EJAIB Vol. 31 (5) July 2021
www.eubios.info

ISSN 1173-2571 (Print) ISSN 2350-3106 (Online)

Official Journal of the Asian Bioethics Association (ABA)

Copyright ©2021 Eubios Ethics Institute(All rights reserved, for commercial reproductions).

page
Editorial: Japan and Reproductive Choices - Darryl Macer 249
Barking Up the Wrong Tree: Who Really Limits Preimplantation
Genetic Diagnosis in Japan? - Silvia Croydon
250
Re lections on the Appropriate Epistemology for an Integrated
and Sustainable World including Reference to Ibn ʻArabī 253- Saeideh Sayari and Darryl R.J. Macer
The Roles of Bioethics in the Formation of Professional
Competence of Students of Medical Universities in
Uzbekistan- Umirzakova Nargiza Akmalovna
258
Ethical issues regarding full disclosure to women with primaryamenorrhea associated with disorders of sex development inJapan Kazuyo Iwam and Tomoko Sumiyoshi
260
Perspectives of students on teacher’s online instructional
competence during the COVID-19 pandemic
266- Morales, Deliva , Villasor,. Sayao, Pableo, Bayod, Cerbo,
Forosuelo, and Camañan
Learning by teaching during the COVID-19 pandemic: Improving
students’ social and technical Skills through peer editing
pedagogy- Rosela Antipuesto-Angelo
274
Bioethics education beyond the economics of biodiversity: The
Dasgupta Review – Time for ecoACE?- Alexander R. Waller 279
Water rights: Ethical issues and developmental impact
284- Christopher Ryan Maboloc
Dealing with the decline of tourism livelihood: The tales ofTricab (tourist cab) drivers amidst COVID-19 pandemic 288- Jamyca Y. Aballe, Randy A. Tudy, Raymond K. Hastings
Livelihood in jeopardy: Troubles experienced by sidewalk
vendors amidst COVID-19 pandemic294- Honeylet A. Via, Randy A. Tudy, Rex B. Buac
Unfolding the ethical perspectives of “SOLD” by Patricia
McCormick - Farah Wasaya, Sumera Zul iqar,- Anila Ra iq 298

Editorial: Japan and Reproductive Choices

f

f

f

f

f

f

f

This July 2021 issue of EJAIB includes a dozen papers
exploring the ethical issues that we face across different
cultures. It explores the concept of vulnerability that is
faced by people in many different circumstances withdifferent needs and desires for what is a good life. The
irst paper by Croydon explains how arbitrary rules of theJapan Society of Obstetrics and Gynecology continue torestrict the access of people living with disability toreproductive technologies that are main stream in many
countries for three decades. It is time for physicians andmedical providers to open up the restrictive markets ofreproductive care to be informed choices of persons whojust want to have a child. Many people living withdisability experience tremendous socio-economic
burdens and poor quality of life that they do not wish topass on to children. Although there are international ways
to overcome these arbitrary barriers to reproductive
choice, it would seem to be ethical that developed
countries respecting informed consent and informed
choice should provide these services to patients or clientsin the country. The fact that there is no law to restrict theservices, suggest that there has been no social and legal
consensus to restrict the rights of persons to selective
implantation of embryos that carry a serious disease.
Although some physicians offer such services in thepast ,they are often subject to quite severe negative
publicity that makes it dif icult for them to offer these
services to clients. The dif icultiies of determining
vulnerability are also explored in the case of sex
determination by Iwam and Sumiyoshi.
The paper by Saeideh and Macer explores how
historical texts can be applied for sustainable living,although it is dif icult to read exactly the meaning of texts
that are written 1000 years ago, it is not unreasonable tosee people were facing challenges of the environment inhistorical times. We can see a number of cities incivilizations which became extinct because of drought or
because of other environmental pressures, and it isreasonable to assume that the philosophers andpolicymakers at that time, which certainly did exist
because of the sophistication of some of the cities whichwere over one million in population around the world,
considered relationships between humans and theenvironment that would be pro itable for a long-term
future. Maboloc also explores the issues of water rights
later in the journal.
We also have papers from Uzbekistan, Japan, thePhilippines, Thailand, England, and Pakistan. There areseveral on education and the challenges of delivering agood education in the pandemic times with lessons that
may be applicable for further online education platforms.
It's often dif icult to ensure a good quality of education
when we don't have face-to-face contact with students, on
the other hand for some learners this is a good platformthat provides a very solid method for development of thelove of learning which is critical for taking on board
lessons that life gives to us.
- Darryl Macer (darryl@eubios.info)sContentsff

Eubios Journal of Asian andInternational Bioethic

250

Eubios Journal of Asian and International Bioethics 31(5) (July 2021)

Barking Up the Wrong Tree: Who
Really Limits Preimplantation
Genetic Diagnosis in Japan?
- Silvia Croydon, D.Phil. (Oxon)
Graduate School of Human Sciences, Osaka University. Suita,
Osaka, Japan
Email: croydon@hus.osaka-u.ac.jp

Abstract
Japan possesses a comparable prowess and know-how inmedical technology and clinical practice as developed
Western nations. Yet, in comparison to these nations, theimplementation of the procedure known commonly as
Pre-implantation Genetic Diagnosis (PGD) in Japan is
strikingly limited. This article considers what factors
account for this small scale of PGD application. It argues
that whilst the Japan Society of Obstetrics and Gynecology(JSOG) serves, as many point out, as the gatekeeper to
PGD domestically, their conservative stance on the matterof who can avail themselves of this procedure isdetermined by parts of the disability and feminist groups.
To illustrate this, the article draws attention to theinteractions of the JSOG with such groups over their
proposed expansion of PGD to couples with heritableconditions that have early life onset.
Keywords: PGD, Japan, life selection, eugenics, JSOG

f

f

f

f

f

f

f

f

f

f

Introduction
Japan was a late comer to the PGD implementation scene.
Indeed, it was precisely the absence of even a single caseof PGD application until as late as 2004 that prompted
geneticists Santiago Munné and Jacques Cohen, two of thescientists who were involved in the development of thisgenetic pro iling procedure for embryos and who
understandably were hoping that its application would
spread, to pick up on the Japanese case (Munné & Cohen
2004). Perceiving the lack of PGD cases in this country as
an imposition of a moratorium by the Japan Society of
Obstetrics and Gynecology (JSOG), these two scientists
argued for its lifting. “The Japanese Society of Obstetrics
and Gynecology”, they wrote, “disapproves of this practicebecause it discriminates against people with genetic
abnormalities [but] patients [have a right] to have ahealthy baby, if necessary by the use of PGD”. “[Thisprocedure] complements the current nature of prenatal
diagnosis and avoids the need for abortions in case ofaf licted embryos”, they argued.
More recently, despite implementation of PGD having
begun in Japan, the rate at which it is performed can befound to be conspicuously lower in comparison to that inmany other developed nations. To cite data released by
the body that Munné and Cohen see as controlling theJapanese PGD situation – the JSOG, by the end of March
2015, there had been 125 cases in which this procedure
had been performed for the purpose of avoiding thetransmission of a genetic disorder (JSOG 2015). Given thatin 2004 there had been zero cases of PGD in Japan, it
might be concluded that 125 cases for a period of justover a decade represents a substantial enough number.
However, on the background of the fact that the number ofcases of PGD in other developed countries often runs in
the thousands for a single year, this igure of 125 cases
overall historically in Japan appears rather meagre andtherefore remarkable. To provide speci ic context in which
this Japanese igure could be understood, a single facility
in the UK (Guy’s Hospital in London, to be more precise),
performs over three times as many cycles involving PGD
in a single year (namely, 370 PGD cases in 2014) as there
have historically been in Japan. Similarly, although it is
dif icult to obtain a comprehensive data about the scale of
PGD practice in Europe as a whole, from information
published by the European Society for Human
Reproduction and Embryology, which re lects thepractices between 2011-2013, it could be established thatthe latter is signi icantly bigger than in Japan – indeed
there were as many as 71 European PGD facilities and1,755 babies born there for this two-year period (DeRycke et al. 2017).
What is further important to notice with regards to theJapanese case is that, in contrast to other countries, here
PGD is far from recognized as a standard clinicalprocedure, with a clear indication as to the heritable
genetic conditions for which it could be applied. Instead, aseparate examination takes place of each individual
application made to the JSOG by the couple who want to
use it for reproduction and their doctor. As the JSOG
statistics cited above indicate, the possibility for patientsto become recipients of PGD treatment is entirely
dependent on that body’s Ethical Committee, withrejection being a real possibility. To specify again by citing
JSOG’s data until 2015, whilst 125 applications for PGD
had been granted approval, there had also been six that
met the fate of rejection (JSOG 2015). Although thisrejection rate might appear rather low and unremarkable,
it is not beyond the inconceivable that patients and theirdoctors might be discouraged by this process fromapplying for PGD in the irst place. Indeed, for couples
who are yearning for a baby and who ought to operate
whilst considering their biological clock, a process such asthat of JSOG might well appear rather time-consuming
and uncertain in terms of the outcome. This might well be
the reason why the very number of PGD applications inJapan stands so low, with only 138 having been iled with
the JSOG by 2015, as per the Society’s own report (JSOG2015).
This article considers the obstacles to implementing
PGD on a larger scale in Japan. With a view to establishingthat the voices that dominate the PGD debate in Japan in
public are those of the section within the disability andfeminist communities who see this procedure as a threat
to their own existence, the article looks through the prismof the most recent debate on the subject.
Looking beyond the JSOG
The aspect of the Japanese PGD regime highlighted above,of it hanging on the JSOG whether a patient obtains accessto this treatment or not, might appear to support thesuggestion made by Munné and Cohen that it is thereinthat the obstacle to PGD expansion lies. However, justbecause JSOG acts as the gatekeeper to PGD in Japan inpractice, it does not follow that they are necessarily
against expanding the application of this procedure. True,Eubios Journal of Asian and International Bioethics 31(5) (July 2021)
it might well be that the examination process that theSociety has put in place puts off many patients to startwith from applying, with the option always existing thatfor them to seek cross-border solution to theirpredicament. It is not negligible indeed that patientsmight worry about how soon they might hear the decisionof the JSOG Ethical Committee and whether the genetic
condition they have would be viewed as “severe” enoughby its members. The low number of applications iled with
the JSOG could be seen as a strong indication that perhaps
such misgivings on the part of patients are at play inJapan. Nonetheless, to automatically attribute the limited
implementation of PGD solely to JSOG, concluding that it istheir conservative attitude towards this procedure thathinders expansion in implementation, seems premature.
Since no organization makes its decisions in isolation ofbroader factors and trends in society, it seems important
to explore what other dynamics exist in Japan withregards to PGD more generally. Indeed, it would be
misguided to conclude that just because the JSOG has
adopted a conservative position with regards to PGD
implementation, they as a whole or the majority amongst
them, are necessarily against applying this procedure on abroader basis. The process of coming up with a decision
on a certain matter in any organization is but a messy
business, with many outside pressures impinging on thatruling. The consciousness of those in charge is often
affected by the existing social debates and interactions insociety. Beyond the JSOG’s involvement on this issue, what
are the interactions in the public surrounding thisprocedure? There certainly appears to be a need to pay
attention to the backdrop against which the Society’s
policy was formed.

f

f

f

f

f

f

The 1990s row over PGDWhen the history of interactions with regards to PGD in
Japanese society is examined, it becomes clear that there
was loud opposition from within the disability andfeminist communities to its implementation. In particular,
the irst Japanese PGD case, which was the culmination of
an initiative taken as early as 1992 by a group of doctors
at Kagoshima University’s Medical School to help a couple
with a child already af licted by Duchene Muscular
Dystrophy, was characterized by a wide-spread opposition
from these circles.
The principal agent behind the blocking of theimplementation of this case for nearly a decade was the
now defunct so-called Network Questioning Eugenic
Thought (Yūsei shisō wo tou nettowāku) – an Osaka-based
non-pro it organization representing various handicapped
and women’s liberation groups. Liaising with other older
organizations of this nature, such as the Zenkoku Aoi Shibano Kai (Green Grass Organization), Boshi Hoken-ho Kaiaku
ni Hantai Suru Josei-tachi: Osaka Renraku-kai (The Women
Objecting to the Changing for the Worse of the Maternaland Child Health Act: The Osaka Liaison Group), theNetwork was galvanized into action when it heard thenews that the Kagoshima team are preparing for the
implementation of this procedure (Shirai 2001;
Toshimitsu 2012 & 2014). Their view was that PGD is not
only putting undue pressure on women (as in toreproduce in a particular way), but that it is also

251

discriminatory towards disabled people, also threatening
the existing diversity in society and by extension thetolerance towards those handicapped.
Following in the media how the Kagoshima doctors’
application cleared various preliminary stages of theapproval process, members of the above-mentioned
Network broke without permission into the Headquartersof JSOG during the Ethical Committee’s deliberation of the
Kagoshima case, shouting in opposition of the procedure.
This action, and the petition they compiled listing 47
individuals and disability groups opposed to PGD(including the Japan Muscular Dystrophy Association),
eventually succeeded in persuading the Society to put thecase on hold until “a thorough debate is conducted,
incorporating all sections of society”.
The moratorium on PGD would continue into the 2000s
until a scandal occurred whereby a gynecologist from
Kobe, Dr. Tetsuo Otani, was revealed to have conducted asimilar procedure in multiple instances without
permission from the JSOG. The procedure which Dr. Otani
would offer is for checking the chromosomal make-up ofan embryo to determine, as the creators of this test claim,
the potential for live birth. Even though the Network andits allies would go on to issue statements of protest toboth Dr. Otani and the Society, as announcements
unfolded of babies being born following Dr. Otani’s
procedure, arguments would become more prominent
within the public that there is room for permitting thiskind of procedure. This is indeed what led to the Society’s
adoption of the strict guidelines for PGD application thatyielded the igures cited above.
The current state of interactions
Most recently, in 2021, the JSOG has been considering the
expansion of PGD application, facing yet again objections
from within the disability and women’ liberation
community. In particular, the Society proposed allowing
PGD to couples with heritable genetic conditions which
are not necessarily life-limiting or with an early-life onset,
which were the two yardsticks against which
permissibility was gauged (HNK 2021). Amongst theconditions for which the JSOG appears to be campaigning
to expand PGD application is Retinoblastoma, which ischaracterized with tumors in the eyes. The speci ic casehighlighted by the JSOG in the public in its bid to bringabout greater social consensus on the expansion of thisprocedure, is that of 37-year-old Maiko Noguchi from
Osaka, who suffers from Retinoblastoma.
Mrs. Noguchi had applied for PGD to the JSOG in thepast, with her application having been rejected by theSociety, since her condition could not be considered“serious” as per the Society’s published interpretation ofthis term from 2010. Mrs. Noguchi had been diagnosed
shortly after birth with eye cancer and had undergone
operation to remove her right eye (Sankei News 2019).
Later, tumor was found in her left eye too, but withtreatment she was able to preserve her vision. The second
time this genetic illness impacted greatly her life wasupon marriage. Her second son was diagnosed soon after
birth with Retinoblastoma in both his eyes, and eventhough he underwent treatment, his vision was so
reduced that he could only see, in a blurred way, closeEubios Journal of Asian and International Bioethics 31(5) (July 2021)

f

f

f

f

f

f

f

objects. Wishing for a third child, Mrs. Noguchi did not
resign herself after receiving the news of rejection from
JSOG, and in April 2019 she applied a second time througha clinic in Osaka, commenting that she wishes for her
affected son too to one day be able to avail himself of PGD.
With Mrs. Noguchi arguing that it is hard for her toaccept that her child would also suffer from the same
illness as her, the JSOG opened in 2020 public discussions
regarding cases such as this, where a danger of blindness
in the child exists but its longevity would not be impacted.
On 7th of February 2021 an online discussion was held,with this being the last of a series of three such gatherings
since January that year. The JSOG proposed a revision of
the 2010 interpretation of its 1997 Guidelines, withregards to the term “serious genetic diseases” so that
illnesses where there is currently no effective treatment
and which put a signi icant burden on a person’s daily life,
including with the symptoms beginning after reaching
adulthood, also become included in this category (Asahi
Shimbun 2021; Nikkei 2021).
In reaction to this JSOG proposal, objections soon
emerged from academics in the ield of bioethics,
members of disability and women liberation groups, andother professional medical societies, amongst which theJapanese Society of Neurology. One of their voicedarguments was that it would lead to application of PGD for
too many genetic diseases. For them, it was signi icant
that within the genetic illnesses there are those where thesymptoms do not become manifest until old age andwhere it is possible to lead a completely healthy life for
decades. It was within no one’s purview, it was implied, todeny the right to exist to such people. Furthermore, withregards to diseases for which there is no effective cure in
existence, there is the possibility, they argued, of aneffective treatment being discovered in the future. An
academic from Meiji Gakuin University, Azumi Tsuge, wasalso shown commenting that the question of PGDapplication cannot be left solely to patients and theirdoctors because society also has a stake in the outcome.
On a more fundamental level, however, it was clear that
the PGD opponents considered ethically questionable thefact that the procedure is currently permitted for any typeof illness at all. Where this is evident is in theirargumentation with regards to “life selection (senbetsu nosenbetsu)”. Speci ically, the opponents of the procedure
say that even though they understand and can sympathizewith the anxiety of passing on a disease, the concern
remains, and is equally valid, that the PGD procedure
represents “life selection” (Niigata Noppo 2021).
Information is gleaned from the PGD procedure, theyargued, with regards to the status of chromosomes suchas 21 and 23 in an embryo (ref., three copies ofchromosome 21 lead to Down’s Syndrome and a missing,or partially deleted, X chromosome manifests itself as
Turner Syndrome – two conditions that are often
compatible with life) (Niigata Nippo 2021). Insofar as thisis the case, in their view, couples might decide against thetransfer of an embryo of such characteristics, which iseffectively “eugenics”. According to the PGD opponents,
when considering whether to extend without inserting
any limits the application of this technology, the question
also needs to be appraised as to whether this would not

f

f

252

eventually lead to a situation where only a certain type ofchildren become born. Rather than going in that direction,
they contended, society should abandon the term
“abnormal (ijō)” and reaf irm the right of a variety ofpeople to exist.
Whilst the social debate about PGD was revolving
around this issue of the extent of its application, it isworthwhile noting that the issue was also raised as towhether the current procedure where everything is left to
the JSOG is appropriate. On the one hand, the Society wasof the view that it would be better for the examination of
applications to be entrusted to the Ethics Committee of
each medical facility where patients ask for it and that the
JSOG’s role is restricted to just providing an opinion to thetreating doctor. However, during the deliberations the twoconcerns were expressed that such a procedure would
lead to unjusti iable variation in PGD implementation andthat in some facilities might be impossible to appoint
experts on the Ethics Committee (Niigata Nippo 2021).
Ultimately, the discussion on this matter also did not
result in any concrete conclusion.
In the end of these interactions, there was no clarity on
would follow. As far as the initiator of the debate isconcerned – the JSOG, it left the public scene with thenoncommittal note that its plan is to ask patients’ groups
and other concerned medical societies for their opinion
and that it would not make a formal decision on how
cases should be dealt with without a consensus. The only
other indication as to how this stalemate might be
resolved was the comment that some members of theSociety made that the political world should not “leave thedecision-making to the JSOG (maru-nage wo suru)”, andthat by picking on the issue in parliament, legislators
could engage the public at large and help guide thepractice.
Conclusion
This article has examined the issue of restricted PGD
implementation in Japan. I have presented evidence tocorroborate my argument that, contrary to what has been
hitherto argued, the factor that accounts for the smallscale application of PGD in the Japanese context is theierce opposition by disability and feminist groups whode ine this procedure as a eugenics practice. Since it was
the JSOG that proposed in public the expansion of PGDapplication, there clearly is considerable support for thiswithin it. It is thus inappropriate to conceive of thedoctors’ community as the barrier to wider PGD
administration. Indeed, the foreign proponents of PGD arebarking up the wrong tree when they direct theircriticisms of the Japanese situation to the JSOG. As I havehighlighted, it is the members of the disability andfeminist groups who cannot see beyond PGD’s “lifeselection” aspect that are blocking a more widespread
application.
With regard to this anti-eugenics activists, even though
it might be surmised that they represent the voices andthe interest of the whole disability and feminist
communities, this is far from the case. Whilst they appear
to be ighting on behalf of anyone with disability or any
woman, and in the interest of protecting their rights, theirdemand to abolish PGD, or least keep it restricted, is inEubios Journal of Asian and International Bioethics 31(5) (July 2021)
effect hurting, and curtailing the rights and options of,those within these same groups who are of reproductive
age. When remembering the irst case of PGD application
made to the JSOG in Japan, for instance, it does not appear
at all to be an act of solidarity on the part of the membersof the disability and feminist groups who petitioned
against this case to deprive their fellow citizens with
Duchene Muscular Dystrophy of the option to use thistreatment. In this sense, it could be concluded that the
purpose of the anti-eugenics community is defeated bythem blocking the way to PGD.
Acknowledgements
This research was supported by a Japan Society for the
Promotion of Science Grant-in Aid for Scienti ic Research (C)(Grant number 20K01446).

References
Asahi Shimbun (2021). “’Jūtoku-na Byōki’ Doko made Taishō ni?
Chyakushō-zen Shindan, Nao Iron mo” (How Far Would‘Serious’ Be Applied”? Objections Also Exist to PGD). Availableath t t p s : / / w w w. a s a h i . c o m / a r t i c l e s /ASP2767D5P27ULBJ008.html (accessed 5 May 2021).
De Rycke, M, Goossens, V, Kokkali, G, Meijer-Hoogeveen, M,
Coonen, E, Moutou, C. (2017). “ESHRE PGD Consortium datacollection XIV–XV: cycles from January 2011 to December
2012 with pregnancy follow-up to October 2013”. Human
Reproduction 32(10): 1974–94.
Japan Society of Obstetrics and Gynecology (JSOG) (2015).
Chakushō-zen Shindan ni kan Suru Shinsa Shō-iinkai Hōkoku
(1999〜2015 Nendo-bun no Chakushō-zen Shindan no Ninka

f

f

f

Jōkyō oyobi Jisshi Seiseki) [Report by the Small Committee
Investigating PGD: The Number of Approvals and
Implementation Record for the period of 1999-2015]. Acta
Obstetrica Et Gyneacologica Japonica 69(9): 1916-20.
Munné, S. & Cohen, J. (2004). “The status of preimplantation
genetic diagnosis in Japan: a criticism”. Reproductive
BioMedicine Online 9(3): 258-259.
Nihon Hōsō Kyōkai (NHK) News. Chakushō-zen Shindan Taishō
Hirogeru Saishyū-an Shimesu: Nihon Sanfujinka Gakkai [JSOG:
Offering a Last Draft Proposal for Expansion of PGDApplication], 8 February 2021, https://www3.nhk.or.jp/
news/html/20210208/k10012854951000.html (lastaccessed 2 April 2021).
Nihon Keizan Shimbun (Nikkei) (2021). Chakushō-zen Shindan,
Taishō Shikkan Kakudai de Nihon Sanfujinka Gakkai ga Saishūan: Hantai mo [Toward Expansion of the Genetic Illnesses for
Which PGD Is Applicable: Objections Registered Too].
A v a i l a b l e a t h t t p s : / / w w w. n i k k e i . c o m / a r t i c l e /DGXZQODG072DP0X00C21A200000
0/ (accessed 2 May2021).
Niigata Nippo (2021). Chakushō-zen Shindan Kakudai: ‘Inochi no
Senbetsu’ no Kenen Hikaenu [The Expansion of PGD: Cannot
Wipe Out the Danger of ‘Life Selection’]. Available at https://w w w. n i i g a t a - n i p p o . c o . j p / o p i n i o n / e d i t o r i a l /20210309603029.html (accessed 4 May 2021).
Sankei News (2019). “’Chakushō-zen Shindan ni Mitchi wo: Me no
Gan Josei Kanja, Jinan ni Iden [A Path to PGD: A Patient with
Eye-cancer and Her Second Son]. Available at https://www.sankei.com/life/news/190831/lif1908310026-n1.html(accessed 4 May 2021).
Sato, K, Sueoka, K, Iino, K, Senba, H, Suzuki, M, Mizuguchi, Y, et al.
(2015). Current status of preimplantation genetic diagnosis
in Japan”. Bioinformation 11(5): 254-60.
Shirai, Y. (2001). “Ethical debate over Preimplantation Genetic
Diagnosis in Japan”. Eubios Journal of Asian and International

253

Bioethics 11: 132-136.
Toshimitsu, K. (2012). Juseiran to Shussei-zen Shindan: Sono
Dōnyū wo Meguru Arasoi no Gendai-shi [Preimplantation
Genetic Diagnosis and Prenatal Diagnosis: Modern History of
the Struggle over Its Introduction]. Tokyo: Seikatsu Shoin.
Toshimitsu, K. (2014). Shussei-zen Shindan wo Meguru Ronsō:Juseiran Shindan wo Chūshin ni [The Battle over Pre-natal
Diagnosis: Focusing on This Issue by Putting the Diagnosis of
Fertilized Eggs in the Center]. In Kokado, M., Yoshida, K. &Matsubara, Y. (eds.), Shussei wo Meguru Gijutsu to Ronri:
Nihon-Yōroppa no Shiza kara The Logic of Technology
Surrounding Birth: From the Perspective of Japan and Europe],
Seizon-gaku Kenkyū Sentā: Report No.22: 40-61. Available atwww.arsvi.com/2010/1403tk.htm (accessed 4 May 2021).

Reflections on the Appropriate
Epistemology for an Integrated
and Sustainable World including
Reference to Ibn ʻArabī- Saeideh Sayari, Ph.D., Ph.D.
Visiting Scholar, Institute of Iranian Studies, Faculty of
Humanities, Gottingen University, Germany
Email: saeideh.sayari@phil.uni-goettingen.de(Corresponding)- Darryl R.J. Macer, Ph.D., Hon.D.
President, American University of Sovereign Nations, USA
Abstract
Every civilization has its own worldview that determines
its approaches towards subjects such as human beings,
nature and God. Most modern humans have tried tocontrol all nature as property. Nature, therefore, wasconsidered as the booty, which should have been used
entirely. Now, the modern perspective has revealed
problems including emerging and dangerous diseases,
resistant bacteria, and extinction of many animals, global
warming, climate change; air, sound and light pollution,and so on. The problem is that human beings cannot
continue these attitudes as a viable survival strategy. In
this paper, using conceptual analysis, we try to explain the
epistemic gap regarding the positions of humankind andnature which happened after modernism and thenpresent the image which Ibn ‘Arabī, a traditional sage andphilosopher depicted for the integrated world. He
developed a comprehensive perspective of the world,
considering it as a manifestation of an Existence (God). He
considered humans as the God’s vice-regent who must
manage the earth and keep the creatures as God'srepresentative.
Key words: integration, sustainability, Ibn ‘Arabī, viceregent, environmental ethics, nature, philosophy.
1. Introduction
During the past two hundred years, a number of scholars
have been obsessed with many controversial discussions
about natural resources. The philosophy of science,philosophy of technology, and some other ields havewitnessed some debates about the way that human beings
follow for using natural resources and creating newtechnologies. After modernism, human beings have been

254

Eubios Journal of Asian and International Bioethics 31(5) (July 2021)

f

f

f

f

f

f

f

f

encountering lots of problems as a result of new crises,
including new diseases, new generations of bacteria andvirus infections, climate change and so on.
In this article, we presuppose two perspectives, premodern and modern perspectives, then show how themodern attitudes towards the position of the universe,
humankind, and God affected, and continue to affect how
we view nature.
Muḥyī l-Dīn Muḥammad b. ʻAlī b. Muḥammade al-ʻArabī
was born in Murcia in 1165 AD in Andalusia (Spain). He is
known as mystical philosopher. Over 800 books are
attributed to Ibn ‘Arabī and Osman Yahya, one of theeditors of his books, estimated that 700 are authentic. He
wrote some books in mathematics and astronomy (Sayari
and Marsuki, 2014). His ideas are very common inplurality and the unity of the religions. After examinationof some of these writings, we argue that Ibn ‘Arabī’s
perspective indicated a coherent, sustainable image of theuniverse in which God, humankind, and nature are notseparated from each other, but human beings as the divine
form include both the divine attributes and the attributesof the universe, and in such a way humans are the medium
between God and the universe. We note that there isongoing debate over whether all these writings attributed
to al-ʻArabī were actually authored by him.
Although the two great schools of thought in Greek
scholarship (Aristotle and Plato) had some different
motives, they did not have an aggressive attitude towards
nature. Plato was preoccupied with the corporeal world asa cave for human souls. The souls were said to be created
before bodies, and the natural world is a vast prison fromwhich these souls have to be relieved. In the world of
becoming, everything “comes to be and passes away, butnever really is” (Plato, 1925a, p. 28a). For Aristotle (2006,
p. 27), this world was representative of the majesty, theorder and the beauty, which makes humans bewildering,and motivates us to ask questions about the quality ofways in which the world acts.
Around the 15th century AD, a new movement,
humanism, appeared in the Western tradition. In their
theory, humanists focused on the human being, not as
metaphysical souls, but as the real rational adventures.
Although in philosophical and religious classical doctrines
humans were the center of the world based on the ideathat all the phenomenal world has been created for them,so the human position as a passive agent had been
reduced to being an obedient servant of God and the gods.
The new anthropocentrism met Cartesian's rationalism
and Locke's empiricism.
The three-dimensional
combination appeared in Newton as a scientist who
opened the horizons of science. He utilized Descartes’
mathematization as a language for discovering the naturallaws. Locke and Newton affected each other; Locke tried
to use the natural law in politics. Meanwhile, the mostimportant aspect in common was the nature of theirphilosophy which was empiricism (Rogers, 1978).
Newton's anthropocentrism manifested itself in his
attitude towards the power of human beings to discoverand explain all the natural laws in the world inmathematical language.
These philosophical bases paved the way for upcoming
scienti ic events in the eighteen and nineteen centuries

and after. During this period, science developed innumerous and various ields. What remains of the earlier
worldviews are fragments of the ethos in the hands ofexperts which were often reduced to interactions of partsor fundamental entities. New technologies arrived, andhuman beings have the most complex instruments
achieved by now. However, the opposite side of the coin
gradually appeared. For example, Carbon dioxide, agreenhouse gas, is one of the most important pollutants,
which is warming the Earth. The living things emit carbon
dioxide when they breathe, but it is widely considered apollutant when associated with cars, planes, and otherhuman activities that involve the burning of fossil fuelssuch as gasoline and other natural gases. In the past 150
years, such activities have pumped so much carbon
dioxide into the atmosphere raising its level. Anotherexample is the problem with some other greenhousegases such as methane and chloro luorocarbons (CFCs),
and CFCs are also problematic for the earth's ozone layer.
Climate change, biological weapons delivering toxins andmicroorganism for in licting disease among people,
animal and agriculture, genetically modi ied crops, andthe extinction of species are a few examples of the resultsof human activities.
On the other hand, in social sciences, new economic
policies, namely cost-bene it analyses as a central tool of
trade, have made challenges to the environment. This newpolicy de ined all society functions and goals througheconomic methods. These consider nature and all its
potential capacities as an instrumental force in developing
human life, the pioneers of new science strategy neglected
to appreciate the cohesive connections between humanbeings and nature, and the cultures and values.
The philosophers of science and other philosophersbegan to revise the principles and theories in science andthe philosophical basis on which the palace of science wasbuilt. Philosophers ask "are we happier than humanbeings living in the past before the modern age?" What
was wrong with the new perspectives towards the nature?
Now, what are the options, at least, for reducing theconcomitants of these activities?
2. The Philosophical perspective
Traditional thought considered knowledge as a collectionof all kinds of consciousness, including natural science,philosophy, and other ields. So-called “modern” thinkers
separated the natural part as a science, reducing it into
empirical knowledge. Claiming to be value-free became
the most important feature of science. The scientists claim
to seek a value-free rational truth. The scientists
encouraged the use natural resources for a more
comfortable life continually. The other feature of theworldview of the science is that in the past people thoughtthat the universe is a creature of God and looking at
natural processes and nature means looking at God'ssigns, but the new worldview of science states that toknow the nature means to make nature meaningful in its
own without a need for the concept of a God of the Gaps in
our knowledge (Macer, 1990). Therefore, the universe
became empty because God was removed. In the past theuniverse was symbolic and mysterious to us, but now it issimple, and mechanical without any spiritual entity.

