for the approach to and observation of bioethical problems

Aim:toexaminethecomplexityofthebioethicalproblem,observeitscom-ponentsandthenecessitytoincludepluriperspectivityandtheintegrativeap-proachintheprocedureofproblemsolution.

Procedure of learning:– Caseinterpretation–presentingtheproblem;– Pointingouttaskstobeachievedthroughanalysisoftheofferedproblem.Material: paper, pencils, felt pens, flipchart,material for theworkof eachgroup:casefrompractice,27theHippocratic Oath,text“Challengesofheter-ologousinsemination”,28“Parentsandchildren”(partfromtheFamily Law ActoftheRepublicofCroatia),29partofthetexts“Medicalmodel”,30“Bio-medicalmodel”,31“Familyplanningandtheregulationofhumanfertility”,32andissuesthataretobediscussedandansweredinasmallgroups.

Introductory activity:introducingthestudentstothecourseandreasonsforgroupwork.Teacherintroducesstudentsintotheirmutualtask,pointsoutthecomplexityofbioethicalproblems,warnsonimportanceofrecognizingproblems’com-ponentpartsandsuggestsapproachfromscientificaswellasotherperspec-tivesthatcancontributetoproblemobservationandsolution.Afterfirstin-structionseachsmallgroupishandedoutmaterialneededforwork(seeitemMaterial)andstudentsareaskedtoequallyparticipateintheinterpretationoffactsandacquiringofknowledge.

Central activity:caseanalysisandanswerstoinitialquestions.Teacherremindsstudentsoftheresultsachievedinpreviousworkshopwhichledtoaconclusionthat Hippocratic Oath isinadequateinfacingnewkindofproblemswhichoccurincontemporarymedical-ethicalpractice.Thisconclu-



siondirectedtoacoursediscussingonthecharacterofthebioethicalproblem,pointingtoitscomplexitywhichdemandsamultidisciplinary(pluriperspec-tive)andintegrativeapproach.Alike,itpointsoutthattheofferedcaseandis-

26

Comparedto thealreadyrealizedworkshop,itmaybesaidthatintheiranalysisofthefirstdefinitionofbioethics,studentshavepointedout the need for new knowledge related tothesciencesof life,ethicsofhealthcareandbioethical principles; analyzing the otherstheydemandedinformationonwhatishiddenbehind themoraldimensions and interdisci-plinarityofbioethics,whileanalyzingtheau-thorial definitions they concluded a need toacquire knowledge on the pluriperspectivityandinterdisciplinarityofbioethics.

27

Case: “Mrs.MaryBethWhitehead, twenty-nine year old homemaker fromNew JerseysignedonFebruary6th,1985,acontractbind-inghertobearachildtomarriedcoupleWil-liamandElizabethStern.TheContractdraft-edbytheCenterforReproductiveMedicineandInfertility inNewYorkcontainedapartbindingMrs.Whiteheadnotto,forthebenefitofthenewbornchild,createortrytocreateaparental relationshipwith the child and thatuponbirth,shewillfreelysurrenderthechildto the care ofMr.WilliamStern, biologicalfatherofthechild.Inaddition,Mrs.Whitehe-adalsosignedawaiverofallparentalrights.Ascompensationforthebirthandlabourex-pensesshereceivedfromtheCenterforRe-productiveMedicineandInfertilityatotaloftenthousanddollarsofthetwenty-fivethou-sanddollarsMr.Sternhadpaidthecentreforthe costs of fertilization, healthcare servicesduringthepregnancyandcostsofmediation.The in vitro conceived child was born on27thMarch, 1986, andMrs.Whiteheadandherhusband,whoalreadyhad twochildren,didnotliketheideaofgivingupthenewbornbabytotheSterns.Beingawareoftheirob-ligationsderiving fromsigning thecontract,three days after the birth they handed overthebabytotheSterns,butrefusedtoreceivethecompensationoftenthousanddollars.InacoupleofdaysMrs.WhiteheadwenttoMr.Stern’sofficebegginghim to allowheronelastweekwiththebaby.TheSternsaccepted,butasMrs.Whiteheaddidnotreturnthebabyfor twomonths, the Sterns filed suitwith ademandforthecustodyofthenewbornbaby.Afterthat,followedeventsthatcanbeseeninthrillermovies.Withacourtordertotakeoverthechild,sixpolicemenwenttothehouseofthe Whiteheads, and refusing to hand overthe baby Mrs. Whitehead managed to givethebabytoherhusbandthroughthebedroomwindowafterwhichheleftNewJerseywiththebabyandfledtoFlorida.Mrs.Whiteheadjoined them soon after without the police

