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A Cross-Cultural Introduction To Bioethics: Darryl R.J. Macer, Ph.D. (Editor)
A Cross-Cultural Introduction To Bioethics: Darryl R.J. Macer, Ph.D. (Editor)
The Eubios Ethics Institute is a non-profit group that aims to stimulate the discussion of ethical issues, and how we may use new technology in ways consistent with "good life". An important part of this dialogue is to function as an information source for those with similar concerns. Other publications are listed at the end of this book. The views expressed in this book do not necessarily represent the views of the Eubios Ethics Institute or UNESCO.
Copyright 2006 Eubios Ethics Institute All rights reserved. The copyright for the complete publication is held by the Eubios Ethics Institute. No part of this publication may be reproduced except for personal use, and non-profit educational use, without the prior written permission of the Eubios Ethics Institute. Cataloging-in-Publication data A Cross-Cultural Introduction to Bioethics / editor, Darryl R.J. Macer. Christchurch, N.Z. : Eubios Ethics Institute 2006. 1 v. xx +280 pp. A4 size. ISBN 0-908897-23-5 1. Bioethics. 2. Medical ethics 3. Environmental Ethics 4. Bioethics Education 5. Genetics 6. Neurosciences I. Macer, Darryl R.J. (Darryl Raymund Johnson), 1962- IV. Eubios Ethics Institute. V. Title (A Cross-Cultural Introduction to Bioethics). Key Words: Asia, Biodiversity, Bioethics, Bioethics Education, Biotechnology, Body, Cloning, Education for Sustainable Development (ESD), Economics, Energy, Environment, Environmental Ethics, Eugenics, Genetic Engineering, Genetic Screening, Genetic Therapy, Human Genetic Disease, Human Genome Project (Scientific, Ethical, Social and Legal Aspects), Medical Ethics, Medical Genetics (Diagnosis, Treatment and Prevention), Patenting of Life, Peace, Reproductive Technology, Surrogacy, Sustainable Development.
On-line version and teachers guides, references, Internet links Project site <http://www.unescobkk.org/index.php?id=2508>
Further copies can be obtained from the Eubios Ethics Institute. For teachers involved in the Bioethics Education Project (open to all), this book is free. For others contributions are appreciated by cheque, or bank or postal order, or VISA or MASTERCARD for the following amounts (includes post). Applications from developing countries for free copies should also be addressed as below, and special arrangements for teaching trials. US $20 Euro 15 UK 10 NZ $30 A$33 C$33 2000 payable to the "Eubios Ethics Institute"; c/o Darryl Macer, Ph.D., Director, Eubios Ethics Institute c/o UNESCO Bangkok, 920 Sukhumvit Road, Prakanong, Bangkok 10110, THAILAND Tel: +66-2-391-0577 ext 141 Fax: +66-2-664-3772 Email: d.macer@unescobkk.org
The above address should also be used to send feedback forms from teachers and students!
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Content list
Preface Feedback Forms Teacher Feedback Forms Student Feedback Forms Authorship and Acknowledgments Authors Profiles A. Bioethics and the Ethics of Science and Technology 1. Making Choices, Diversity and Bioethics 2. Ethics in History and Love of Life 3. Moral Agents 4. Ethical limits of Animal Use 5. Ethics and Nanotechnology B. Environmental Ethics 1. Ecology and Life 2. Biodiversity and Extinction 3. Ecological Ethics 4. Environmental Science 5. Environmental Economics 6. Sustainable Development 7. Cars and the Ethics of Costs and Benefits 8. Energy Crisis, Resources and Environment 9. Ecotourism 10. The Earth Charter Initiative C. Genetics 1. Genetics, DNA and Mutations 2. Ethics of Genetic Engineering 3. Genetically Modified Foods 4. Testing for Cancer Gene Susceptibility 5. Genetic Privacy and Information 6. The Human Genome Project 7. Eugenics 8. Human Gene Therapy 9. Universal Declaration on the Human Genome and Human Rights 10. International Declaration on Human Genetic Data D. Medical Ethics 1. Informed Consent and Informed Choice 2. Telling the Truth about Terminal Cancer 3. Euthanasia 4. Brain Death 5. Organ Donation 6. Brain Death and Organ Transplant Drama v vii xiii xviii xviii 1 6 18 22 27 30 36 40 43 51 63 73 78 85 93
98 102 107 110 113 117 121 122 129 134 145 147 153 158 164 170
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A Cross-Cultural Introduction to Bioethics 175 176 177 183 188 189 192 198 204 205 208 211 214 215 222 224 229 235 241 251 253 269 277