Eubios Journal of Asian and International Bioethics 31(5) (July 2021)
Hence, scientists considered the universe by putting in big
theories.
Another thing is that the question of "why" shifted into
"how". In the past, scientists asked why the phenomenon
works in such a manner, in fact; they searched for theultimate goal of the universe. In the new age, what is
important for scientists is the quality of its function. In
this way, one of the most important concepts that lost its
meaning is humanity and human self because asking forthe meaning is meaningless. The reductionism(Polkinghorne, 2002) and the specialism changed theintegrated image of the universe into some divided
fragments that should be investigated one by one. The
other feature of the new science was that everything that
we cannot explain in the way of quantity, would not be
considered as a scienti ic event. Therefore, sociology,
psychology, metaphysics, and so on may not be consideredby natural scientists as scienti ic and it means that they
are not valid to research as empirical subjects. That fallacy
is that since the scienti ic method is materialistic and it
just seeks the material causes, non-material cases cannot
be investigated by scienti ic methods and scientists
should put them aside. The image which gave us the newscienti ic worldview was mechanical, material, andreductionist. The dominance of this image isolated otherparts of human life, such as values, ethics, and existential
realms and it has led to crises and unsustainablesituations in the global level of human beings as a result of
the lacking of transcendental support.
3. What is Sustainability?
Key concepts of sustainability include the need for thesustenance, survival and lourishing of a process, anorganism or a resource. The entity to be sustained often
consists of a large variety of interacting factors in acomplicated position (Polkinghorne, 2002). Now the
problem is how the necessary and suf icient situation forsustainability can be de ined. It seems it depends on thenature of the object in question like the natural entity,
physical phenomena and human actions and life. A
description of sustainability identi ies, classi ies andexplains crucial factor for the sustainability of aphenomenon or entity (Polkinghorne, 2002). In fact, there
are three fundamental questions along which thephilosophies of sustainability are categorized: What are
we to sustain? Why should it be sustained? How do wesustain it?
Three following concepts can provide various answers
to these questions:
1-Natural sources should be sustained only because they
have an instrumental role for human well-being.
2- To sustain the irreversible natural sources, whether or
not they are regarded as critical to human well-being
because of their intrinsic value.
3- The nature has an intrinsic value generally. Holland(1994) argues "the recognition that nature, and its various
component events and processes, is a particular historicalphenomenon should be valued as such."

f

f

f

f

f

f

f

f

f

f

f

f

f

f

f

f

f

f

f

f

f

f

4. Interdisciplinary approach
The new challenges in science agitate new approaches.
After restructuring of knowledge in the late twentieth

255

century, new calci ications in the de initions, research
priorities and ields of studies increased the need forborrowing from other disciplines to unify theperspectives, and created the tendency and capacity to goover traditional ields of knowledge. The permeability ofthe boundaries of knowledge, and blurring and mixing
genres promoting in the postmodern developed some
activities labeled "interdisciplinary." (Klein, 1990).
Turning to an interdisciplinary approach, researchers andscholars work in team groups in order to ind a range ofobjectives such as solving the complicated problems,
addressing broad issues, introducing some ields between
traditional disciplines and going over disciplines fortaking integrated knowledge. The ield of bioethics is oneof emergent interdisciplinary and multidisciplinary
approaches to knowledge production (Macer, 1994).
Although the term interdisciplinary has beendeveloped in the modern era, it is not a completely new
term. Philosophers and sages have used it without
mentioning. In philosophical and mystical schools whichappeared after the advent of Islamic thought, someschools of thought considered the features of uni ied
knowledge. One of them is transcendent theosophy which
originated from the ideas of mystical philosophers such as
Ibn ʻArabī. The features of mystical philosophy include
blurring and mixing themes such as the realities andsymbols, and accepting the variety in the existents andphenomena as a necessary rule for the manifestation of
the divine attributes. In Ibn ʻArabī's worldview, rational
existence is one of the God's attributes.
5. Human beings and development
One of the most important distinctions between themodern and the pre-modern tradition is the position of
the human reason or rationality. Considering the reason
as an absolute value, the modern age validated
individualism and even gave an absolute value for theindividual. Hence, one of the main cornerstones of themodern development is the highest position of humanreason which is the heritage of the Cartesian, Newtonian,and their followers. As Kevin Kelly (2002, p. 46) explains
after the Western scienti ic revolution, a paradigm shift
occured so that humans were displaced from the center ofthe universe, and there came a shift in our ability to give a
uni ied explanation of the world.
To survey the effects of this shift, we can consider two
realms. One that is related to the human life in physicalparts such as the advances in medicine to control diseases
and to rescue many people, inding easier and faster
instruments for communications, development ineducation and information technology, accessible facilities
for increasing the creativity and so on. Here, the questionis that if the mentioned development is a sustainable one.
In other words, does it include all physical aspects ofhuman life? Have the developments guaranteed the new
medicine to be safe and ef icient? Have the newtechnologies, for example, communications technologies,
been safe and harmless for the human body?
Unfortunately, in most cases, we are not sure, and in somecases now, we think that they may be harmful. We knowthat some medications have dangerous side effects for the(human) users and even for other species exposed to256

Eubios Journal of Asian and International Bioethics 31(5) (July 2021)

f

f

f

f

f

f

f

f

them through the environment. One case was mentioned
in Nature. The story is about a kind of antidepressantnamed Fluoxitine. The article reported that this medicine
is excreted in the urine of people taking it and reaches
lacks and waterways and affects ish reproductive
behavior seriously (Lovett , 2012). We know that
insecticides, fossil fuel, nuclear waste, and many
developments, in fact are detrimental to the environment
and nature. It seems our knowledge to understand acomprehensive development has been inef icient.
Another realm is related to the non-physical part of ourlife, such as our feelings, faith, hope, rights, happiness,love, freedom, and so on. There is no doubt thatrationality has yielded the valuable achievements ofhuman beings such as human rights, women's
emancipation (although not complete), social institutes,
children's rights, and so many other rights. Now, are wehappy with all achievements? Are we hopeful about our
future? Bertrand Russell (1917) wrote:“That man is the product of causes which had no
prevision of the end they were achieving; that his origin, his
growth, his hopes and fears, his loves and beliefs, are but theoutcome of accidental collocations of atoms; that no ire, noheroism, no intensity of thought and feelings, can preserve
an individual life beyond the grave; that all the labours of
the ages, all the devotion, the inspiration, all the noonday
brightness if human genius, are destined to extinction in thevast death of the solar system, and that the whole temple ofman's achievements must inevitably be buried beneath thedebris of a universe in ruins – all these things, if not quite
beyond dispute, are yet so nearly certain, that no philosophy
which rejects them can hope to stand. Only within thescaffolding of these truths, only on the irm foundation ofunyielding despair, can the soul's habitation henceforth besafely built (47f)”
Hossein Nasr believes that modern man, who feels athome on earth, tries to conquer earth and becomes morenatural while he losses his own existence within it. Nasr
(1968) explains that “modern man learned the laws of thephysics of the earth” and also other laws of science, then allof his knowledge became terrestrial. Hence, when man nolonger makes spiritual lights try to ly with a capsulate tothe other planets.”
To consider human beings as a machine or a mere
combination of atoms or rational animal cannot provide
us with a comprehensive perspective of human beings
because human being is something more than these
reductionist aspect. An extension of love to other species
could be considered under the concept of stewardship(Macer, 1990). Stewardship can apply to both the way
people use other humans and the rest of nature (Macer,1998). It has often been neglected, but has a long history
in many religions, being central to a Judeo-Christian
doctrine of creation. Usually people prefer to ignore it andto think of dominion of humans over the earth, treating
the earth with little value in the mechanistic manner ofwhat we have called “rational” science, however we see
what problems this has caused. There are numerous
pollution problems that we can readily see, which affecthumans and other species. Throughout time many haveconsidered nature has intrinsic value, but usually thesecalls have been neglected. Alfred North Whitehead (1925)

in Science and the Modern World said “The western worldis now suffering from the limited moral outlook of thethree previous generations ... The two evils are: one, theignoration of the true relation of each organism to its
environment; and the other, the habit of ignoring the
intrinsic worth of the environment which must be allowed
its weight in any consideration of inal ends”. The intrinsic
value of nature can be argued by Christian and Buddhist
values, as shown by Schumacher (1968, 1974).
6. Wisdom of the traditional sages: Ibn ‘Arabī’s
perspective
There are many theories about human beings and theirnature and the aspects of their life. There are also avariety of world-views of nature (Rai et al., 2010). The
sages from all traditions have accepted that humans are
not a mere material object or rational animal. For somesages such as Ibn ʻArabī, human reason is one of Godgiven gifts to manage the material life. Depicting acomplete portrayal nature of humankind, the universe andGod, Ibn ʻArabī indicates the inseparable relationshipbetween humans, the universe and God. The names of God
are a Qurāʼnic theme which he used in his texts. Regarding
the theory of the divine Names and the theory ofsyntheses of divine Names in the human being (Adam as asymbol of man), he explained the position of the humanbeing and the universe.
All the creatures are the Names of God. They are
manifestations of God. The nature and the entire of thecreatures are the relationships and modes that God
manifests himself in the universe (Ibn ʻArabī, 1946, p. 52).
Adam as a symbol of human being is syntheses of all
divine Names, on the other hand, he includes the entire
universe. It means man has all the aspects and attributes
that all creatures have. Humankind is not limited just to
one or two features of being, and because of his speci ic
trait (synthesis of all features of the creatures), God put
him as His vice-regent on earth (Qurāʼn, 2:30), and God
puts Adam as a governor of God on earth.
Here for our aim, and as a result of the discussion, what
are important in this system of thought are two points;
the responsibility of human beings as a vice-regent of God
and the attitude of human beings towards the universe, atleast, as believers in God. Someone who believes in God
cannot behave towards nature in a careless way, because
nature and all its sources are sacred in the meaning of avaluable gift. Humans have many capacities and talents
such as rationality, consciousness, spirituality, mercy, andother attributes that God endowed us as His vice-regent.
Therefore, humans has to use our appropriate talents inthe appropriate position. Our rationality helps us tocontrol and manage the natural sources in the way that itprovides us with the possibility of sustainable life.
Looking at the world through consciousness andspirituality gives the insight to the human being formaking the world meaningful as a manifestation of God.
Then, can humans ethically destroy the natural resources?
Can he just think of his capricious desire to intervene innature irresponsibly?
God created human beings in his form based on the Ibn‘Arabī’s idea. Ibn ‘Arabī, in Futūḥāt, explained three levelsof the manifestation: outer (ẓāhir), inner (bāṭīn) and theEubios Journal of Asian and International Bioethics 31(5) (July 2021)

f

f

f

f

f

f

f

f

f

intermediate that is the human being who possesses two
aspects: the inner and the outer form (Ibn ʻArabī, 1911,
Vol. 4, p. 2). In another book, he mentioned that becauseof these two forms, the human being has the real form ofGod (Ibn ʻArabī, 1946). Then, Ibn ‘Arabī interpreted themeaning of the form of God. He stated that God createdthe human being in His form by transferring all of His
attributes to him. Also the human being includes all formsof the universe which exist in God. He argued that if
human beings did not have all the names of God, we could
not be His vice-regents on earth. Ibn ‘Arabī emphasizedthat God refers to the dignity of the human being who has
been created with His two hands (Qurʾān, 38: 75) or the
divine form and the form of the universe (Ibid). The viceregent must be capable to bring all the requirements of
his servants since God protect his creatures through man(Ibn ʻArabī, 1946).
God said “I will create a vice-regent on earth.” (Qur᾿ān,
2: 30). In addition to this command, God put all of His
names and the attributes in the human being to manage
the nature and keep the creatures. Humans cannot
exercise their power and authority over the othercreatures without the divine form, and they cannot know
how should use their power and authority without
knowing the realities of the things in the universe.
Therefore, humans need to have a comprehensive imageof themselves, the universe and God. This image lets us, as
the vice-regent of God, exercise our power to protect thenature.
For Ibn ‘Arabī, the perfect man is someone who cancompletely be God’s representative on earth. William
Chittick (1989) explains that the most perfect man issomeone who actualizes the divine names in the complete
equilibrium in accord with his divine form. Nevertheless,there are variations of the perfect men who manifest one
or more divine names in the complete form. The mostimportant feature of the perfect man is his knowledge,
according to Ibn ‘Arabī (1911, p. 2). This knowledge
originates from the divine names which God put in thehuman being and based on that, humans have the divineform. The divine form includes the features of theuniverse and God’s attributes. Therefore, a human being
who has knowledge of things is God’s representative onearth to manage it. Ibn ‘Arabī (1957) connected theservitude (ubūdīyyah) to the vice-regency. They areintertwined. It will be dangerous to be the vice-regent
without being a servant of God because the integrated
image which originated from the intertwined connectionof servitude and vice-regency will be lost. Claude Addas(1994) explains that vice-regency is a hazard for thehuman being since we may even proclaim to be God or aperson can deems that they are completely autonomous.
Then, people forget that vice-regency really does notbelong to them, but God bestowed them to be His
representative. In fact, vice-regency gives people thepower and authority over other creatures while theservitude indicates that each one of us is responsible forour deeds. The power and responsibility before God are
two important features of the vice-regent. If people takethe power and authority and leave their responsibility,
they will lose their reality as the manager of othercreatures in a comprehensive sustainable universe. This

257

situation causes people to descend from their dignity toan alien being to other parts of the creation.
7. Conclusions
The epistemic gap in our modern age is that we forgot therelationship of humankind, God and the universe. We
forgot our responsibility as a vice-regent of Him, and in
the other words, we reduced the comprehensive,
integrated image of the existence into the separated
fragments while we overemphasize one of our capacities,
namely rationality, but forgot the others. Ironically by
doing that we are not even that rational! Without that
integrated map of the existence, and without revising all
his aspects as a human being, people cannot reach to theintegrated and sustainable life. Humans as vice-regents of
God have power through which they can govern overother creatures and nature. Meanwhile, humans are also
responsible before God and His creation. Unfortunately,
after modernism, humankind took their power and left
their responsibility, and in such a way we destroyed thecomprehensive and integrated image of existence onearth. Now, we need to examine the epistemology of
reductionism and rationality.
Further research andexploration of our foundations will be timely as we
grapple with approaches to deal with the environmental
challenges and opportunities that we face. The wisdom ofsome of our historical scholars, such as Ibn ‘Arabī can be
useful reminders that there is more to life than Cartesianscience and epistemology.
8. References
Addas, C. (1994) The Paradox of the Duty of Perfection in the
Doctrine of Ibn ‘Arabī, Journal of the Muḥyiddin Ibn ʻArabī
Society 15.
Aristotle (2006) Metaphysics, M. lati i (Trans) Tarhe nov, Tehran.
Holland, A. (1994) Natural Capital, in R. Att ield & A. Belsery,(ed.) Philosophy and the Natural Environment, University
Press, Cambridge.
Chittick, W. C. (1989) The Su i Path of Knowledge:Ibn Al-ʻArabī’s
Metaphysics of Imagination, State University of New York
Press, Albany.
Ibn ʻArabī (1911) Al-Futūḥāt Al-Makkīya. A. ʻAlā ʻA ī ī (ed.) 4
Vols. Dār Al-kutub Al-ʻArabīya Al-kubrā, Cairo.
Ibn ʻArabī (1946) Fuṣūṣ Al-Ḥikam. A.ʻAlā ʻA ī ī (end.) Beirut: Dār
Al-Kitāb Al-‘Arabī, Beirut.
Ibn ʻArabī (1957) Inshā Al-dawā᾿ir (The Description of theEncompassing Circles) M. M. Nāṣīr al-Dīn (ed.) Brill, Leiden.
Kelly, K. (2002) theology for nerds, in Science and the Spiritual
Quest. W. Mark Richardson & R. J. Russell & P. Clayton & K. W.
Manelly (eds.) Routledge, London and New York.
Klein, T. J. (1990) Interdiciplinarity: history, theory, and practice,
Wayne State University Press, Detroit.
Lovett. A. R. (2012) Human drugs makes ish lounder, Nature,
16th Novmber.
Macer, D.R.J. (1990) Shaping Genes. Ethics, Law and Science ofUsing Genetic Technology in medicine and Agriculture (Eubios
Ethics Institute).
Macer, D.R.J. (1994) Bioethics for the People by the People (Eubios
Ethics Institute).
Macer, D.R.J. (1998) Bioethics is the Love of Life (Eubios Ethics
Institute).
Nasr, S. H. (1968). Who is man? the perennial answer of Islam,Studies in comparative religion 2 (1).
Plato (1925) Plato in Twelve. W.R. M. Lamb (Trans.) MA Harvard
University Press, Cambridge.

258

Eubios Journal of Asian and International Bioethics 31(5) (July 2021)

Polkinghorne, J, C. (2002) Reductionism, Interdisciplinary
Encyclopedia of Religion and Science.
Rogers, G. A. (1978) The empiricism of Locke and Newton, Royal
institute of philosophy lectures 12 : pp. 1-30.
Rai, Jasdev Singh, Celia Thorheim, Amarbayasgalan Dorjderem,
Darryl R.J. Macer. (2010) Universalism and Ethical Values for
the Environment. Bangkok, Regional Unit for Social and
Human Sciences in Asia and the Paci ic (RUSHSAP), UNESCO
Bangkok. v + 55 p. 31.
Russell, B. (1929) Mysticism and Logic ( irst published 19) Allenand Unwin, London.
Sayari, S. & Marsuki, M. Z. (2014) The integration andsustainability: the forgotten image of the universe, WCIT: 2ndWorld Conference on Islamic Thought & Civilization, Vols. I &II: Rise & Fall of Civilization Contemporary States of Muslim
Affairs, 414-419, Ipoh, Malaysia, Aug, 18-19.
Schumacher, E.F. (1996) “The age of plenty: A Christian view”,
pp. 159-172 in H.E. Daly & K.N. Townsend, eds., Valuing the
Earth. Economics, Ecology, Ethics, MIT Press. Cambridge.
Schumacher, E.F.(1996) “Buddhist economics”, pp. 173-181 in
H.E. Daly & K.N. Townsend (eds.) Valuing the Earth.
Economics, Ecology, Ethics (Cambridge, Ma: MIT Press.
Whitehead, A. N. (1925) Science and the Modern World. Simonand Schuster.

The Roles of Bioethics in theFormation of Professional
Competence of Students of Medical
Universities in Uzbekistan- Umirzakova Nargiza Akmalovna
Senior Lecturer at the Department of Social and
Humanitarian Sciences, Tashkent State Dental Institute,Tashkent, Uzbekistan
Email: n.a.umirzakova@mail.ru
Abstract
The knowledge of future doctors about a person is not
limited to biomedical natural science, it also presupposesa humanitarian dimension and spiritual ful illment,
therefore ethical issues are inseparable from any type of
medical activity. This article points to the relevance of thestudy of bioethics, which appears as a practicalphilosophy of life and as a value orientation of future
doctors.
Key words: bioethics, humanization, humanistic paradigmof education, value imperatives, humanism, bioethicalworldview, human dignity.

f

f

f

f

f

 ​​

f

f

f

f

f

f

Global trends in the development of higher education
include the constant adaptation of educational programs
to current and future needs; increasing the adequacy ofhigher education with a long-term focus on achievingsocial goals and quality improvement. In the twenty- irst
century, these and other qualities of higher educationmust become an integral part of the global project ofcontinuing education for all. Thus, global trends in thedevelopment of higher education re lect in theirstrategies, the transition from a technocratic paradigm toa humanistic orientation. Today we are in the space of astill functioning technocratic and emerging new

humanistic paradigm of education. The present and future
well-being of civilization largely depends on how soon thehumanization of education will become an effective
practice of the social institution of education [1].
The globalization of health problems in thedevelopment of mankind, on the one hand, and thesuccess of biomedical research, on the other, haveradically changed the face of medicine as a form ofknowledge and activity, de ining the actualization of its
value component in a new way. Today, the development
and implementation of the value imperatives of bioethics
in medical education, in the activities of medical
personnel, necessary for the formation and developmentof their professionalism, is of great importance.
The concept of "professionalism", in contrast to"profession", implies not only the form and type of humanactivity, but also the degree of mastery of special
knowledge, skills and practical skills acquired as a resultof special training or work experience, as well as thequality and originality of knowledge related to to thisprofession, related to it and inherent in it.
Do physician morality and ethical imperatives relate to
the professional competence of medical personnel? Whatmoral qualities are important and are the main ones in theprofessionalism of a doctor? To try to answer thesequestions, it is necessary irst of all to answer thequestion about the peculiarities of the moral and ethicalfoundations of medical practice.
Modern concepts of humanism and humanization of
education are undergoing changes. As you know,humanism is one of the fundamental foundations of social
consciousness, the essence of which is the attitude of aperson to other people as to the highest value. It manifests
itself in altruism, the desire to sow good, in mercy,
compassion and the desire to help others. The de initionof humanism as a "set" of views expressing the dignity
and value of a person, his right to free development, andaf irming humanity in relations between people, re lects
only one - the subjective side. The essence of humanism
can be de ined as a set of objective and subjective
attitudes towards each person as the highest independent
value. The essence of humanism lies in any manifestationof one person's concern for the well-being of another. But
today this provision sounds problematic. Can it be called
humane, despite the obvious manifestation of concern forhuman well-being, for example, euthanasia, the use of
fetal tissues of the human embryo in vivo and posthumous
donation of human organs and tissues? Human values
should be pluralistic, eternal, democratic, global,
supporting the universal provisions of the declaration ofhuman rights, based on family values and ethics. This ispossible through education. Then, not theoretical, but
practical questions arise about the organization ofbioethical education: which course to teach, whom toteach? At the Tashkent State Dental Institute, theDepartment of Social and Humanitarian Sciences with acourse of bioethics (UNESCO Department) prepared
textbooks and teaching aids, monographs, the teachers ofthe department actively participated in the creation of astandard program for medical universities of the Republic,
which ensures that the theoretical part of bioethics will be
conducted in coordination with the humanities :

f

f

f

f

f

f

f

f

f

 ​​

 ​​

f

f

f

philosophy, law, religion and other subjects. Answering
the question - who needs bioethical education at themodern level, the following groups of people should be
noted:- irst of all, the medical workers themselves: doctors andresearchers (doctors, pharmacists, geneticists, biologists);- students of medical colleges and universities;- representatives of authorities and legal institutions thatmake laws and decisions in the ield of biomedicine andhealth care;- members of bioethics committees with medical, but not
special ethical education;- subjects, information about which presupposes thepresence of at least some "preliminary knowledge" in theield of modern bioethics;- the population from which the subjects are "recruited"
and whose public opinion has a certain in luence on the
direction of biomedical and genetic research in society[2].
Insuf icient ethical and educational level of the above
categories is a problem not only of modern Uzbekistan
and the regions of the post-Soviet space, but also of manyother countries. This puts us before the need to form a
new ethical and humanistic attitude of doctors, biologists,
geneticists, politicians and ordinary citizens, which isachieved through bioethical education.
In modern philosophy, it is recognized that the "basis"of any action is its goal. The goal of medical knowledge
and medical practice is to save a person's life and help him
maintain health. Among the reasons for the formation of
the profession of a doctor, and this is one of its features,the determining factor is not only economic, not only
cognitive, but also moral - "decisive action for the bene itof a suffering person." Therefore, throughout the historyof its existence, both at the level of theory and at the levelof practice, medicine has thousands of threads associatedwith the values and worldview of people. The
professionalism of a doctor is determined not only by how
well he knows the etiology and pathogenesis of diseases,
methods of their diagnosis and treatment, but also theability to recommend, teach, ind contact with the patientand instill in him con idence in the success of treatment.
Knowledge about a person is not limited to naturalscience - medical and biological, but also includes a socialand humanitarian dimension, spiritual content, therefore
ethical issues are inseparable from any type of medical
activity.
Since the time of Hippocrates, it has been generally
accepted and indisputable that the moral culture of a
doctor is not only the characteristics of his personalitythat deserve respect, but also the qualities that determine
his professionalism. In fact, the high cultural level of a
doctor is inextricably linked with the purity of his moral
image. This truth is perfectly expressed in the well-known
aphorism: “There will not be a good doctor if he is not agood person ...” [4]. The progress of biomedical scienceand practice in the late XX - early XXI centuries led to thestrengthening of social and value aspects in the activitiesof the modern medical worker.
The globalization of health problems in thedevelopment of mankind, on the one hand, and thesuccess of biomedical research, on the other, haveff

Eubios Journal of Asian and International Bioethics 31(5) (July 2021)

259

radically changed the face of medicine as a form ofknowledge and activity, determining the actualization ofits value component.
Modern medicine addresses a wide range of new
problems using the achievements of genetic engineering,biotechnology, organ transplantation, which have apronounced moral, philosophical, religious, socio-culturalcharacter. In de ining the psychosomatic and sociocultural
nature of health and disease, medicine has to turn to thepsychological, economic, political and legal components.
The modern physician has the means to signi icantly
control fertility, life and death, and human behavior. The
doctor's actions can affect demographics and economics,
law and morality. The value imperatives of modern
medicine are becoming deeper and more in demand.
In these conditions, philosophical knowledge andeducation play a special role in the formation of theprofessional qualities of a doctor. Philosophy as the selfawareness of society and the quintessence of the spiritualand moral values of culture is an indicator of a person's
education and general culture. It is aimed at the formationof theoretical thinking, a systemic vision of the world andself-re lection. Therefore, a philosophical education helps
not only to develop the mind, but also helps understandthe value foundations of culture, to develop life attitudes,
to form the spiritual and moral orientation of theindividual. Philosophy as a re lection on culture is a
purposeful activity aimed at realizing value-signi icant
orientations of human life in the world, among which thelife and health of a person are becoming more and more
relevant[4].
Today, biomedical research on animals and humans
continues to be a necessary form of existence for
medicine, biology and clinical disciplines.
But conducting research on a person can pose a threat
not only to his health and life, but also leads to a violationof his rights and dignity. And in these conditions, the task
is protection of the object from the risk that experimental
science inevitably exposes. Society begins to look forforms of this protection. One of the forms of suchprotection is bioethics, its theoretical and practical
approaches and imperatives.
New opportunities in biology and medicine, associatednot so much with treatment as with the management of
human life (for example, genetic correction of humancharacteristics, permission of donation without consent,
destruction of life at embryonic stages, organ and tissuetransplantation from a living and dead donor,
resuscitation or refusal and the termination of medicalcare for a hopeless patient) con lict with establishedmoral principles and values. Because of thesecontradictions, bioethics emerged as a system ofknowledge about the limits of permissible interference
and manipulation of human life and death, as "asystematic study of human behavior within the life andhealth sciences, conducted in the light of moral values."
and principles ”[3].
The subject of bioethics is the moral attitude of society
and a person to the other person, to his life and health,and to all living things. Bioethics seeks to understand themoral issues of biomedicine and society by rethinking the

260

Eubios Journal of Asian and International Bioethics 31(5) (July 2021)

f

f

f

f

 ​​

 ​​

approaches and values of modern life. In these conditions,bioethics acts as a practical philosophy of human life andas a value direction for future medical personnel.
The practical form of bioethics itself is the existence
and activities of ethics committees. This practical form ofbioethics was discovered by members of the World
Medical Association in 1964 in the Helsinki Declaration.
Its "Basic Principles" section, paragraph 2, reads: "Theoverall design and plan for each type of research should
be clearly described in the Protocol, which is submitted
for review and approval of the special Commission. The
members of the Commission must be independent on
the people conducting the research and the sponsor of
the research. The composition of the commission isformed in accordance with the legislation of the country
in which research is being carried out ”[2]. The irst
bioethics committee was organized under the Ministry of
Health of the Republic of Uzbekistan in 2000, it washeaded by academician M.S. Abdullakhodzhaeva. With her
active participation, the irst congress of bioethics withinternational participation was held in Uzbekistan in
2005. In 2013, the Bioethics Committee of the Associationof Doctors of Uzbekistan appeared. [5]. The main
provisions of the Helsinki Declaration become legal norms
in many national legislation, including the legislation of
the Republic of Uzbekistan. In recent years, Uzbekistan
has adopted a number of laws regulating the reproductive
rights of citizens (2019), the law on organ and tissuetransplantation (2018), on palliative care for seriously illpatients (2013), etc., which contribute to the regulation of
biomedical problems in modern society.
Biomedical ethics is a modern stage in the developmentof medical ethics and medical deontology, where theproblems of duty, honor, dignity of a doctor, moral andethical regulation of relations in the ield of medical
activity are raised to the level of respect and protection of
the rights and freedoms of the patient, his life and health.
Biomedical ethics is a practical philosophy of the medical
profession of a physician-scientist, as it protects basic
human values - the human right to life and health,autonomy and freedom of choice, developing modern
ethical positions of medical science and practice, helps torecognize moral principles. dilemmas and con licts thatare characteristic of medical practice and are equallyimportant for both the doctor and the patient.
Thus, the formation and improvement of theprofessional competence of medical students includes
both a constant striving to deepen medical knowledge andmastering special skills, and a purposeful, conscious
determination of medical activity by the highest ethicalapproaches and moral values.
Education and training of medical personnel is basedon the cognitive achievements of modern science and theaxiological imperatives of bioethics. Knowledge of
biomedical ethics and the conscious acceptance by
students of moral and ethical norms and rules will allow
them to purposefully study basic subjects and maintainthe dignity of a medical professional, knowledge and skills
that should ensure that the achievements of modern
science, medicine, and biology are only for the good bothin the interests of society and the individual, based on theprinciple of respect for life [6].

References
1. Mukhamedova Z.M. The paradigm of improving the liberal arts
education in medical universities. Ўzbekiston tibbiet
journals ”, No. 5-6 2002 TS-117-118; Mukhamedova Z.M.
Paradigm of humanization of education. 1TashGosMI.T
2004.148s. ; Mukhamedova Z.M. Problems of ecoethics andbioethics in the context of the paradigm of humanization of
education in the Republic of Uzbekistan. Social ecology in the
Republic of Uzbekistan and sustainable development: searchfor solutions to problems and forecasts. Tashkent 2008, 104
pp. (Part 2) S26-54
2. WMA Declaration of Helsinki
http://rostgmu.ru/wp-content/uploads/2014/12/
WMA_Helsinki.pd;
3. Kulik, S.P. "Medicine is the sister of philosophy" // Kulik, S.P.
History of Philosophy: Textbook. allowance S.P. Kulik, N.U.
Tikhanovich. - Vitebsk: VSMU, 2009 .-- 328 p.
4. Mukhamedova Z.M. Integration of spirituality and science inthe context of a new educational policy. Talim tizimida
iztimoy-humanitarian fanlar. No. 1, T. 2004. C.-26-34;
Mukhamedova Z.M. Philosophy and technology of modern
medicine in the context of the spiritual culture of a doctor.
Falsafa wa ҳuқuk. No. 1, T. 2004 P.54-60; Mukhamedova Z.M.
The moral component of the medical knowledge of the future
doctor in the context of bioethics. O'zbekiston tibbiyot jurnali
No. 3.T.2004. C.-161-167
5. Mukhamedova Z.M. The role of bioethical committees inensuring guarantees of social protection and health securityin Uzbekistan Bulletin of the Association of Doctors of
Uzbekistan No. 2 2014 T. P. 96-100
6. Mishatkina, TV Universal principles and norms of bioethics /TV Mishatkina // Medicine. - 2008. - No. 2. - S. 1-4. ;Mukhamedova Z.M. Universal Declaration in Bioethics and
HUMAN RIGHTS and patients' rights as fundamental principleof the public health Democratization and human rights. No. 1,
T. 2006. С-49-53

Ethical issues regarding full
disclosure to women with primaryamenorrhea associated withdisorders of sex development inJapan- Kazuyo Iwami, MSN,
Department of Nursing, Faculty of Medical Technology,
Teikyo University, 2-11-1 Kaga Itabashi-ku, Tokyo
173-8605, Japan
ORCID: 0000-0003-3491-3505
Email Address: iwami@med.teikyo-u.ac.jp- Tomoko Sumiyoshi, Ph.D.
School of Health Sciences, Niigata University, Niigata,Japan
ORCID: 0000-0002-7220-7735
Abstract
In this study, we assessed the age of women with primaryamenorrhea associated with disorders of sex
development at the time of full disclosure (FD), examined
the appropriateness of FD based on their subjective views,
and investigated inhibitory factors and ethical issues of
FD. The corresponding narratives from interview data ofEubios Journal of Asian and International Bioethics 31(5) (July 2021)
19 women aged 25 years or older were classi ied. The
patients were divided into two groups according towhether they considered the timing of FD to beappropriate (appropriate group) or late (late group). The
appropriate group included nine individuals with ages at
FD of 18.3 ± 2.29 years, whereas the late group comprised
10 individuals with ages at FD of 25.2 ± 5.77 years (p <0.01). The number of years between diagnosis and FD wassigni icantly higher in the late group (13.2 ± 10.69 years)
than in the appropriate group (1.9 ± 5.70 years; p < 0.05).
The preference of parents and pediatricians was often thereason for delayed FD. Many patients showed confusion in
their gender identity at the time of FD. These indings
highlight the importance of FD and the need for carefuland continuous support.
Keywords: disorders of sex development，full disclosure,gender identity, amenorrhea, women

f

f

f

f

f

f

f

f

f

f

f

Introduction
Disorders of sex development (DSD), characterized byexternal genital abnormalities as a core symptom at birth,
are estimated to occur at a frequency of 1/4,500 births inJapan and worldwide, accounting for 0.022% of the global
population (Hughes et al., 2006; The Committee on
Disorders of Sex Development and Adrenal Disease, theJapanese Society for Pediatric Endocrinology, 2016). DSD
include abnormal development of secondary sexual
characteristics, chromosome abnormality, and abnormal
hormone levels. The highest prevalence rate, as
determined by an international survey, has been reported
to be 1.7% of the population (Blackless et al., 2000).
DSD are incurable diseases leading to decreased qualityof life (QOL) owing to gonadal tumor development,
infertility, external genital abnormalities, and abnormal
development of secondary sexual characteristics (Ogata etal., 2011). However, DSD can be a hidden disease;
therefore, the actual status of DSD has remained unclear(Oyama, 2011). Moreover, medical policy has
recommended not notifying patients of their exact
physical condition to avoid emotional and physical trauma(Callens, 2017). Thus, patients were advised not to speak
to others about their physical conditions (Money, 1994).
Recently, full disclosure (FD) of available nonbiased
information about DSD has become the international
standard (Van Lisdonk, 2014), directing attention to thepsychosocial health status of DSD patients and theirfamilies (Bean, 2009; Jurgensen, 2014; Sandberg, 2017)
and to the importance of educational support (McCauley,2017). However, no standardized guidelines for FD andsupport for DSD patients have been published,despite international guidelines for Turner’s syndrome(Gravholt et al., 2017) and educational programs forpatients with congenital adrenal hyperplasia. In Japan,
only three medical institutions have a team care system
consisting of multiple professional members (Yeo, 2019),
resulting in a delay in patient support.
In East Asia, where DSD tend to be hidden, someparents and medical professionals still hesitate to disclose
DSD to the patients themselves, and legislation for suchdisclosure has not been established (Tejima, 2019).
Particularly, in women with DSD, FD often involves
noti ication of problems with chromosomes and fertility,261

which can lead to long-term issues with QOL, including
psychological con lict and confusion, luctuations ingender identity and identity formation, and treatment
refusal.
As stated in the World Medical Association Declarationof Lisbon on the Rights of the Patient, patients’ rights to
information about their own diseases and receive
suf icient information before providing informed consent
should be protected. However, in Japan, many families andphysicians still feel that suf icient information should not
be given to the patient to avoid psychological damage.
This problem has been left unsolved for several decades.
Accordingly, in this study, we aimed to clarify thecurrent status of FD from the standpoint of patients todetermine the appropriate timing of FD and factors andproblems related to delayed FD.
Methods
ParticipantsParticipants were recruited through members of self-helpgroups and physicians belonging to specialized
institutions in Japan who agreed to cooperate with theresearch. Participants were DSD patients who
spontaneously clari ied their intention to participate by email or other means. The participants were required tomeet all of the following criteria: women aged 25–59
years who were diagnosed with primary amenorrhea
associated with DSD and who were noti ied of the name of
their disease; patients who belonged to a self-help groupfor DSD patients or who were attending a medical
institution with extensive experience in the treatment of
DSD located in the Kansai or Kanto region among core
institutions for DSD (Japanese Society for PediatricEndocrinology website: 28 institutions as at 2018); andpatients who were mentally calm and competent toprovide information regarding their own experience, as
judged by the representative of the self-help group or an
endocrinologist. The following patients were excluded:
those whose participation was not approved by the selfhelp group representative or endocrinologist, despite
their wish to participate; those who had a past history of
disease other than DSD; and those aged less than 25 years.
Twenty-three women expressed their intention toparticipate in the study, and 19 women eventuallyprovided consent for participation.
The participants included nine women in their 20s, ive
in their 30s, four in their 40s, and one woman in her 50s(mean age: 32.8 ± 8.66 years). The average interview timewas 63.8 min (range: 42–134 min). The diagnosis wascomplete androgen insensitivity syndrome in 10
individuals, 46,XY DSD in 5 individuals, partial androgen
insensitivity syndrome in 1 individual, ovotesticular DSD
in 1 individual, mixed gonadal dysgenesis in 1 individual,
and 46,XX DSD in 1 individual. Of these patients, 14 hadundergone gonadectomy, and 4 were married. All
participants except two were full-time employees (Table
1).
Data analysis
The period of implementation was between November
2018 and May 2020. Each participant was interviewed by
the same researcher once for approximately 1 h according262