questioningheratall.After threemonthsofliving on various addresses in Florida, theWhiteheadswerefoundandthejudicialpro-ceedingscouldtakeplace.Thecourtproceed-ingswereprolongedduetoMrs.Whitehead’sstatementonthepossibilityoffatherhoodofher husband since she engagedwith him insexual relations at the time of the artificialinsemination.Withholding the fact that herhusbandwassubjectedtoaprocessofsterili-zationafterthebirthoftheirsecondchild,sheconsciouslymisled the judgeandprolongedthe legal proceedings until the final testingofthepossiblefatherhoodofMr.Whitehead.The legal proceedings were concluded assuchthatthebabywas,registeredinthejudi-cialdocumentsasBabyM–handedoverbycourtordertotemporarycustodyoftheSternswhowerealsograntedadoptionrights,whileMrs.Whiteheadwasgrantedlimitedrightstochildvisitations.”Thiscaseisknownunderthetitle “TheBabyM Case”, and was published in: Pence, E.Gregory (1990): Classic Cases in Medical Ethics. Medical Ethics with Philosophical, Legal and Historical Backgrounds, SchoolofMedicine andDepartment ofPhilosophy,University ofAlabama at Birmingham, pp.89–114.ThecasedrewgreatattentionoftheAmerican academic community and public,and Pence stated that it was analyzed andwrittenaboutby:WilliamPrior,ed.,(1988):Manufactured Motherhood: The Ethics of the New Reproductive Techniques in Logos: Philosophic Issues in Christian Perspective, 9,PhilosophyDepartment,SantaClaraUni-versity,EdwinMellenPress, (1987):On the Problem of Surrogate Parenthood:Analyzing the Baby M Case; Steinbock,B.(1988):“Sur-rogate Motherhood as Prenatal Adoption”, Law, Medicine & Health Care, Spring1988,16:1–2.; Chesler, P. (1989): Sacred Bond: The Legacy of Baby M,Vintage,NewYorkStateTaskForceonLifeandLaw, Surrogate Parenting: Analysis and Recommendations for Public Policy.

28

The subject under consideration is the textfromthebookofMatulić,T.(2006):Medicin-sko prevrednovanje etičkih granica, GlasKoncila,Zagreb,pp.132–135.

29

NN.No.116/2003.

30

“Medicinski model”, Klinička psihologija, mimeographed course material, pp. 18–19,accessibleat:www.psihologija.ffzg.hr.



suesservetotestanassertionaccordingtowhichthecontemporarymedical-ethical(bioethical)problemscannotbesolvedonlybyadominantapproachofone,principallymedicalscience.Hence,studentsinsmallgroupsanalyzereceivedcasesbyansweringthefollowingquestions:1. IsthereasolutionforthiscaseintheHippocratic Oath,andifso,what

doesitprescribe?2. Canthemedicalandhealthcarepersonnelsolvethereceivedcasethem-

selves?3. Iftheycannot,whycan’tthey?4. Whichprofessionsandperspectivesoutsideofmedicineshouldbeinclud-

edintocasesolvingandwhatdotherepresentativesoftheseprofessionsandperspectiveshavetooffer?

5. Forwhichpartofthesolutionaconsensusmaybereachedandwhichsci-entificperspectivescontributetotheachievementofaconsensus?

6. Areyoufamiliarwiththesolutionofthiscaseinanotherculturalsetting?

Final activity:observationofthecomplexityofthebioethicalcaseandneces-sityof includingdifferent scientificandnon-scientificperspectives into itssolution.Teacherwritesdownontheflipchartanswersreceivedingroupdiscussion,she/heparticularlymarksthoseforwhichnoconsensuswasreachedingroupworkandunderlinesreasonsfortheinabilityofreachingaconsensus.Intheclosingpartoftheworkshop,studentsindialoguewiththeteachergivecom-mentsontheacquiredanswersandderiveacommonconclusion.