7. The Heart Transplant 8. SARS (Severe Acute Respiratory Syndrome) 9. AIDS and Ethics 10. Ethical Principles for Medical Research Involving Human Subjects 11. Bird Flu 12. Indigenous Medicines and Access to Health E. Reproduction 1. Lifestyle and Fertility 2. Assisted Reproduction 3. Surrogacy 4. Choosing Your Childrens Sex and Designer Children 5. Prenatal Diagnosis of Genetic Disease 6. Female Infanticide 7. Human Cloning 8. United Nations Declaration on Human Cloning 9. Human Genome Organization (HUGO) Ethics Committee Statement on Stem Cells F. Neurosciences 1. Advances in Neuroscience and Neuroethics 2. Learning to Remember: The Biological Basis of Memory 3. The Neuroscience of Pleasure, Reward and Addiction G. Social Ethics 1. Revisiting the Body 2. Child Labour 3. Peace and Peace-keeping 4. Human Rights and Responsibilities Movie Guides and Questions (Samples)
Note that the Teaching Guides, References, Internet links, are in a separate document that can be downloaded from the Internet site http://www.unescobkk.org/index.php?id=2508 or <http://www2.unescobkk.org/eubios/BetCD/BetbkTR.doc>
Update : Download a copy of the UNESCO Universal Declaration on Bioethics and Human Rights, and make an analysis of this framework that was agreed by all member countries of the world in October 2005 for bioethics. <http://www2.unescobkk.org/eubios/udbhr.pdf>
Preface
Bioethics could be defined as the study of ethical issues and decision-making associated with the use of living organisms. Bioethics includes both medical ethics and environmental ethics. Bioethics is learning how to balance different benefits, risks and duties. Concepts of bioethics can be seen in literature, art, music, culture, philosophy, and religion, throughout history. Every culture has developed bioethics, and in this book there is a range of teaching resources that can be used that are written from a cross-cultural perspective by a variety of authors. In order to have a sustainable future, we need to promote bioethical maturity. We could call the bioethical maturity of a society the ability to balance the benefits and risks of applications of biological or medical technology. It is also reflected in the extent to which public views are incorporated into policy-making while respecting the duties of society to ensure individual's informed choice. Awareness of concerns and risks should be maintained, and debated, for it may lessen the possibility of misuse of these technologies. Other important ideals of bioethics such as autonomy and justice need to be protected and included when balancing benefits and risks. Bioethics is not about thinking that we can always find one correct solution to ethical problems. Ethical principles and issues need to be balanced. Many people already attempt to do so unconsciously. The balance varies more between two persons within any one culture than between any two. A mature society is one that has developed some of the social and behavioural tools to balance these bioethical principles, and apply them to new situations raised by technology. The title of this book is A Cross-Cultural Introduction to Bioethics, which includes second editions of the chapters in the 2004 textbook Bioethics for Informed Citizens Across Cultures, with a doubling of size due to the presence of more chapters. The chapters can be used at a variety of levels and at different years of teaching. They are combined here in one formulation that has worked in some cultures, but other teachers may wish to use only some of the chapters. Inside a school, the different chapters may fit into the curriculum across several years of education, supplementing existing courses in disciplines such as social studies, ethics, biology, science, history and foreign language classes. The objectives of this book (and on-line resources at UNESCO Bangkok website and the teaching pack on the Eubios CD/DVD) are to provide a free on-line resource teachers and students can use to learn about bioethics, and think more widely about life. A variety of styles are used, and we would like feedback from teachers, students, anyone who wishes to use it. List serves function in English for educators and students, and persons from a wide range of countries have tried these resources, and contributed to this project over the past three years. Internet site <http://www.unescobkk.org/index.php?id=2508> Internet site <http://www2.unescobkk.org/eubios/betext.htm> Education listserve <http://groups.yahoo.com/group/Bioethicseducation/> Student listserve <http://groups.yahoo.com/group/ Bioethics_for_students/> This project aims to produce free on-line teaching materials for bioethics education in different countries. The main products will be: 1) Materials for teaching bioethics; 2) A textbook that could be used in school and university classes to teach about bioethical issues; and 3) A network of teachers in different countries.
