Advocacy, Ethics & Civic Leadership
Engage with ethical frameworks around donation, informed consent, and civic responsibility while developing advocacy skills.
Learning Objectives
- Apply ethical principles (autonomy, beneficence, justice) to donation scenarios
- Analyze the importance of informed consent in medical decisions
- Evaluate the relationship between individual choice and community responsibility
- Identify effective and ethical approaches to health advocacy
Materials
- Ethical scenarios handout (provided below)
- Note-taking materials
Lesson Content
Introduction: Ethics in Medicine (3 min)
- "Medicine operates under ethical principles that guide decisions."
- "Today we'll apply these principles to blood and bone marrow donation."
- "There aren't always clear answers—ethics requires careful reasoning."
Ethical Principles Framework (8 min)
The four principles below are the framework set out in Beauchamp & Childress, Principles of Biomedical Ethics — the canonical reference in bioethics and the standard taught in medical and nursing programs.
Autonomy
Individuals have the right to make their own decisions about their bodies. No one should be forced or manipulated into medical procedures.
Beneficence
The obligation to act for the benefit of others. Donation can save lives, which is a clear benefit.
Non-maleficence
"First, do no harm." Donation processes must minimize risk to donors. Donor safety is paramount.
Justice
Fair distribution of benefits and burdens. All patients should have equitable access to matching donors.
Informed Consent Deep Dive (5 min)
- What it requires: Complete information about procedures, risks, benefits, and alternatives.
- Understanding: Information must be presented clearly; questions must be answered.
- Voluntariness: Decision must be free from coercion, pressure, or manipulation.
- Capacity: The person must be able to understand and reason about the information.
- In donation: Consent is obtained at multiple points—registration, confirmation, pre-donation (Source: NMDP donor process; WMDA donor safety standards).
- "A person can say no at any point, even after committing to donate. This right is absolute."
Individual Choice vs. Community Responsibility (7 min)
- "This is a genuine ethical tension without easy answers."
- Individual rights perspective: My body, my choice. No one is obligated to donate anything.
- Community responsibility perspective: We have duties to each other. Participation strengthens society.
- Middle ground: Education and access without pressure. Create conditions where informed choice is possible.
- "How societies balance these values reflects their culture and ethics."
Ethical Advocacy (5 min)
- What is advocacy? Speaking up for a cause while respecting others' autonomy.
- Ethical advocacy:
- Provides accurate information
- Respects the right to say no
- Avoids guilt, shame, or manipulation
- Addresses barriers rather than just pushing action
- Unethical approaches: Emotional manipulation, incomplete information, social pressure.
- "As future adults and citizens, you can advocate for causes you believe in—ethically."
Closing (2 min)
- "You've now explored the science, the disparities, and the ethics of this topic."
- "As you become adults, you'll make your own informed decisions."
- "Whatever you decide, you'll do so with knowledge and ethical reasoning."
Activity: Ethical Scenarios Discussion
Discuss in small groups, then share with class:
Scenario A
A potential donor is called as a match for a patient. They agreed to be on the registry years ago but now have concerns. The patient will likely die without a transplant. Should the donor feel obligated to proceed?
Consider: autonomy, beneficence, the meaning of commitment.
Scenario B
A school holds a registry drive. Some students feel pressured by peers to sign up. Is this ethical? How should such drives be conducted?
Consider: informed consent, voluntariness, social pressure.
Scenario C
A community has very few registered donors, contributing to disparity. A local organization wants to increase registration. What approaches would be ethical? What would be unethical?
Consider: justice, respect for autonomy, community engagement.
- Autonomy
- The right of individuals to make their own informed decisions about their bodies and actions.
- Informed Consent
- Agreement to a procedure after receiving and understanding complete information about risks and benefits.
- Altruism
- Unselfish concern for the welfare of others; acting to benefit others without expectation of reward.
- Civic Responsibility
- The duties citizens have to participate in their community and contribute to the common good.
- Advocacy
- The act of supporting, recommending, or arguing for a cause or policy.
Reflection Prompts
- How do you balance individual rights with community responsibility in your own thinking?
- What would ethical health advocacy look like in your community?
- What questions about this topic would you want answered before making any decisions as an adult?
- How has this unit changed or clarified your understanding of public health?
Optional Extension
Reflection essay: "What does civic responsibility mean to me?" Connect your understanding from this unit to your broader views on community and citizenship.
Curriculum Complete
You've completed "Public Health, Ethics & Civic Leadership." You now understand the biology, genetics, disparities, and ethics surrounding blood and bone marrow donation.
Remember: Donation is always a personal choice made by informed adults. This education prepares you to make your own decisions when the time comes.
Sources & Further Reading
- Beauchamp, T.L. & Childress, J.F. Principles of Biomedical Ethics(Oxford University Press, current edition) — canonical bioethics text, source of the four-principle framework (autonomy, beneficence, non-maleficence, justice).
- World Marrow Donor Association (WMDA) — Donor safety standards
- NMDP / Be The Match — Donor process and consent points
- HHS — The Belmont Report (foundational US framework for research ethics and informed consent)