Evaluation of the achieved in the workshop

Fromanextensivescaleofassessmentwhichwasofferedtostudentsfortheevaluationofclasswork,weselectanswerstoissuesrelatedtotheacceptabil-ityofthedescribedmethodofwork.Thescaleofassessmentincludedstudiesandstudentswithwhomthepresentedcourseunitwasrealizedwiththeintentofanalyzingtheimplementationofapedagogicalstrategyintheconceptuali-zationofcoursecontentsandmethodologyofperformingclass.The pattern included students of the integrated pre-graduate and graduateuniversitystudyofDentistry,pre-graduateuniversitystudyofOrganization,PlanningandManagementinHealthcare,andprofessionalstudyofMedicalRadiology.ThefirststudyincludesthecourseoflecturesinMedicalEthics,thesecond–Bioethics,andthethird–EthicsofHealthcare.Commontoallcourses of lectures is the introductory part regarding the thematic field ofactualizationofthedefinitionofbioethics.33Theteachingprocessassessednine(oftenenrolled)studentsoftheprofessionalstudyofMedicalRadiol-ogy,twentythree(oftwentyfour)studentsoftheintegratedpre-graduateandgraduateuniversitystudyofDentistryandthirteen(offourteen)studentsofthepre-graduateuniversitystudyofOrganization,PlanningandManagementinHealthcare–atotaloffortyfivestudents.



Results of the scale of assessmentTotalresults:

Question1.Iassessthecontentofthesubjectas:Modality of answers %Veryinteresting 24,44Partlyinteresting 33,33Interesting 40,00Uninteresting 2,22Icannotassess 0

Question 2. Methodsofcourseperformancemadethecoursemoreinterest-ingandeasiertome:Modality of answers %True 48,98Partlytrue 35,55Iamsure 11,11Iamnotsure 2,22Icannotassess 0

Question 3. Igivethefollowinggradetomethodofcourseperformance(5–verysatisfied,1–notsatisfied):

Modality of answers %5 44,444 46,663 46,662 01 0

Question 4. Igivethefollowinggradetothelectures(5–verysatisfied,1–notsatisfied):


31

“Biomedicinskimodel”,Klinička psihologija,mimeographed course material, pp. 19–20,accessibleat:www.psihologija.ffzg.hr.

32

Kodeks medicinske etike i deontologije(2003), Article3,CroatianMedicalAssocia-tion,Zagreb,pp.10–11.

33

About the pedagogical-methodological con-ceptualization of the bioethics course at theMedical School in Rijeka, see: Gosić, N.(2005):Bioetička edukacija,Pergamena,Za-greb.



Question 5. Igivethefollowinggradetoseminars(5–verysatisfied,1–notsatisfied):


Question 6. Roundofthestatementyouagreewith–Ihaveparticipatedindiscussionsinsmallgroups:Modality of answers %True 88,88False 0Iamnotsure 2,22Iamindecisive 0Iwasnotdisposed 4,44Noanswer 4,44

Question 7. Givegradesfrom1to5toassesscommunicationofteacherinclassassuchthatyouwillputthegradefrom1to5(5–verysatisfied,1–notsatisfied)aftereachassertion:

Modality of answers 5 (%) 4 (%) 3 (%) 2 (%) 1 (%) No answer (%)

Presentsthecoursematerialarticulately

71,11 22,22 13,13 0 0 0

UsespracticalexamplesinpresentingtheethicsoftheprofessionIbelongto

73,33 17,77 6,66 0 0 2,22

Encouragesdiscussion 51,51 20 13,33 2,22 0 0Encouragescriticaldeliberation

62,22 26,66 11,11 0 0 0

Helpsstudentsrealizecoursetasksmoreeasily

68,88 17,77 11,11 0 0 0

Takesintoconsiderationideasandopinions

71,11 22,22 6,66 0 0 0

Holdsclassregularly 91,11 6,66 2,22 0 0 0Answersstudentquestionsclearlyandarticulately