Eubios Journal of Asian and International Bioethics 31(5) (July 2021)

to the one-on-one semistructured interview method
based on an interview guide. The participants were asked
to speak freely about the following interview items:
history of medical consultation, timing of de initive
diagnosis, timing of FD, institution/person making FD,
course of treatment, reason why a long time was required
until FD, and emotional condition at the time of FD. The
content of the interview was recorded after obtaining
permission from the participant, and anonymized wordfor-word transcripts were prepared.
For analysis, passages from the transcripts, including
timing of de initive diagnosis and FD, medical institution,and understanding and acceptance of the disease at thetime of FD, were read carefully, and psychologicalcondition with regard to understanding and confusion at
the time of FD were classi ied. The participants were thendivided into two groups according to whether the timingof FD was appropriate or late. IBM SPSS Statistics V24.0
was used for statistical processing at a signi icance level ofless than 5%. Intergroup comparisons were made byindependent t-tests and Fisher’s exact tests. The validityof the study was con irmed based on the advice andguidance of an instructor of qualitative nursing studies.
The study content was reviewed by one physician who
was a study intermediary, and the lack of biases anderrors in the results of analysis and their interpretations
was con irmed.
Ethical consideration
This study was approved by Niigata University Ethics
Review Committee (approval number: 2018-0169) and by
the ethics review committees of two medical institutions(approval number for institution A: 1139; approval
number for institution B: 2019b-57). The intermediary
explained the outline of the study verbally and in writing
to eligible participants and referred them to investigators
after consent was obtained. The investigators provided
verbal and written explanations of the study aims andguidelines, particularly consent issues. Then, participants
provided written informed consent for participation.

f

f

f

f

f

f

f

f

f

f

f

f

Results
De initive diagnosis and timing of FD
Based on the transcripts of the participants, theparticipants were divided into the appropriate timinggroup (appropriate group; n = 9, 47%) and late timinggroup (late group; n = 10, 53%). No participants reported
that FD was given too early. Table 2 shows thecharacteristic features related to FD in these two groups.
The mean ages at the time of survey were 26.1 and 37.3
years in the appropriate and late groups, respectively(t(17) = 3.16, p = 0.006). Although there was no
signi icant difference in the timing of presentation
between the two groups, most patient presentations
occurred when they were in preschool or when they werein high school or older. In the appropriate group, thetiming of presentation was in preschool for three (33%)
patients and in high school or older for four (45%)
patients, whereas in the late group, there were six (60%)
patients with presentation in primary school and three(30%) patients with presentation in high school or older
The mean age at FD was 18.3 years in the appropriategroup, which was lower than that (25.2 years) in the lategroup (t(17) = 3.47, p = 0.005). FD was given at 15–19
years in seven (78%) patients in the appropriate groupand one (10%) patient in the late group; FD at 20–24
years was given in two (22%) patients in the appropriategroup and ive (50%) patients in the late group. FD at age
25 or older was given only in the late group (25–29 years
in one [10%] patient and 30 years or older in three [30%]patients). There were signi icant differences between thetwo groups (p = 0.013).
De initive diagnosis and FD were made in the samedepartment (pediatric or gynecologic department).
Pediatric departments included specialized children’s
hospitals and pediatric departments in university or
general hospitals, and gynecologic departments included
gynecologic departments in university or general
hospitals and gynecologic clinics. FD was given by agynecologist for six (67%) patients in the appropriategroup and three (30%) patients in the late group. FD wasgiven by a pediatrician for three (33.3%) patients in theappropriate group and seven (70.0%) patients in the lategroup. Although there were no signi icant differences
between the two groups, the timing for FD bypediatricians was late.
Table 1: Participant Characteristics (N = 19)
Characteristicsn (%) or mean ± SD

Age (years)

32.8 ± 8.66

20−29

9 (47.4)30−39

5 (26.3)40−49

4 (21.0)

50−59

1 (5.3)

Gender identity (female)

19 (100.0)

DiseasesCAIS

10 (52.6)

46,XY DSD

5 (26.3)

PAIS

1 (5.3)

Ovotesticular DSD

1 (5.3)MGD

1 (5.3)

46,XX DSD

1 (5.3)

Gonadectomy

14 (73.7)

Married4 (21.1)

Employment status
Full-time employment

17 (89.5)

Part-time employment

2 (10.5)

Eubios Journal of Asian and International Bioethics 31(5) (July 2021)

263

Table 2: Characteristic features related to FD in participants
Appropriateness oftiming of FD
Personal characteristics

Appropriate (n = 9)

Late (n = 10)

n (%) or mean ± SDn (%) or mean ± SD

26.1 ± 6.8

37.3 ± 8.6

range (25−42)

range (25−51)

Preschool (≦ 6)

3 (33.3)

6 (60.0)

Elementary school (7-12)

0 (0.0)0 (0.0)Junior high school (13-15)

2 (22.2)

1 (10.0)

High school or older (16 ≦)

4 (44.5)

3 (30.0)

18.3 ± 2.3

25.2 ± 5.8

range (15−23)

range (18−37)

15 − < 20

7 (77.8)

1 (10.0)

20 − < 25

2 (22.2)

5 (50.0)

25 − < 30

0 (0)1 (10.0)

≦ 30

0 (0)

3 (30.0)

Pediatric

6 (66.7)

3 (30.0)

Gynecologic

3 (33.3)

7 (70.0)

1.9 ± 5.7

13.2 ± 10.7

range (0-16)

range (0-29)

Decision by physician and parent

2 (22.2)

3 (30.0)

Parent's wishes

1 (11.1)

4 (40.0)

No long time required

6 (66.7)

3 (30.0)Yes

4 (44.4)

8 (80.0)No

5 (55.6)

2 (20.0)Yes

6 (66.7)

7 (70.0)No

3 (33.3）

3 (30.0）

Age at the time of survey (years)at

p value

3.16

0.006

**

Timing of presentation (Age)b

Age at implementation of FD (years)a

Breakdown b

Clinical department for FD b

Time interval from de initive diagnosis to
FD (years)a

0.570

3.47

0.005

**

0.013

*

0.179

2.63

0.020

*

Reason for long time required until FD b
0.363

Acceptance at the time of FD (consent)b
0.170

Confusion in gender identify at the time ofFD

a: Independent t-test

b: Fisher's exact test

SD: standard deviation * p < 0.05 **p < 0.01

f

f

The mean time interval from de initive diagnosis to FD
was 1.9 years in the appropriate group, which wassigni icantly shorter than that (13.2 years) in the lategroup (t(17) = 2.63, p = 0.020). For two (22%) patients inthe appropriate group and three (30%) patients in the

f

1.000

late group, the long time until FD was related to thephysician and parents deciding to withhold information.
In contrast, in one (11%) and four (40%) patients in theappropriate and late groups, respectively, the reason forthe delay was the parents’ wishes. There were no264

Eubios Journal of Asian and International Bioethics 31(5) (July 2021)

signi icant intergroup differences.
Understanding and acceptance at the time of FD
Shock, surprise, or anxiety was felt at the time of FD in 13(68.4%) patients, including 7 (78%) in the appropriategroup and 6 (60%) in the late group. In contrast,
acceptance at the time of FD was reported for four (44%)
patients in the appropriate group and eight (80%)
patients in the late group. Generally, patients who thought
the timing of FD was late tended to be able to accept thecontent of FD.
Confusion of gender identity due to noti ication of the46,XY karyotype occurred in six (67%) patients in theappropriate group and seven (70%) patients in the lategroup. Therefore, explanation of the pathologicalcondition caused confusion of gender identity.

f

f

f

f

f

f

f

f

f

f

f

Discussion
Difference in timing of FD according to the clinicaldepartment
Herein, we found that most patients tended to feel that thetiming of FD was late; patients who were given FD in theirteens felt the timing was appropriate. During thedevelopment of secondary sexual characteristics, womenexperience various changes, including breast budding andm e n s t ru a t i o n . Howeve r, wo m e n w i t h p ri m a ry
amenorrhea associated with DSD have none or only someof these physical changes and therefore feel some anxiety
or doubt about their own bodies. A lack of suchdevelopmental characteristics in young individuals inadolescence may affect identify formation. We found that
promptly making a de initive diagnosis and FD without
hiding anything from individuals could result in feelings
that the timing of FD was appropriate, despite initialshock immediately after FD.
FD was implemented in the late group in the 20s to 30s;
many patients received FD at 10 years or more after
de initive diagnosis. Particularly, visits to adolescentoutpatient clinics or specialized gynecologic departments
were delayed because patients had been treated at
pediatric departments since infancy, resulting in a longer
time until FD.
There were differences in the timing of FD at different
clinical departments in Japan. Notably, there aredifferences in patient age between pediatric departments
and other departments treating adult patients. In
gynecologic departments where adult patients aretreated, informed consent can be obtained from patientsthemselves; however, in pediatric departments, FD isgiven to parents or legal representatives irst when thepatients are minors, and disclosure of the disease tochildren is limited to explanations that are easily
understood. This may have contributed to the differencein timing of FD for different departments. Children are
still developing cognitive abilities, and protection of theirrights by informed assent rather than informed consent isrecommended. This may lead to delays in implementationof FD in pediatric departments (American Academy of
Pediatrics, Committee on Bioethics, 1995).
Parents have the legal right to represent their minor
children. In Japan, individuals aged less than 20 years areminors. Therefore, the right to make healthcare decisions

is given to persons with parental authority. This applies
not only to decision-making related to medical
interventions but also to explanations given to children. In
cases of DSD, parents often object to FD (Sawai, 2018). We
found that non-implementation of FD related to parents’objection was common in the late group. Because DSD
include matters related to sexuality, the essential part ofthe patient’s identity (Iwami et al., 2019), physicians may
consider the wording and timing of FD carefully, resulting
in FD delays.
Confusion and acceptance at the time of FD
Patients in both groups showed confusion with gender
identity. This confusion occurred at considerably highfrequencies, although there are variations in the degreeand duration of confusion among individuals. Patientswith primary amenorrhea associated with DSD were moredeeply shocked by their infertility and the presence of XY
sex chromosome than by issues of appearance, such as theabsence of breast growth and menarche. Because having
DSD affects the self-image with regard to gender(Alderson et al., 2004), the self-image of female patients
may be damaged by the idea that they are “not fully
quali ied” as women (Callens, 2017). Therefore, it isimportant that all information is given to help patients
accept their physical status (Alderson et al., 2004;
MacKenzie et al., 2009). Our indings suggest thatthoughtful wording when providing information andcontinuous psychological support are important, rather
than merely notifying a patient of their diagnosis and themechanisms of the disease.
Regarding acceptance at the time of FD, we found thatpatients in the late group tended to accept their diseasestatus better, suggesting the underlying deep andprolonged distress of the patients. For example, adiagnosis of 46,XY DSD may be overlooked until reaching
adulthood or may not be de initive in some cases(Massanyi et al., 2013; Thyen et al., 2014). Therefore, later
FD may give patients more time to become suspicious of
their condition, leading to increased feelings ofacceptance and reassurance that there is a medical
explanation for their condition. However, patients in thelate group stated that they would have liked to have beennoti ied of their disease status at an earlier age. The needfor earlier disclosure highlights the promotion of early FD
in the ield of pediatric care.
Implementation of FD in DSD patients in Japan
Disclosure of all information to patients is now a standard
policy in DSD care, in contrast to the former tendency tohide information from patients (van Lisdonk, 2014).
However, only recently was an active approach to
implementation of FD to children with DSD used in Japan(Iwami et al., 2019). Timely provision of accurate
information is important for helping patients understandtheir disease. Moreover, a well-planned and stepwise
approach is necessary for deciding the timing of FD; wefound that the best timing was the late teens. Because
people have both the right to know and the right to not
know, it is necessary to con irm whether the patientswant to know. Accordingly, clinicians should be careful toconsider patients’ concerns and provide psychologicalEubios Journal of Asian and International Bioethics 31(5) (July 2021)
support to patients based on their understanding of thedisease and treatment as well as their growth anddevelopment.
Herein, we found that parents tended to avoid
implementation of FD, likely owing to parental anxiety
and lack of correct understanding of the disease(Bennecke et al., 2015). Particularly, in cases in which adiagnosis of DSD is made at birth or in childhood, thepriority is support for parents in understanding andaccepting the disease. This could improve the child’s
understanding and acceptance of the disease in the future.
Additionally, coordinated healthcare by a support team,including nurses and psychologists, is effective forproviding support for DSD patients and their families(Fisher et al., 2016).
Conclusion
The appropriate timing of FD in women with primaryamenorrhea associated with DSD was found to be the lateteens. Many patients reported confusion regarding theirgender identity at the time of FD. Thus, continuous andwell-planned support for patients and their parents basedon knowledge and psychology is necessary after FD and at
the time of FD.
Funding: This work was supported by a Grant-in-Aid for
Scienti ic Research from the Japan Society for the
Promotion of Science (grant no. 18K11905).
Declaration of con lict of interests: None declared.
References

f

f

f

Alderson, J., Madill, A., & Balen, A. (2004). Fear of devaluation:
Understanding the experience of intersexed women withandrogen insensitivity syndrome. British Journal of HealthP s y c h o l o g y, 9 ( 1 ) : 8 1 - 1 0 0 . h t t p s : / / d o i . o r g /10.1348/135910704322778740
American Academy of Pediatrics. Committee on Bioethics.
(1995). Informed consent, parental permission, and assent inpediatric practice. Pediatrics, 95(2): 314-317.
https://
pediatrics.aappublications.org/content/pediatrics/
95/2/314.full.pdf
Bean, E. J., Mazur, T., & Robinson, A. D. (2009). MayerRokitansky-Kuster-Hauser syndrome: Sexuality. psychologicaleffects, and quality of life. Journal of Pediatric and Adolescent
Gynecology, 22(6): 339-346. https://doi.org/10.1016/
j.jpag.2008.11.006
Bennecke, E., Werner-Rosen, K., Thyen, U., Kleinemeier, E., Lux,
A., Jurgensen, M., et al. (2015). Subjective need forpsychological support (PsySupp) in parents of children andadolescents with disorders of sex development (dsd).
European Journal of Pediatrics, 174(10): 1287-1297. https://doi.org/10.1007/s00431-015-2530-8
Blackless, M., Charuvastra, A., Derryck, A., Fausto-Sterling, A.,
Lauzanne, K., & Lee, E. (2000). How sexually dimorphic are
we? Review and synthesis. American Journal of Human
Biology, 12(2): 151-166.
https://doi.org/10.1002/(SICI)1520-6300(200003/04)12:2%3C151::AIDAJHB1%3E3.0.CO;2-F
Callens, N., Longham, C., & Matmans, J. (2017). Samenvattingintersekse/DSD in Vlaanderen. Translated by nexdsd Japan.
Intersex/disorders of sex development in Flanders, Belgium.
2018. https://docs.wixstatic.com/ugd/
0c8e2da7277d1bfeff439bb6f8d358ededee72.pdf(accessed
January 20, 2021).
Fisher, A. D., Ristori, J., Fanni, E., Castellini, G., Forti, G. & Maggi,
M. (2016). Gender identity, gender assignment and265

reassignment in individuals with disorders of sex
development: a major of dilemma. Journal of
Endocrinological Investigation, 39(11): 1207-1224. https://doi.org/10.1007/s40618-016-0482-0
Gravholt, C. H., Andersen, N. H., Conway, G. S., Dekkers, O. M.,
Geffner, M. E., Klein, K. O., et al. On behalf of the International
Turner Syndrome Consensus Group. (2017). Clinical practiceguidelines for the care of girls and women with Turner
syndrome: proceedings from the 2016 Cincinnati
International Turner Syndrome Meeting. European Journal of
Endocrinology, 177(3): G1-G70. https://doi.org/10.1530/
EJE-17-0430
Iwami, K., & Sugata, S. (2019). Chapter 7: Support team; nurse. S.
Ida, M. Kawai, F. Matsui, K. Iwami and N. Eguchi (eds.). Let’s
think about disorders of sex development: for patients,
parents and heath care providers. Shindan to Chiryo Sha, pp.
84-85. (in Japanese)
Jurgensen, M., Lux, A., Wien, S. B., Kleinemeier, E., Hiort, O., &Thyem, U. (2014). Health-related quality of life in children
with disorders of sex development (DSD). European Journalof Pediatrics, 173(7): 893-903. https://doi.org/10.1007/
s00431-014-2264-z
Lee, P. A., Houk, C. P., Ahmed, S. F., & Hughes, I. A. (2006).
Consensus statement on management of intersex disorders.
Pediatrics, 118(2):e488-500. https://doi.org/10.1542/
peds.2006-0738.
Lundberg, T., Lindstrom, A., Roen, K. & Hegarty, P. (2017). Fromknowing nothing to knowing what, how and now: Parents'
experiences of caring for their children with congenital
adrenal hyperplasia. Journal of Pediatric Psychology, 42(5):520-529.
h t t p s : / / s i t e s . o x y. e d u / c l i n t / p h y s i o / a r t i c l e /HowSexuallyDimorphicAreWeReviewandSynthesis.pdf(accessed March 1, 2021).
MacKenzie, D., Huntington, A., & Gilmour, J. A. (2009). The
experience of people with an intersex condition: A journeyfrom silence to voice. Journal of Clinical Nursing, 18(12):1775-1783. https://doi.org/10.1111/
j.1365-2702.2008.02710.x
Massanyi, E. Z., Dicarlo, H. N., Migeon, C. J., & Gearhart, J. P.
(2013). Review and management of 46,XY disorders of sex
development. Journal of Pediatric Urology, 9(3): 368-379.
https://doi.org/10.1016/j.jpurol.2012.12.002
McCauley, E. (2017). Challenges in educating patients andparents about differences in sex development. American
Journal of Medical Genetics Part C: Seminars in Medical
Genetics, 175(2): 293-299. https://doi.org/10.1002/
ajmg.c.31563
Money, J. (1994). Sex errors of the body and related syndromes:
A guide to counseling children, adolescents, and theirfamilies. Paul H. Brookes Publishing Co.
Ogata, T., Ida, S., & Horikawa R. (2011). Disorders of sex
development: classi ication of social gender assignment.
Japanese Journal of Clinical Urology, 65: 897-902. (inJapanese)
Oyama, K. (2011). Current status of disorders of sex
development in Japan: a survey on disorders of sex
development. The Journal of the Japan Pediatric Society, 115:
1-4. (in Japanese)
Sandberg, D. E., Garden, M., Callens, N., & Mazur, T. the DSD-TRN
Psychosocial Workgroup: the DSD-TRN Advocacy Advisory
Network, and Accord Alliance. (2017). Interdisciplinary carein disorders/differences of sex development (DSD): The
psychosocial component of the DSD-Translational research
network. American Journal of Medical Genetics Part C:
Seminars in Medical Genetics, 175(2): 279-292. https://doi.org/10.1002/ajmg.c.31561
Sawai, H. (2018). Correspondence to Androgen insensitivity

266

Eubios Journal of Asian and International Bioethics 31(5) (July 2021)

syndrome. Women’s Healthcare Update, 5(3): 131-135.
Tejima, Y. (2019). Recent legal topics regarding the disorder ordifference of sex development (DSD) in the United States.
Kobe Law Journal, 68(4): 253-272. (in Japanese). http://
www.lib.kobe-u.ac.jp/repository/81011171.pdf (accessed
January 20, 2021).
The Committee on Disorders of Sex Development and Adrenal
Disease, the Japanese Society for Pediatric Endocrinology(December 1, 2016). Webtext titled “Diagnosis and treatment
of disorders of sex development. http://jspe.umin.jp/
medical/ iles/webtext_170104.pdf(accessed January 20,2021). (in Japanese)Thyen, U., Lux, A., Jürgensen, M., Hiort, O., & Köhler, B. (2014).
Utilization of healthcare services and satisfaction with care inadults affected by disorders of sex development (DSD).
Journal of General Internal Medicine, 29(3): 752-759. https://doi.org/10.1007/s11606-014-2917-7
van Lisdonk, J. (2014). Living with intersex/DSD: An exploratory
study of the social situation of persons with intersex/DSD.
Sociaal en Cultureel Planbureau. Translated by nexdsd Japan.
Living with intersex/disorders of sex development 2015.
https://131e3702-27f0-8862-14efb 9 d d c b a 3 d a 5 b . i l e s u s r. c o m / u g d /0c8e2d_36b9cbb9aa864fca821ad8bf5ab35b25.pdf(accessed
January 20, 2021).
Yeo, H. (2019). DSDs：Basic knowledge of various developmentsof physical sex and Support for school. In Kasai, M. (Eds.),
Support for LGBTQ + children / students / students. Seishin
shobo, pp. 68-84. (in Japanese).

these were on p. 242 xxxx

Perspectives of students onteacher’s online instructional
competence during the COVID-19
pandemic- Maria Elena C. Morales (ellenmorales2017@gmail.com)(Corresponding author)- Princess Fe C. Deliva, Harry Dave B. Villasor, Lemuel M.
Sayao , Jeopril Jane R. Pableo, Rogelio P. Bayod, Anna Liza
Cerbo, Erikka June D. Forosuelo, Cristian T. Camañan
Cor Jesu College, Philippines

f

f

f

f

f

f

f

f

Abstract
The sudden shift of the mode of instruction of many
schools from the conduct of face-to-face classes to online
classes because of Covid-19 pandemic has brought
different challenges not only to the students but to theteachers as well. To be able to prepare their teachers forthis new trend, Cor Jesu College has provided avenues forthe teachers to be oriented on how to manage online
learning modalities such as google classroom, zoom andother social media platforms to provide relevant andmeaningful learning to the students. This paper focuseson the perspective of students on the online instructional
competence of their teachers. Results revealed that somestudents experienced unfavorable learning situations due
to problems of internet connectivity, content and workoverload, time constraints in submitting tasks and themonotonous mode of delivery. However, most of themacknowledged the competence of teachers in handling

online classes by manifesting passion, lexibility, masteryof content knowledge and ICT integration. They also felt
the compassion and consideration of their teachers totheir varied circumstances. This paper highlights the needfor additional training for teachers to create moreinteractive and collaborative learning approaches tomaximize students’ learning experiences in the newnormal.
Introduction
Lockdowns, social distancing and limited travels are someof the measures implemented by governments around theworld to lessen the number of cases of COVID-19 in theircountries. Because of that, all forms of actual physicalgathering were prohibited. Because of this, educational
institutions in many parts of the world were forced toshift to online classes/distant learning modality from theusual face-to-face learning modality (Li & Lalani, 2020).
The global data from UNESCO revealed that as ofMarch 2020, about 1.38 billion learners from pre-primary
to tertiary levels are out of the classroom resulting in a
dramatic change in education, with the distinctive rise ofelectronic learning whereby teaching is undertaken
remotely and on digital platforms. This shift of instructiondelivery was seen to be the best option that schools may
still be able to deliver for quality education to students.
However, several studies revealed that because of thesudden shift of curriculum, teachers and students
experienced dif iculty. In fact, the study of Islam, Rahman,
Danesh & Kabir (2020) revealed that students in
Bangladesh had a great challenge over the lack offacilities, limited interaction with their teachers, andpersonal and psychological well-being. Because of that,learning was not that effective to them.
In the Philippines, particularly in the hinterlands of
Mindanao where Internet access is lacking, many schools
were forced to prepare modules and Learning Activity
Sheets (LAS) for the students (Bayod, R. & Bayod, C.,2020). However, this has brought different challenges tomany students not only in terms of ensuring suf iciency oflearning among the students given the fact that there are
no teachers who can really assist them, but also economic
challenges to their parents since they are forced to spendmoney for their fare to go down the schools every week to
get the modules of their children (Bayod & Morante,2020). In addition, parents of indigenous people
experienced different struggles and dif iculties with theimplementation of modular and/or distant education of
their students during the pandemic as reported in the
study of Bayod et al. (2021) among indigenous parents in
Davao del Sur, Philippines. It was reported in that study
that indigenous parents have dif iculty assisting theirchildren in the modules because they are not equipped
academically to be able to guide them. While all of them
are willing to help their children, they have also many
works to do for their economic survival. Thus, they hopethat face-to-face classes will be implemented again by the
Department of Education (DepEd).
It is not only the students and parents who
experienced dif iculty in online delivery, but teachers as
well. For instance, Delgado (2020) pointed out that in
Guatemala only one out of four teachers was prepared toEubios Journal of Asian and International Bioethics 31(5) (July 2021)

f

f

f

f

f

f

hold online classes. Many of them are not oriented indoing virtual class. Similarly, the study of Joshi, Vinay &Bhaskar (2020) revealed that teachers in India had
problems too in this sudden shift of curriculum. Some ofthose include lack of training on conducting online
classes, lack of technical support from their schools andlack of clear direction in regards to the implementation of
online class. As such, teachers do not know if they are
doing the online class the right way to let their students
learn.
In Southeast Asia, teachers had voiced out theirworries, too. Most of the dif iculties experienced by theprofessors and teachers in the region are related todelivery of lessons and low Internet connectivity (Jalli,2020). Aside from internet connection, there are also
cases that some teachers did not receive proper training
on how to conduct online classes. For instance, inIndonesia, Angdhiri (2020) reported that teachers had notexperienced training on how to implement online classes.
As a result, students were stressed out because of the new
way of teaching and the number of tasks given to them.
This is supported by the study of Irfan, Kusumaningrum,
Yulia & Widodo (2020) when they reported struggles byteachers especially on writing mathematical symbols andon managing their classes. In Cambodia, the study of Heng
& Sol (2020) revealed that the country’s educational
institutions, teachers, and students were generally notready for this unexpected disruption in traditional
teaching and learning methods pointing out technologicalinfrastructure and digital competence among thechallenges they are experiencing.
In the Philippines, the height of the pandemic fellwithin the course of the regular opening of the school year
in 2020. In June, the Omnibus Guidelines of the national
government’s Inter-Agency Task Force (IATF) through its
43rd resolution on June 2020 prescribed that youths aged
21 and below were prohibited to go out of their homes(Of icial Gazette of the Republic of the Philippines, 2020).
With college students mostly falling within the given age
range, schools were forced to take the online modality oflearning as the best option to continue delivering
education in the tertiary level. This posed a challenge tomany if not all who are part of the academe since the shift
in the mode of instructional was new in the context ofPhilippine education. In fact. as far as tertiary education isconcerned, professors were airing their apprehensions
about online teaching as most teachers are generally seen
to have only limited knowledge of computer and had notundergone training before the start of online classes(Moralista & Oducado, 2020). As a result, they had doubtson the integrity of their classes and exams as well as thequality of the delivery of their instruction. This is
supported by the result of the study of Reyes-Chua et. al(2020) when it was reported that in Region IV of thecountry, teachers experienced lack of resources, poorinternet connection and lack of training, thus affecting thequality of online instruction.
Though there was a form of orientation of how to
conduct online classes, but some problems are stillencountered. The study of Alpos et al. (2020) revealed
that teachers had struggled on the use of technology, on
engaging students on their discussion, and on choosing

267

the appropriate teaching strategy in online classes. Also,
students had encountered problems in their online
classes. The problems they faced were low internet
connection, unclear lesson delivery, and the number oftasks given (Bernados, Dingding, & Mangcal, 2020).
It can be seen that teachers and students had
encountered dif iculty in the sudden shift of instruction.
Because of that, we would like to ind out how thestudents perceive the on-line competence of theirteachers especially because some studies revealed thatthey lacked training. We would like to see from theperspective of the students if their teachers had beeneffective in delivering online classes. The result of thisstudy may give ideas for teachers to improve their online
class delivery and may provide data for school
administrators help their teachers in providing quality
online education.
To be able to gather the different experiences andviews of the students as regards their online classes, we
asked them the following questions: What are yourexperiences as regards to online instruction conducted byyour teachers? Do you ind your teacher competent inhandling online classes, why? What are your insights on
your teachers' online instructional competence?
Methods
Since we wanted to know the perspective of the students
on the online instructional competence of their teachers,
we interviewed them and asked them about theirexperiences. For our study participants, we have thefollowing selection criteria: That he or she should bethird year college student of Cor Jesu College and that heor she must have good standing in the attendance of his/her online class; thus, she or he is active and does submit
all tasks on time. In the selection of the participants, wemade sure that each college has a representative to makethis study comprehensive and encompassing. There were
20 key informants in total. Each researcher had to selecttwo students to be interviewed based on the prescribedcriteria. In the collection of data, we used Google Meet andFB messenger to get responses from the students. After
this, we met as a group and together made collaborative
analysis on the responses of the key informants andidenti ied emerging themes. Ethical consideration waspracticed from the moment we asked permission to
conduct the study and do the interview. We also oriented
our informants that their responses would be for research
purposes only and their identity would not be divulged in
the writing of the research report .
Experiences as regards to online instruction
conducted by teachers
This study explored the actual experiences of tertiarylevel students in the online modality of learning. Going
through the experiences shared by the participants, wewere able to identity that the teacher’s competence inonline instructional delivery were manifested throughPedagogical Practice and Information Technology
Infrastructure.
The way how teachers handle and manage their online
classes were pointed out by students to be a crucial factor
in the quality of student’ learning. Students pointed out