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There has been consensus among those involved that we can measure the success of bioethics education in several ways. Some goals of bioethics include: 1) Increasing respect for life; 2) Balancing benefits and risks of Science and Technology; 3) Understanding better the diversity of views of different persons. We do not need to achieve all three goals to consider education to be successful, and different teachers and institutions put a different amount of emphasis on each goal. This book has pages for students at many levels of learning, and for teachers. Please access the on-line site for a growing list of chapters and teaching materials and resources in different languages (currently, Korean, Japanese, Spanish, Chinese and Tamil). Chapters as well as whole sections and the textbook can be used in any way the educators wish. It is suggested that teachers select the appropriate length of text (from the introductory styles in the one page versions to the detailed long versions) to give to students to read, but that students can read all the text if they have time and interest. There are also detailed lists of websites and academic references that both teachers and more senior students who wish to spend more time reading about these issues may use. The versions of chapters and materials that are on-line are in colour, but this book is printed for economic reasons in monochrome. The Eubios Ethics Institute website has about 2000 files available for download, including the UNESCO/IUBS/Eubios Living Bioethics Dictionary, and regular News updates. Further copies of chapters and updates, teaching guides, evaluation sheets, etc. are available upon request. We are also interested in assembling student projects and different teachers' materials in a global site that all can use, and can inform us all. We welcome improvement and additions to this project. Short backgrounds of some authors are in the section on Authorship and Acknowledgments. In the case that no author is mentioned on the first page the author was the editor. We also thank the essential financial support of Sasakawa Peace Foundation for the project 2003-2005, and the ongoing support of UNESCO Bangkok. Above all we thank the thousands of students and hundreds of teachers from many countries who have already shared their comments to help improve the materials. That feedback is essential to further improvement of the materials, and the feedback forms follow this. The limit to this project is only the imagination of those involved.
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Date of evaluation:
(
Native language Classroom language Dept. and School Email
Name of the course Student information Grade level Size of the class
Nationality
Evaluation Instructions
(Please write your email if you have any.) Use pen. Write/check clearly. Completed form should be returned to the teacher or sent to the email below.
Class hours
Total:
Please write any comments you wish to make about the textbook, teacher and course in the comments and suggestion box. Should you have any suggestion about the feedback form, please email to Darryl Macer, d.macer@unescobkk.org
Teacher
1
What is your academic background? (e.g. name of the school/institution and program/major/department, the name of the city, degree, title, etc.) What are the classes do you usually teach at your school/institute? What grade levels do you usually teach? Have you taken any Bioethics or Ethics class before? (Circle the class if YES) / NO If yes, when (your age and school year), where (name of the school or institution and the city), and by whom (name of the teacher or program)? If you do not remember clearly, please provide as much information as possible.
Give us the names of historical/popular figures whom you think practiced higher ethical values throughout their life.
Have you ever discussed these persons in class? If yes, in what chapter of the textbook or topic did you refer to them?
Yes / No
7 8
Do you think elders play a positive role when forming the ethical values of their children?
Yes/No
Other than direct family or relatives, who or what do you think has an influential role when forming the ethical and/or moral values of children?
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In your opinion, which ethical values are important for young people to learn?
10
How long was the course ? Which chapters of the textbook did you use?
12
Which key words were used throughout the course among students?
13
Which of the chapters were difficult for your students to understand, and why? Which of the topics were not covered during the course and why?
14
15
Did you modify any of the textbook and activities to make them more suitable for your own context?
16
What were the useful guiding questions (from the text book, your own questions, and/or student questions) that helped to have good classroom activities and discussions?
17
Which of the chapters were not appropriate for your cultural values and norms? Were there any contents and questions that were not easily understood by your students? Please describe briefly what they are and why. (Should you need more space, please continue in the comment box below.)
** Please indicate your agreement or disagreement using this seven point scale:
SA(Strongly agree), A (Agree), PA (Partially agree),NA (Not applicable), PD (Partially disagree), D (disagree), SD (Strongly disagree) **
18 19 20 21 22
The textbook is very useful. The suggestions for classroom activities were helpful. The textbook was helpful in provoking meaningful discussion in class. The textbook was well organized and contains meaningful information. The questions in the textbook are helpful in guiding meaningful thinking and further study/research on the topic.