66,66 28,88 2,22 2,22 0 0

Introducesaimsofthecourse,methodofcourserealization,tasksandexamquestions

86,66 8,88 2,22 0 0 2,22

Startedandendedclassintheestimatedtime

73,33 17,77 8,88 0 0 0

Respectfultostudentsandtheiropinions

84,44 8,88 2,22 0 0 4,44



Results according to studies

Question 1. Iassessthecontentofthesubjectas:

StudyVery

interesting(%)

Partially interesting

(%)

Interesting(%)

Uninteresting (%)

I cannot assess(%)

MedicalRadiology

11,11 22,22 55,55 11,11 0

Org.,Plan.andManagementinHealthcare

15,38 38,46 46,15 0 0

Dentistry 34,78 37,78 30,43 0 0

Question 2. Methods of course performance (lectures and seminars) havemadethecoursemoreinterestingandeasiertome:

Study Correct (%)

Partially correct

(%)

I am sure (%)

I am not sure (%)

I cannot assess (%)

MedicalRadiology

11,11 55,55 33,33 0 0

Org.,Plan.andManagementinHealthcare

61,53 30,76 0 0 7,69

Dentistry 56,52 30,43 8,69 3,34 0

Question 3. Igivethefollowinggrade(5–verysatisfied,1–notsatisfied)tomethodofcourseperformance:

Study 5(%)

4(%)

3(%)

2(%)

1(%)

MedicalRadiology 22,22 33,33 44,44 0 0Org.,Plan.andManagementinHealthcare

30,76 46,15 23,07 0 0

Dentistry 47,82 52,17 0 0 0

Question 4. Igivethefollowinggrade(5–verysatisfied,1–notsatisfied)tolectures:

Study 5(%)

4(%)

3(%)

2(%)

1(%)


53,84 23,07 23,07 0 0

Dentistry 39,13 56,52 3,34 0 0



Question 5. Igivethefollowinggrade(5–verysatisfied,1–notsatisfied)toseminars:

Study 5(%)

4(%)

3(%)

2(%)

1(%)


61,53 38,46 0 0 0

Dentistry 69,65 21,73 8,69 0 0

Question 6. Roundoffthestatementyouagreewith.Ihaveparticipatedindiscussionsinsmallgroups:

Study True(%)

False(%)

I am not sure(%)

I am indecisive

(%)

I was not disposed

(%)

No answer

(%)MedicalRadiology 88,88 0 11,11 0 0 0Org.,Plan.andManagementinHealthcare

92,30 0 0 0 0 0

Dentistry 86,95 0 0 0 3,34 8,69

Question 7. Givegrades1do5 toassesscommunicationof theprofessorinclassbyputtingthegrades1to5(5–verysatisfied,1–notsatisfied)aftereachstatement:

ProfessionalstudiesofMedicalRadiology:

Modality of answers 5(%)

4(%)

3(%)

2(%)

1(%)

No answer

(%)Presentsthecoursematerialarticulately

55,55 44,44 11,11 0 0 0


33,33 44,44 22,22 0 0 0

Encouragesdiscussion 33,33 44,44 22,22 0 0 0Encouragescriticaldeliberation

22,22 33,33 44,44 0 0 0


55,55 22,22 22,22 0 0 0


44,44 44,44 11,11 0 0 0

Holdsclassregularly 66,66 22,22 11,11 0 0 0Answersstudentquestionsclearlyandarticulately

33,33 55,55 11,11 0 0 0

Introducesaimsofthecourse,methodofcourserealization,tasksandexamquestions

55,55 22,22 11,11 0 0 11,11




4(%)

3(%)

2(%)

1(%)

No answer

(%)Startedandendedclassintheestimatedtime

55,55 22,22 22,22 0 0 0


55,55 22,22 11,11 0 0 11,11

Pre-graduateuniversitystudyofOrganization,PlanningandManagementinHealthcare:


4(%)

3(%)

2(%)

1(%)

No answer

(%)Presentstheteachingmaterialarticulately

69,23 23,07 7,69 0 0 0


69,23 23,07 7,69 0 0 0

Encouragesdiscussion 61,53 15,38 15,38 7,69 0 0Encouragescriticaldeliberation

61,53 30,76 7,69 0 0 0


69,23 23,07 7,69 0 0 0


53,84 30,76 7,69 0 0 0

Holdsclassregularly 92,30 7,69 0 0 0 0Answersstudentsquestionsclearlyandarticulately