Eubios Journal of Asian and International Bioethics 31(5) (July 2021)

f

f

f

f

f

f

f

that when classes shifted to virtual or online learningfrom the traditional face-to-face classes, their teacher’s
methods and practices became more pronounced to them.
Also, the Information Technology (IT) infrastructure
which in this context is the quality of internet connectivity
was noted to be a signi icant player in the quality ofteaching-learning experience.
When it comes to Pedagogical Practice, one of thenotable experiences as reported by most of key
informants was the Interesting and Well-planned Lessonsof their teachers. They expressed that even on the newnormal mode of learning, they enjoyed their lessons
because they were easy to follow and that they were selfdirected and that they were learning a lot. For instance
one informant shared: “I enjoyed the online course. Online
instructions conducted by our teachers were well planned
and laid out and easy for me to follow”. This is supported
by another informant when she said: “I also enjoy learningin online instruction because it made me more responsible
where the learning is self-directed”. Another informant alsosaid, “lessons are delivered in the most comprehensive andeasiest ways that students are able to understand and learn
from”. Similarly, another informant said: “There aremodules that are simpli ied already which is very helpful
to us”. These experiences of students manifest thecreativity and preparedness of the teachers in crafting
lessons. Students feel that even if the lessons are delivered
through a virtual meeting, lessons can still be engaging
and enjoyable.
The prioritization of the roles and competencies of
online teachers varies in the literature depending upon
the context where online teaching takes place. For
instance, technology-related competencies (Egan &Akdere, 2005), communication competencies (Williams,
2003), and assessment-related competencies (Aydin,2005) can be more important than others depending on
the context and culture within the online teachingenvironment. These can be the factors why students still
ind virtual meetings enjoyable and engaging because of
the capacity, innovativeness and strategies that theteacher employs to facilitate learning during the conductof online classes.
Moreover, many informants also cited that the online
instructional delivery in the new normal promoted
Interactive Discussion between teachers and students.
This is beautifully captured by the sharing of one
informant when he said: “some of my teachers help us tounderstand more about the activities, they are open to
answer questions”. In addition, another informant shared:“The subject is already fun to learn and then the activities
that are given by our teacher are very exciting”. This is in
the same line of thought with the answer of anotherinformant when she stated: “Our teachers encourage us toshare our opinions and insights in the class”. The students’experiences suggest that even in virtual learning, it ispossible for students to still experience interactive
discussion despite the limitations of their learning
experience. The skills, values and attitudes of the teachers
are very crucial in ensuring interactive, fun- illed andrelevant learning even if the classes were held virtually.
Despite the fact that shifting to the virtual face-to face
was sudden and urgent due to the pandemic, delivering

f

f

268

learning to students posed some positive observations.
The pandemic has posed challenges to the learning
experiences of students but many teachers remained
enthusiastic and positive in their approach to the newnormal. The same is also observed in other countries. For
instance, the study of Fatani (2020) in Saudi Arabia
showed that students were satis ied with their teachers’
teaching quality despite the technical issues that theirteachers face. Similar indings are also presented by
Chakraborty, Mittal, Gupat, Yadav and Arora (2020)
claiming that the students felt that professors have
improved their online teaching skills since the beginningof the pandemic (68.1%). Many students also believe thatonline education is a viable alternative in the current
circumstance (77.9%).
The study of Scull, Phillips, Sharma & Garnier (2020)highlights the signi icance of engaging learners throughmaking personal connections. The study draws attention
to the bene its associated with using various tools todifferentiate the curriculum and to optimize theparticipation of all learners. If the teachers explored otheroptions to engage students using the online platform
during class discussions, the students feel the concern anddedication and this encourages them to ask questions andprovides them opportunities to share their insights; thus,
it becomes an interactive form of learning.
However, not everyone shared the same experiences.
While there were students who reported that theirteachers promote class interaction, there were also those
who experienced Ineffective Instructional Delivery. There
are students who expressed they have teachers who havenot given the quality of teaching they believe they deservein the new normal. To cite one, an informant said: “duringclass, the teacher is focused, allowing everyone to speak
compromising the discussion”. The same sentiment was
expressed by another informant who shared that: “It's notthat they are not trying, but the way they do classes is likeit's constricted, to the point that it feels repetitive andbland”. In addition, another informant said: “I can say thatmany teachers changed in their instructional delivery.
There are teachers who performed very well during thephysical face-to-face but did not sustain when classes
shifted to the online class, they cannot explain suf iciently
anymore the lesson. They used to be very good before
during the face-to-face classes. Some teachers do not evengive modules regularly”. We found out that many of ourstudents knew their teachers very well. They have beenwith their teachers during the face-to-face classes andduring the on-line classes. Thus, they have established akind of baseline measurement as to the effectiveness of
their teachers. However, it is a fact that face-to-faceteaching is very different from on-line teaching. For one
thing, the challenge of internet connectivity is always
present to disrupt the momentum of the on-line classes
both from the teachers as well as from the students’ end.
In addition, since the mandate of the Commission on
Higher Education (CHED) is to give on-line lecture for only
one hour a week, teachers made sure that during thisschedule, important concepts must be discussed.
Likewise, to ensure that students will have something to
do to continue their learning during the days when there
are no on-line classes, teachers have to prepare modules

f

f

f

f

f

f

f

f

f

f

f

f

f

or student activities for their independent learning. Thishas provided another concern for the students asreported by our participants.
These indings show that the source of students’
frustrations or satisfaction was the ways on how teachers
carry out their lessons together with their attitude
towards how to carry it. These experiences are supportedby the indings of Mcdougall, Orlov and McKee (2020)
which revealed that the switch to remote teachingbrought about by the pandemic took a toll on student
learning emotionally and academically pointing out thatonline classes could be one possible reason. Similarly,
Chakraborty et al. (2020) reported that students in India
did not feel better that teaching is done online compared
to when they held classes in physical classrooms. More so,according to Adams (2020), the pandemic has caused
teachers to lose their ability to con idently gauge student
levels of engagement and motivation jeopardizing thequality of interaction in the online class and even caused
some students to get bored.
Research shows that students are mostly suf iciently
skilled to take part in digital lessons, but the developmentof these lessons by teachers turn out to be a lot more
dif icult (Aslan & Chang 2015). It has been observed thatsince institutions shifted the mode of learning, manyteachers struggled in terms of adjustments and copingwith added tasks like making modules and attending toscheduled online classes. There are teachers who arereally comfortable delivering the lessons through face toface learning and since the pandemic started and modalityof teaching had various changes, some teachers were notprepared for the sudden shift of online teaching; thus,
they are still in the period of adjustment.
As to the actual experiences of students alone, it was
revealed that teachers’ instructional delivery is acombination of positive and negative ones. It means thatthe pandemic has not fully brought catastrophic effects to
education. These indings reveal that teachers play theimportant role on how the teaching-learning will takeplace in the virtual classrooms.
Another issue that concerns students is the Content
Overload and Time Constraints in Performing Tasks thatthey experience in online learning. For these students,
online classes have brought so much work with too little
time to complete tasks or activities and so many contents
to learn which f is not good in general. One informant
said: “There are teachers that seem like always in a rush
when discussing. Not that they talk so fast but because theypresent a lot of lessons in just one meeting, information
overload”. This goes true to another informant when hesaid: “Some of our lessons become vague because some of
the teachers present too much of their lessons more thanstudents are able to comprehend which gives information
overload”. The same sentiment is expressed by anotherinformant saying: "This is one thing that makes online
learning dif icult for me, because some of our teachers havebeen giving either too many tasks (number of tasks or the
dif iculty of them) or too little time to do it (deadline).”Similar experience is claimed by still another informant
who said: “Sometime I feel the pressure especially intimes when teachers altogether give tasks, not just one
task but many from one teacher”. Moreover, anotherff

Eubios Journal of Asian and International Bioethics 31(5) (July 2021)

269

informant said: “The teachers attempt to inish the lesson
regardless of we understand or not”.
Apart from a sense of urgency and experiencing theadded value of Information Communication andTechnology (ICT), the short transitioning period due tothe Covid19-pandemic has left many teachers unprepared(van der Spoel, Noroozi, Schuurink, & van Ginkel, 2020).
One of the factors that hamper professionalization interms of ICT competency is limited time to become
familiar with technology (Almekhla i and Almeqdadi,
2010; Ungar and Baruch, 2016), as well as a lack ofknowledge and skills to support learning with use of ICT(Koehler, Mishra, and Cain 2013). A inal impeding factor
is absence of adequate training focused on teachers’
teaching practice (Baran 2014; Hadar et al. 2020). These
are all true most especially in slow developing countries
when coping with technological advances is not a priority
in academic institutions. There are instances whenteachers ind it hard to balance lecture and giving online
tasks that burden students in coping with their academic
requirements.
Indeed, there are many challenges that students
encountered in the implementation of online classes. But
many of these challenges are brought about by Internet
Connectivity Problems. Many of our informants said thatthey have regularly experienced intermittent internet
connection while attending classes. Many students whoavail of online learning modality are using either WiFi
connections or 3G or LTE data using either mobile phones
or laptops and our respondents expressed that this is acommon barrier in online learning. For instance, one
informant shared: “Sometimes our lessons are not clearly
explained maybe because of time constraints and internet
interruptions.” The same experience was shared by an
informant who said: “I encountered various challenges
such as internet connectivity problems and powerinterruptions which cause delays of submission and
dif iculty in attending classes. The worst part of poorconnection is it may fail you in exams especially whenexams are done by Google forms.” Similarly, anotherinformant said: “Sudden internet connection loss makes
me rush to catch up with lessons from meetings I was notable to attend”.
According to Kapasia et.al. (2020) students were also
facing problems related to poor internet connectivity(32.4%), followed by absence of a favorable environment
to study at home (12.6%). This also corroborates theindings of Mishra, Gupta & Shree (2020) and Amir et.al(2020) who claim poor internet connectivity and video
issues due to remote locations contribute to problematic
online learning. In fact, students residing in rural andremote areas face poor internet connectivity. Moreover,poor economic conditions might lead to an unfavorable
environment and lack of a separate room for their study.
Students with no internet connectivity really ind a hardtime coping with online classes. Some are very eager tolearn but they get discouraged especially when there islimited internet connectivity.
Based on the experiences shared by the informants, wefound that students have mixed of positive and negative
experiences with the online instructional delivery of thetheir teachers. Most of the experiences they pointed out

Eubios Journal of Asian and International Bioethics 31(5) (July 2021)

relate to the methods and practices that their teachers
employ during online classes. Many of these challenges
are brought by internet connectivity problems. When thestudents are cut-off from the online discussion because ofpoor internet connection, they cannot wholly experience
everything that the teachers did during the lectures. Theirintermittent internet connection also resulted inintermittent on-line class participation. Thus, they cannot
totally bene it from the entire on-line discussion andactivities given by their teachers. Considering thatteachers have different educational backgrounds,
trainings, pedagogical knowledge, levels of information
technology literacy, and unique personalities, teachers
may vary in their approaches during online classes. Somemay have plenty of activities to ensure students’interaction while others may only resort to pure lecture tocover the topics. Thus, it is expected that students share a
mix of experiences just like any other learning situationand set-up.
The online learning process is often discriminatory.
Many students face enormous challenges in e-learningand a substantial proportion of students could not attend
online classes. Students from remote areas andmarginalized sections mainly denied online learning due
to the lack of electricity and internet connectivity. Poverty
further exacerbates the problem of digital learning in thisunwanted crisis (Kapasia, et.al, 2020). Thus, teachers playsigni icant roles in facilitating students’ online learning.
The roles were de ined within the online discussion
context, in which the pedagogical role meant facilitating
the learning in discussions; the social role meantencouraging and promoting working together; themanagerial role meant organizing and designing thelogistics of the discussions; and the technical role meant
providing a transparent technology environment to thelearners (Berge, 2009; Berge & Collins, 2000). There iscertainly the need for adjustment in both the teacher andthe students to cope with the demands of the pandemic inorder to sustain in this challenging time.

f

f

f

f

f

f

f

f

f

Teachers’ competence in handling online classes
Among the 20 student participants, 14 (70%) commended
that teachers showed competency in doing the online
class while six (30%) expressed that teachers in this newnormal learning modality are performing withincompetence. Most of them agreed that their teachers
possess technology literacy having the ability to use thetechnology to organize their lesson and communicate
information. Their perspective on the teacher’scompetence as well as incompetence are based on thefollowing themes: ICT Skills Content Knowledge andPedagogical Skills.
When it comes to ICT skills competence of teachers,
ive students complimented that the ICT skills
competence transpires during the conduct of online
classes. One student said, “They have enough technicalskills and they teach with passion in order to meet ourlearning needs.”. The exact line from another student
speaks his con irmation as he uttered, “Yes. Technology
and media literate, lexible and creative teachers.” These
multi-literate teachers know how to use various
technologies in teaching according to De Leon (2020) as a

f

f

270

tool to communicate information that make their online
classes interesting and interactive.
Apart from being multi-literate, teachers maintained
their content knowledge competence and they were able
not only to deliver the lesson but also transfer thelearning to the students. One student remarked that “Yes,contextualized and comprehensible inputs”. Other students
supported as they added: “teachers have subject matter
mastery” and “they deliver quality lessons”. Barnett andCeci (2002) articulated that the hallmark of true learningis when the transferred knowledge or skill can be appliedin a different context. Transfer signals that a learner’s
comprehension allows them to recognize how theirknowledge can be applied effectively outside original
learning conditions. Evidently, to teach all students
according to today’s standards, teachers need tounderstand the subject matter deeply and lexibly so they
can help students create useful cognitive maps, relate one
idea to another, and address misconceptions. A focus onconceptions, and in many cases a particular interest in
student misconceptions, acknowledges that accounting
for how students understand a content domain is a key
feature of the work of teaching.
However, the compliance of the new normal modality
risks the quality performance of several teachers
especially those who are not technologically adept. Somestudents irmly said that their teachers lack technology
competence that affects their online class performance
like by coming in late or creating a boring class. These are
the exact words from the student who was asked if his
teachers are competent in handling online class. “No, comelate, not tech savvy, boring class.” Additionally, twoparticipants said: “Pedagogically, some teachers really haveto improve ICT integration”, and they are: “becoming
pedagogically incompetent,” since they manifested
inconvenience in the use of technology as stated by two of
our informants. Other teachers as well are “struggling to
be competent in online classes.” as observed by anotherinformant. One must be pro icient in using a variety oftechnology tools to solve problems, make informed
decisions, and generate new knowledge (Raob, AlOshaibat & Ong (2012). Nonetheless, they added thatmany of our educators lack the necessary skills
themselves to be comfortable in the integration oftechnology into classrooms. This argues to the point of
Koc & Baker (2010) that the role of the classroom teacher
needs to change signi icantly as technology is used in amore widespread manner of instruction.
Challenged by the utilization of a wide array oftechnological tools to assist them in online class platform,
teachers turn to a dispenser of knowledge making theclass less engaging and causing students saturated andoverloaded with information. When asked if teachers arecompetent in handling online classes, one informant
answered: “No, because of too much focus on the content/materials to be covered” and another participant said: “No,
content of the lesson not enough to be discussed once a
week.”The statement above signi ies that teachers attempt tocover many lessons regardless if students are learning or
not because of time consumed in manipulating thegadgets and connectivity; hence,“becoming pedagogicallyEubios Journal of Asian and International Bioethics 31(5) (July 2021)

f

f

f

f

f

f

f

f

f

f

f

f

incompetent” commented a student participant. In the
study of Chen, Pedersen & Murphy (2012), computermediated communication (CMC) has been used widely toengage learners in academic discourse for knowledge
construction. Due to the features of the task environment,
one of the main problems caused by the medium isinformation overload. The results indicated that although
information overload did not affect every student becausesome seemed to have learned how to manage thesaturation of information, yet, it in luences students’participation and levels of cognitive processing in online
discussions.
Further to say, the effect of the pandemic threat affects
the continuous dramatic change of education that also
in luences the teaching performance of teachers.
Nevertheless, the resilience among the teachers keepthem composed by sustaining their lexibility and passion
for quality teaching. Five students categoricallymentioned that teachers exhibit online class competenceby being passionate in delivering the lesson. These aresome of the informants’ utterances:“Yes, passionate in teaching who sees the value ofdeveloping and working with others.” “Skillful, passionate,
positive and can easily adjust.” “They teach with passionin order to meet our learning needs.” “Yes, ensures thatstudents maximize their potentials.”
Teachers are passionate for excellent teaching ascomplimented by other students because their teachers
established class engaging classroom in online modality.
They said in verbatim: “Yes (conducts engaging
strategies.)” and “Yes. (engaging class discussion)”. One
student added: “Yes. delivers quality lessons, considerate,
make time to have make up classes, creative”. Whatever thecall of adversities, teachers must possess passion in theteaching profession to ensure that students are motivatedto learn under their guidance and care (De Leon, 2020).
The teaching quality of teachers in this COVID
pandemic is indeed challenged. Yet, despite theunpleasant situation, teachers reveal their lexibility andadaptability as they balance several responsibilities atonce, like learning the technicalities of technology, andstill making students smile and feel appreciated in the
online class. The students as well expressed theirappreciation as stated by one of the participants: “ Yes, I
am really pleased by the adaptability and positivity of ourteachers in approaching them.” He added that the teachers
are “Skillful, passionate, positive and can easily adjust”.
Another participant complimented on the lexibility andadaptability of teachers in doing online modality as hesaid: “Yes, adapting to the new ways of teaching” while theother one commended: “The teachers are mostly flexible
because they know how to find alternatives. I also noticed
that this time the teachers in CJC are very creative whether
young or old, they have many ideas.”Hence, having lexible teachers and experiencing
interactive online classrooms provide fun in learning
amidst adversity. Being lexible according to De Leon
(2020) enables teachers to adapt to various learning
styles and needs of the learners. They can still facilitate
the learner-centered teaching in the midst of thesigni icant surge of teaching on digital platforms andsudden shift away from the classroom brought by recent

271

pandemic. Consequently, any threat to teaching
performance cannot weaken teachers as they areprepared for alternative modes of delivery and are online
teaching competent in this new normal modality.
Insights of the students on teachers’ competence
The pandemic due to Covid 19 has created a different
setting for learners to experience learning through coldand heartless devices like cellphones and laptops.
Challenged and distressed by the new normal learningmodality, the student participants shared their insights on
their teachers’ online instructional competence. The
insights of the students fall into the following themes:
High Satisfaction and Con idence on Teachers’ Online
Class Competence, Emphasis on Student-Centered
Approach in Teaching and More Compassionate andUnderstanding Teachers.
High satisfaction and con idence on teachers’ online
class competence.
Most of the informants expressed high satisfaction andcon idence on their teachers’ ability to deliver the lessons
through the online modality. One of the informants said:“ I’m very much contented on how our teachers have built awell-designed instructional method that has led us tocontinue our learning in an active and productive manner.”Moreover, despite the hassles of intermittent connectivity
during online class , one student expressed her joy in her
observations on how her teacher managed to come up
with relevant learning tasks and a well-organized classand on how her teacher valued them. Her words are: “I am
glad that our teachers present learning materials in a clear
and organized manner and gives learning tasks with clear
purpose. They also demonstrate expertise in their respective
subjects. They encourage us to improve our grades andalways motivate to do our best and to be honest during
online exams.”
Furthermore, another informant commented: “Almost
everyone is competent. I have seen the way my teachers areconveying their thoughts about their topic. Though someare not into technologies and how to manipulate such, but
still they’re giving their best.” With their words, students
can still see the efforts of teachers to maximize theopportunities for learning.
Emphasis on student-centered approach in teaching.
Though most of the students commended on thecompetence of teachers in handling online classes, few
were frustrated and unsatis ied on the manner theirteachers conducted their classes, on the kind of learning
tasks their teachers gave them, and on the attitude theirteachers showed towards them. One of the students
commented:“With the instructional strategy of teachers inonline classes, sometimes they forget to make the discussioninteresting and lively. Sometimes, I felt sleepy due to theineffective approach of the teachers that made the classboring.” Similarly, dismayed with non-interactive classdiscussions, one informant demanded: “Make the classinteractive, allow students to talk because there areteachers who just lectured hurriedly.” This lack of active
engagement among learners is supported with statementsof another informant:Eubios Journal of Asian and International Bioethics 31(5) (July 2021)“… but some are just really being stagnant with thelecture approach and interaction in class is just like limited
to ‘can you read this? Okay, now explain.’ I feel like we cando more than that….These days it’s just always been theteacher, and there’s a part of me that wants to interact but
just can’t , because that’s the kind of vibe that has been
established.”
The students want more from their teachers. They
want their teachers to involve them and make them partof the teaching and learning processes despite thedistance. They need to be engaged actively to ind
meaning in their virtual meeting. As active social
individuals in a very dynamic realm, learners want active
learning settings (Dziuban et al., 2003). Petress (2008)
believes that active learning is making the learners “as anengaged and motivated partner in the learning process”
which allows learners to immediately apply what they
have learned. Moreover, according to Ediger & Rao (2013),
teachers should create learning experiences that areinteresting, purposeful, and relevant to the lives of thelearners for them to learn. The class is for the students;
thus, they must take part in whatever is happening in thevirtual classroom.
The experience of the online class to a few of thestudents is demotivating. One student expressed: “The
impact to me is that I am not anymore motivated to study;
it is all for compliance only. I am not motivated to doadvance reading anymore.”
Student participants could not hide their desire for theteacher to improve their online teaching strategies tocreate a more student-centered teaching approach. Theysuggested that teachers should undergo more workshop
and training in using technology as the major teaching
device during this new normal or post pandemic learningmodality. One student said: “to provide online
instructional competence, teachers need to take part intraining sessions … and hone their abilities in using
technology … and this will allow both teachers andstudents to achieve learning goals or objectives in online
courses.”
It cannot be denied that teaching in the new normal
brought about by the COVID pandemic is challenging. The
shift to online modality becomes more dif icult because of
the unpreparedness of teachers in terms of unavailable
learning modules and lack of technological skill ( Bilbao,
Dayagbil & Corpuz, 2020). However, the pandemic cannot
be used as an excuse for not delivering lessons
competently because students deserve meaningfullearning whatever the condition is. Moore (2009) points
out that “faculty preparation for teaching online
measurably improves learning effectiveness andsatisfaction” (p. 90). Thus acquiring set of technologicalskills and competencies must be acted on by teachers toprovide opportunities for effective learning (Bigatel et al,2012).

f

f

f

f

f

f

f

f

More compassionate and understanding teachers. With
the new normal learning modality, students need theirteachers not only to teach them the lessons but also tounderstand their present condition. Though they do notexperience the hassles of going to the physical classroom,

f

f

272

they still feel the pressure and dif iculties while having
their online classes.
Most of the student participants desired that teachers
empathize with them by considering their present
condition as online learners. They want their teachers see
their struggles to be able to participate in class actively
and to respond to their assignments or tasks excellently.
For instance, one student participant expressed: “…
teachers have to be considerate and compassionate totheir students at this time.” They must listen to thestudents’ challenges and dif iculties and to help them deal
with these problems.” Regarding the kind of learning tasksteachers gave, two informants commented: “ Teachers
have to consider the level of dif iculty of the tasks theygive their students and the deadlines.” and “… it’s thegiven tasks which caused pressure in me”. The students
ind it more dif icult to learn in online classes because
they do not ind them valuable and inspiring, and theycannot feel the concern of their teachers in their struggles
to get connectivity and comprehend the course content.
According to Coskun (2019), “compassionate teachers areable to re lect on characteristics of passion, inspiration,
motivation, and openness to the students. With the aid of
these, the teachers are likely to make the lesson happen
with positive outcomes.”
Conclusions
The sudden shift of curriculum delivery from thetraditional face-to-face classes to online classes hasbrought challenges to Cor Jesu College teachers as well as
to the students. While the school administration gaveorientation to the teachers on how to conduct and manage
online classes, some teachers faced challenges in handlingand managing online classes. Some of them are perceived
by their students as not as competent enough comparedto the way they handled classes before in the traditional
face-to-face classes.
There are many factors to consider in the assessment
by students of online competence of their teachers. For
one, the internet connectivity problem has affected thecreativity and competence of teachers in handling online
classes. Second, since many of the teachers are used tohaving face-to-face classes where they can see andevaluate the physical as well as emotional reactions ofstudents, many teachers also ind online classes boringsince they cannot see whether the students are reallyinterested in the lesson or not. In most cases, teachers do
not oblige or even categorically discourage students not toturn on their video camera during classes so as not to
disrupt the internet connection. There are no other means
to check if students are really attentive or not except whenteachers make a random call of students to answer somequestions or share their insights on the topics. Students
can also make the internet connection issue as an excuse
why they cannot answer to their teachers. As a result,teachers are often content only on delivering lecturesduring the online classes. Third, considering that teachers
have only one hour to deliver their lesson, they are mostoften focused on employing purely lecture method andoccasionally ask questions to their students to check ifthey are still present in the virtual classroom. Because of
these, some students said that the competence of theirteachers had declined. Not surprisingly, those who said
that the competence of their teachers had declined are
education students or students who prepare themselves
to become teachers. Since they are trained on teaching
methodology as future teachers, they can assess thecompetence of their teachers based on their knowledge ofthe teaching profession and their previous experienceswith teachers in different classroom activities as
education students. Similarly, those who said that theirteachers were not really technological savvy are mostly
coming from the College of Engineering and Technology(CET). These students are quite advanced in terms of ICT
skills as compared to many teachers who are not teachingprofessional subjects in engineering, information
technology and computer science.
Regardless of what college or what program theinformants belonged in the school, the results of thisstudy have provided several implications to the teachers
and to the school in general. On the part of the teachers,
they may consider creating and implementing different
tasks that will let their students interact and connect with
their fellow students even during online and modular
classes. Teachers may come together and discuss tasks
that will integrate disciplines or subjects so that there will
be duplication of tasks. This is to address the clamor of
students about heavy workload. It would be good forteachers to devise tasks that can cater to the different
learning domains of students. Lastly, teachers may employ
activities and questioning techniques to ensure interactiveclass discussion. On the part of the school administration,
they may provide additional training to teachers as
regards management of online classes. They need to look
into the internet connectivity issues and address theseissues by building more infrastructures that will help aid
the speed of internet connection.
References

f

f

f

f

Alpos, L., Alpos, M., Mariscal, T. & Recana, F. (2021). Teaching English in a
virtual classroom: a phenomenology. Undergraduate thesis, Cor Jesu
College
Almekhla i, A. G., and F. A. Almeqdadi. 2010. “Teachers’ Perceptions ofTechnology Integrationin the United Arab Emirates School Classrooms.” Educational Technology
and Society 12: 165–175.
Amhag, L., L. Hellström, and M. Stigmar. 2019. “Teacher Educators’ Use of
Digital Tools and Needs for Digital Competence in Higher Education.”
Journal of Digital Learning in Teacher Education, 35 (4): 203–220.
doi:10.1080/21532974.2019.1646169.
Amir, L.R., Tanti, I., Maharani, D.A. et al. Student perspective of classroom
and distance learning during COVID-19 pandemic in the undergraduate
dental study program Universitas Indonesia. BMC Med Educ 20, 392(2020). https://doi.org/10.1186/s12909-020-02312-0
Angdhiri, R. (2020). Challenges of home learning during a pandemic
through the eyes of a student. https://www.thejakartapost.com/life/
2020/04/11/
Aydin, C. (2005). “Turkish mentors’ perception of roles, competencies
and resources for online Teaching”. Turkish Online Journal of Distance
Education, 6(3). Retrieved from http://tojde.anadolu.edu.tr/
Ball, Deborah & Thames, Mark & Phelps, Geoffrey. (2008). Content
Knowledge for Teaching What Makes It Special?. Journal of Teacher
Education. 59. 10.1177/0022487108324554.
Baran, E. 2014. “A Review of Research on Mobile Learning in Teacher
Education.” Journal of Educational Technology & Society 17 (4): 17,https://www.jstor.org/stable/pdf/jeductechsoci. 17.4.17.pdf?seq=1
Barnett, S., & Ceci, S. (2002). When and where do we apply what welearn? A taxonomy for far transfer. Psychological Bulletin 128, 612-37.

f

f

Eubios Journal of Asian and International Bioethics 31(5) (July 2021)

273

Bayod, R., & Bayod, C. (2020). Laying the groundworks for education ofchildren in the new normal: The case of DepEd Southern Mindanao,
EJAIB30(8) (October 2020)
Bayod, R., & Morante, J. (2020). Fears and Hopes of Indigenous Students
in Southern Mindanao
During Covid-19 Pandemic, EJAIB 30(6)(August 2020)
Bayod, R., Forosuelo, E.J., Morante, J., & Guerra, M. (2021). Bracing for the
new normal or post-normal? Challenges and aspirations of indigenous
parents for education of their children, EJAIB 31(3) (March 2021)
Berge, Z. (2009). Changing instructor’s roles in virtual worlds. Quarterly
Review of Distance Education, 9(4), 407–415. Retrieved from http://
www.infoagepub.com/quarterly-reviewof-distance-education.html
Bilbao, P. , Dayagbil, F, And Corpuz,B. (2020). The Teacher and the School
Curriculum. Quezon City: LORIMAR Publishing,Inc.
Bigatel,P., Ragan, L., Kennan,S., May,J. and Redmond,B. 2012. The
Identi ication of competencies for online teaching success. Journal of
Asynchronous Learning Newtworks, 16:1. Retrieved
March 2021.
Available @https:// iles.eric.ed.gov/fulltext/EJ971040.pdf.
Chakraborty, P., Mittal, P., Gupta, M. S., Yadav, S., & Arora, A. (2020).
Opinion of students on online education during the COVID -19
pandemic. Human Behavior and Emerging Technologies, 1–18. https://doi.org/10.1002/hbe2.240
Chen, CY., Pedersen, S. & Murphy, K.L. (2012). The in luence of perceived
information overload on student participation and knowledge
construction in computer- mediated communication. Instr Sci 40, 325–
349. https://doi.org/10.1007/s11251-011-9179-0
Coskun, L. (2019). The characteristics of compassionate teachers as rolemodels opens ways for passion, inspiration, and openness to thes t u d e n t s . Re t r i eve d M a rc h 2 0 2 1 . Ava i l a b l e a t h t t p s : / /www.researchgate.net/publication/334226589
Delgado, P. (2020). Teacher training, the great challenge of online
education. https://observatory.tec.mx/edu-news/
De Leon, E. (2020). Building and Enhancing New Literacies Across the
Curriculum. Quezon City: LORIMAR Publishing Inc.
Dziuban, C., McMartin, F., Morgan, G., Morrill, J., Moskal, P., & Wolf, A.
(2013). Examining student information seeking behaviors in higher
education. Journal of Information Fluency, 2(1), 36-54. Retrieved March
2021 at https:// iles.eric.ed.gov/fulltext/EJ1062943.pdf
Ediger, M. and Rao, D. (2013). Curriculum and school teacher. New Delhi.
Egan, T., & Akdere, M. (2005). Clarifying distance education roles andcompetencies: Exploring similarities and differences between
professional and student-practitioner perspectives. American Journal ofDistance Education, 19(2), 87–103, doi: 10.1207/
s15389286ajde1902_3
Fatani, T. H. (2020, October 31). Student satisfaction withvideoconferencing teaching quality during the COVID-19 pandemic. BMC
Medical Education. https://bmcmededuc.biomedcentral.com/articles/
1 0 . 1 1 8 6 / s 1 2 9 0 9 - 0 2 0 - 0 2 3 1 0 - 2 ?
bclid=IwAR39bxUlFB9KTw_cAtnL8hH0eVCiIu-Eu1voMfGRiUZfPOsQwcFtU_BrE8
Heng, K., & Sol, K. (2020, December). Online learning during COVID-19:
Key challenges and suggestions to enhance effectiveness. Https://W w w. R e s e a r c h g a t e . N e t / P u b l i c a t i o n /346719308_Online_learning_during_COVID-19_Key_challenges_and_su
ggestions_to_enhance_effectiveness.
Irfan, M., Kusumaningrum, Yulia, Y., & Widodo, S. (2020). Challenges
during the pandemic: use of e-learning in mathematics learning inhigher education. http://e-journal.stkipsiliwangi.ac.id/
Islam, R., Rahman, M., Kabir, Z., Rahman, S. & Kabir, S. (2020). Assessing
the challenges in online class during Coronavirus (Covid-19) pandemic in
Bangladesh. https://www.abacademies.org/articles/assessing
Jalli, N. (2020). Lack of internet access in Southeast Asia poses challenges
for students to study online amind COVID-19 pandemic. https://theconversation.com/
Joshi, A., Vinay, M. & Bhaskar, (2020). Impact of coronavirus pandemic on
the Indian education sector: perspectives of teachers on online teaching
and assessments. https://www.emerald.com/insight/content/doi/
Kapasia, N., Paul, P., Roy, A., Saha, J., Zaveri, A., Mallick, R., … Chouhan, P.
(2020). Impact of lockdown on learning status of undergraduate andpostgraduate students during COVID-19 pandemic in West Bengal,
India. Children and Youth Services Review, 105194. doi:10.1016/
j.childyouth.2020.105194
Koc, M., & Bakir, N. (2010). A needs assessment survey to investigate preservice teachers’ knowledge, experiences and perceptions aboutEubios Journal of Asian and International Bioethics 31(5) (July 2021)

preparation to using educational technologies. Turkish Online Journalof Educational Technology TOJET, 9(1), 13-22
Koehler, M. J., P. Mishra, and W. Cain. 2013. “What Is Technological
Pedagogical Content Knowledge (TPACK)?” Journal of Education 193(3): 13–19. doi:10.1177/002205741319300303
Li, C. & Lalani, F. (2020). The COVID-19 pandemic has changed education
forever. This is how. https://www.weforum.org/
Marshall Cavendish Education. (2020, July 6). Sustaining Quality
Education during the Pandemic “ Responses, Risks and Opportunities.
https://www.mceducation.com/mce-intl/about-us/social-media-pagesharing/spark/2020/07/06/sustaining-quality-education-during-thepandemic-responses-risks-and-opportunities?
b c l i d = I w A R 3 Q _ Q D Ta Vn z c g m x 3 W l s y V h 5 S 5 I Ru _ A- _ I N l W- - oSaHYaYksZu8r75cBRg
McDougall, A., Orlov, G., & McKee, D. (2020, December 10). Learning
during the COVID-19 pandemic. VOX, CEPR Policy Portal. https://
voxeu.org/article/learning-during-covid-19-pandemic?
bclid=IwAR38_U8cdy2I93TWL47x_vKi7C-QGDN95SZgEBEcnUy6skAT_qLk65Njwo
Mishra, L., Gupta, T., & Shree, A. (2020). Online teaching-learning inhigher education during lockdown period of COVID-19 pandemic.
International Journal of Educational Research Open, 1, 100012. https://doi.org/10.1016/j.ijedro.2020.100012
Moore, J. (2009).A Synthesis of Sloan-C Effective Practices. Journal of
Asynchronous Learning Networks 13(4): 73-94.
Petress, K. (2008). What Is Meant by “Active Learning”? Education
128(4): 556-569
Raob, Al-Oshaibat, & Ong (2012). A Factor Analysis of Teacher
Competency in Technology. New Horizons in Education. Vol. 60, No.1,
May 2012
Scull, J., Phillips, M., Sharma, U., & Garnier, K. (2020). Innovations inteacher education at the time of COVID19: an Australian perspective.
Journalof
Educationfor
Te a ch i n g ,1–
10. doi:10.1080/02607476.2020.1802701
Van der Spoel, I., Noroozi, O., Schuurink, E., & van Ginkel, S. (2020).
“Teachers’ online teaching expectations and experiences during theCovid19-pandemic in the Netherlands.”. European journal of teacher
education, 43(4), 623-638.
Ungar, O. A., and A. F. Baruch. 2016. “Perceptions of Teacher Educators
regarding ICT Implementation.” Interdisciplinary Journal of e-Skills andLifelong Learning 12: 279–296. http:// www.ijello.org/Volume12/
IJELLv12p279-296Ungar2793.pdf
UNESCO. (2020, April 20). 1.3 billion learners are still affected by schoolor university closures, as educational institutions start reopening aroundthe world, says UNESCO. https://en.unesco.org/news/13-billionlearners-are-still-affected-school-university-closures-educationalinstitutions? bclid=IwAR3IvrKjWG_h5RuqgpazrSQoOZmMfg7vWkYQjTSpOc2t_7zyLg4TqpfV6o
Williams, P. (2003). Roles and competencies for distance education
programs in higher education institutions. American xxx MISSING xxx

Learning by teaching during the
COVID-19 pandemic: Improving
students’ social and technical Skills
through peer editing pedagogy- Rosela Antipuesto-Angelo
Digos City National High School, Digos City Philippines
Email: roselaangelo74@gmail.com

f

f

f

-

f

f

Abstract
Because of the COVID-19 pandemic, most schools in thePhilippines, especially in Mindanao were forced to shift
the mode of curriculum instruction from face-to-face, toRadio-Based Instruction (RBI) and Television-Based
Instruction, among others. This mode of delivery posed
challenges to teachers who are handling technical subjects
which need to have hands on instruction. For students

f

f

f

274

under the Science, Technology, and Engineering (STE)
Program, academic writing is a skill they need to master.
They are required investigatory projects, essays, etc.
However, students’ writing de iciencies are evident. The
purpose of this classroom action research was todetermine if there is an improvement in their writing
quality when peer editing is applied. There were 20
students participating in the peer editing activity and in
the key informant interviews. Findings showed that themost common writing problems or errors of the students
were capitalization, punctuation, subject-verb agreement,
tenses, irrelevant materials, order, vocabulary use, andrun-on sentences with the latter as the most predominant.
Results showed that, after applying peer editing, errors
signi icantly decreased. Findings further showed that not
only the technical aspect was enhanced but also thepersonal, and social dimensions were addressed during
the peer editing activity. Students who got bored due tolockdowns have found something worthwhile to do. Thisin turn, enhances their self-esteem as well as theirempathy and sense of respect to their classmates. It canbe argued that peer editing as intervention strategy wasable to improve not only the writing quality of students
but also their humanity.
Introduction
Writing is no easy task as it involves various skills thatmany may lack or may not be able to develop completely(Carnegie Mellon University, 2021). According to Heaton(1989) varied skills are necessary for better writing which
can be grouped into ive main areas. These areas are: irst,
language use is the ability to write correct andappropriate sentences. Second, mechanical skill is theability to correctly use capitalization, spelling, andpunctuation. Treatment of content comes third, the ability
to think creatively and develop thoughts excluding all
irrelevant ideas and information. Fourth, stylistic skill isthe ability to manipulate sentences and paragraphs, anduse language effectively. Lastly, judgment skill is the ability
to write in an appropriate manner for a particularpurpose and a particular audience, together with theability to select and organize information.
At this point, Grade 9 students of Digos City National
High School (DiCNHS) under the Science, Technology, andEngineering (STE) Program are asked to craft different
types of essays, research papers, science investigatory
project, and other types of academic writing tasks.
However, based on submitted write ups, de iciencies are
obvious in their writing skills. There is incompetence insyntax, order and coherence, idea expansion, sentenceplacement, mechanics, organization, lack of vocabulary,and inappropriate use of vocabulary.
There are many writing tasks assigned to thesestudents. As a teacher whose task is not just to check
papers, time is too limited to provide comprehensive
feedback. Upon submission, teachers reads, makecorrections, assigns grades, and record them. This is thereality in English classrooms in the Philippines. It cannot
be denied, that students would just accept whatever thegrade is (and sometimes the teacher does not evenprovide feedback). If there are about four sections with 40
students in a class, it would literally mean a huge task.

