Swiss psychologist Jean Piaget (1896-1980) classified cognitive development into periods of increasingly more sophisticated adjustment to the world. Children typically from 11 to 15 years of age can be classified as concrete operational thinkers as they reason with a finite number of possibilities, use logical principles for concrete and specific possibilities, and do not contribute readily to hypothetical arguments. They are likely to come to limited rational decisions.
   Students typically 16 to 18 years old are more often formal operational thinkers who can imagine both the obvious and the subtle. Their thinking moves from the realm of things to that of ideas. They can construe the world abstractly, hypothetically and inferentially. Ultimately they discover that others have feelings similar to their own and have experience life in much the same ways.

    American educator Lawrence Kohlberg (1927-1987) studied the development of children's moral reasoning and their thinking about right and wrong. Each of the following stages builds upon the previous one:

1. Obey authority to avoid punishment
2. Behave in self-serving ways
3. Behave to please oneself and "to be good"
4. Obey laws to maintain institutions, systems and order
5. Believe that most rules and values are relative
6. Follow universal principles of justice, not laws that violate them.

        In order to assist you in advancing through the various stages of moral development vis-a-vis medical/physiological issues I have a little exercise for you. Select one of the Moral Dilemmas below and write a 500 word essay on the subject. Try to analyze the issue from conflicting viewpoints. As an example of an effective, I have copies of Ellen Goodman's column of March 8, 1996 (Birmingham News) titled "The moral dilemma of determining your fate.

Alzheimers Disease:
    A test for a gene that can cause Alzheimer's diseasse is available. The test also detects a gene that causes some people heart disease. If scientists test people for heart disease, and find they carry the gene causing Alzheimer's disease, should the scientists report the possibility of Alzheimer's disease to the patiens? How might such reporting affect a persons ability to get insurance? Would you want to know if you carried the gene?

Infertility
    What is in vitro fertilization? Who should bear the cost? Should government impose a ceiling on the mother's age? For some women and men who have had difficulty conceiving children, this fertilizaion method has been a solution.  What should happen wwith a zygote that results from a united egg and sperm that scientists store and never use? What laws should regulate its use? Should someone else be allowed to carry the zygote to term? Should the parents or scientists make it available for research?

Organ Donation
    Should schools require students to learn about organ donation? Should we get our blood analyzed and the description included in the registry of possible bone marrow donors? Should we donate blood to blood banks regularly?
    Signing an organ donor card does not guarantee medical professionals will use the organs for donations.  Nor does not signing guarantee health care providers will not donate the organs. Should we change the law so anyone who dies is a potential organ donor unless the next of kin request no donation? People who allow their loved ones organs to be donated usually express a feeling of comfort, knowing the death brought about some good because of the organ donation. What about organs of deceased people with no next of kin and no living will?
 
 
 

Note:
Piaget, Kohlberg and list of moral dillemmas are all from the A.D.A.M. Essentials study guiude: ADAM Software, 1600 Riveredge Pkwy, Suite 800, Atlanta, GA 30328. http://www.adam.com