53,84 30,76 0 7,69 0 0

Introducedaimsofthecourse,methodofcourserealization,tasksandexamquestions

92,30 7,69 0 0 0 0

Startedandendedclassintheestimatedtime

38,46 46,15 15,38 0 0 0


84,61 15,38 0 0 0 0

Integratedpre-graduateandgraduateuniversitystudyofDentistry:


4 (%)

3(%)

2(%)

1(%)

No answer

(%)Presentstheteachingmaterialarticulately

78,26 22,22 11,11 0 0 0


91,30 4,34 0 0 0 4,34

Encouragesdiscussion 78,26 22,22 11,11 0 0 0Encouragescriticaldeliberation

78,26 21,73 0 0 0 0




4 (%)

3(%)

2(%)

1(%)

No answer

(%)Helpsstudentsrealizecoursetasksmoreeasily

78,26 22,22 4,34 0 0 4,34


91,30 8,69 0 0 0 0

Holdsclassregularly 100 0 0 0 0 0Answersstudentsquestionsclearlyandarticulately

86,25 13,04 0 0 0 0

Introducedaimsofthecourse,methodofclassrealization,tasksandexamquestions

95,65 4,34 0 0 0 0

Startedandendedclassintheuforeseentime

100 0 0 0 0 0


95,65 0 0 0 0 4,34

Interpretation of results and conclusion Generally taken, the presentedmethod of content conceptualization at thehighestpercentage (40%)wasgradedas interesting; the largestnumberofstudentsthoughtthatmethodsofcourserealizationinfluencedamoreinter-estingclass(48,98%);thesamepercentage(46,66%)recordgrades4and3withwhichstudentsnumericallygradedthemethodofcourseperformance,grades5and4forthelectureshavethesamepercentage(44,44%);60%ofstudentsgavethegrade5toseminars;thattheyparticipatedinworkinsmallgroupsdeclared88,88%of students.Among theofferedmodalities for theprocessofcommunicationbetweenprofessorandstudents,thehighestper-centage(91,11%)wasgiventothemodalityofaregularholdingofclass,thenfollow:introducedofthecourse,methodofclassrealization,tasksandexamquestions(86,66%),andrespectfultostudentsandtheiropinions(84,44%).Withsuchhighgradesobtainedbyscaleofassessmentitisimportanttopointout thedifferences inanswers receivedaccording to thestudies.Thehigh-est percentage (34,78%) to subject contentwas givenby students ofDen-tistrywhograded it asvery interesting,while studentsofMedicalRadiol-ogy (55,55%) and Organization, Planning andManagement in Healthcare(46,15%)gradedthecontentasinteresting.Answertothequestionofmethodofteachingrealizationthatinfluencedamoreinterestingandeasierclasshasthewidestrangeofanswers.Thatthisistrueassessed61,53%ofOrganiza-tion,PlanningandManagementinHealthcarestudents,56,52%ofDentistrystudents,and11,11%studentsofthestudyofMedicalRadiology.Thehigh-estgrade(5)formethodofteachingrealizationwasgivenby47%Dentistrystudents, thelargestnumberofOrganization,PlanningandManagementinHealthcare students (46,15%)gave the grade4, and the largest number ofMedicalRadiologystudents (44,44%)gave thegrade3.ThehighestgradeforthelectureswasgivenmostlybystudentsofOrganization,PlanningandManagementinHealthcare(53,84%),whilethelargestnumberofDentistrystudents(56,52%)gavethegrade4,aswellaslargestnumberofstudentsofMedicalRadiology(44,44%).Thehighestgradeforseminarswasgivenby69,65%ofDentistrystudents,thenby61,53%ofOrganization,Planningand