Much more so, the current COVID-19 pandemic adds tothese limitations as it deprives students of the face-to facemode of instruction necessary in giving better monitoringin terms of their writing. At this point, basic grammar andother mechanical skills of the students are supposedly theleast concerns of the researcher (as their English teacher)in the students’ writing. However, bigger problems arisein the higher writing tasks when the fundamental errors
are not addressed and resolved. To make their writing
better, giving grades for their work is not enough. The
students need other strategies to improve their writing.
The writing de iciencies, the huge workload, and thecurrent pandemic have pushed the researcher to look forintervention to bridge the gap. Though, it is not expectedfrom them to have fully mastered all the writing skills
based on Heaton’s (1989) criteria; students are expected
to have learned the basic writing competencies and skills
such as grammar, organization, and mechanics.
Therefore, the researcher intended to apply peer
editing to the students. Peer editing is a strategy used by
students in the process of sharing, revising, editing, or
evaluating a writing. In applying peer editing strategy,
students are given the opportunity to share their workwith another classmate for corrections, and suggestions
on how to improve their writing. It is hoped that thestudents’ mastery of the basics of writing improve while
editing another classmate’s work. It is learning by
experience as a two-way process of engaging (Ord, 2012).
In short, the objective of this research is to see how peer
editing improves students’ writing skills.

f

f

f

f

f

f

f

f

f

f

f

Peer editing
According to Oshima & Hogue, (2007), peer editing is aninteractive process of reading and commenting on aclassmate’s writing. It is teaching students to critique awork constructively. Providing comprehensive feedback is
the most challenging part in teaching writing, and manystudies show that peer editing as a strategy of giving
feedback has been an effective tool in teaching writing
pro iciency. Responding to student writing is basicallyprovided by the teacher; however, despite the fact that it isso time-consuming and so rigorous, it is unful illing
because teacher corrections, whether detailed or lessdetailed, does not guarantee students’ learning andunderstanding of the responses. Much more so, Zheng(2007) added teacher correction sometimes affects
students’ con idence and motivation as they suffer “deathby the red pen.”
Students who did peer editing produced bettercompositions from the usual feedback, a better
understanding of each other’s mistakes, and a goodhoning of their editing skills which will have long-term
effects (Siew, 2011). Accordingly, Fahriyana (2005) agreed
in a study conducted on the value of peer editing in a
writing class that students responded positively to peer
editing and considered it very valuable. It was also foundthat the peer editing process resulted in improved
motivation in writing and in writing quality (Katstra,
Tollefson & Gilbert, 1987). Pasca (1987) studied theeffects of peer editing in pairs and found signi icant
improvement in the quality of students’ writing.

ff

Eubios Journal of Asian and International Bioethics 31(5) (July 2021)

275

Calimbo, et al. (2016) concluded that allowing
students to evaluate their own outputs enables them tosee their own errors, thus harnessing critical thinking
skills. This poses a challenge for language teachers todesign writing activities which can help students tobecome more independent and more responsible for theirown learning. Among the evaluation methods, peer
editing resulted in better writing performance. Thisinding reaf irms the value of collaboration among
students especially in the cognitively demanding task ofwriting. It was also highlighted in the study that theteacher’s mediation in the process (by providing editing
checklists or by giving speci ic editing instructions) isvery signi icant. This inding should encourage language
teachers or writing teachers in particular, to continue
exploring novel approaches in getting students more
involved in the learning process. The study dealt only withediting which is one of the stages in the writing process.
While student collaboration in the prewriting stage andevaluation stage may work well if properly mediated by
the teacher, it would be more challenging if students are
asked to come up with a collaborative writing output.
The main purpose of this classroom action research
was to determine if there are improvements in the writing
quality and social skills of Grade 9 Students of STE
Program in DiCNHS when peer editing is applied. The
research questions were:
1. What happens to the writing quality and social
skills of Grade 9 STE students when peer editing
is applied?
2. What are common writing problems encounteredby Grade 9 STE students?
3. What are the contributions of peer editing toGrade 9 STE students to improve their writing?
Methodology
This classroom action research is qualitative in nature as
it took place in its natural setting and it was “emergent
than tightly pre igured” (Cresswell, 2003). According toGreenwood and Levin (2007) action research is acombination of action, research, and participation. There
have been several models of action research spiraling
cycles (Kemmis and Mc Taggart, 1990), the helix model(Stringer, 2004), and the ive-step action process modelsof Sagor (2000) and Calhonn (1994). In this study, thespiraling model of Kemmis and Mc Taggart (1990) was
employed, which involves (a) planning, (b) acting, (c)observing, (d) re lecting, and (e) re-planning.
The study was conducted at Digos City National HighSchool, (DiCNHS) Digos City, the Philippines. Participantsof the study were Grade 9 students in the Science,
Technology, Engineering (STE) program. The selection ofparticipants was purposive in nature. The current
government protocol due to the COVID-19 pandemic does
not allow under 15 years old to leave home. For the
purposes of convenience and safety of participants,
students are limited to those living within Digos City
alone. A total of 20 students from three English 9 classes
under STE program participated in the study.
I formulated simple mechanics of peer editing to be
implemented as the strategy to intervene in the students’
writing problems. The researcher then set up online

276

Eubios Journal of Asian and International Bioethics 31(5) (July 2021)

classes about basic grammar and mechanics to refreshstudents. A general question was prepared as common
basis for the participants to write an essay. The criteria of
success of this classroom action research was also
determined in this step, i.e. this research was consideredsuccessful if there was a decrease in the total number of
error occurrences in the essay of the students after peer
editing was conducted.
Acting. I requested students to write essays. Two days
later, essays were collected from students at their houses.
After the essays were retrieved, the teacher conducted
online discussion on the basics of writing compositions torefresh students. Included in the discussions were thepresentation of the nature and purpose of peer editing
activity. Students were assigned randomly to edit an essay
written by a classmate. Since these students are generally
under 15 years of age, and mindful of the government
protocols, the researcher delivered the papers to thestudents. Students were given two days to edit the work of
the student assigned to them. After two days, the papers
were collected. The results of editing in terms of writing
errors occurred as identi ied by the editors wererecorded. The researcher returned the papers to theowner. Students were asked to make necessary revisionon their essays based on the comments and suggestions of
the editors. Revised essays were inally collected. During
the collection, the researcher made use of the opportunity
to interview each participant about their learnings in thepeer editing activity.
Observing. During the course of peer editing activity,
the researcher monitored the students’ status of drafting,editing, revising, and making the inal paper. The
researcher entertained any questions, clari ications anddiscussions raised by the participants. This was done
through online meetings and social media individual
conferences. Alongside these, the researcher recorded thestudents’ feedbacks and responses putting an emphasison the improvement these students claimed to have. She
also collated the common writing problems identi ied by
the peer editors. Secondly, the researcher did the inal
evaluation of the writings of students comparing thepaper before and after editing. She compared the common
errors made by students on capitalization, punctuation,subject-verb agreement, tenses, irrelevant materials,
order, vocabulary use, and run-on sentences. By
comparison of the initial paper and the inal paper, theteacher evaluated whether there was a signi icant
improvement in the student writing or not. This was doneby identifying if there was a decrease in common errors
made by students before and after the peer editing.
Re lecting. The researcher analyzed whether thisaction research achieved the purpose or not. When the
research results showed decrease of error occurrences inthe essay by students, it was considered successful andthe researcher stopped the action.
Re-planning. The result of this classroom action
research led the researcher as English teacher in looking
for ways to improve the implementation of peer editing.
She continues to identify appropriate development tomake peer editing responsive to the needs of the students.

f

f

f

f

f

f

f

f

f

f

f

f

f

f

f

Data collection

Two methods were utilized to collect data to identify ifpeer editing contributed and improved the writing quality
and social skills of Grade 9 students under STE Program,and to determine common problems encountered by thestudents. First, notes were written down promptly after
peer editors identi ied errors in the essays. Students’
writing samples were observed and noted. Second, theKey Informant Interview (KII) was conducted to all 20
participants to draw out their learnings from the peer
editing activity.
Ethical considerations. Full consent was obtained fromthe participants prior to the study. Protection of theprivacy of participants was ensured. There wascon identiality of the data, and anonymity of individuals
participating in the research.
Results and discussion
Thematic Analysis was employed in the interpretation ofdata. The results presented are mainly based on theexperiences described by the participants.
Table 1: Common writing errors identi ied by editors
before editing
Frequency of error
before editing

Rank

Capitalization

11

8

Punctuation

32

4

Subject verb agreement

27

6Tenses36

3

Irrelevant materials

21

7

Order

41

2

Vocabulary use

315Run-on sentences

43

1

Most common writing problems identi ied by peer
editors
Table 1 shows the writing errors editors encountered inessays they had edited. Common writing problems
identi ied were run-on sentences (rank 1), order (rank 2),
and tenses (rank 3), punctuations (rank 4), vocabularyuse (rank 5), and subject-verb agreement (rank 6). They
also had problems with irrelevant materials (rank 7)
which includes information, or examples that is out of thecentral idea. Capitalization problem ranked eight (8).
Writers had problems in sentence placement
particularly with run-on sentences. This was re lected aswell in their problems with punctuations (e.g. comma,
semi-colon or period) which act as signposts within asentence to help readers follow what the writer is saying.
For example, an editor noted a run-on sentence on thisstatement: “I managed to overcome my insecurities and I’m
still trying to accept who I am, how I look, and how I
function as human being.”
The editor is correct. It can be observed that “Imanaged to overcome my insecurities” is connected by aEubios Journal of Asian and International Bioethics 31(5) (July 2021)

f

f

f

f

f

f

f

f

f

conjunction, and, to “I’m still trying to accept who I am,
how I look, and how I function as human being.” In theoutset, the sentences involved are closely related anddividing them just doesn’t seem right. However, they need
to be divided by a period because the irst sentence, “Imanaged to overcome my insecurities” already can standalone and is totally a separate idea. While the second
sentence, “I’m still trying to accept who I am, how I look,and how I function as human being”, is not needed tosupport the irst sentence as it presents another concept.
In fact, a conjunction, such as or for example, must be
added to make the sentence conceptually sound. So, it
becomes: “I’m still trying to accept who I am such as how I
look, and how I function as human being.” The sentence is
now clear to state that how one looks and functions
become examples of who a person is as the writer seems
to convey.
Writers incorrectly fused sentences affecting
signi icantly the coherence and unity in a paragraph.
Coherence means creating relationship between ideas in aparagraph or essay while unity means that the entire
paragraph or essay focuses on a main idea. Run-on
sentences can generate mixed-up ideas in a paragraphespecially if details are not actually supporting the mainidea. The essay can become confusing, dif icult, andintricate to understand. The paragraph below is an
example of the use of run-on sentences. It does not haveorder in the structure and ideas, thus, it has no coherence
and unity: “COVID-19 pandemic has taught me to be more
responsible, I learned to help in the household chores more
frequently, it also help me to lessen the stress brought by
face-to-face learning at school and enhanced my work low
to be more productive everyday.”Moreover, tenses come along as rank three (3).
Students had issues with keeping consistency in the use oftenses. According to Douglas(2020), mastering grammar
takes years; mastering the use of tenses can be anightmare for students, in particular, to maintain the sametense throughout a piece of writing. For example, an
editor observed the inconsistency with keeping the tenseon this part of an essay: “Most of them have negative
opinions about what was happening right now. Before the
COVID-19 pandemic started, I was very busy at school andwhen I’m home I am always inside of my room. I don’t think
I communicated with my family that much because I’malways on my phone.” Besides problems of run-on
sentences, structure, grammar, and comma splices, there
is obviously a struggle in maintaining tenses. The writerconfusingly starts with past tense, “about what was
happening,” but wants to describe the present “right now.”
The writer gets so caught up in the action that s/he
unwittingly drifts from past, “I was very busy at school,”
into present tenses “when I’m home I am always inside myroom,” and moves again into past tense then present.
Results after conducting peer editing
Table 2 shows the comparison of occurrences in errors
before and after peer editing in the essay of Grade 9
students. It shows a signi icant decrease in theoccurrences of errors in the essays of the students after
peer editing. This indicates that students became
conscious of the errors and corrected these errors
accordingly. Surface error occurrences in punctuations,277

capitalization, subject-verb agreement, and vocabulary
use have been reduced. The students have indeed
improved in those areas. In the use of relevant
information or materials, the table shows that students
improved the most. By reading the essays, the researcher
observed development in the sentence structure andideas. Coherence and unity in their inal paper became
evident.
Table 2: Comparison of occurrences in errors before andafter conducting peer editing
Frequency oferrorsbefore editing

Frequency oferrors after
editing

Capitalization

11

2

Punctuation

32

5

S u b j e c t - ve r b
agreement

27

11

Tenses36

18

Irrelevant materials

21

4

Order

41

11

Vocabulary use

314Run-on sentences

43

8

In most instances, peer editors were able to identify
errors and made accurate corrections and suggestions.
For example, in vocabulary use, a student wrote: “Since
March 2020, we have been ordered to stay indoors and bequarantined since there is a virus spreading.” After
underscoring “stay indoors and be quarantined,” the editor
made a note: “I suggest that you use other terms since “bequarantined” has the same meaning with “staying indoors.”
Another editor also commented: “I admire your idea;
however, avoid repetition of words in a sentence or in aparagraph.” One editor wrote rubber stamps commentsthat made him/her sound like the teacher: “Not the best
sentence construction. The thought’s there but not properly
conveyed.” “I don’t think it is necessary.” In othercomments, they stated: “I respect your answer but it would
be nice and right if the main topic is stated in the
introductory paragraph.” Another said: “It would be nice if
this was found in the concluding paragraph.” The editors
here wittingly corrected incoherence, thus, suggesting to
put order in the paragraph.
Moreover, another editor noted a punctuation error: “Isuggest you put an apostrophe on ‘mothers doing’ to refer‘mother is doing’.” “Make your commas distinguishable aswell.” In another essay where a student wrote: “It wasn’t soeasy to get use to it even now. I ind out I can be
independent on my own.” The editor was quick to see theerror in the tense. He noted: “ ‘Use and ind,’ should be in
the past tense.” An editor suggested: “You could add
sentences or phrases that could catch the reader’sattention.” Though not part of the technical aspect, theeditor went beyond suggesting creativity.

278

Eubios Journal of Asian and International Bioethics 31(5) (July 2021)

Tenses, though, proved to be dif icult as it is the only
area with the lowest rate of improvement that is from 36
error occurrences to 16. This can imply that students indtenses to be dif icult. Douglas (2020) stated it well sayingthat there are so many tenses that itting them into simple
rules cannot happen. Thus, it is no wonder that students
struggle so much with tenses.
Finally, it must be noted that although the results show
positive results in the students’ quality of writing, there is
still so much to improve. The process of peer editing may
pose problems. Accordingly, Calimbo, Arambala &Sususco(2017) noted Zheng (2007) stating that some students
may not consider the comments of their peers and not allcomments are always correct. More importantly, somelinguistic errors are beyond the language pro iciency levelof the students. This may explain the occurrences oferrors in the inal paper.
Contributions of peer editing to Grade 9 students
When asked what they have learned from peer editing, theGrade 9 students commonly noted that it has given themthe opportunity to see their own writing weaknesses andstrengths while they are in the process of editing theirclassmates’ works. It was learning by doing, so to say, an
af irmation of Dewey’s learning by doing concept orexperiential learning (Ord, 2012). Moreover, four themescame out from the responses of the students: technicallearning, personal learning, intellectual interaction, andsocial dimension.
Technical learning: Interviews revealed that editors
realized the need to gain more knowledge, understanding,and application of the fundamentals of writing. To them,
there is so much to master on the technical side of writing.
Students indicated that they found peer editing‘challenging,’ ‘interesting’, and ‘useful.’ They also statedthat peer editing:• Helps (me)see(my) own laws in writing.
• Tells (me) that (I) have so much to improve in my own
writing.
• Corrects my grammar, tenses, sentence structures,punctuation, etc.
• Gives me suggestions on how to make my essay moreinteresting to the readers.
• Helps (me) to use of words properly if (I) am to convey
my feelings and thoughts.
• Helps (me) see that, in order to catch the interest of thereader, striking statements or igurative languages areuseful.
• Helps me see my own life journey.

f

f

f

f

f

f

f

f

f

f

f

f

f

f

f

Personal and social dimension
Worthy to note is the line uttered by a student when asked
to describe the whole peer editing activity. She said: “Itmakes me feel like a teacher.” The statement implies aboost in the student’s sense of self-esteem, con idence andresponsibility. The activity provided her an opportunity tobe empowered as she assumed the role of a teacher.
Others were in the same position also as evident in theircomments, such as: “Make your commas distinguishable.”,“You could add sentences or phrases that could catch thereader’s attention.” A sense of authority can be observed.

Students showed openness and humility in accepting
criticisms. They said: “I learn how to accept criticisms, andtaking them to heart. As I learn to correct others, I also see
myself in their shoes.” Still another student learned to behonest in pointing out the mistakes by others.
The social interaction between students provided anavenue for af irmation of ideas as well as empathy and asense of respect to their classmates. A student wrote: “Ineed to stop focusing on the bad things and should startacknowledging the good things.” The editor af irms thisview by responding: “Yes, train your mind to see the goodin every situation and start acknowledging it.”
The comments seem insigni icant. However, students
did not only concern themselves of the technical aspect ofediting but also on how they interact with theirclassmates. Peer editing has functions other than quality
checking. It functions in linking and developing social
interactions. To further argue the social dimension of peer
editing, interview results showed its collaborative aspect.
Students were able to discuss their work with each other.
Students experienced the sense of responsibility,communication, and empathy which are elements ofsocial collaboration. Comments like “I suggest that you
use....,” I admire your idea; however...,” “I respect youranswer but...,” “It would be nice if...,” showed an attempt by
the students to be respectful and polite in making
criticism and suggestions. Students became conscious
enough of their responsibility towards others. One
student said: “I have to be careful in commenting so as not
to offend the feeling of my classmate.” Another student
stated: “I learned to be patient with my classmate.”
Accordingly, they expressed that writing was not easy.
Conceptualizing what to write, organizing relevant ideas
and information, constructing correct sentences, using
proper words and punctuations are just one side ofwriting process. Creativity, personal touch, emotions, andnot dictating the mind of the writer are to be considered
as well. In the study of Calimbao et al. (2017) they cited
Diab (2010) saying that there is eventually cognitive
development in students during their interactions
through peer editing.
Finally, despite challenges that may arise during peer
editing sessions which may make the task timeconsuming and seemingly unrewarding, peer editing has
positively affected the technical aspect of the students’
papers. This should motivate students to work together
more in order to improve their quality of writing.
Implications
Based on the results and insights from the experiences ofthe students during the peer editing activity implications
are drawn. Peer editing can be useful not only for Grade 9
but to other Grade levels. It can be used not only inEnglish subjects but in other subjects as well. Elementary
students can also bene it from this activity since peer
editing activity doesn’t have standard system. On theother hand, the indings imply that peer editing, whenwell-planned and organized, can be effective to address
the problem which teachers with huge writing classes
cannot possibly accomplish.

279

Conclusions
Based on the responses of the participants, peer editing as
an intervention strategy to improve the writing quality
and the social skills of Grade 9 STE students of DiCNHS
was successful. The intervention was able to help students
become aware of their writing de iciencies through theeditors’ suggestions and error identi ication. and to
improve their social skills. Therefore, students learned
while they taught. The next cycle of action starts as thescope of peer editing expands its application to wider
groups of high school Students.

Zheng, C. (2007). A study of peer error feedback. Retrieved fromh t t p : / / w w w. m e d s c i . c n / w e b e d i t o r / u p l o a d i l e /200903/20090323093402844.pdf

References- Alexander R. Waller, PhD
ST. Stephens International School, Kaho Yai, Thailand;
AUSN Visiting Professor of Environmental Ethics andEducation
Email: arwaller1@hotmail.com

f

f

f

f

f

Calhonn, E. (1994). How to use action research in the selfreviewing school. Alexandria,Virginia.
Calimbo, A., Arambala, C. & Sususco, M. (2016). Effects ofCollaborative Evaluation Techniques on Students’ Writing
Performance
Carnegie Mellon University, 2021. Why are students coming tocollege poorly prepared to write?. Pittsburgh, PA 15213
Creswell, W. (2003). Educational Research, Planning, Conducting
and Evaluating Quantitative
andQualitative
Research. New jersey: Merryil Prentice Hall
Diab 2010 Diab, N.M. (2010). Peer-Editing Versus Self-Editing in
the ESL Classroom.
Retrievedfromhttp://www.iiis.org/
CDs2010/CD2010SCI/ISPR_2010/PapersPdf/VA
09UP.pdf
Douglas, H. (2020). Classroom Grammar: The Trouble with
Teaching TensesRetrieved fromhttps://
prowritingaid.com/art/1135/how-to-teach-verb-tenses-inwriting.aspx
Fahriyana 2005 Fahriyana, I. (2005). Peer editing in the processof learning writing done bythefourth semester
students at the English Department of Muhammadiyah
University.
Retrieved from http://eprints.umm.ac.id/
197/
Greenwood, D.J., & Levin, M. (2007). Introduction to action
Research. Sage Publication
Heaton, J. B. 1989. Writing English Language Test. New York:
Longman
Katstra, J., Tollefson, N. & Gilbert, E. (1987).The effects of peer
evaluation on attitude
towards w r i t i n g a n d w r i t i n gluency of ninth grade students. The Journal of Educational
Research.
Retrieved from http://www.jstor.org/pss/
27540253
Kemmis, S. & Mc Taggart, R. (1990). The Action Research
Planner. Victoria, Australia:
Deakin University Press
Ord, J. (2012). John Dewey and experiential Learning:
Developing Theory of youth work. University of St. Mark and
St. John, Plymouth, Uk.
Oshima, A., & Hogue, A. (2007). Writing Academic English.
Massachusetts: Addison Wesley Publishing
Pasca, S. S. (2011). Improving Students’ Writing Ability by Using
Peer Editing Technique
An Action
Research at The
Third Semester Students of English Study Program of
StkipHamzanwadiSelong In the Academic Year of 2010/2011).
Retrieved from http://digilib.uns.ac.id/pengguna.php?
mn=showview&id=19978
Sagor, R. (2000). Guiding School improvement with action
Research. Alexandria, Virginia
Siew, K.T. (2011). How does peer editing improve the quality ofstudents’ writing. Retrievedfrom
h t t p : / /conference.nie.edu.sg/paper/Converted%20Pdf/ab00279.pdf
Stringer 2004 Stringer, E. T. 2004. Action research in education:
Pearson/ Merrill/Prentice Hall.

ff

Eubios Journal of Asian and International Bioethics 31(5) (July 2021)

Bioethics education beyond theeconomics of biodiversity: The
Dasgupta Review – Time for
ecoACE?

Abstract2010 was the United Nations International Year of
Biodiversity, which was followed by the Decade on
Biodiversity that ended in 2020. However, the decline inbiodiversity continues unabated at genetic, species, taxa
and ecosystem levels. In February 2021, The Economics ofBiodiversity: The Dasgupta Review was published by the
UK Treasury. Like the WWF’s report from more than adecade ago, it urges moving beyond GDP and valuing andmanaging natural capital as one would for any otherportfolio. Further recommendations include restructuring
food production and consumption patterns, andinstitutional changes in education and inance systems.
The Dasgupta Review says many of the right things, butwill it be instrumental in affecting the required change?
The Dasgupta Review ends with a call for ecological andenvironmental education within all stages of education.
This paper recommends that ‘ecology’ education be
imbibed with the principles of bioethics and makes some
initial suggestions of what this could include at different
levels of education.
Introduction
The WWF’s Living Planet Report 2010: Biodiversity,
biocapacity and development listed several considerations
for achieving a green economy. These included using
measures such as the Human Development Index (HDI) or
ecological footprint assessment rather than Gross
Domestic Product (GDP) alone, investing in natural capitalby protecting wild areas and the diversity within them,enhancing biocapacity, valuing ecosystem services and theequitable sharing of natural resources, and reassessing
how we make provisions for food and energy. It identi ied
failures in governance and markets as reasons why the
global decline in biodiversity had become so apparent.
2010 was the United Nations International Year of
Biodiversity, which was followed by the Decade on
Biodiversity that ended in 2020. The Economics of
Ecosystems & Biodiversity (TEEB 2010) report focused on
the monetary consequences of biodiversity loss, putting a
price on nature and ecosystem services; these concepts
have in luenced economic policies. However, the decline inbiodiversity continues unabated at genetic, species, taxa
and even ecosystem levels. The Living Planet Index for280

Eubios Journal of Asian and International Bioethics 31(5) (July 2021)

2020 shows in average a 68% decrease in vertebrate
species that were monitored from 1970 until 2016. The
Living Planet Report 2020 predicts further declines andgreater economic costs if we carry on with a business as
usual approach. It advocates further conservation efforts,
sustainable production and consumption as well as
adopting more nature based solutions. Mangroves, forexample, although not as rich in biodiversity as sometropical hotspots, are habitats for many endemic species
and provide lood security for some human societies, aandare sources of food and other resources for generations tocome, if sustainably is cared for. So what needs to be done
to stem the loss of biodiversity from nature?
Dasgupta Review
In February 2021, The Economics of Biodiversity: The
Dasgupta Review was published by the UK Treasury withan introduction by Sir David Attenborough and acclaimedby the Prince of Wales. This is in good time, ahead of boththe UN Biodiversity Conference (COP 15) and the UN
Climate Change Conference (COP26) to be hosted by the
UK. It has been hailed in the media as being a landmark
publication. The Dasgupta Review, like the WWF’s reportfrom more than a decade ago urges moving beyond GDP
to valuing and managing natural capital as one would forany other portfolio. Indeed Dasgupta had previously
noted that the HDI that does incorporate education andhealth metrics still does not include natural capital andecosystem bene its when accounting for human welfare(Dasgupta, 2008). Further recommendations include
restructuring food production and consumption patterns,
and institutional changes in education and inancesystems. Indeed The Dasgupta Review says many of theright things, but will it be instrumental in affecting therequired change? It does introduce some new terminologythat helps to frame nature in economic terms, such as
de ining the mismatch between nature’s capacity tosupply and our demands on her resources as the ‘Impact
Inequality’. It lays the blame of this inequality largely upon
governments who subsidize unsustainable activities,
practices and systems. It emphasizes that we are within
and a part of, rather being apart from, nature andtherefore we can learn from studying ecosystemprocesses and limits on human economy and sustainable
development. It recognizes that she provides us withmore than just basic physical needs but also
psychological, recreational and spiritual ones; andacknowledges that nature may well have more thanpurely instrumental worth. “…like education and health,nature is more than a mere economic good. Nature
nurtures and nourishes us, so we will think of assets asdurable entities that not only have use value, but may also
have intrinsic worth.” (Dasgupta, 2021)

This re-valuation of nature means that there are
inextricable links with so many aspects of life and society.
Gandhi connected the environment with polity, economy,
health and development, concludes Moolakkattu (2010).
It was almost a hundred years ago that Gandhi wrote: “Atime is coming when those, who are in the mad rush today
of multiplying their wants, vainly thinking that they add tothe real substance, real knowledge of the world, will retrace
their steps and say: 'What have we done?’" 1
In line with internationally recognized reports thatwere reviewed by Dasgupta’s team, such as IPBES (2019),
Dasgupta urges for immediate action in economic terms,
as the costs of unharnessed loss in biodiversity areunspeakable. This echoes planetary health proponents
such as ten Have (2019), Myers and Frumkin (2020) andCole (2018), Halonen et al (2021); an imperative that is
welcomed by many as exempli ied in this quote by the 15
year-old British conservationist Indy Kiemel Greene: “Asthe British naturalist, Charles Darwin, once said, ‘A man
who dares to waste one hour of time has not discovered thevalue of life.’ Time is against us. Life in all its forms is so
precious. Without biodiversity we have nothing. Financial
sectors worldwide have to take a lead from this vital reportand invest in natural wealth, which ultimately will
determine our own health.” (Greene, 2021)
Will the Dasgupta Review be instrumental in affectingchange?
The Dasgupta Review has been compared to the 2006
Stern Review on the Economics of Climate Change, which
is often cited as being highly in luential. That review was
not without critics, being accused of exaggerations andselective reporting that could amount to scaremongering,see Tol and Yohe (2006) for example. The Stern Review
did, nonetheless, inspire a huge amount of subsequenteconomic research and has been quoted in many policy
documents since that time. It called for new technology
and interdisciplinary collaborations, both of which havebeen instrumental in seeing an exponential rise inconstruction of renewable energy systems around theworld. Indeed changes in UK law such as the Environment
Bill (2020) and policies like the phasing out of petrol
vehicles as announced by the government in November
20202 could claim to be originally inspired by Stern’sreport.
Likewise, Dasgupta calls for prompt action based on
discount modeling, as protecting nature now is cheaper
than the costs of restoration at a later date. Lilley (2016)
argued that the technological changes resulting fromincreased support for renewable and clean energy weremost likely independent of the Stern Review. The hot air
debate over the in luence of such work epitomizes thedrag on transformative change due to political processes
while global warming continues with record temperatures

1 A quote of Gandhi taken from Bombay Sarvodaya Mandal / Gandhi Book Centre [Accessed online 9-3-21.]

2 In mid November 2020 a news story spread through the media that the UK government took a step towards net-zero with end of sale of

f

f

f

f

f

f

f

new petrol and diesel cars planned to end by 2030. https://www.gov.uk/government/news/government-takes-historic-step-towardsnet-zero-with-end-of-sale-of-new-petrol-and-diesel-cars-by-2030