SA SA SA SA SA
A A A A A
PA PA PA PA PA
NA NA NA NA NA
PD PD PD PD PD
D D D D D
SD SD SD SD SD
23
What have you learned through the textbook and the interaction with students during the course?
x
24
25 26 27 28 29 30
The students were interested in the textbook topics. The students were interested because of classroom activities The students made good use of examples and illustrations. All students had equal chance to answer and comment. The students were active in discussions. The students questions were answered/responded to their questions and comments clearly and concisely.
SA SA SA SA SA SA
A A A A A A
PA PA PA PA PA PA
NA NA NA NA NA NA
PD PD PD PD PD PD
D D D D D D
SD SD SD SD SD SD
Technology integration 31 What types of educational aids in addition to the text did you use in the classroom activities? Please
circle all those used in the class: charts, role-play, video, flash cards, computer, projector, OHP, cassette, CD, DVD, guest speaker, field trip and others ( )
(Please list the names and titles of educational materials that were used when integrating educational technology, such as name of the video tape, DVD title etc.)
32
Please specify for which parts of the textbook you used what types of educational aid.
33
Do your students have regular access to a computer and the internet? At where?
34
Did any classroom activity involve searching further materials on the internet? How often did this happen and what websites were suggested? Did students mention websites they found themselves?
Overall ratings 35 Rate this chapter using the following scale. 36 Would you like to recommend this chapter to other teachers? Comments and Suggestions
(You can write more on additional sheets, and please send copies of your student reports)
Excellent
SA A PA NA PD
Poor
D SD
Nationality
Age Gender
M / F
Evaluation Instructions
(Please write your email if you have any.) Use pen. Write/check clearly. Completed form should be returned to the teacher or sent to the email below.
Total:
Please write any comments you wish to make about the textbook, teacher and course in the comments and suggestion box. Should you have any suggestion about the feedback form, please email to Darryl Macer, d.macer@unescobkk.org ** Please indicate your agreement or disagreement using this seven point scale: SA(Strongly agree), A (Agree), PA (Partially agree), NA (Not applicable), PD (Partially disagree), D (disagree), SD (Strongly disagree) **
How much of the total class time was used for the chapter? What key words were repeated throughout the discussion among the students? Do you think this chapter provides good learning experience for students? What were the guiding questions that helped the discussion? Yes/No
3 4
** Please indicate your agreement or disagreement using this seven point scale:
SA(Strongly agree), A (Agree), PA (Partially agree),NA (Not applicable), PD (Partially disagree), D (disagree), SD (Strongly disagree) **
5 6 7 8 9 10 11
I am very interested in this chapter. The allocated time was adequate for the chapter and the topic. The chapter was helpful in provoking meaningful discussion in the class. The chapter was well organized and contains meaningful information. The questions in the chapter are helpful to guide meaningful thinking and further study/research on the topic. The examples and contents were not adequate to address the issue in the chapter. I recommend this chapter to other teachers.
SA SA SA SA SA
A A A A A
PA PA PA PA PA
NA NA NA NA NA
PD PD PD PD PD
D D D D D
SD SD SD SD SD
SA SA
A A
PA PA
NA NA
PD PD
D D
SD SD
12
Was there any content and/or questions that are not appropriate for your cultural values and norms? Or was there any content and/or questions that were not easily understood by the students? Please describe briefly what they are and why. (Should you need more space, please continue in the comment box below.)
13
What have you learned through the chapter and the interaction with students during the class?
** Please indicate your agreement or disagreement using the seven point scale **
14 15 16 17 18
The students were interested in the topic. The students made good use of examples and illustrations. All students had opportunities to answer and comment. The students were active in discussion. The students questions were answered/responded to clearly and concisely.
SA SA SA SA SA
A A A A A
PA PA PA PA PA
NA NA NA NA NA
PD PD PD PD PD
D D D D D
SD SD SD SD SD
Technology integration 19 What types of educational aids did you use? Please circle all those used in the class: charts, role-play,
video, flash cards, computer, projector, OHP, cassette, CD, DVD, guest speaker, field trip and others ( )
Please list the names and titles of educational materials that were used when integrating educational technology, such as name of the video tape, DVD title etc.
20
Please specify what types of educational aid you used for each part of the chapter that you used.