ManagementinHealthcarestudents,whilethelargestnumberofstudentsofMedicalRadiology(44,44%)gavetheseminarsagrade4.Thattheypartici-patedindiscussionsinasmallgroupsdeclared92,30%studentsofOrganiza-tion,PlanningandManagementinHealthcare,88,88%ofMedicalRadiologystudentsand86,95%studentsofDentistry.Asignificantdifferenceinanswersalsoexistsintheassessmentofthequalityofteacher-studentscommunica-tion.ThelargestnumberofMedicalRadiologystudents(66,66%)gavethegrade5tothemodality:holdsclassregularly;thathighestgradewasgivenby55,55%studentstomodalities:presentstheteachingmaterialarticulately;helpsstudentsrealizecoursetasksmoreeasily;introducedaimsofthecourse,methodofclassrealization,tasksandexamquestions;respectfultostudentsandtheiropinions.Thegrade5inthehighestpercentageonthestudyofOr-ganization,PlanningandManagementinHealthcarewasgiventomodalityofanswers:holdsclass regularly (92,30%); introducedaimsof thecourse,methodofclassrealization, tasksandexamquestions; thenfollowmodali-ties:respectfultostudentsandtheiropinions(84,61%),andmodalitieswiththesamepercentage(69,23%)ofanswersandgrade5:presentstheteachingmaterialarticulately;usespracticalexamplesinpresentingtheethicsoftheprofessionIbelong to;andhelpsstudentsrealizecourse tasksmoreeasily.OnthestudyofDentistry,100%percentgavethegrade5tomodalities:holdsclassregularlyandhasstartedandendedclassintheforeseentime,96,65%of students gave the grade 5 tomodalities: introduced aimsof the course,methodofclassrealization,tasksandexamquestions,andsheactsrespect-fullytostudentsandtheiropinions.

Conclusivelythefollowingmaybepointedout:– Thedifferences in assessmentwere influencedby the following factors:the length of the studies and acquired experience in evaluation and theentireorganizationoftheteachingprocessonstudies.Therefore,thehigh-estgradestothecourses,independentlyofthelengthoftheirstudies,weregivenbystudentsofDentistry(secondyear)andstudentsofOrganization,PlanningandManagementinHealthcare(firstyear)forwhomclasseswereorganizedbythesystemofshifts,whichiscarriedoutinawaythatinanintenseperiodoftwoweeksstudentsareoccupiedwithonlyonecourseoflecturesandbyorganizinganexamattheterminationoftheshift;

– Fromtheofferedscaleofassessmentmaybeconcludedthatstudentspreferworkinsmallgroups;

– Inclasscommunication,studentssupportmostaregularholdingofclass,atimelyintroductiontotheaimsofthecourseoflectures,methodofteach-ingcontent realization, tasks theymustmasterandexamquestions; thattheteacheractsrespectfullytotheiropinions,andthatpracticalandethicalcases andexamples for theprofession studentswhichmyoccur in theirfuturepractiseareusedinclass;

– Forthefollowingperiodofcourseteaching,theobtainedresultsindicatethatspecialattentionshouldbededicatedtotheachievementofmodalityvery interestingfortheassessmentofsubjectcontents,andinvestefforttoreceivethegrade5formethodsofcourserealization;

– Althoughmorethanahalfofthestudentsgavethegrade5tomodalityofencouragingclass,inthefollowingcourseteachingperioditisnecessarytoacquirenewcommunicationalartsandapplyskillsthatshallinfluenceanadditionalsupportofdiscussion.

Finally, thepresentedbioethical content,methodologyofperformanceandcommunicationalteachingprocessinfluencesthequalityofbioethicalcom-



municationandgivesinsightintotherealizeddynamicsoftheteachingpro-cessand,takenintotal,servesasaguidefortheadvancementofbioethicaleducation.

Literature

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“Bioethics”.Wikipedia,www.wikipedia.org/wiki/Category:Bioethics.

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Čović,A.(2004):Etika i bioetika,Pergamena,Zagreb.

Gosić,N.(2005):Bioetička edukacija,Pergamena,Zagreb.

Jonsen,R.A.(1998):The Birth of Bioethics,OxfordUniversityPress.

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Potter,V.R.(2007):Bioetika – most prema budućnosti,MedicinskifakultetuRijeci,Hr-vatskodruštvozakliničkubioetiku,Hrvatskobioetičkodruštvo,Međunarodnoudruženjezakliničkubioetiku(ISCB),Rijeka.

Šegota,I.(1999):“Novadefinicijabioetike”,Bioetički svesci,MedicinskifakultetuRijeci,br.1.