Eubios Journal of Asian and International Bioethics 31(5) (July 2021)

f

f

f

f

f

f

being broken and increasingly common extreme weather
events occurring year on year. A BBC report from earlyFebruary 2021 optimizes this: “The Public Accounts
Committee pointed out that ministers had irst pledged adecade ago to improve the natural environment within ageneration. But it complained of serious delays in tackling“critical” issues like air pollution, water quality and wildlife
loss. The committee - made up of MPs - said the 25-Year
Environment Plan, published in 2018, lacked a coherent setof long-term objectives or interim targets.” (Harrabin 2021,
BBC News)
Optimistically, The Dasgupta Review, goes further than
Stern as it calls for more than just technological solutions.
It may be possible to tweak climatic conditions using
technologies or we may be able to use new technologies toadapt, but once a species is extinct it is irretrievably lost.
Such losses can lead to ecosystems that are degradedbeyond repair, with potentially disastrous consequences
for economies and human wellbeing. The review states
the need to radically rethink our economic systems; unity
between economists and environmentalists can beachieved if the conservation of nature is seen to bene it
our wealth, health, and wellbeing as well as preserving
nature for its own sake.
One chapter of the report explores intergenerational
wellbeing starting from a utilitarian perspective. It
stresses that change is required at not only governmental
and institutional levels but within society at large incommunities and that every individual plays a part.
Dasgupta advocates ‘ecology’ education for all andexplicitly for women’s access to family planning education
to help tackle the impact of the ever growing humanpopulation. These are not new approaches, as Waller(2019) outlined when calling for more discussion of
population ethics to prevent a catastrophic age, but such
issues are not regularly raised in the politics ofgovernance and policy making. The Dasgupta Review ends
with a call for ecological and environmental education
within all stages of education from the youngest to
making it a compulsory component of all university
courses.:“The three pervasive features of nature – mobility,
silence, and invisibility – mean that the consequences ofactions which desecrate nature are often untraceable tothose who are responsible. Neither the rule of law nor the
dictates of social norms are suf icient to make us accountfor nature in our daily practices. Institutional rules, nomatter how well designed, would be insuf icient foreliminating environmental externalities. We will have torely also on self-enforcement, that is, be our own judge andjury. And that cannot happen unless we create anenvironment in which, from an early age, we are able toconnect with nature.”“The development and design of environmental
education programs can be directed to overcome theproblems. In their wide-ranging survey documenting direct
impacts of environmental education, Ardoin, Bowers, andGaillard (2020) have suggested that focusing on local issues
or locally relevant dimensions of broader issues, such as
collaborating with scientists, resource managers andcommunity organizations, is of enormous help. Ouremphasis in the Review on the role of communities and civil281

societies in the economics of biodiversity is consonant withthat line of thinking.” (Dasgupta, 2021, p. 496).
One way to engage communities more is to promote
citizen science projects, as extolled by the British
Ecological Society (BES): “Ecological projects involving
citizen scientists have rapidly increased in number andthere is a general consensus that they can produce highquality data that allow novel ecological questions to beaddressed.” (Hoggart, 2021)
A current example is the study of slime moulds andeven the discovery of two new species by Teresa Van Der
Heul in Australia, as reported by Motion (2021). The BES
has recently launched a citizen science hub and special
feature journals to support this venture. Is there scope fora similar platform of citizen bioethics projects to reinforce
transformative change in attitudes towards and thevaluation of nature? Engaging people with nature will
hopefully make them more aware of being economical,
being more self-reliant, and less avaricious. Thereby,
treating the ultimate cause of our environmental crises;
human greed, especially greed as seen in mostwesternized societies. Gandhi is often quoted as saying:“There is enough in the world for everyone's need but notenough for anybody's greed.” (Gandhi quoted by Kumar,2013).
The point is that what is required is for us to learn tobe less consumeristic, but grateful and satis ied with a“less is more” attitude. As Moolakkattu (2010) writes:“From a Gandhian perspective, the present environmental
mess, ranging from deforestation, soil and biodiversity loss,
to pollution and climate change is not a disease but only asymptom. A good doctor treats the disease and not thesymptom.”
ecoACE for the perpetuation of life
So what should this ‘ecology’ education, proposed by
Dasgupta, include? If it has to encourage a more conscious
appreciation of and greater value placed on nature, thensurely it should be more than the science of ecology ordeveloping the skills of a naturalist, although both of theseare vital parts. As the report says: “Research from theliterature on outdoor education and experiential learning
also points to the positive effect Nature-immersion
experiences have on the sense of autonomy and othermeasures of psychological well-being (self-esteem, selfregulation, social competency) as well as objective
measures such as vitality. In a consensus statement,
Bratman et al. (2019) include on their list of bene its ofnature experiences positive social cohesion, the ability tocarry out life tasks, reductions in mental distress,
improvements in cognitive functions, memory, attention,
creativity and children’s performance at school. The
authors also note that in addition to improvements in
psychological well-being, Nature also helps to reduce therisks of poor mental health and ameliorate the burdens ofexisting illness.” (Dasgupta, 2021, p.297).
This is where broad bioethics must be an essential
ingredient; without full appreciation of what we are a partof, we are unlikely to know its true value. There areseveral bioethical principles that should be imbibedwithin this ‘ecology’ education from the very start. These
principles include justice, protection from vulnerability,282

Eubios Journal of Asian and International Bioethics 31(5) (July 2021)

f

f

f

f

f

f

f

f

f

f

f

f

f

f

global stewardship and equitable sharing of goods andbene its as identi ied by ten Have (2019). Fostering a loveof life in all its forms is the ultimate foundation ofbioethics as proposed by Macer (1998). Even with young
children for example, who have increasing access to newtechnology apps, the joy of identifying and ilming many
‘mini-beasts’ can be a stimulating activity that leads to alifelong passion for nature, in a similar way to citizen
scientists Indy Kiemel Greene and Teresa Van Der Heulmentioned above. “The conclusion we should draw fromthis is unmistakable: if we care about our common future
and the common future of our descendants, we should all inpart be naturalists.” (Dasgupta, 2021, p. 6).
Behavioral economics has moved on from being purely
based on rational choice theory to recognizing thatemotions play a signi icant part in decision making(Balconi and Terenzi, 2012) Therefore, it is prudent tostimulate an emotional connection with all living entities
as well as developing scienti ic understanding of
ecological principles and processes.
Classical ecology education would be incomplete
without addressing concepts of carrying capacity.
Likewise, Dasgupta’s proposed ‘ecology’ education should
be bold regarding the need for, bene its of andconnections with family planning policies, thereby
impressing from the earliest age that it is the burgeoning
human population that has put the global ecosystems
under such strain. The inclusion of family planning in
middle years is essential, and many would advocate that it
could justi iably start earlier. The key is that thiseducation is more than planning to exercise rights but
also for people to become empowered to exercise their
responsibilities as well. Writers such as Ehrlich (2013)
argue that family planning is the most importantcomponent of ‘ecology’ education.
Formal philosophy education, including ethics, hasbeen shown to academically bene it both primary andsecondary students (Gorard et al, 2015 and Waller et al,2018 respectively). To understand why GDP is foundwanting and why HDI or ecological footprint assessments,
requires an exploration into the meaning of happiness andful illment, which are essentially philosophical inquiries.
Therefore, the inclusion of classical ethical frameworks aspart of the middle years of education is relevant.
Continually raising awareness of the bene its of andexercising virtues such as compassion, kindness,
resilience, prudence and temperance towards each otherand nature that we are immersed in could be the antidote
to the destructive vices of consumerism and hedonismthat have gripped modern societies.
There are many principles of this ‘ecology’ educationthat are common with planetary health concepts. Indeed,
the Planetary Health Alliance offers freely available
suggestions for several university level courses on theirwebsite. Some courses are available free from universities
such as the online course offered by TelessaúdeRS-UFRG.
There are various classi ications of educational ideologies
that distinguish different purposes, forms of knowledge,
learning theories, curriculum content and desirable
student outcomes amongst other factors (Fien, 1993;
Bartlett et al, 2001; Schiro, 2013). The details vary, butthese are essentially traditional academic, social

behaviorist, humanistic learner centered, and social
reconstructionist, according to Schiro (2013). This may be
a little simplistic, but it can be argued that for many
countries the (hidden) curriculum is largely focused on
educating the young about the ideals of consumerism andletting them become ef icient components in the enginesof production. The ideological differences of the purposeof pedagogy and curriculum content of education meansthat certain ideologies such as social reconstructionist arelikely to embrace a wider interpretation of ecologicaleducation. Fien (1993) identi ies that a socially critical
ideology could assist in overcoming inequalities andempowering students to become actively engaged insocial, political, economic and environmental issues andclaims that this ideology places stress upon social,political and moral con lict resolution. Naturally, this may
not be readily welcomed by authorities who have control
over the education system. An ecologically Active
Citizenship Education (ecoACE) curriculum would placeconcern for nature at the core, which may in many
countries be more congruent with the visions of thegoverning parties and less contentious than social
reconstructionism. The tables in Figure 1 below provide apartial comparison of ecoACE with socially critical orreconstructionist ideology. In ecoACE the ultimate desired
outcome is that students fully realize their responsibilities
towards one another in society and that that society idfully dependent of nature herself.

Figure 1: Comparison of some curriculum features anddesired outcomes of Ecological Active Citizenship
Education (ecoACE) with social reconstructionist
ideology.
UNESCO (2018) produced a template for teachers todeliver Global Citizenship Education (GCE) and theEubios Journal of Asian and International Bioethics 31(5) (July 2021)
guidance has suggestions of how to embed GCE across thecurriculum. GCE has three central attributes: educationmust be transformative, knowledge (cognitive domain)
must touch the heart (socio-emotional domain) and turninto action to bring about positive change (behavioral
domain). These attributes match what Dasgupta deems
necessary, except for lacking an emphasis on ‘ecology’. So
now is the time to broaden GCE, and embrace principles
from planetary health including the protection of
biodiversity. The purpose of ecoACE would be to equip
students with skills and knowledge, so that they are able
to actively engage in environmental and social issues.
Learning principles from nature, that has enabled theexistence of progressively complex bio or life systems forseveral billion years, should include thinking based on
concepts such as:
Interdependence and a network of interconnections, notmonocultures and monopolies.
Communication networks such as the extensive fungal
hyphae that are vital in most terrestrial ecosystems.
Regulation, monitoring and feedback loops analogous to
the neural and hormonal systems that sustain
homeostatic conditions in vertebrates.
Recycling as achieved seamlessly and locally with the
involvement of numerous specialized actors fordifferent substances and environments.
Carrying capacities, the recognition of basic pyramidal
nature of trophic levels and that this implies how
humans, being higher than producer organisms, have amaximum population density.
Furthermore, inspiration can be drawn from nature in
how organisms have evolved to take advantage of every
opportunity illing any void niche. This has led to a widebiodiversity that generally provides nature with resilience
to changes in otherwise adverse environmental
conditions. The knowledge for ecoACE must be foundedon scienti ically acquired data in both natural and social
sciences. Ultimately, this will ensure the health andwellbeing of all and all life in our ecosystems. To further
develop and roll out a new ecoACE necessitates acommitment to education for all communities at a global
level, as part of the medicine for a sick humanity that has“diseased” its own life support systems and habitat.

f

f

f

f

f

Summary
The Dasgupta Review reiterates indings of several global
assessments of biodiversity adding economic perspectives
that must be taken seriously and into full consideration in
future policies. Dasgupta does not mince his words. He
emphasizes that time is of essence to adopt a threefold
approach of balancing the impact equation, changing how
we measure economic success, and transforming
institutions and systems such as education. Nonethelesshe remains cautiously optimistic hoping that: “…our innate
capacity can be redeployed to bring about transformativechange, perhaps even in just as short a time. Although time
is not on our side, it is not too late for us, both individuallyand collectively, to make the conscious decision to change
paths. Our descendants deserve nothing less.” (Dasgupta,
2021, p. 486).
He passes the baton to the rest of us to act promptly.
This will involve rethinking our ideology for education

283

putting our interest in the wellbeing of all life and living
systems at the centre, thereby promoting engagement inmore purposeful citizen science and bioethics projects.
Furthermore, we in the bioethics community can take thisas an invitation to contribute towards refocusing andinvigorating GCE to develop an ecoACE curriculum. By
including the moral medicine of broad environmentally
inclusive bioethics in education programs, we can stop the
bleeding of biodiversity – the very life blood that sustains
our biosphere – thereby healing ourselves and our planet.
Acknowledgements
Thanks to participants at the Fifteenth International
Public Health and Bioethics Ambassador Conference(IPHA15) who provided helpful feedback and comments
to a presentation based on an earlier version of this paper.
Thank you also Mr Terry Morgan CBiol MRSB forsuggestions of additional sources of data andconsideration of alternative perspectives for this paper.
References
Ardoin, N. M., A. W. Bowers, and E. Gaillard (2020),‘Environmental Education Outcomes for Conservation: A
Systematic Review’ Biological Conservation, 241, e108224 citedin Dasgupta, P. (2021), The Economics of Biodiversity: The
Dasgupta Review. (London: HM Treasury)
Balconi, M. and Terenzi, A. (2012) “Neuropsychology of moral
judgement and risk seeking: what in common?” Ch. 5 in
Innocenti, A. and Sirigu, A. (Eds.) Neuroscience and theEconomics of Decision Making. Pp 86-108. London and New
York: Routledge, Taylor and Francis.
Bartlett, S., Burton, D. and Peim, N. (2001) Introduction to
Education Studies. London: Paul Chapman.
Bratman, G. N., C. B. Anderson, M. G. Berman, B. Cochran, S. de
Vries, J. Flanders, C. Folke, H. Frumkin, J. J. Gross, T. Hartig, P. H.
Kahn Jr., M. Kuo, J. J. Lawler, P. S. Levin, T. Lindahl, A. MeyerLindenberg, R. Mitchell, Z. Ouyang, J. Roe, L. Scarlett, J. R. Smith,M. van den Bosch, B. W. Wheeler, M. P. White, H. Zheng, G. C.
Daily (2019), ‘Nature and Mental Health: An Ecosystem Service
Perspective’, Science Advances, 5(7), eaax0903 cited in
Dasgupta, P. (2021), The Economics of Biodiversity: The
Dasgupta Review. (London: HM Treasury)
Cole, J. (2019) (Ed.) Planetary Health: Human Health in an Era of
Global Environmental Change. Wallingford, UK: CABI.
Dasgupta, P. (2008) “The Welfare Economic Theory of Green
National Accounts.” Environmental and Resource Economics
42(1):3-38
DOI: 10.1007/s10640-008-9223-y [Accessed
online 1-3-21. Available from:https://www.researchgate.net/
p
u
b
l
i
c
a
t
i
o
n
/
23779206_The_Welfare_Economic_Theory_of_Green_National_
Accounts]
Dasgupta, P. (2021) The Economics of Biodiversity: The Dasgupta
Review. (London: HM Treasury) [Accessed online 10-2-21.
Available from: www.gov.uk/of icial-documents]
Ehrlich, P.R. and Ehrlich, A.H. (2013) “Can a collapse of global
civilization be avoided? Proceedings of The Royal Society B 280:
20122845 [Accessed online 21/1/19. Available from: http://dx.doi.org/10.1098/rspb.2012.2845]
Fien, J. (1993 ) “Major characteristics of the vocational/neoclassical, liberal/progressive and socially critical orientationsin education.” In Fien, J. Teaching for a Sustainable World.
Australia: Grif ith University.
Gorard, S., Siddiqui, N., & Huat, B. (2015). Philosophy forChildren, Education Endowment Foundation, [Accessed online
15-2-21.
Availablefrom:https://

Eubios Journal of Asian and International Bioethics 31(5) (July 2021)

f

f

f

f

f

f

educationendowmentfoundation.org.uk/uploads/pdf/
Philosophy_for_Children.pdf]
Halonen,J.I., Erhola, M., Furman, E., Haahtela, T., Jousilahti, P.,
Barouki, R., Bergman, A., Billo, N.E., Fuller, R., Haines, A.,
Kogevinas, M., Kolossa-Gehring, M., Krauze, K., Lanki, T., Lobo
Vicente, J., Messerli, P., Nieuwenhuijsen, M., Paloniemi, R.,
Peters, A., Posch, K-H, Timonen, P., Vermeulen, R., Virtanen,
S.M., Bousquet, J., and Ant´o, J.M. (2021) “A call for urgent
action to safeguard our planet and our health in line with theHelsinki declaration.” Environmental Research 193 (2021)
110600. [Accessed online 12-2-21. Available from: https://doi.org/10.1016/j.envres.2020.110600]
Harrabin, R. (2021) Government 'painfully slow' on protecting
environment. BBC News. [Accessed online 16-2-21. Available
from: https://www.bbc.com/news/uk-politics-55911645]
Hoggart, S. (2021) Introducing the Citizen Science Special Featureand Hub. British Ecological Society. [Accessed online 15-2-21.
Available from: https://www.britishecologicalsociety.org/
introducing-the-citizen-science-special-feature-and-hub/]
IPBES (2019) Summary for policymakers of the global assessment
report on biodiversity and ecosystem services of theIntergovernmental Science-Policy Platform on Biodiversity andEcosystem Services. Díaz, S., Settele, J., Brondízio, E. S. et al(eds.). IPBES secretariat, Bonn, Germany. [Accessed online
9-12-20. Available from from: https://ipbes.net/sites/default/
i
l
e
s
/
2
0
2
0
0
2
/
ipbes_global_assessment_report_summary_for_policymakers_en.pdf]
Kiemel Greene (2021) quoted in The Economics of Biodiversity:
The Dasgupta Review – Reactions (London: HM Treasury)[Accessed online 10-2-21. Available from: www.gov.uk/of icialdocuments]
Kumar, S. (2013) Soil, Soul, Society: a new trinity for our time.
Leaping Hare Press, Brighton.
Lilley, P. (2016) “The Stern Review: Ten years on.” The
GlobalWarming Policy Foundation Brie ing 23. GlobalWarming
Policy Foundation: London [Accessed online 11-2-21. Available
from: www.thegwpf.org]
Macer, D.R.J. (1998) Bioethics is Love of Life: An Alternative
Textbook Christchurch, N.Z. : Eubios Ethics Institute. [Accessed
online 15-2-21. Available from: https://www.eubios.info/
BLL.htm]
McMichael, A.J. (2017) Climate Change and the Health of Nations:
Famines, Fevers, and the Fate of Populations. New York: Oxford
University Press.
Moolakkattu, J.S. (2010) “Gandhi as a Human Ecologist.” Journalof Human Ecology 29(3): 151-158.
Motion, A. (2021) “Breaking the mould.” Chemistry World. 18(1):11Myers, S.S. and Frumkin, (2020) Planetary Health: Protecting
Nature to Protect Ourselves. Washington, DC: Island Press.
Schiro, M.S. (2013) “Introduction to the curriculum ideologies.”
In Schiro, M.S. (2013) Curriculum Theory: Con licting Visions
and Enduring Concerns 2nd Edition. pp 1-13. Thousand Oaks,
CA: SAGETEEB (2010) The Economics of Ecosystems and Biodiversity:
Ecological and Economic Foundations. Kumar, P. (Ed.) London
and Washington, DC: Earthscanten Have, H.A.M.J., (2019) Wounded Planet: How Declining
Biodiversity Endangers Health and How Bioethics Can Help.
Baltimore: John Hopkins University Press
Tol, R.S.T. and Yohe, G.W. (2006) “A Review of the Stern Review”
World Economics 7 (4): 233-250
UNESCO (2018) Preparing Teachers for Global Citizenship
Education: A Template United Nations Educational, Scienti ic
and Cultural Organization, Paris and Bangkok. [Accessed online
16-2-21. Available from: https://unesdoc.unesco.org/ark:/
48223/pf0000265452]

f

f

284

Waller, A.R., Suchai, S., Buosonte, R. and Thanarak, P. (2018) “Theuse of simpli ied energy calculations in ethical decision makingof biofuels by secondary school students: From a case study ina Thai international school.” Journal of Renewable Energy andSmart Grid Technology, (13) 1:
Waller, A. (2019) “Preventing the Catastrophian Age:mechanisms to negate the need of lifeboats.” Eubios Journal of
Asian and International Bioethics 29(1): 36-41.
WWF – World Wide Fund For Nature (2020) Living Planet Report
2010: Biodiversity, biocapacity and development. Gland,
Switzerland.[Accessed online 13-2-21. Available fromwww.panda.org]

Further online resources
UK Environment Bill (2020) available from https://publications.parliament.uk/pa/bills/cbill/
58-01/0220/200220.pdf
UK phasing out of petrol vehicles by 2030. “Government takes
historic step towards net-zero with end of sale of new petroland diesel cars by 2030” available from: https://www.gov.uk/government/news/government-takes-historicstep-towards-net-zero-with-end-of-sale-of-new-petrol-anddiesel-cars-by-2030
Design suggestions for undergraduate and postgraduate
planetary health courses are freely available at https://planetaryhealthalliance.org/build-your-course. This has
several dimensions and principles in common witheducation to sustain a biodiverse world.

Water rights: Ethical issues anddevelopmental impact- Christopher Ryan Maboloc, PhD
Associate Professor, Ateneo de Davao University
Visiting Professor for Global Justice, AUSN
Email: ryanmaboloc75@yahoo.com
Abstract
Ethical approaches and the right development framework
are critical in water use and conservation. Water as aresource is not unlimited. Darryl Macer et al. (2011) point
to the necessity of understanding the basics of water, usesof water, water resource availability, and con lict. Water isa very precious resource that in the future can be a sourceof tension due to unabated urbanization. In the Kaliwa
Dam Project in the Philippines, the Dumagat Tribe is at
the heart of the issue. If the right policies are not in place,progress can have a severe impact on communities. Water
has become a commodity because urbanization has
resulted in massive water use in big cities that do not havetheir own source. This means that urban centers need to
get their water from somewhere else resulting in social
discord and disputes pertaining to water rights. In
addressing the issue of water supply and use, this paper
examines the role of policy, ef icient infrastructure, andgood governance.
Introduction
The complexity of social problems includes harsheconomic repercussions, socio-political consequences,and deep ethical issues that need to be analyzed. The useof limited water resources is one of them. Dams provide

Eubios Journal of Asian and International Bioethics 31(5) (July 2021)

f

f

f

f

f

f

f

f

f

f

f

f

hydro-electric power and irrigate farmlands. But big dams
have been blamed for the displacement of indigenous
communities due to looding in low-lying areas. The Three
Gorges Dam in China, for instance, caused thedisplacement of many people (Padovani, 2007). Finding
the balance is dif icult when it comes to protecting theenvironment and pursuing national progress. The ethicalapproach is to achieve both ecological sustainability andeconomic development. This requires a type of growththat does not harm the environment.
According to Rola et al. (2018) “global projection
states that, for 2025, only 10% of renewable water shallhave been withdrawn.” The right development framework
must be chosen when for water use and conservation.
While the planet is about two-thirds water, less than 1%of that water is drinkable. According to the World Bank
(2021), 2.2 billion people do not have access to safe
drinking water. To develop the water infrastructure of anurban center requires billions in investment. In thePhilippines, two companies, Maynilad and Manila Water
have invested in repairing old distribution lines to solve
water leaks. Privatization, however, does not come cheapon the part of consumers.
Urbanization means concrete roads, toweringbuildings, and more condominiums. Massive urban
projects, either by governments or the private sector,
require huge improvements in the supply of water. For
this reason, the government has to look for sustainable
water resources. When it comes to supplying water toMetro Manila, the construction of the Kaliwa Dam wastouted as the biggest project so far. It is a 12.2 billion-peso
project funded by Of icial Development Assistance (ODA)from China through the China Export-Import Bank asreported by the Metropolitan Waterworks and Sewerage
System, a government regulatory agency (MWSS, 2021).
However, this project is contentious. The reason is that theethnic Dumagat Tribe in Quezon Province has not given its
consent due to the fact that they will be displaced by thedam (Manila Standard, 26 March 2021).
Indigenous Peoples are under constant threat due toindustrial expansion in the cities. Corporate interests
undermine the way of life of the marginalized sector. Rolaet al. (2018, p. 7) write that “rapid increase in populationand creeping urbanization gave rise to con licting
demands for water for domestic, agricultural, andindustrial purposes.” The ethics of water use andconservation need to identify various points of contention
and determine the points of convergence. Development
involves questions about its meaning. Des Gasper (2004,p.14) asks: “is development material advance orsomething else or a combination of material advance andsomething else?” The question of development, in thisregard, is about inding the right model that goes beyond
the economic.
The above situation gives rise to discussions on waterrights. What is the right to water? The access to safe
drinking water was recognized by the United Nations in2010. The global body sees the importance of water as afundamental resource that is necessary for the realizationof other human rights. According to the UN Water (2021),“lack of access to safe, suf icient and affordable water,
sanitation and hygiene facilities has a devastating effect285

on the health, dignity and prosperity of billions of people.”
Rights correspond to particular obligations (Pogge, 2007).
In this respect, there is a need to draw what theseobligations are on the part of the state and the corporate
sector, if societies are to sustain equitable growth andprogress.
The value of water
An important dimension when it comes to the experienceof ethnic groups is that for them the land is the source ofthe life of the community. An essential element when it
comes to the ability of land to enable people to live iswater. According to Karl Gaspar (2021), for indigenous
peoples land is sacred. Even the development of Western
Civilization reveals that the irst permanent settlers dwelt
in an oasis. The irst settlements lived in the Tigris andEuphrates Rivers. The reason is simple. Without water,
people cannot survive. Water is the source of life andwithout it, living is impossible. The emergence of humancivilization, in this case, is rooted in the value of water not
as a material resource but as something that is oftranscendental value.
The irst human beings devoted their time hunting. It
was the case since no social system was established yet.
The idea is that the abundance in nature meant that there
was no need to produce nor compete for resources. As theearliest people began to settle near riverbanks, farming
started. This meant growing something for consumption.
This requires the presence of a steady supply of water. In
this case, agriculture emerged as an economic activity
since water was present as a resource. Later on,
waterways and rivers were used as important traderoutes. This implies that water serves not only an
economic purpose, but also a political one as countries
compete with each other in a globalized environment.
The progress in the science of economics, however, hasresulted in the commodi ication of our natural resources.
In this case, nature becomes some form of raw material.
The consumer market desires the making of products on
the basis of pro it and earnings. Just like the early settlers,
water is crucial in order to sustain communities. But
water resources are exploited by corporate interests.
Development is a question of prioritization. In an
industrial society, water is used to satisfy the appetite of
big business instead of securing the basic need of thepeople. The right way forward is a policy direction that ismotivated by the concern for the interest of the public.
Rola et al. explain (2018, p.5): “This situation is brought
about, on one hand, by increased water demand arisingfrom economic and population growth, and, on the other, bydecreased water supply associated with degradation offorest watersheds in the country. Second, the data on
aggregate availability are illusory in that they indicate
average supply per capita per year, without regard to the
distribution of available supply.”
When it comes to water resources, three factors are
critical: sound water policy, ef icient infrastructure, andgood governance. Policy-wise, the state must look into
water sources, use and conservation to improve people’squality of life. Golf courses, the construction boom,
condominiums, and big malls, among others, consume somuch water. But while this is the case, policy making lacks

286

Eubios Journal of Asian and International Bioethics 31(5) (July 2021)

the foresight in terms of planning for the future. Whilebuildings are being erected in big cities, there is no
guarantee as to where cities might get their water supply.
An example is Cebu City. There is no water shortage rightnow in this emerging center in the Philippine South, but
this may not be the case in the next 50 years. Urbanization
brings many problems. But there is no greater problem
than a water crisis. Policy must look into the question ofpriority and values when it comes to the type ofdevelopment introduced to the people.
Corporate investments are needed to improve water
distribution facilities. But the point is that when it comesto rights, the good of the people must be the priority, notthe corporations or any private interest. The right ofindividuals to clean water cannot be limited to theeconomic aspect. Economic rights are rooted in thematerial wellbeing of persons. Access to clean water is an
undeniable part of it. When it comes to a natural resourcesuch as water, reducing it to an economic right diminishes
its essential purpose which is sustaining life. First World
societies use innovative ideas to improve water
conservation. Good and ef icient infrastructure areneeded, but considering holistic development is necessary
to integrate the issue of water use with other things.
Good governance means that policy makers recognize
the fact that water concerns national patrimony. People
are entitled to access to well-managed water systems.
What must be noted is that although concessionaires
invest big money in the infrastructure and are allowed bylaw to recoup their investments and pro it from the same,
there must be a limit to pro it making. Indeed, corporate
interests cannot commodify water resources because it isviolative of the national patrimony. The constitutionalright or entitlement to water can only be based on the
pursuit and promotion of the public good. Selling water at
a rate that is unaffordable to the poorest people is not
acceptable. The government, in this sense, has an
obligation to protect the interest of the least advantaged,
since water is a public good.

f

f

f

f

f

f

Resiliency and the challenge of sustainable
development
Sustainable development means that progress is balancedwith the care for the natural environment. If growth is notsustainable, people cannot make meaningful choices. A
life that is well-lived is anchored in the basic capacities ofthe person. The components of a good life are education,
healthcare, and the protection of one’s civil rights. The
government must ensure the availability of drinkablewater for people as without it, life becomes dif icult. In the
future, the growth of local communities and other sectors
will largely depend on water supply. Pulhin et al. (2018,p.21) say: “future projections pose a major challenge interms of making water available to meet the increasing
demands of the different sectors.”
The concept of sustainability is an important factor in
the ethics of development. The United Nations hasrecognized that water is at the core of sustainable
development (UN Water, 2021). Sustainability is foundedin the concept of reconciling our present demands with
the needs of the future. This means caring for thegeneration in the decades to come. Progress is importantbut it should not be at the expense of future generations.
Human well-being is by and large about the availability ofresources in the future. Droughts, for instance, cause
starvation and famines. Without crops to harvest,
indigenous peoples are forced to go into cities to beg. Sucha situation is the result of years of neglect and exclusion.
As a result, women and children from indigenous tribes
experience humiliation.
But while the problems persist, the Philippine society
has overcome many calamities, the most prominent of
which include the eruption of Mt. Pinatubo and Typhoon
Yolanda (Haiyan). David Sauri (2018, p.147) writes that
“resilience is replacing sustainability as the buzzword fordeveloping better solutions to our current environmental
issues.” Resiliency is a multifaceted concept. On the part ofFilipinos, the core values of the family have something to
do with it. The tight culture of the country is rooted in ahistorical context. As a colony of Spain, people have been
subjected to harsh rules and conditions. The desire forliberation meant that nationalism needed a type ofcohesion that empowered people to survive despite allodds. This cultural context is relevant in understanding
the issues confronting Philippine society in the postcolonial period.
Sauri (2018, p.147) explains that the “the concept ofresilience needs to expand its horizons and move from therelatively well known and safe world of technology andmanagement to the much more dif icult and uncertainsocial and political arenas.” The Philippine society iscomplicated by its elitist system. The people in themargins of society, in this respect, have to rely on
communal values. The concept of “bayanihan” (the word
“Bayani” means hero; it is rooted in the word “Bayan”
which means nation) implies putting others above
oneself. This means that people can draw from their life
experiences the value and meaning of social solidarity.
People know that the community is out there, able andwilling to give support in times of need. Mansueto (2020,p.88) says that “in terms of their socio-political existence,
the Filipino ethnic groups are communal.”
The approach to resilience, according to Sauri (2018,
p.147), is “the classical paradigm of risk reduction by
diversifying sources of supply but including in the process
a strong compromising in diversifying decision making aswell and making citizens active in their water futures.” Aholistic strategy may be lacking when it comes to water
conservation, utilization, and development in thePhilippines (Rola et al., 2018). Some leaders only consider
the economic impact of development projects before
making a decision. For this reason, projects often result inunintended consequences to the environment. The
problem, it can be argued, comes from a top-down
approach to decision making. The input of the community
needs to be considered seriously if meaningful change isdesired.
Water rights and good governanceInstitutional problems reveal the weakness of statecentric approaches. Con licts that have an effect on water
source involve local culture and its role in development.
However, this study intends to advance an integrated andholistic approach that will consider various areas crucial

Eubios Journal of Asian and International Bioethics 31(5) (July 2021)

f

f

f

f

f

f

f

f

f

f

in the use and conservation of water resources. Policy
makers must understand the meaning and value ofresiliency and its relation to the idea of sustainability.
These are not just NGO (Non-Government Organization)
terms. Rather, they have implications on policy andtherefore, the lives of people. The issues concerning watersupply and use involve the problem of governance.
According to Rola et al. (2018, p.3): “The impending water
shortage is an outcome of weak governance. This weakness
is further revealed through destruction of tropicalrainforests and catchment areas, water pollution, excessive
extraction of groundwater, general water misuse, and poor
resource management. It must be known that thePhilippines has a multitude of laws and policies as
governance instruments, but structural constraints in water
policy in the Philippines persist.”
The role of the state is the promotion and protection of
the public good. Thus, it is the obligation of the state tosecure the good of the people when it comes to their basic
necessities. Water is an essential component of a life welllived. Without water, the ability of people to improve theirliving standards is constrained. In this regard, the stateshould ensure that water is not commodi ied. Unlike othergoods, water is a natural resource that belongs to the state
and thus, the ultimate entitlement to it belongs to thepeople. While we need the investments to develop water
sources and make the distribution ef icient, a line must be
drawn when it comes to making a pro it out of business.
There is an apparent lack of transparency when it
comes to water management and governance. Decisions
made on operations have an impact on the utility of water(De Asis et al., 2009). The problem is that the public does
not have the opportunity to express themselves as
stakeholders. Since water distribution belongs to thecategory of being a public utility, the nature of theundertaking should be to advance the interests ofconsumers. The state has the role to regulate the waterbusiness since it is the people who must ultimately bene itfrom every activity concerning water as a natural
resource. De Asis et al. (2009) propose a public complaint
mechanism. Without such an initiative, they argue that the
public will be severely disadvantaged by private interests.
The search for water sources might lead to a con lict ofvalues when it comes to the right to water. On one hand,
the Kaliwa Dam issue is about providing more than 11
million people a sustainable source of water supply in thenext 50 years. This is important not only for the future of
the country but for the survival of Metro Manila as well.
On the other hand, there is a need to recognize thecultural heritage of indigenous peoples who have been at
the receiving end of extractive economic activities brought
about by the unimpeded growth of urban centers. The
main consideration must be the holistic well-being of all.
The solution lies in the right policy and an effective
enforcement of measures that will protect the interests ofboth parties. The government must provide enough safety
nets. However, while this is the practical way forward, theright of the Dumagat Tribe to their unique culture andway of life must be recognized by the government. It is notenough that only economic provisions are given. There
must be opportunities for people to live well if they are to
be relocated somewhere. This will require building

287

schools and health facilities and creating open spaces forthe community and livelihood opportunities.
To achieve the above, good governance is needed. A
mechanism against corruption must be enforced. A purely
utilitarian approach that considers the bene its andoutcomes may not be enough. The integrity of thegovernment in pursuing the interest of all parties is
crucial in maintaining the delicate compromise between
progress and ecological balance. Progress is necessary forthe population to attain a higher standard of living. But itshould never be at the expense of the marginalized. The
support for the future of marginal peoples can only comefrom a government that respects the identity of the latter.
Conclusion
The access to clean and potable water is a universal rightthat must be respected by the government and the private
sector. For this reason, the government has the duty toprotect the interests of the public when it comes to water.
It must not allow the exploitation and commodi ication ofwater by corporate interests since this natural resource isa basic property of the state’s national patrimony. The
ultimate role of the state is to promote and protect theinterest of the public. Such is a requirement of social
justice.
Sustainability is crucial to achieve holistic progress.
But this should not mean that a resilient spirit on the partof the people will no longer matter. It matters becausesuch values come from the life experiences of people thatallow them to develop skills to survive dif iculties and to
overcome life’s obstacles. As a matter of policy, the idea ofsustainability is about having the foresight to strategicallyplan for the future and not just be contented with thebene its derived from the present. In this sense, thatdelicate balance between progress and environmental
preservation must be maintained.
When it comes to con lict of rights and values, theappropriate approach is not just to rely on one ethicalprinciple. For instance, integrity is crucial when it comes
to issues and the tension involving indigenous
communities and the needs of mainstream society. While
the good of the majority is preferred from a utilitarianend, the concept of social justice demands that indigenous
communities must be respected and their right to live
their unique way of life be recognized.
References
De Asis, M.G.; O’ Leary, D; Ljung, P., & Butterworth, J. 2009.
Improving Transparency, Integrity and Accountability in Water
Supply and Sanitation. Washington: The World Bank.
Gaspar, K. 2021. Handumanan: Digging for Indigenous Wellspring.
Manila: Claretian Publication.
Gasper, D. 2004. The Ethics of Development. Edinburg: Edinburg
University Press.
Macer, D.; Liu, J.; Dorjderem, A.; Fu, J.; Lei, X.; Liu, H.; Qiao, Q.;
Sun, A.; Tachiyama, K.; Yu, L. & Zheng, Y. 2011. Water Ethics andWater Resource Management. Bangkok: UNESCO.
Manila Standard. March 26, 2021. “Lack of tribes’ consent stalls
12.2 Kaliwa dam project funded by China’s export-importbank.” [Internet] https://manilastandard.net/mobile/article/
350490288