21
How interested were students when you integrated educational aids into the classroom activities?
22
23
If there is an on-line interactive bioethics course or CD textbook, how is your schools facility if you were to use the website or electronic textbook for your class?
Overall ratings 23 Rate this chapter using the following scale. Comments and Suggestions
(You can write more on additional sheets, and please send copies of your student reports)
Excellent
Poor
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(If you do not wish, you do not have to write your name.)
Nationality
Age Gender
M / F
Evaluation Instructions
(Please write your email if you have any.)
Use pen. Write/check clearly. Completed form should be returned to the teacher or sent to the email below.
Please write any comments you wish to make about the textbook, teacher and course in the comments and suggestion box. Should you have any suggestion about the feedback form, please email to Darryl Macer, d.macer@unescobkk.org ** Please indicate your agreement or disagreement using this seven point scale: SA(Strongly agree), A (Agree), PA (Partially agree), NA (Not applicable), PD (Partially disagree), D (disagree), SD (Strongly disagree) **
Student
1
Have you taken any Bioethics class before? Yes / No If yes, when (your age and school year), where (name of the school or institution and the city), and by whom (name of the teacher or program)? If yes, how long was the course and what were the textbooks? Were there other books and materials (movies, story books, slides, documentary, field trip etc.) for the class? Yes / No If yes, what were they? Have you taken a general ethics class before?
Yes / No
2 3
4 5
What is your religion, and cultural/ethnic background? Do you think it affects your ethical values? If you happened to find a wallet with $100 and the persons ID card on a street, and there is no one around, would you return the money and the wallet to the police? Yes / No Would you act differently if there is no ID card? Yes / No Do you think the answers to the previous questions tell us a persons morality? Please share with us why you think so.
Yes/No
In your view, what is ethical thinking and action? Is it the same as moral thinking?
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What topics and which chapters were covered? What do you think the key words from this course are?
** Please indicate your agreement or disagreement using this seven point scale:
SA(Strongly agree), A (Agree), PA (Partially agree),NA (Not applicable), PD (Partially disagree), D (disagree), SD (Strongly disagree) **
12 13 14 15 16
The textbook is very interesting. The allocated time was adequate for the course and the topic-bioethics. The textbook was helpful in provoking meaningful discussion in class. The course and the textbook were well organized and contained meaningful information concerning bioethics. The questions in the textbook are helpful in guiding meaningful thinking and further study/research on the topics. List three important things that you learned through this course.
SA SA SA SA
A A A A
PA PA PA PA
NA NA NA NA
PD PD PD PD
D D D D
SD SD SD SD
SA
PA
NA
PD
SD
17
18
Were any of the chapters not appropriate given your cultural values and norms? Please describe briefly why. (Should you need more space, please continue in the comment box below.)
19 20 21 22 23
The teacher helped students get interested in the topic. The teacher made good use of examples and illustrations. The teacher welcomed questions/comments. The teacher answered/responded to questions and comments clearly and concisely. The ethical concepts were learned through a series of discussions more than the teachers lecture. Do you have access to a computer? Yes / No
SA SA SA SA
A A A A
PA PA PA PA
NA NA NA NA
PD PD PD PD
D D D D
SD SD SD SD
SA
PA
NA
PD
SD
Technology integration
24 25
Did the classroom activity involve searching for further materials on the internet? If yes, how often did you search the internet in and out of class? What websites did you use?
Overall ratings
26 27
Excellent
SA A PA NA PD
Poor
D SD
Rate this chapter using the following scale. Would you recommend this textbook to your friends?
Comments and Suggestions (You can write more on additional sheets, and please send copies of your student reports)
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Date of evaluation:
(
Native language
Classroom language
Nationality
Use pen. Write/check clearly. Completed form Name of the course Class hours should be returned to ( )hrs/week the teacher or sent to the email below. Please write any comments you wish to make about the textbook, teacher and course in the comments and suggestion box. Should you have any suggestion about the feedback form, please email to Darryl Macer, d.macer@unescobkk.org ** Please indicate your agreement or disagreement using this seven point scale: SA(Strongly agree), A (Agree), PA (Partially agree), NA (Not applicable), PD (Partially disagree), D (disagree), SD (Strongly disagree) **
How much of the total class time was used for the chapter? What key words were repeated throughout the discussion?