Vidović,V.V.,Kletzien,Sh.B.,Bekavac,M.C.(2002):Aktivno učenje i ERR okvir za poučavanje, Aktivno učenje i kritičko mišljenje u visokoškolskoj nastavi,Priručnikzana-stavnike,1.dio,Forumzasloboduodgoja,Zagreb.

Nada Gosić

Definicije bioetike u bioetičkoj edukaciji u Hrvatskoj

SažetakCiljrada: izložiti i analizirati pedagoške strategije i komunikacijski pristup definicijama bioeti-ke, zajednički dio bioetičkih sadržaja koji se održavaju na sveučilišnim studijima Stomatologije i Organizacije, planiranja i upravljanja u zdravstvu, te Stručnom studiju medicinske radiologije na Medicinskom fakultetu u Rijeci.Metode:metodaanalize sadržaja korištena je za istraživanje i prezentiranje enciklopedijskih i nekih autorskih definicija bioetike, s posebnim naglaskom na definicije bioetike autora – bio-etičara iz Hrvatske; metodauzorka 1. uključivala je kurikulum Medicinske etike, Bioetike i Etike zdravstvene skrbi te istraživala stajališta 45 studenata studija na kojima se održavaju bioetički



kolegiji. Uzorak je specifično stratificiran jer je: a) uključivao studente čiji se kurikulum odvija u turnusima – intenzivnim predavanjima u trajanju od dva tjedna, te one čija su se predavanja održavala svaki tjedan tijekom jednog semestra; b) različite godine studija (Stomatologija – stu-denti druge godine, Organizacija, planiranje i upravljanje u zdravstvu te Medicinska radiologi-ja – studenti prve godine), 2. skalaprocjene korištena je za istraživanje i prikupljanje stajališta studenata o sadržaju kurikuluma, metodama izvođenja i postignutoj razini komunikacije između studenata te komunikacije s profesorom.Očekivanirezultati: izložena metoda rada i rezultati dobiveni skalom procjene bi trebali po-kazati prihvatljivost i uspješnost prikazanih pedagoško-metodoloških načina rada, ukazati na slabosti i nedostatke te konačno zaključiti o razmjeru u kojem izloženi koncept i pristupi aktua-lizaciji definicija bioetike doprinose realizaciji dijaloga i komunikacije u kojoj studenti istovre-meno doživljavaju kurikulum kao nužan, koristan i zanimljiv te takav da potiče na razmišljanje, razmjenu ideja i nuđenje mogućih rješenja. Skala procjene bi trebala istaknuti različite stavove nastave (u turnusima i/ili tjednoj nastavi tijekom cijelog semestra).

Ključne riječibioetika,definicijabioetike,orijentacijskoznanje,analizaslučaja,moralnaorijentacija,radionica