Eubios Journal of Asian and International Bioethics 31(5) (July 2021)

Mansueto, M. 2020. “The Value System in our Nation’s History.”
In Ethics in Contemporary Philippine Society. Edited by CRB
Maboloc. Davao City: SMKC Publishing.
MWSS. 2021. New Centennial Water Source – Kaliwa Dam Project.
[Internet] https://mwss.gov.ph/projects/new-centennialwater-source-kaliwa-dam-project/
Padovani, F. 2007. “Displacement from Three Gorges Dam.” In
China Perspectives 66: 1-14.
Pogge, T. 2007. Severe poverty as a human rights violation. In T.
Pogge (Ed.), Freedom from poverty as a human right. Oxford:
Oxford University Press.
Pulhin, J.; Ibabao, R.; Rola, A. & Cruz, R. 2018. “Water Supply and
Demand and the Drivers of Change.” In Water Policy in thePhilippines. Edited by Rola, A.; Pulhin, J. & Hall, R. Springer.
Rola, A.; Pulhin, J. & Hall, R. 2009. “Water Resources in thePhilippines: Overview and Framework of Analysis.” In Water
Policy in the Philippines. Edited by Rola, A.; Pulhin, J. & Hall, R.
Springer.
Sauri, D. 2020. “Book Review: Resilient Water Services andSystems: The Foundation of Well-being.” In Environmental
Research and Technology 3 (3): 147-48.
U N Wa t e r. 2 0 2 1 . Wa t e r Fa c t s . [ I n t e r n e t ] h t t p s : / /www.unwater.org/water-facts/
Wo r l d B a n k . 2 0 2 1 . Wa t e r . [ I n t e r n e t ] h t t p s : / /www.worldbank.org/en/topic/water/overview

Dealing with the decline of tourism
livelihood: The tales of Tricab(tourist cab) drivers amidst
COVID-19 pandemic- Jamyca Y. Aballejamycaaballe@gmail.com (Corresponding author)
Department of Environment and Natural Resources,
Philippines- Randy A. Tudy
randytudy@g.cjc.edu.ph- Raymond K. Hastings
hastingsraymond1@gmail.com
Cor Jesu College, Philippines

f

f

f

f

f

f

f

f

f

f

Abstract
Tourism creates jobs and helps the economy. A sub-sectorof tourism is the transportation industry. In Kapatagan,
Digos City, Philippines, which is technically part of the Mt.
Apo National Park, tourists love to visit because of several
tourist spots, including, of course, the majestic Mt. Apo,
the highest mountain in the Philippines. However, tourism
was badly hit because of the COVID-19 pandemic. Thisqualitative study aimed to describe the tales of Tricab(Tourism Cab) drivers in Kapatagan amidst the COVID-19
pandemic. We employed a phenomenological qualitative
design. Ten (10) Tricab drivers willingly participated in
the Key Informant Interview (KII). Results have shown thefollowing themes regarding their struggles: dealing withgovernment protocols, loss of income, and con lict withcolorum (illegal) drivers. As to their coping strategies,
they could ind other sources of income, borrow from loan
sharks, increase fare rates, and self-promote. They also
shared their viewpoints. The themes that emerged werebeing lexible and offering optimum quality service. The

COVID-19 pandemic has greatly affected the tourism
industry, and this has trickled down to other sub-sectors,
particularly in transportation. Despite the challenges, theTricab drivers were able to ind ways to deal with the
declining livelihood opportunities and gained worthy
insights.
Introduction
The COVID-19 epidemic is a disaster affecting hundreds ofthousands of people. In the transportation industry, the
COVID-19 pandemic presents a signi icant threat. People's
usual movement, using different modes of transportation,
has been severely threatened by this pandemic, reducing
demand and revenue (Tirachini & Cats, 2020). Cities havegrappled with containing people to minimize the spreadof the virus and continue providing services to thecommunity, like the transportation service. Because of the
COVID-19 pandemic, for the next few months or longer(Rabbi, 2020), corporations would have to deal with ahigh degree of uncertainty and concern regarding theirsales, pro it, and cash low.
Countries around the world have responded to the
COVID-19 pandemic. In the Philippines, community
quarantine was strictly implemented, which prevented
people from moving. Domestic and international travels
were cancelled. These lockdowns, although the term used
is community quarantine, greatly affected the whole
tourism industry. The COVID-19 pandemic poses a threat
to people's businesses and livelihood in the tourism
industry, particularly in the transportation sector.
The same can be said about people's livelihood in
Kapatagan, Digos City, located in Southern Mindanao,
Philippines. Kapatagan is located at the foot of Mt. Apo,
the highest mountain in the Philippines, and is a popular
tourist destination. One group who bene ited from thetourism industry in Kapatagan were the tricab (touristcab) drivers. In this paper, we present the lived
experiences of tricab drivers amid the COVID-19
pandemic. The study's indings contribute to thediscussion on how to support the public transportationindustry amid a pandemic. Does it provide a sustainable
or comparative advantage amid this current pandemic? Is
it feasible? This study will assess future research
directions focusing on how pandemics should be managed
and the need to construct sustainable and human-scalecities in light of public transportation. The experiences oftricab drivers provide a picture of this phenomenon.
Transportation challenges during COVID-19 pandemic
The pandemic hampered human activities, particularly
public transportation. The decline in passenger transportdemand due to a combination of government lockdowns
was an important consequence of this pandemic. Given
the public transport networks' capacity and transportdemand (passenger, traf ic), it is challenging to enforce
social distance criteria effectively (Mukherjee, 2020).
Moreover, in general, drivers violate the one-car-length
rule, so individuals frequently fail to maintain propersocial distance (Smith, 2020). Hence, while some modes oftransportation are permitted, there is a problem infollowing the protocols.

Eubios Journal of Asian and International Bioethics 31(5) (July 2021)
Globally, the COVID-19 has had many consequences forfood security and food supply chains, such as labor andtransport (Salik & Suleri, 2020). In the Philippines, with
the intensi ied neighborhood quarantine, drivers face
both health and livelihood uncertainty (Cabrera, 2020).
With more people avoiding daily public transport due tothe social distance, auto-rickshaw drivers in India lost
income (Shyam & Thakkar, 2020). Indeed, those in thetransportation services, especially the small ones, aresuffering and are losing means of livelihood.
In the Philippines, aside from the imposition ofcommunity quarantine, public transportation was initiallystopped. When the restrictions were slowly relaxed,
drivers had to deal with the curfew. It means limiting thenumber of hours. It was problematic for those who wereused to taking transportation in the evening, like the callcenter agents and people working until evening time. In
Digos City, police of icers and barangay tanods (village
volunteers) roam around the city with sirens wailing loudto remind the people to stay inside. Naturally, there is no
more public transportation.
Measures in the transpiration industry
Public transport is the lifeblood of the economy.
Maintaining transportation services even during the
pandemic is crucial. Both in the formal and informaltransportation sector, fewer passengers continued to get
drivers and operators (Maimunah, 2020). Murano et al.
(2020) suggested some milder travel restrictions would
be imposed, not total lockdown, to help the economy
recover. One of the obvious means is wearing masks andsocial distancing (Dzisi & Dei, 2020). Experts recommendthat people wear face masks in public (Greenhalgh et al.,2020). No one can commute without the mask while seats
are arranged so that social distancing is ensured. Anothermeasure is environmental cleaning and disinfection (Shenet al., 2020). It is an added expense, but it ensures thecouches, seats, and handles go through the sanitization
process.
Limiting people’s movement, including travels,
remains a potent strategy in containing the virus. For
instance, in the Philippines, public transportation isslowly going back to normal, but only limited, like not all
buses can run the streets. However, essential travels are
permitted, such as the delivery of necessities and goods.
The minimum health protocols must be maintained, andcurfews are still in effect in some parts of the Philippines,
including the area where this study is conducted. The
tricab drivers are affected by the pandemic but continue
to operate subject to government regulations andguidelines during the pandemic.

f

f

f

f

f

f

f

Research Methods
We used a phenomenological qualitative design. The studyof people's experiences concerns phenomenology(Creswell, 2007; van Manen, 1997). To understand tricab"tourist cab" drivers' living experiences, we adopted thedescriptive phenomenological approach. We cfocused onunderstanding the lived experiences of tricab "tourist cab"
drivers. We looked into their struggles and coping
mechanisms speci ically. To make a careful explanation of
the phenomena, we listened to their stories as we sought289

to be consistent with what Moustakas (1994), as cited by
Creswell (2007), suggested. We focused on describing
their experiences, not placing our interpretation. Our goal
was to see how "tourist cab" drivers thrived during the
pandemic.
Participants
Ten tricab "tourist cab" drivers who were driving under
the Kapatagan, Digos Tricab Operator Drivers Association(KADE TODA), the only registered tricab association
within Digos City, Southern Mindanao, were participantsin the study. Whatever their age and gender, the selectionof eligible participants was based on their workplacelocation and area of residence. We ensured that the
informants had the criteria set: (a) The participants must
be Filipino and resident of Digos City; (b) The participants
must be tricab "tourist cab" drivers in Kapatagan, Digos
City’ and (c) All participants had at least three months to 5
years of experience as a tricab driver. We used purposive
methods. The purposive sampling technique enabled us to
get information from participants witnessing a speci ic
phenomenon (Creswell, 2007). This sampling techniqueenabled us to identify the informants who had thephenomenon's experience and could provide reliable
information (Creswell & Plano Clark, 2011).
Data collection
Using a Key Informant Interview (KII), driven byquestions from the interview protocol, the data necessary
for the analysis was taken from the informants. According
to Kumar (1989), KII is typically selected because alimited number of participants are needed to provide
information about the phenomenon. Interviews wereconducted in September, 2020. This technique helps
understand the depth of a person's real experiences.
We followed the data collection cycle, as identi ied by
Creswell (2007). First, we got the recommendation fromour colleagues and friends who know our targeted
participants who met speci ic inclusion requirements.
Second, before the beginning of the interview, weestablished rapport with them. We allowed them to speakin their native language. Third, through the key informant
interview, we collected the data from their responses.
Based on the primary purpose of the study, we asked
them questions. The interview was in Cebuano, theinformants' local dialect. The informants were asked threeresearch questions: (1) What are the struggles theyexperienced in Southern Mindanao considering vehicle's
new-entry public transportation amidst the COVID-19
pandemic? (2) What are their coping mechanisms? (3)What are their viewpoints?
We did audio recording and note-taking during ourinterview, allowing precise data to be collected. Fourth,
we recorded and transcribed the interviews. Fifth, wesecurely stored data, and back-up copies of iles. Sixth,
after the interviews' conduct, we analyzed andinterpreted using Colaizzi's (1978) method. The
methodology is helpful in descriptive phenomenologicalresearch (Shosha, 2012).

290

Eubios Journal of Asian and International Bioethics 31(5) (July 2021)

Data analysis and interpretation
After conducting the interviews, data was systematicallyclustered and analyzed using the method used by Colaizzi(1978). We used the tables in the analyzes as suggested by
Tudy and Gauran-Tudy (2020), a minor adjustment usedby Anderson and Spencer (2002).
Trustworthiness and ethical considerations
Tricab drivers shared experiences were essential in thisstudy. We ensured trustworthiness to ensure this study's
quality and credibility. As Guba (1981) suggested, we
strictly observed credibility, transferability, dependability,
and con irmability to guarantee trustworthiness. In
observing ethical standards, we received permission fromthe tricab "tourist cab" drivers to conduct the study. We
told them that we would protect their rights and maintaincon identiality. By requesting them to sign the informed
consent form, we secured their informed consent. We
used aliases in the encoding of names to protect theirprivacy and to ensure con identiality. Weis and Fine
(2000) advise establishing a supportive and respectful
relationship with the informants. Because of theinformants' local dialect, we encouraged them to use it.
Results
The following results were presented based on the threeresearch questions of the study. Results are presented inthree clusters: (1) struggles, (2) coping mechanisms, and(3) viewpoints of tricab drivers in Southern Mindanao.
Struggles of tricab “tourist cab” drivers
After the interviews, we analyzed the data, and threethemes emerged. These were dealing with government
protocols, loss of income, and con licts with colorum
drivers.

f

f

f

f

f

f

f

f

f

f

f

Government protocols: The majority of the tricab "tourist
cab" drivers said their struggles amidst the COVID-19
pandemic are due to government protocols. The InterAgency Task Force (IATF) guidelines, particularly thesocial distancing and lockdowns, affect the usual set-up oftricab drivers. Through the strict imposition, speci icallythe maximum of two passengers only, they are prevented
from taking more passengers, which hampered their usual
income. Moran, a tricab "tourist cab" driver for four years,
shared his experience, saying: “It is a little bit dif icult
because earlier, in a typical scenario, no limit of passengers
as compared now. The government limits up to a maximumof two passengers. We need to abide by these rules;
otherwise, the police, particularly at the Teril checkpoint,
will arrest us if we ferry 3 or 4 persons. Unlike before, wecannot cater up to 4-5 passengers. (Moran, T1, P1, L5-8)
Moreover, Elcan, a seven-years drier, shared his
sentiments that the government does not allow people ofcertain age to go out, which added to the decrease of thenumber of passengers. “The number of passengers has
decreased because the government prohibited seniorcitizens and below 21years old to go in public places due tothe stay at home policy.” (Elcan, T2, P2, L26)
Based on the shared experiences of tricab "tourist cab"
drivers, the government's guidelines have a huge impact
on their lives. It hampered their regular operation due tonumerous restrictions and new regulations, but they haveno choice but to follow.
Loss of income: The implementation of government
protocols affected the daily operations of the tricab
drivers. With fewer passengers needing transportation
due to lockdowns and other mitigating measures, they areleft with little to make money from. The participants
agreed that being a tricab driver, compared to others
using a single motorcycle, is more bene icial. But, thepandemic somewhat eradicated this advantage. Ventho, adriver for just four months, shared his experiences bysaying: “It was better earlier compared with now as the
pandemic is still ongoing. However, tricab driving is muchbetter than "habal-habal" since I have been a "habal-habal"
driver. In tricab I can have an income with a minimum of
P500 and a maximum of P1,000, but because of COVID, it
decreased due to limites up to 2 passengers. It is notenough, especially if you have a family to feed.” (Ventho, T7,
P10, L4-6)
Con licts with colorum (illegal) drivers: Before tricabs
were allowed as public transportation in Kapatagan, there
were PUVs, and "habal-habal" (single motorcycle). Manyof these modes of transportation are not registered. The
tricbas are legitimate as the drivers and operators havepermits to operate. However, their existence creates
con lict with other drivers, especially the habal-habal.
“The "habal-habal" drivers got angry to us, tricab drivers,
but our village captain in Kapatagan announced that weare authorized to ferry passengers. One of the aims is
uniformity and legitimate public transportation for thepeople of Kapatagan amidst COVID-19.” (Belon, T5, P7,
L6-8)
Moreover, during the pandemic, as people are in needof income and money, the tricab drivers appear to be
subject to jealousy. “The situation is chaotic because,
during COVID-19, tricab was duly authorized as public
transportation in Kapatagan. Most of the single motorcycleor "habal-habal" drivers reacted to the declaration.
However, they have no choice because the authorization has
been given to us. This dispute was raised because the daily
net income of "habal-habal" drivers is decreasing.” (Sixto,
T6, P9, L7-10)
Coping mechanism of tricab “tourist cab” drivers
We asked the informants how they coped with all thechallenges they experienced. After analyzing all their
responses, four emerging themes were identi ied. These
were other sources of income, borrowing money fromloan sharks, increase of fare rates, and self-promotion.
Other sources of income: Tricab drivers createdstrategies and coping mechanisms amid the pandemic andits impact on their livelihood. They shared that theirincome was not enough to sustain their daily lives fromtricab driving only. The best way to survive was to ind
other sources of income. “If the source of sustainability for
my family and my unit's monthly payment is from tricab
driving only, it can sustain somehow, however, if there will
be other sources of income, much better. I have a vegetable
farm, wherein I planted various goods, such as carrots,

Eubios Journal of Asian and International Bioethics 31(5) (July 2021)
cabbage, and a small area for pickles in Kapatagan.”(Moran, T1, P1, L20-22)
Also, from being tricab drivers, others prefer to do
multitasking to sustain their family and other needs.
Other informants are engaged in some stuff, like what
Belon shared: “Aside from tricab driving, I do manual laborin any form. We do not have a farm, so I work in Kapatagan,
like harvesting bananas. I wake up every 1:00 am to carry abunch of bananas. By 5:00 am, it is the time to prepare fordriving my tricab at exactly 6:00 am.” (Belon, T5, P7,
L38-40)Borrowing money from loan sharks: What tricab drivers
are looking for was survival during the pandemic.
Borrowing money either for capital, payment of interest,
monthly bills, or maintenance payment was essential forthem to survive. Our informants disclosed that they could
not operate immediately due to the absence of money. Byborrowing money, they could start up and roll theirborrowed money until they could fully pay. Morandisclosed his lesson learned: “I borrow money like thearawan (daily payment scheme) for my needs. But, to pay
for it, I needed to wake up early in the morning to be theearly bird in torno (schedule). There is no room to be lazy
because you are also indebted, and pray to the Lord to giveyou grace.” (Moran, T1, P1, L23-25)
Increase of fare rates: The Tricab Association conducteda series of meetings and discussions to strategize how todeal with restricted passengers as per government's
guidelines. They came up with the suggestion of fareadjustment, from 100 pesos at the regular rate to P150.
The tricab drivers were happy about this little adjustment
because they could only carry two passengers at a time.:“It is okay for me since I can do a roundtrip and earn morebecause of the adjusted fare. During the COVID-19
pandemic, due to the limit with only two passengers, anadditional 50 pesos is added compared to just 100 before.”(Elcan, T2, P2, L34-36)
Moreover, the fare increase was helpful for the drivers.
However, they were worried about their passengers andtheir capacity to pay: “It is okay right now, because eventhough there are only two people on board, our fare isadjusted. However, the increase adds more dif iculties to thepassengers. The fare is P150 as compared to P100 before.
However, we are implementing this to recover lost income
since the number of passengers is limited.” (Dech, T3, P4,
L23-26)

f

f

f

f

f

f

f

Self-promotion: Furthermore, the participants recognized
the importance of promoting themselves. They might not
do promotions like commercial transportation companies,
but they do have their own. One of these was establishinga good relationship with commuters and having a social
media presence: “Some tourists contacted me on my
Facebook and chatted with me because I posted pictures of
tourist spots in Kapatagan. For my passengers from Davao(another city) who want to visit Kapatagan, they would
contact me. If there are more than two tourists, I willcontact my colleagues. Say, for instance, there are 8 or 6
visitors. I would call my co-tricab drivers to bring two
tricabs.” (Belon, T5, P7, L23-26)

291

Other drivers made a proper arrangement of theschedule or bookings. They promoted themselves to theirneighbors, relatives, and friends if they needed a ride: “Imaintain good communication by contacting my booked
passengers and arranging the schedule to wait for them. It
is the only technique to cope-up since it is dif icult to steal
passengers. I also arranged schedules with my former
teachers, cousins, and other relatives. I tell my neighbor inadvance what time they will go to Digos proper and whattime they will be back so that in the afternoon I can arrange
my schedule. That is our way to cope-up with our daily
quotas.” (Belon, T5, P7, L29-36)
Viewpoints of tricab "tourist cab" drivers
I asked the informants about their viewpoints as tricab"tourist cab" drivers. Based on their responses, thefollowing themes emerged. These were being lexible andoffering optimum quality of service.
Being lexible: The preferences of the passengers arealways right, at any rate. The majority of tricab drivers
shared that respect and patience are needed. When it
comes to fare, although there was already an announced
fare rate increase, they understood that they are not the
only ones suffering because of the pandemic. They knew
their passengers also suffered: “I have respect andunderstanding for the passengers. For example, when apassenger would say he has only 100 pesos and asked if I
would still carry him, I would gladly do that.” (Pedro, T4,
P6, L28-32)
Aside from being lexible with fare rates, the tricab
drivers shared that they should be considerate with otherco-drivers. They suggested being mindful of theircharacter towards their passengers.
Offering optimum quality of service: Tricab drivers
disclosed that to provide an optimum quality of service,
they should possess self-discipline. Most tricab drivers
agreed that personality is important. They should give thebest quality of service to each passenger for comfort andsecurity of health and safety must be considered. One ofthe participants shared this statement: “Before going todaily tricab driving, my irst advice is to take a bath, brush
your teeth, and change clothes and shoes. Furthermore,advise those stubborn drivers to learn respect in "torno,"
and those who smoke while driving. The essential thing is tohave complete documents; otherwise, it will be anotherburden in your daily operation if apprehended.” (Moran, T1,
P1, L35-39)
Additionally, tricab drivers shared that they provide
the best service quality to any passenger. They should be
responsible enough. They said each one must possess selfdiscipline and always be vigilant, especially during thispandemic. Health is wealth. Moreover, abiding by the rules
and regulations to ight against this pandemic shows a
responsible tricab driver: “I render the best quality ofdriving for each passenger. I always seek the passengers'
safety. I have self-discipline and consider health safety to
avoid this deadly pandemic. As a tricab driver, always abideby the rules.” (Sixto, T6, P8, L13-14.)292

Eubios Journal of Asian and International Bioethics 31(5) (July 2021)

f

f

f

f

f

f

f

f

f

f

f

f

f

f

f

f

f

f

f

f

f

Discussion
This study explored the dif iculties, coping strategies, andviewpoints of the tricab "tourist cab" drivers in Southern
Mindanao amidst the COVID-19 pandemic. Tricab drivers
experienced various dif iculties as to the crisis. It is shownthat they dealt with each problem and struggled due tothe current situation's demand. They revealed their
viewpoints through their learnings, re lections, and advice
to their colleagues and co-tricab drivers. Interviewing thetricab drivers is a way to acquire data and scrutinize theircurrent situation.
Tricab drivers have struggled over the protocols set by
the national government and local government units. This
serves as safety measures for the drivers and the safety ofpassengers and their colleagues. The IATF guidelines,
particularly social distancing and series of lockdowns, areamong the main struggles by each tricab driver. There
should be at least 6 feet distance between passengers(Centers for Disease Control and Prevention, 2020).
Tricab drives were limited to up to 2 passengers only. All
these provisions are not only for the passenger’s safety
but also for the drivers themselves. Although the drivers
considered the government measures as their main
struggle, they understood the importance and necessity
during the pandemic. Naturally, the protocols affected
their income. However, this is not only happening in thePhilippines. The pandemic has affected the economy of allnations (Donthu & Gustafsson, 2020). The con lict withcolorum drivers remains a controversial issue. In villages
like Kapatagan, there is some tolerance of transportation
with no permits because people have no jobs and found it
easier and feasible. However, it does not prevent the local
government from imposing its local laws like authorizing
legitimate organizations, like the tricab association.
It is interesting to note that these tricab drivers are
venturing into other ways of income generation. People
will be able to weather the Covid-19 inancial storm bycreating a more balanced collection of income sources,
and that is what tricab drivers portrayed. When people
are pressed to the wall, and family needs are in jeopardy,
they will ind ways. This pandemic has pushed people togo out of their comfort zones. The tricab drivers managed
to ind other means of livelihood. It is the ighting spiritthat drives them as their main source of income is notenough. Unfortunately, it involves borrowing from loan
sharks, which creates another problem because of highinterest rates. But, when people have nowhere to go, theseloan sharks are practical. The increase in fare rates wasjusti ied as the government imposed passengers' limits
depending on the vehicle. Interestingly, these tricab
drivers made use of social media and other forms of selfpromotion. In the irst place, promotion is not their forte,
but they knew how to maximize it in times of need toincrease their income.
It is amazing to learn from these drivers and theirre lections which they shared. Being lexible is nothing
new to them, but all the more needed during a pandemic
when everyone is suffering. Their compassion forunderstanding the plight of the passengers by accepting
payment below the adjusted rate is a testament to theirconcern for humanity. While they are struggling, they arewilling to meet half-way. Moreover, there are non-negotiables that they advised to other drivers. They haveto offer quality service for their commuters. Otherwise,
their business is over, especially during a pandemic.
Limitation of the study
The study was limited only to the experiences of thosetricab drivers. The results could not be generalized tore lect the sentiments of other drivers. The study did nottouch other aspects such as the tourism side, but purely intheir struggles, coping, and viewpoints as tricab drivers.
Implication of the study
One of the main struggles of the participants is thegovernment protocol. The study's result could provide
feedback to the government as to the proper handling of
the situation in the transportation industry. The
government can look into an appropriate and effective
supporting mechanism for drivers affected by the
protocols. The other area is on colorum drivers who run
in con lict with those with authorized business. For otherdrivers, the indings can be sources of re lection,
especially in coping with the challenges brought about by
the pandemic. For those in the tourism industry,transportation plays a major role. This study's indings
provide a window of how to address the problem of apandemic in a bigger scope, which includes thetransportation sector.
Concluding remarks
The journey of tricab drivers is a picture of people trying
to survive during a pandemic. Just like any other sector,
the tricab drivers had to deal with several challenges.
This pandemic has created so much inconvenience, like
limiting the movement of people. Thus, it severely affects
those in tourism and transportation. In particular, thetricab drivers had to deal with government protocols, lossof income, con lict with colorum drivers. However, despite
the challenges they encountered, they could ind ways tosurvive, such as inding other sources of income,borrowing money, increasing the fare rates, and doing
self-promotion. Their lived experiences are not far fromother people who are affected by the pandemic. However,
the richness of their experiences and the lessons people
learn from them are worth noting.
References
Centers for Disease Control and Prevention (2020). Protect
Yourself When Using Transportation: Public transit,
rideshares and taxis, micro-mobility devices, and personalvehicles. Retrieved from https://www.cdc.gov/coronavirus/
2019-ncov/daily-life-coping/using-transportation.html.
Colaizzi, P. F. (1978). Psychological research as thephenomenologist views it. In R. Valle & M. King (Eds.),
Existential phenomenological alternatives in psychology (pp.
48-71). Oxford University Press.
Creswell, J. (2007). Qualitative Inquiry and research design:
Choosing among ive approaches. Thousand Oaks, CA: Sage.
Dzisi, E. K. J., & Dei, O. A. (2020). Adherence to social distancing
and wearing of masks within public transportation during
the COVID 19 pandemic. Transportation ResearchInterdisciplinary Perspectives, 7, 100191. https://doi.org/
10.1016/j.trip.2020.100191
Donthu, N., & Gustafsson, A., (2020). Effects of COVID-19 on
business and research. Journal of business research, 117, 284–

Eubios Journal of Asian and International Bioethics 31(5) (July 2021)

f

f

f

f

f

f

f

f

f

289. Retrieved from https://doi.org/10.1016/
j.jbusres.2020.06.008.
Greenhalgh, T., Schmid, M. B., Czypionka, T., Bassler, D., & Gruer,
L. (2020). Face masks for the public during the covid-19
crisis. Bmj, 369. https://doi.org/10.1136/bmj.m1435.
Guba, E. (1981). Criteria for assessing the trustworthiness ofnaturalistic inquiries. Educational Communication andTechnology Journal, 29(2), 75–91.
Kumar, K. (1989). Conducting key informant interviews indeveloping countries. AID Program Design and Evaluation
Methodology Report No. 13, Agency for International
Development.
Maimunah, M. S., (2020). Even during a lockdown, public
transport can be a lifeline. Next City.Org, Retrieved fromhttps://search.proquest.com/magazines/even-duringlockdown-public-transport-can-be/docview/2396354795/
se-2?accountid=37714.
Moustakas, C. E. (1990). Heuristic research: Design, methodology,
and applications. Thousand Oaks, CA: Sage.
Mukherjee, S., (2020). Emerging challenges in public transportsystem amid pandemic. Retrieved from https://www.timesnownews.com/business-economy/economy/
article/emerging-challenges-in-public-transport-systemamid-pandemic/588330.
Murano, Y., Ueno, R., Shi, S., Kawashima, T., Tanoue, Y., Tanaka,S., ... & Yoneoka, D. (2021). Impact of domestic travel
restrictions on transmission of COVID-19 infection using
public transportation network approach. Scienti ic
reports, 11(1), 1-9.
Cabrera, R. (2020, March 20). Tigil pasada: Millions of Public
Transport Drivers to be Affected by Quarantine. Retrieved
from https://www.onenews.ph/tigil-pasada-millions-ofpublic-transport-drivers-to-be-affected-by-quarantine.
Salik, K.M & Suleri, A.Q., (2020). Managing food supply chain
amid COVID-19: Insights from global efforts. Sustainable
Development Policy Institute. Retrieved from http://
hdl.handle.net/11540/12174.
Shen, J., Duan, H., Zhang, B., Wang, J., Ji, J. S., Wang, J., ... & Shi, X.
(2020). Prevention and control of COVID-19 in public
transportation: experience from China. Environmental
pollution, 115291. https://doi.org/10.1016/
j.envpol.2020.115291
Shyam, A. & Thakkar, K., (2020). Financiers turn cautious on 3wheeler buyers. The Economic Times Industry. Retrieved
from https://economictimes.indiatimes.com/industry/auto/
two-wheelers-three-wheelers/ inanciers-turn-cautiouson-3-wheeler-buyers/articleshow/75883573.cms?
from=mdr.
Smith, S., (2020, Apr 15). Today’s transportation challenge:
Maintain proper spacing. Next City.Org. Retrieved fromh t t p s : / / s e a rc h . p ro q u e s t . c o m / m a ga z i n e s / to d ay- s transportation-challenge-maintain-proper/docview/
2390198565/se-2?accountid=37714.
Shosha, G. A. (2012). Employment of Colaizzi's strategy indescriptive phenomenology: A re lection of a researcher.
European Scienti ic Journal, 8(27), 31–43.
Tirachini, A. & Cats, O., (2020). COVID-19 and Public
Transportation: Current Assessment, Prospects, andResearch Needs. Journal of Public Transportation, 22 (1).
Retrieved from https://doi.org/10.5038/2375-0901.22.1.1.
Tudy, R. A., & Tudy-Gauran, I. G. (2020). Struggles, Coping
Mechanisms, and Insights of Childless Teachers in thePhilippines: A Descriptive Phenomenological Approach. The
Qualitative Report, 25(5), 1256-1278. Retrieved fromhttps://nsuworks.nova.edu/tqr/vol25/iss5/7
van Manen, M. (1997). Researching lived experience: Human
science for an action sensitive pedagogy (2nd ed.). Ontario,
Canada: The Althouse Press.

293

Weis, L., & Fine, M. (2000). Speed bumps: A study-friendly guide toqualitative research. New York, NY: Teachers College Press.

