Abstract:

Background:
Teaching Bioethics is complex and challenging within multi system educational program as in Pakistan for secondary schools. The objectives are difficult as bioethics teaching require change in knowledge, skills and attitudes along with strong improvement in moral reasoning. Currently nationwide Pakistan has been in the phase of infancy for bioethics teaching. In secondary schools there have been several systems in Pakistan. The optimums of education system have not been practiced in Pakistan. Bioethics teaching requires pedagogies that engage students in participatory and emergent activities to develop multiple dimensions in ethical decision making. Teaching Bioethics is complex and challenging within multi- system educational program as in Pakistan for secondary schools. There have been famines in education delivery to new generations particularly in developing countries like Pakistan. Therefore this study was conducted to determine the comprehension and skills of ethical reasoning by secondary school students.

Objectives:
To teach bioethics, evaluate comprehension and skills of ethical reasoning by secondary school students

Methods:
It was a Quasi experimental study conducted in two schools (Public and Private). 110 students were recruited. All students of class VIII and IX both genders were recruited for bioethics education in the class room. Simple Random Sampling was used and 110 students were recruited. The qualitative analysis of comprehension and skills were evaluated on numeric scales. The selections of topics were based on simple and measurable issues in bioethics. There were multiple methods used for teaching purposes which included interactive lectures, structured discussion, guided readings (Handouts/News Papers), case studies and role plays (scenario based). The teaching plan included Presentation on overheads for 10 minutes, interactive discussion for 15 minutes, Feedback after session to assess modules and teaching. The final assessment was made through Perform.

Results:
The mean age of the total students were (mean ± SD) 12.5 ± 1.5 years. The male participants were 69(62.7%). Mostly student`s mothers were 80(72.7) unable to read and write. The qualitative analysis of comprehension and skills were evaluated on numeric scales to quantify the comprehension and skills of reasoning for ethical issues. The sessions held showed comprehension by students on introduction of bioethics 63(57.3%), advantages of Bioethics 68(61.8%), respect for a person 67(60.9%), self-rule 57(51.8%), informed consent70 (63.6%) and organ transplant ethics 73(66.4%). The comprehension regarding respect of autonomy was esteemed by all female (41) compared to male students. (P Value < 0-0001, ᵪ2:41.949:df;1).
The informed consent knowledge was enunciated correctly by all female students equated to male. (P Value < 0-0001, ᵪ2: 37.350:df;1) similarly the study found that role of benefit and risk in informed consent and distributive justice in health care was best expressed by female students.( P value< 0-0001) Theses reflections provide greater emphasis to focus primarily on class room bioethics teaching at secondary school with various modes of instructions used in this intervention.

Conclusion:
Teaching bioethics at secondary level found higher comprehension and skills development for ethical reasoning in female (66 %) compared to male students in class room sessions.

Keywords:

Teaching Bioethics, secondary school, Respect for autonomy, informed Consent, Benefits, Risk, self-rule.