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Introduction to the Project on Bioethics for Informed Choices - page 24 / 115





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554Challenges for Bioethics from Asia

special ethical, moral, legal and social considerations, together with the ensuing measures, were identified differently, between foreigners and Chinese, and notably among the group of Chinese contributors. Some called for greater respect for the individuals’ decision under all circumstances, others opted for some professional leeway in the name of medical paternalism, others again argued, that issues of social justice and the patient’s responsibility for others, (such as family members or society), should be acknowledged. This inconsistent landscape of opinions seems to represent a plurality of ‘moral cultures’ and ethical approaches inside China, as well as in medical ethics in general. These moral denominators are much more significant for the constructive part of culture in ethics than the categories of the compass, such as ‘East versus West’, or ‘North versus South’, which are still put forward from time to time.

5 Towards an integrated conceptual framework of teaching ethics

Occasionally, participants commented that they preferred the ‘Western’ stile of teaching to what they were used to. It was easy to sympathise with their frustration about the current Chinese situation. However, this denominator (‘Western’) struck me oddly. Most people in Europe are familiar with authoritarian, ‘preaching stile’ or mere technical ways of teaching in general, and serious shortcomings in the teaching of ethics, especially concerning practical skills.

It is the purpose of these courses to facilitate the development of a state of the art design of teaching medical ethics according to the particular needs of Chinese colleagues. Another consideration was to develop a teaching approach in situ that is not established in any medical curriculum, although studies in pedagogy and ethics recommend it (Neitzke 1999, Ballauf 1966). Hence, a special session was dedicated to the outlines of a conceptual approach from a view of history and theory of pedagogy. Teaching stiles should be understood as expressions of certain historical situations, with a particular context, sociological circumstances, social assignment and political purpose of the respective teaching institutions, such as monasteries or universities in the formative stage of higher education in Europe. (For example, originally, the ‘lecturing’, or reading stile was owing to limited accessibility of books in Europe, a hierarchical ontological, political and social world view and authorities in charge of managing what is ‘true, good and right‘).

Three different paradigmatic models of teaching situations were described, with their respective structure, constructive functionality and limitations for teaching ethics.

(a) The traditional method of frontal teaching creates a unilateral communication structure (‘teacher gives, student receives’). It depends on a hierarchical order of the superior, knowing teacher in opposite to the subordinate student, or a distance between ‘what should be known‘ and ‘what is known’. Its symbol is the desk as a barrier (recently amended by or exchanged for pointer and screen), or, a metaphor from organic life, a sprout in solution. It is constructive when intellectual guidance is required and suitable for presenting facts. It may command and does demand respect for clearly distinguished roles. Besides the teacher’s oration, reading and writing (board), no communication skills come in. Technical skills and knowledge are imparted. For lessons with a practical relevance, this stile can be problematic, because no response is expected that would check the students’ understanding. It may deteriorate into preaching, losing touch to students and de-motivate them. The size of class matters merely physically (can students find a seat, hear and see the teacher?). It mainly requires passive students as objects of receiving content.

(b) The established classroom relationship shows a reciprocal communication structure. This allows for contained dynamic exchange between teacher and student, while a hierarchical social arrangement and order is maintained. Its symbol is the bilateral interplay of questions and answers, focused, through the teacher, by board or screen, or metaphorically, a greenhouse. Its functionality depends on a plausible authority and basic attendance. This setting constitutes a first step across boundaries, towards class. It encourages students to communicate and the teacher to reflect upon the actual teaching situation, beyond the subject matter. It facilitates interaction and stimulates creativity. When conducted by a skilful teacher, it can become the beginning of an interpreting mode of learning that permits, in class, to adjust the teaching procedure and,

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