Nada Gosić

Definitionen der Bioethik in der Bioethik-Ausbildung in Kroatien

ZusammenfassungZielderArbeit: Die Autorin präsentiert und analysiert pädagogische Strategien sowie einen bei der Bioethikdefinierung zum Tragen kommenden Kommunikationsansatz, ferner die gemein-samen bioethischen Inhalte, die innerhalb verschiedener Studiengänge an der Medizinischen Fakultät in Rijeka gelehrt werden (Zahnmedizin; Organisation, Planung und Verwaltung im Gesundheitswesen; Radiologie).Methode: Die Methodeder inhaltlichen Analyse wurde eingesetzt, um bestimmte enzyklopä-dische Bioethikdefinitionen sowie die Definitionen einzelner weiterer Autoren, insbesondere bio-ethischer Autoren aus Kroatien, darzulegen und zu untersuchen; die ExemplarischeMethode wurde angewandt 1) auf die Curricula der Medizinischen Ethik, der Bioethik sowie der Ethik der Gesundheitsfürsorge und schloss eine Umfrage unter 45 Studenten mit ein, die im Rahmen ihres Studiums bioethische Kollegs besuchten. Die Gruppe der Umfrageteilnehmer wies eine besondere Stratifizierung auf: a) Manche Studenten besuchten die Fakultät in Turnussen, die jeweils zweiwöchig mit intensiven Lehrveranstaltungen abgehalten wurden, andere wiederum hatten allwöchentliche Vorlesungen innerhalb eines Semesters; b) an der Umfrage nahmen Stu-denten verschiedener Jahrgänge teil (Zahnmedizin – 2. Studienjahr; Organisation, Planung und Verwaltung im Gesundheitswesen sowie Radiologie – 1. Studienjahr). 2) DieBewertungsskala wurde eingesetzt, um zu ermitteln, wie von den Studenten die Lehrinhalte, Unterrichtsmethoden und die Kommunikation zu Kommillitonen und Professoren eingeschätzt werden.ErwarteteResultate: Aufgrund der angewandten Methode und der Ergebnisse der Bewertungs-skala müsste zu erkennen sein, inwiefern die präsentierte pädagogisch-methodologische Un-terrichtsweise von den Studenten akzeptiert wird und erfolgreich ist, welche Schwächen und Mängel vorliegen und in welchem Maße das vorgestellte Lehrkonzept sowie die Ansätze zur Aktualisierung der Bioethikdefinition dazu beitragen, dass die Curricula als notwendig, nütz-lich und interessant bewertet werden und zum Nachdenken, Gedankenaustausch und zur Suche nach bestimmten Lösungen anregen. An der Bewertungsskala müssten unterschiedliche Ein-stellungen abzulesen sein, je nachdem, in welchem Semester sich die Befragten befanden und in welcher Form ihre Lehrveranstaltungen abgehalten wurden (in 2-Wochen-Turnussen oder allwöchentlich).

SchlüsselwörterBioethik,Bioethikdefinition,Orientierungswissen,Fallanalyse,moralischeOrientierung,Werkstatt



Nada Gosić

Les définitions de bioethics dans l’éducation bioethics en Croatie

RésuméObjectifdel’étude : exposer et analyser les stratégies pédagogiques et l’approche communi-cationnelle des définitions de la bioéthique, un contenu bioéthique commun aux études univer-sitaires de Stomatologie, aux études universitaires d’Organisation, de planification et d’admi-nistration des soins de santé, ainsi qu’aux études professionnelles de radiologie médicale à la Faculté de médecine de Rijeka.Méthodes : laméthoded’analysedecontenu a été utilisée pour examiner et présenter les défi-nitions encyclopédiques de la bioéthique et quelques définitions d’auteur, avec l’accent sur les définitions de la bioéthique données par les auteurs experts en bioéthique croates ; la méthode depanel incluait 1. le curriculum de L’Éthique médicale, de Bioéthique et de L’Éthique des soins de santé, et examinait les points de vue de 45 étudiants qui suivaient les matières rela-tives à la bioéthique. Le panel a été stratifié car il prenait en compte : a) les étudiants dont le curriculum se déroule par alternance, avec des cours intensifs durant deux semaines, puis les étudiants dont les cours avaient lieu chaque semaine au cours du semestre ; b) les différents niveaux d’études (pour la stomatologie, il s’agissait des étudiants en deuxième année ; pour l’Organisation, la planification et l’administration des soins de santé, il s’agissait des étudiants en première année) ; 2. une grilled’évaluation utilisée pour l’examen et la collecte des points de vue des étudiants à l’égard du contenu du curriculum, des méthodes de mise en oeuvre et du niveau de communication – entre étudiants ainsi qu’avec le professeur – accompli.Résultatsattendus : la méthode de travail exposée et les résultats obtenus par le biais de la grille d’évaluation devraient montrer la recevabilité et l’aboutissement des moyens pédago-mé-thodologiques cités, indiquer leurs faiblesses et leurs insuffisances, puis conclure dans quelle mesure le concept et les approches de l’actualisation des définitions de la bioéthique présentés contribuent au dialogue et à la communication, ce qui permet en même temps de vivre le cur-riculum comme nécessaire, utile, intéressant et incitant à la réflexion, à l’échange d’idées et de propositions. La grille d’évaluation devrait mettre en relief les différents points de vue des étudiants en fonction de la durée (du niveau) de leurs études et de leur adhésion à une méthode de cours (par alternance / hebdomadaire durant tout le semestre).

Mots-clésbioéthique,définitiondelabioéthique,savoird’orientation,analysedecas,orientationmorale,ate-lier

definitions of bioethics in bioethics education in croatia1

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