** Please indicate your agreement or disagreement using this seven point scale:
SA(Strongly agree), A (Agree), PA (Partially agree),NA (Not applicable), PD (Partially disagree), D (disagree), SD (Strongly disagree) **
3 4 5 6 7
The chapter is very interesting. The allocated time was adequate for the chapter and the topic. The chapter was helpful in provoking meaningful discussion in the class. The chapter was well organized and contains meaningful information. The questions in the chapter are helpful to guide meaningful thinking and further study/research on the topic. The examples and contents were not adequate to address the issues in the chapter. What have you learned through reading the chapter?
SA SA SA
A A A
PA PA PA
NA NA NA
PD PD PD
D D D
SD SD SD
SA
PA
NA
PD
SD
SA
PA
NA
PD
SD
SA
PA
NA
PD
SD
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Were there any contents and/or questions that are not appropriate for your cultural values and norms? Or were there any contents and questions that were not easily understood by the students? Please describe briefly what they are and why. (Should you need more space, please continue in the comment box below.)
11 12 13 14 15
The teacher helped students get interested in the topic. The teacher made good use of examples and illustrations. The teacher welcomed questions/comments. The teacher answered/responded to questions and comments clearly and concisely. The ethical concepts were learned through a series of discussions more than the teachers lecture.
SA SA
A A
PA PA
NA NA
PD PD
D D
SD SD
SA SA
A A
PA PA
NA NA
PD PD
D D
SD SD
SA
PA
NA
PD
SD
Technology integration
16
If the classroom activity involved educational aids, please circle all those used in the class: video/ computer/projector/OHP/cassette/CD/DVD/and others (
(Please list the names and titles of educational materials that were used when integrating educational technology, such as name of the video tape, DVD title etc.)
17
Did any classroom activity involve searching further materials on the internet? How often and what are the websites?
Overall ratings
18
Excellent
Poor
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Authors Profiles
Darryl R.J. Macer, Ph.D., New Zealand d.macer@unescobkk.org
Darryl is Regional Advisor on Social and Human Sciences in Asia and the Pacific, in RUSHSAP, UNESCO Bangkok, Thailand, and Affiliated Professor in Bioethics at United Nations University Institute of Advanced Studies since 2002. He is also Director, Eubios Ethics Institute, Japan, New Zealand and Thailand. He taught bioethics at the University of Tsukuba, Japan from 1990-2005, and in many countries. He has a B.Sc (Hons) in Biochemistry from Lincoln College, University of Canterbury, 1983; Ph.D. in Biochemistry at the MRC Laboratory of Molecular Biology, and Trinity College, University of Cambridge, U.K., 1987.
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Morgan is a postgraduate student in the environmental sciences, currently working on a PhD project on the modelling of sustainable development through Southern Cross Universitys School of Environmental Science and Management in Lismore, New South Wales, Australia. He has completed a BSc double major in ecology and environmental geography at the University of Sydney, with an Honours thesis in marine biology. He has travelled widely in lesser developed countries, and these travels and studies have led him to his current interests in fostering a sustainable world.
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A Cross-Cultural Introduction to Bioethics Michael Anjello Jothi Rajan, Ph.D., India anjellojothi@rediffmail.com
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Jothi is FDP Research Scholar, School of Physics, Madurai Kamaraj University, Madurai, India. He is also a lecturer at Arul Anandar College, Karumathur, Tamil Nadu. His specialty is nanotechnology research. His wife who also contributed to some chapters, Arockiam Thaddeus, is a biology lecturer in Jayaraj Annapackiam College for Women, Periyakulam, Theni District, Tamil Nadu, India.
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U.S.A./Japan
Richard is an Associate Professor in the Graduate School of Life and Environmental Sciences, University of Tsukuba, Japan, where he teaches biology, oceanography, and scientific writing to both graduate and undergraduate students. Though Rick was born in New York and has made his home in Japan since 1990, he is a citizen of the Earths Quaternary biota. Rick is the editor-in-chief of ELSS, a scientific editing and translation company. His recent research has been conducted in Japan and China and is focused on environmental policy and ethics, especially related to biodiversity.
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Note that some authors did not provide their profile for distribution in which case only names are included under the chapters they contributed to.
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Life is something we are all in together. This book is intended to make people think, respect, love, and question. We hope that this book will help readers develop their own bioethics.