Livelihood in jeopardy: Troubles
experienced by sidewalk vendors
amidst COVID-19 pandemic- Honeylet A. Via
Local Government Unit of Digos, Philippines
honeylet1581@gmail.com (Corresponding author)- Randy A. Tudy
Cor Jesu College, Digos City, Philippines
randytudy@gmail.com- Rex B. Buac
Retired Regional Manager III. Philippine Coconut
Authority
rbbuac@gmail.com
Abstract
The COVID-19 pandemic has created a lot of chaosthroughout the world. Its devastating indirect and directconsequences spare no one. This paper explores the
struggles of sidewalk vendors in the Southern Philippines
during the COVID-19 pandemic. It seeks their coping ways
and insights about their experiences during the crisis. We
employed a descriptive phenomenological research
design. Ten sidewalk vendors participated in the semistructured key informant interview (KII). The indings
revealed three themes for their struggles. These areincapability of earning, helplessness, and loss of income.
For their coping mechanisms, small trading, gain
assistance, and monetary loans were the identi iedthemes. For their insights, two themes emergedhopefulness and frugality. Sidewalk vendors were left
with no choice but to stop selling temporarily because of
the virus's threat. Even if their livelihood is in jeopardy,
they became resilient and continued to ind a living.
Introduction
There are different ways of earning a living. One, which isvery common and probably easier to venture into, isstreet selling. However, it is very seasonal or evenirregular. Many development projects in low-income
countries aim to eliminate street vending. City
governments often take punitive steps to ban street
vendors from public spaces. Nevertheless, street vendingor selling offers a vital service for the urban poor, as it
delivers food and supplies at a lower price. Many people
take advantage of this kind of business. It can be ixed inany place. It can be mobile. The street vendors provide
essential services in cities worldwide, especially in Africa,
Asia, and South America, where residents rely on them forbasic needs. They are part of a huge informal food
network that prevents a part of the world from starving.
But, the pandemic has ravaged street vendors' livelihoods,
crippling their ability to do their jobs and leaving many
behind in a ight for survival.
When the health protocols are relaxed, some essential
services are allowed to resume gradually. National leaders
are keen to foster economic recovery with appropriate

Eubios Journal of Asian and International Bioethics 31(5) (July 2021)

precautions for public health. However, it was not easy forstreet vendors. In this paper, we explore the lived
experiences of street vendors in the Southern Philippines.
As pandemic is still around the corner, not much has been
discussed about the experience of the vendors who areproviding services to the people. This research cancontribute to the body of knowledge by hearing theperspective of the sidewalk vendors themselves. This
could be a great help for the local government toeffectively provide support and assistance to sidewalk
vendors affected by the COVID-19 pandemic.
Sidewalk vendors and the law
Almost two decades have passed with street vending as anincreasing trend in Asia (Bhowmik, 2005). Around theworld, the same scenario happened as more and more
people converged in urban areas. To prevent fromclogging the streets and to install order, local and national
governments introduced laws. Batréau and Bonnet (2016)
discuss its management informally, referring to how
Bangkok deals with street vendors. In several countries,
the legislative/regulatory frameworks regulating street
trading discourage, rather than encourage, establishing asustainable informal sector where street vendors canmeet the demand for their goods. Street vendors caneither be mobile or be at a ixed location (such as a kiosk
or sidewalk table). Others merge mobile and ixed sales.
Each form of work entails varying regulatory challenges.
Local permit laws can limit entry into the market. Zoning
regulations sometimes limit street vendors to places thatare unbearable for both sellers and their clients.
Street vendors are frequently forcefully displaced as
their typical sale areas con lict with planned construction
sites. Like any other informal economy, street vendors are
not part of the social security programs. But, when theirlivelihood is threatened, they may become de iant toauthorities and go as far as bribing them (Gumisiriza,
2021). Indeed, dealing with street vendors is complicated.
Sometimes, the law's application depends on the sincerityof the implementers and how the vendors perceive its
rationality and bene its on their part. In a global review
about street vending and public policy, Bromley (2000)
discovered no consistency in the implementation of laws,
and the government sees unexpected circumstances.

f

f

f

f

f

f

f

f

f

Advantages of sidewalk vendors
Being a sidewalk vendor or in the informal sector has its
own advantages. It helps boost the economy (Anetor,
2015; Martínez et al., 2018). It provides other job
opportunities or livelihood opportunities for the jobless.
It enables people to set up a store without many funds,
less recording, and minimal income tax to earn a living.
Being in the informal sector, one can avoid ridiculous laws
and regulations (such as absurd formal currency
luctuations or subsidies), which render tradeunpro itable and keep goods out of the store. Informal
traders will sell at market prices, and they can store theitems customers want.
The informal sector plays a crucial role in society, for it
provides what the established structures cannot offer toordinary people. Hence, people prefer to buy products
from street vendors because of easy and convenient

f

f

294

access. On the part of the vendors, it allows them to earn adecent living. Moreover, those who have jobs may feelthat their salary is not enough and ind street vending thesolution to their needs (Huang et al., 2018). They venture
into street vending to earn extra income. In short, street
vending provides opportunities for anyone who has the
skills to do business.
Plight of sidewalk vendors during the Covid 19 crisis
The COVID-19 pandemic has greatly affected street
vendors worldwide (Arsene et al., 2020; Resnick, 2020;
Romero et al., 2021). Several countries and cities allowed
street vendors to resume business as the economy andpeople's needs hit rock bottom. This was after street
vending was banned to contain the virus. However,despite good intentions, the vendors suffered a lot. Losing
one's livelihood with minimal or no support to sustain
their needs was catastrophic.
In the Philippines, the Community Quarantine (theterm used instead of lockdowns) prevented people fromleaving their homes. The government distributed relief
goods, but it was not sustained. The street vendors wereasked to stop selling. This prompted a crisis among street
vendors, for they depend on street vending for their dailyneeds. In this study, we focus on the lived experiences ofthe street vendors during the pandemic.
Research methods
In this study, we utilized a qualitative phenomenologicaldesign. Phenomenology focuses on making sense of anindividual’s human experience (Patton, 2002). The
signi icant phenomenology-derived observations are aninterpretation of a phenomenon seen through the eyes of
those who have witnessed it. We seek to understand theexperiences of the sidewalk vendors in Digos City. We
strive to know their struggles, coping mechanisms, andthe visions they have attained throughout theirexperience.
The participants of this study were sidewalk vendors.
We personally made sure that the participants wereindividuals quali ied to take part in this study. The criteria
included the following: a) They must be a sidewalk vendor
for at least 3 to 5 years; b) They must be residents in
Davao del Sur, Philippines; and; c) They have expressed ahuge impact of the pandemic in their lives as vendors. In
selecting the participants, we used purposive sampling. In
gathering the participants or informants, we asked for theCity Economic Enterprise Management Of ice (OCEEM) toassist us.
Data collection and analysis
We employed a semi-structured interview with key
informants, and used the data collection processsuggested by Creswell (1998). We asked them questions
based on the study's primary objective. The interview wasin Cebuano, the informants' native dialect, using thefollowing three research questions: (a) What are thestruggles experienced by sidewalk vendors during the
COVID-19 pandemic? (b) What are ways of coping by
sidewalk vendors during the COVID-19 pandemic? (c)What are the visions attained by sidewalk vendors fromtheir experiences during the COVID-19 pandemic?

In analyzing the data, we used the seven-step methodof Colaizzi (1978), which offers a detailed analysis, witheach step closer to the results. The method relies on rich
irst-person experiential accounts. We used tables in theanalysis as employed by Tudy and Gauran-Tudy (2020).
Trustworthiness and ethical Considerations
Trustworthiness refers to the validity and reliability ofqualitative studies. However, this concept is more obscurein qualitative studies. We demonstrated the criteria
suggested by Guba (1981), which are credibility,transferability, con irmability, and reliability. We secured
permission from the City Economic EnterpriseManagement Of ice, where our informants belonged, topursue the study for ethical consideration. After
identifying potential informants, we asked for theirconsent to participate in the study through a semistructured interview. We told prospective informants wewould respect their rights and maintain con identiality.
We obtained their informed consent by asking for theirsignatures on the informed consent form. We usedpseudonyms to observe anonymity and to protect
con identiality. We kept all other information private, suchas the location of the informants while selling.
Results
Based on the research objective, we discuss the results inthree categories-discussions of the challenges faced bysidewalk vendors, coping mechanisms, and their insights.
Struggles of sidewalk vendors during the pandemic
The irst part of the interview was all about the struggles
they have experienced during the crisis. As a result, we
identi ied three themes: loss of earning, helplessness, andloss of income.

f

f

f

f

f

f

f

f

f

f

f

f

f

Loss of earning: They were vendors. Every day theyearned money to support their family and their helpers.
As the quarantine mandate was issued, sidewalk vendors
were forced to stop selling even though it was their only
income source. Pedro, the head of the family of six,
expressed his experiences: “We are prevented from selling.
We lost our livelihood. We cannot ind money for our dailyneeds. Our helpers have nothing to eat. “(Transcript 1, Page
1, Line 10-11).
Although some of them managed to continue selling inthe sidewalks, there was a huge difference in their income.
If before they can earn a thousand pesos a day, now it ishard just to make ive hundred pesos. Due to fewer people
going outside of their homes, only a few customers cancater. Nenita, a mother of 4, addressed her experience
while selling during the quarantine period: “My biggest
problem was food. My family had nothing to eat. I only hadvery little sales, like 130 to 300 pesos only unlike before
when I used to earn around 3,000.00 pesos daily. It was very
dif icult.” (T2, P2, L11-13)
Since it was mandated to limit going outside of one’s
home, the sidewalk vendor’s income dipped. They wereincapable of supporting their family's needs because of
the shortage of funds and resources.

f

f

f

Eubios Journal of Asian and International Bioethics 31(5) (July 2021)

295

Helplessness: Sidewalk vendors felt distressed andworried about what the future may bring to them. They
said they did not have a choice because it is mandated bylaw. Being helpless resulted in worries and distress.
Geneva confessed saying: “I really worried much what to
do with my family. My money was not enough for our dailyneeds.” (T4, P4, L8-9).
Despite the danger, some continue selling. They werealready sacri icing their health just to have some income.
They were very worried about their source of income andwhere they could get funds to provide for their needs. At
the same time, they were concerned about catching thevirus spreading in the city. Nestor expressed his worries
about selling during the quarantine: “I was very worried atthat time about the quarantine. I was afraid of the virus
and worried about my small business. What will be oursource of income if it stops for good?” (T6, P7, L6-7).
In times like this, people are torn between choosing
their safety and providing for their families. They were
worried for their own safety and their families, for if they
get sick, who will earn a living then? They were sacri icing
themselves to sustain their family's needs, although theirincome was below the usual. Thus, the situation madethem helpless.
Loss of income: Although it was obvious that their sales
dropped or even stopped, the participants were quick toadmit the loss of their income as one of the major
challenges. They were forced to stop for their safety andsecurity because of government protocols. A confession
from Jane revealed her experience when the quarantine
was mandated: “When we were told to stop selling becauseof the community quarantine, we really suffered because
street vending is our only source of livelihood. We were notprepared, especially with saving money and even buying
groceries. We did not have savings. We had nothing. It wasvery abrupt.” (T9, P11, L8-10)
Some of the informants confessed that being asidewalk vendor is their only source of income. When
street vending was taken away from them because of thepandemic, they struggled to survive. Henry expressed his
experience as he lost his source of income: “I lost mysavings. We did not have money to buy our daily food. It wasvery dif icult, and I did not know where to ind something to
ill our stomach. We did not have our business, our only
source of income.” (T10, P13, L12-14).
It was tough for these sidewalk vendors to lose their
only income source, not because they wanted to but
because they were forced for their own good. Although
they understand the government’s sentiments, they
couldn’t fathom the thought that they can no longer
sustain their family’s needs.
Coping mechanisms of sidewalk vendors during the
pandemic
After analyzing the participants' responses regarding
coping mechanisms, we identi ied three themes: Small
Trading, Gain assistance, and Monetary loans.
Small trading: As they were prohibited from going backto their areas where they used to sell, the participants
made innovations to earn money even if they stayed atEubios Journal of Asian and International Bioethics 31(5) (July 2021)

home. They indulged in small trading. It may not fully help
them inancially, but it eased some of their inancial
problems. Editha, a housewife and a mother of 4, shared
her experience relate to this: “I did everything. I soldlowers since it became a trend during the pandemic. Since
I just stayed at home, I sold barbecue to do business while
just at home.” (T3, P3, L16-18)
As the sidewalk vendors struggle to ind other ways toearn, they ind it feasible to do small trading by being
innovative. Liezl indulged in small business at homeduring the quarantine period: “I sold anything at homewith my customers coming from the neighborhood. I
provided them with basic needs. In this way, I was able toearn money.” (T5, P6, L15-16)
Filipinos are known to be resourceful and innovative.
In times like this, sidewalk vendors seek other options tosustain their needs. Though not as satisfying as before, atleast they have a small income which helps theminancially.
Gain assistance: The participants recognized the effortsof the government and other individuals. They havereceived aid from several people and organizations
reaching out to help. A testimony from Nestor, in which headmitted he had received help from both the government
and private individuals, proved that some vendors gained
assistance: “We relied so much on the government’s subsidy.
We depended on the relief goods like rice and sardines. We
also received cash assistance of 6,000.00 pesos.” (T6, P7,
L14-15)The participants recognized that the assistance was
not enough, but at least it gave them support for a wholemonth or a week. At least, it lessened their worries anddistress. Edilito, a father of ive, stated how these reliefs
had helped his family, including those from otherorganizations: “It was a big help to receive assistance fromseveral people and organizations. Those food items reallyhelped us. No matter how small or big the assistance, we
considered it a big help to us.” (T7, P8, L16-18)

f

f

f

f

f

f

f

Monetary loans: It is undeniable that when people arestruggling inancially, they may resort to borrowing fromother people, especially on the case of our participants
who are into business and want to continue doing it orsimply just to satisfy their basic needs. According to theparticipants, they had to borrow money. A confession
from Oscar described his experience with loaning: “Iborrowed money, unfortunately. I had no one to go to if notborrowing money to have something to spend for ourneeds.” (T8, P10, L14-15).
These informants were left with no choice but toborrow money from various people. It is not their will, but
circumstances pushed them to do such. Jane was pushed
to borrow money because of her child’s medication: “Iborrowed money so that I can buy medicines for my child.
The other reason is for our expenses at home.” (T9, P11,
L16-17)
Although this coping strategy can result in anotherstruggle, the informants take risks to sustain their basic
necessities as they have no other option. Borrowing
money from other people can help them get funds to

f

f

f

296

establish a small business or simply buy their basic needs.
These funds are needed to survive.
Insights of sidewalk vendors during the crisis
After interviewing the informants on their struggles andcoping mechanisms, we then asked for their insights fromtheir experiences. The results revealed two themes,
namely, hopefulness and frugality.
Hopefulness: In times of crisis, hope is one of the things
that make people get going. The participants hoped thatthe future may bring a difference and that whatever they
were experiencing at the moment may end in a better
tomorrow. Henry, stated how he longed for a better
future: “Maybe we should not lose hope in life. We should
not allow this problem to linger on because I believe it
would be resolved in the future. We should not forget topray to God because he is the only one who can turneverything around. “(T10, P13, L22-24)
Hoping for a better future is a great step for theseinformants. Nestor shared his belief in hoping for the
betterment of everyone: “Just continue! We should not lose
hope that these sufferings will end. We put trust in God that
good things will come in the end. We should surpass all ofthese things. We should also be strong to defeat our
problems.” (T6, P8, L19-22)
Frugality: Frugality is the state of being thrifty ofresources and money. Unfortunately, saving was not a
habit for some of the participants. They realized how
important it is, especially during a crisis. When people areprepared, they can only feel half of the ill effect of thecrisis. Sidewalk vendors were not prepared for this crisis.
They relied on their business for their livelihood. Editha
talked about the importance of being frugal and the valueof saving: “Because of the dif iculties brought about by
the pandemic, you should think of being frugal and dosome saving measures so that you have something to pullout when needed. Members of the family should help eachother to get out of this crisis.” (T3, P4, L20-22)
Being thrifty is a must during a pandemic or even
without it. The vendors realized its importance. Thesetestimonies from the participants show that being frugal
and saving money can help with survival in times of crisis.
Discussion
The COVID-19 pandemic has wreaked havoc on people's
lives, but we did not expect much on the seriousness of its
impact until we conducted this study. We have learned a
lot about the struggles of sidewalk vendors during the
pandemic. The pandemic did not only threaten their lives
but also their main source of income for living. However,they were not alone, as a similar experience was
happening globally, wherein street vendors dealt with the
pandemic's severe impact (Arsene et al., 2020; Resnick,
2020; Romero et al., 2021). When the government
imposed lockdowns, they had no choice but to stop theirbusiness. The participants of this study identi ied
helplessness as one of their struggles. Street vendors are
not new to being helpless as they were subject to manypressures, including the implementation of government
laws (Bromley, 2020), which pushed them to the wall.

Ultimately, it was the loss of income that really affected
them since street vending is their livelihood. Despite thegovernment's help, it did not suf ice for their needs(Unnamalai, 2020) compared to when they had theirregular income before the pandemic. Indeed, the strugglesof sidewalk or street vendors were real. Their situation
was a picture of people from all walks of life who areseverely affected by the pandemic.
Despite their struggles, the participants were able to
ind ways to cope as much as they can. Doing business athome is their main weapon to survive despite not having
the usual number of customers. They managed to earnmoney at very limited returns. Also, according to theparticipants, they received some form of assistance fromgovernments and individuals. Governments all over theworld took the pandemic very seriously. They know how
people suffered. Hence, people received several forms ofassistance and inancial aid (Ashraf, 2020; Razumovskaia
et al., 2020) to keep the economy loating and provide thepeople's basic needs. However, any assistance remains anaid. It could not replenish what was lost. As a result, theparticipants took money loans. It is undeniable thatborrowing money would only result in more complicatedinancial problems. Informants state that they do not haverecourse but to borrow money for they are not prepared
for the crisis, and their funds are not enough to last formonths of quarantine. Unfortunately, in the Philippines, oras in many developing countries, people are victimized byloan sharks (Aldohni, 2013). The participants did not
explain the dynamics of loan sharks, but it is a fact that it
adds burden to the already burdened individuals seeking
relief from their situation.
After sharing their coping strategies, the participants
were generous enough to share their insights for others tolearn in dealing with the pandemic's impact. They pointed
out hope as the best way to express positivity in life. Whenmany are suffering from mental health problems (Paulino& Tudy, 2020) following government regulations (Tudy,
2020a) and dealing with ethical issues (Tudy, 2020b), theparticipants acknowledged the importance of faith to be
hopeful that the pandemic will end and things would bebetter in the end. Moreover, in the practical sense, theparticipants identi ied the importance of frugality. They
speci ied saving as one of the most practical and effective
ways to counter a crisis.

f

f

f

f

f

f

f

f

f

f

f

f

f

f

Implications of the study
The indings of the study are essential pieces of
information for sidewalk vendors. Local governments may
maximize their powers and help mitigate some of the
problems these sidewalk vendors are experiencing. The
study's indings could also give society a new perspectiveof the realities, and struggles of sidewalk vendors during
times of crisis like a pandemic. The study's indings could
be a source of information they can re lect on for othersidewalk vendors. The pandemic has a huge impact on
their lives. The participants' strategies and insights could
be sources of information to survive during a pandemic.
Moreover, it is interesting to dig deeper into the effective
laws and mechanisms to appropriately support the
sidewalk vendors during a pandemic. It is another area for
future research worth pursuing.

f

f

f

Eubios Journal of Asian and International Bioethics 31(5) (July 2021)

297

Concluding remarks
This study highlights the struggles, coping mechanisms,
and insights of sidewalk vendors. The indings describe
their struggles of incapability to earn, hopelessness, andloss of income. These struggles were expected, especiallywith the magnitude of disruptions this pandemic brings.
However, despite the dif iculties, the sidewalk vendors
were able to cope with the situation as much as possible,
like indulging in small trading at home, gaining assistance,and borrowing money. They were generous in sharing
their viewpoints, particularly on being hopeful and frugal
during a pandemic. Hence, despite the threat to theirlivelihood, they continued to survive and found ways tolive. There are many things to learn from the sidewalk
vendors. They represent a segment of society that is
affected by the pandemic. How they survived and learningfrom their insights are worth re lecting on.
References
Aldohni, A. K. (2013). Loan Sharks v. Short-term Lenders: How
Do the Law and Regulators Draw the Line?. Journal of Law andSociety, 40(3), 420-449.
Anetor, F. (2015). An investigation into the value of street
vending in Nigeria: A case of Lagos State. Journal of Marketing
and Consumer Research, 11.
Arsene, M. B., Lebon, H. M., Maurice, K. N., Benjamin, M. B.,
Faustin, B. M., & Jean-Hélène, K. K. (2020). Understanding theRoles of Street Vendors of Agricultural Commodities during the
COVID-19 Outbreak in the Informal Economy. Open Journal ofSocial Sciences, 8(9), 115-129.
Ashraf, B. N. (2020). Economic impact of government
interventions during the COVID-19 pandemic: International
evidence from inancial markets. Journal of behavioral andexperimental inance, 27, 100371.
Batréau, Q., & Bonnet, F. (2016). Managed informality:
Regulating street vendors in Bangkok. City & Community, 15(1),29-43. https://doi.org/10.1111%2Fcico.12150
Bhowmik, S. R. (2005) Street Vendors in Asia: A Review
Economic and Politcal
Weekly 40 (22) 2256-2264
Bromley, R. (2000). Street vending and public policy: A global
review. International Journal of Sociology and Social Policy,
20(1/2), 1-28.
Creswell, John W. (1998). Qualitative Inquiry and Research
Design: Choosing
Among Five Traditions. Sage Publication Inc. USA.
Colaizzi, P. (1978). Psychological research as a phenomenologist
views it. In: Valle,
R. S. & King, M. (1978). Existential Phenomenological
Alternatives for Psychology. Open University Press: New York.
Guba, E. (1981). Criteria for assessing the trustworthiness ofnaturalistic inquiries. Educational Communication andTechnology Journal, 29(2), 75–91.
Gumisiriza, P. (2021). Street Vending in Kampala: From
Corruption to Crisis. African Studies Quarterly, 20(1). http://
www.africa.u l.edu/asq/v20/v20i1a5.pdf
Huang, G., Zhang, H. O., & Xue, D. (2018). Beyond unemployment:
Informal employment and heterogeneous motivations forparticipating in street vending in present-day China. Urban
Studies, 55(12), 2743-2761.
Martínez, L., Short, J. R., & Estrada, D. (2018). The diversity of thestreet vending: A case study of street vending in Cali. Cities, 79,
18-25.
Patton, M. Q. (2002). Qualitative research and evaluation
methods 3rd ed. Thousand

298

Eubios Journal of Asian and International Bioethics 31(5) (July 2021)

Oaks, CA: Sage.
Paulino, G.M., & Tudy, R. (2020). COVID-19 and Mental Health:Government Response and Appropriate Measures. Eubios
journal of Asian and international bioethics: EJAIB, 30(8),378-382.
Razumovskaia, E., Yuzvovich, L., Kniazeva, E., Klimenko, M., &Shelyakin, V. (2020). The Effectiveness of Russian Government
Policy to Support SMEs in the COVID-19 Pandemic. Journal ofOpen Innovation: Technology, Market, and Complexity, 6(4), 160.
Resnick, D. (2020). COVID-19 lockdowns threaten Africaâ€™ svital informal urban food trade. IFPRI book chapters, 73-74.
Romero-Michel, J. C., Mokay-Ramírez, K. A., Delgado-Machuca, M.,
Delgado-Enciso, J., Aurelien-Cabezas, N. S., Tiburcio-Jimenez, D.,... & Delgado-Enciso, I. (2021). Health and economic measuresin response to the COVID-19 pandemic-Effect on street
ve n d o r s . T h e J o u r n a l o f I n f e c t i o n i n D e v e l o p i n g
Countries, 15(02), 198-203.
Tudy, R. A., & Gauran-Tudy, I. G. (2020). Struggles, coping
mechanisms, and insights of childless teachers in thePhilippines: A descriptive phenomenological approach. The
Qualitative Report, 25(5), 1256-1278. Retrieved from https://
nsuworks.nova.edu/tqr/vol25/iss5/7
Tudy, R. (2020a). Are the measures for COVID-19 realistic,
justi ied, or overblown? Preparing the path to the new normal.
EJAIB 30(6),292-295
Tudy, R. (2020b). The ethical dilemma of healthcare
professionals in the midst of COVID-19 pandemic. EJAIB 30(5),259-264.
Unnamalai, T. (2020). Socio economic conditions of womenvegetable vendors in Tiruchirapllai town during COVID-19
period (March-June). Research Explorer, 8(29), 88-93.

Unfolding the ethical perspectivesof “SOLD” by Patricia McCormick- Farah Wasaya, MScN Scholar, MAS, BScN (Corresponding
Author)Aga Khan University School of Nursing and Midwifery;
Clinical Nurse Coordinator – Neurosurgery (The Aga Khan
Hospital, Karachi, Pakistan)
Email: farah.wasaya@gmail.com- Sumera Zul iqar, MScN Scholar, BScN
Aga Khan University School of Nursing and Midwifery
Email: sumera.danish@aku.edu- Anila Ra iq, MScN Scholar, BScN
Aga Khan University School of Nursing and Midwifery
Email: anila.ra iq@aku.edu

f

f

f

f

f

f

f

f

f

f

f

f

f

f

Abstract
Abducting children for sexual exploitation and traf icking
them to other nations is happening since a long time ago.
After being traf icked and experiencing extreme dif icult
situations of life, these victims are often unacceptable bytheir families and other society members. The community
make them experience stigma, blame, bias, loneliness,shame, loss of identity along with unrecognizedsocioeconomic and citizen status. The paper will provide a
structural debate on the ethical perspectives on whether
or not a sexually traf icked person should return to thesociety they belong. Moreover, the religion Islam has astrong obligation in viewing all mankind with an equal
right to exercise. To conclude, multiple attainable

recommendations could be implemented to support
traf icked victims in a society.
Introduction
This paper reviews a book titled “SOLD” which was
penned by Patricia McCormick in 2006. The article
unfolds the story of a thirteen-year-old teenage girl“Lakshmi” who was sold by his father and traf icked to
India for sexual exploitation. The structured debate covers
supporting arguments and counterarguments on the
proposition of social and religious perspectives regarding
the concern in the light of ethical theories. The book
“SOLD illustrates the story of a 14-year-old teenage girl“Lakshmi” from rural Nepal who arrives in India withcompassion to support her family. As soon as she reaches
India, in the twinkling of an eye, she realizes the miserable
truth of her being sold to prostitution. We ind this also
relevant in the Pakistan context.
Case scenario
Lakshmi lived in a slum area of Nepal with her motherand step-father. Lakshmi and her family did not have aluxurious way of living but she blissfully enjoyed playing
with her goat, sitting in the light of a lamp with motherbrushing her hair. One unfortunate day when the
Himalayan monsoon struck and devastated all the crops.
Lakshmi’s step-father made her meet an attractive
glamorous lady who asked Lakshmi to come along with
her to the big city and work for a rich lady named“Mumtaz”, who in return gave Lakshmi delight andaf luence. Although Lakshmi’s mother was not willing tosend her, the young teenage girl wanted to buy happinessand a tin roof for her family so that no rain can destroy
her house any further.
Lakshmi made her way to the “Happiness House” of
Mumtaz, which she thought would be a place ofdelectation and ecstasy. However, she soon learned theglooming truth of her being sold to prostitution, and theonly way out was to pay off Mumtaz’s debt that she paid toher stepfather. Each passing day added to Lakshmi’sagony and despair. She made friends who had similar
suffering and pain Lakshmi was going through. The little
innocent girls being brought in and diseased girls withAIDS being thrown out enumerated Lakshmi’s aggression.
Moreover, Lakshmi grasped different skills that she wasgoing to use in the escape from happiness house.
In the darkness of night between the noises of areligious celebration, she successfully managed to evade
Mumtaz’s prison and made her way to a shelter home.
Lakshmi successfully saved herself with many other girls,
who caved in the same brothel.
Propositions
The paper aims to address the proposition in the light of
ethical consideration and answer whether or not, asexually traf icked person should return to theirrespective society? and what does religion instruct in thisregard?
Sexually traf icked people returning to their society
Supporting argument: Powell et. al. (2017) cited in his
study that approximately 21 million people (children andEubios Journal of Asian and International Bioethics 31(5) (July 2021)
adults) in the world are being traf icked for speci ic
purposes such as forced labour and uplifting sex industry.
Gender preference plays a huge role in human traf icking
for sexual exploitation. The United Nations Of ice on Drugand Crime has shown that traf icking is gender biased
since the women traf icked account for 49%, whereas only
18% men are affected, and 33% children of both genders
get traf icked. (Erdogdu et al., 2016). The victims are often
discouraged and demoralized from acquiring help fromsociety due to the fear of getting rejected and being
shamed. Moreover, when the traf ic victims are recoveredfrom the brothels, they are hardly embraced by society
due to stigmatized preconceptions associated with them.
According to Peláez Echeverry (2016), stigma possesses
major constituents including blame, bias, loss of identity,
loneliness, and shame, loss of socioeconomic and citizen
status, language barriers, and uncommon religious norms
and values. Additionally, a qualitative study by Iram et al.
(2019) suggested that victimized people do not prefer toreturn to their homes due to multiple reasons that include
poverty, unemployment, disrespect, honor, and sexual
violence at home. Ultimately, these factors become therationale to bounce back in the sex industry. It has beenstudied that they are prone to undergo the same trauma
and negligence if they return to the society. This
stigmatization would lead to re-traumatizing of victims,
which propells these victims to remain in the brothel. Oneof the sex workers in the story named “Monica” was very
happy to go back to her home after paying debts to
Mumtaz for ages. Monica was tortured physically andmentally by her family when she returned home, leading
her to bounce back to the same brothel within a few days.
Secondly, it is observed that the children growing in thebrothels will be working for the same cause and run thesame business. This can also be relatable with the story,
when the toddler baby girl of other sex worker in thehouse of happiness was expected and bound to work for
Mumtaz in the future. In a country like Pakistan, when
there is an existence of unmet socio-economic needs andunemployment, young girls are often trapped by atraf icker to opt for the quickest means of earnings (Iramet al., 2019). This is the vicious cycle of cause and effect,
which adds signi icant prevalence to the growing
pandemic of sex workers around the globe.
Communitarianism
Incorporating the communitarianism concept in thecurrent scenario, bringing a sex traf icked victim back into
society would increase the transmission of diseases suchas HIV and AIDS, risking other members of the community
to in lict fatal disease. Therefore, for the betterment ofother members of the society, these victims should not be
reintegrated into the society to prevent the further burdenof the disease in the country. Also, it may lead abused
victims to return to the exploiters due to poor
subsistence, social isolation, stigmatization, andvulnerability to intimidation.

f

f

f

f

f

f

f

f

f

f

f

f

f

f

f

f

f

f

f

f

Counterargument:
On the contrary, the sexually traf icked person should
return to society as they recognize these victims as
nationals with active citizenship status. A few parts of the299

society are striving through multiple non-governmentalorganizations (NGOs), women protection bureau, andwelfare centers to extend support for these victims
socially and mentally. Moreover, this is not always the casethat offspring are anticipated to do similar things that
their mother has done. This is an individual ight, andsuccess depends upon a person’s intensity to strive to
break the chain of a vicious cycle and fetch a difference. A
piece of news shared on CNN world in 2013 highlighting
Shweta Katti, a girl who grew up in a brothel and with her
hard work and dedication towards education won ascholarship in the US to become a psychologist and is now
a leading motivational speaker, who aims to uplift theimage of sex workers.
According to the constitution of the Islamic Republic ofPakistan, both women and men in society have equal
rights, and any physical violence against women isrigorously outlawed. However, the dark side of society still
considers sex workers as characterless and immoral,
whereas the consumers (males) are considered as arespectable part of the community (Iram et al., 2019).
Men play a signi icant role in spreading contagious
diseases in society, as they are the major group using sex
services and running a successful sex industry. The bittertruth of society is that consumers (men) are notconsidered characterless and immoral, whereas women as
sex worker have such biased image.
Libertarianism
The Libertarian approach advocates that sex workers
should have the autonomy to be part of society and enjoy
all the bene its that any citizen holds. In libertarianism, anindividual action of happiness should not violate otherindividual’s rights. Libertarians appreciate movements
and activities that foster fairness and justice in society andeventually give a healthy opportunity for the sex worker
to get back to their homes. Also, the stewardship approachrequires the authorities to be accountable to the needs ofthe individual and community level by addressing theinequalities based on their demographic background andsocial status. This approach may include activities to be
initiated in the society before returning to society, which
includes rescuing, repatriation, and producing an
atmosphere that respectfully reintegrates and embraces
traf icked victims in society. A comprehensive approach isdemanded to combat the sex-traf icking problem, ethicallyby empowering, equalizing, making them accountable andallowing them to participation in the society with respectand dignity.
Religious perspective
To commence the discussion on the concept of sex
traf icking about the Islamic school of thought, it isvaluable to understand the concepts of traditional slavery
since it constitutes a form of exploitation under traf icking
in persons. The religion Islam now prohibits slavery,broadly based on its primary and secondary sources
which are the divine book of Koran, Prophet’s Sunnah(PBHM), and the doctoring of Islamic scholar’s consensus
beliefs that is Ijma. Slavery was common in the period
before the advent of Islam, and that it did not abolish thisconcept. According to one of the traditions of the prophet

300

Eubios Journal of Asian and International Bioethics 31(5) (July 2021)(PBUH), “there are three people whose prayers Allah will
not accept and the one who enslaves a free man is amongthem”.
He further said: “Whoever frees a Muslim slave, Allah
will save all the parts of his body from the (Hell) Fire as hehas freed the body-parts of the slave”. Moreover, thecommandments in Koran with the human sex traf icking
forbids forced sex since it is an abuse regarding which
Koran (24:33) says: “but force not your maids toprostitution when they desire chastity, so that ye may
make a gain in the goods of this life.” Additionally, Islam
views all human beings as equal and considers being
superior and oppressing others as a satanic logic. Islamic
law calls for the welfare of human beings by teaching the
ethical principles of equality and justice and therefore
provides equal rights to both genders.

Erdogdu, E., McNett, S., Winstead, D., & Friend, R. (2016).
Breaking the Stigma against Child Sex Traf icking and Bacha
Bazi in Afghanistan. The Journal of Penn States University, 1, 13.
Iram, T., Ilyas, M., Bilal, A. R., & Parveen, S. (2019). Socioeconomic
acceptability of prostitutes in Pakistan: A diversion fromprostitution. Cogent Social Sciences, 5(1).
Doi:10.1080/23311886.2019.1646110
Peláez Echeverry, J. M. (2016). Traf icking in Persons in the UK:
Women’s Identities-Stigma and Struggles.
Powell, C., Dickins, K., & Stoklosa, H. (2017). Training US healthcare professionals on human traf icking: where do we go fromhere? Medical Education Online, 22(1), 1267980. https://doi.org/10.1080/10872981.2017.1267980
Rijal, A., Adhikari, T. B., & Aro, A. R. (2016). Ethical perspectives
on combating sex traf icking in Nepal. Medicolegal andBioethics, 6, 3-7. https://doi.org/10.2147/mb.s111877

Recommendations
There are some recommendations to support traf icked
victims in a society. Ethically, there should be an activerole of policy developers to design interventions andassess its implementation about ethical approaches ofdoing upright, avoiding detriment, and providing courtesy,
equity, enablement, sustainability, social obligation,
opportunity to participate, sharing concerns and selfaccountability within the society. The issue can be
discussed through multiple ethical perspectives that
include libertarianism, paternalism, stewardship, andvirtue of ethics. By the libertarian approach, the provisionand protection of rights about international human rights
standards should be incorporated, where NGOs play ahuge role in preparing traf icked victims mentally, socially,and physically before returning to society. A paternalistic
aspect to inhibit and alleviate child traf icking is byconstructing all-inclusive and detailed awarenessregarding the understanding of sex traf icking. Concerning
the scenario in the book, when Lakshmi was being moved
across the border, the event could be prevented through apaternalistic approach. Likewise, Rijal, et al. (2016)
suggested that checking when crossing border by
individuals if securitized strictly, can be successful inpreventing and protecting girls from illegal transit. Lastly,
through virtue ethics, the stakeholders all around theworld would take measures to combat the issue at global
level with an aim to bring difference at mass level. Since it
is a time-consuming process, it may not immediately bringdifference but changing the mindset will bring bene it for
the long-term goals.

Chief Editor: Darryl R.J. Macer
Associate Editor: Nader Ghotbi
Editorial Board: Akira Akabayashi (Japan), Sahin
Aksoy (Turkey), Martha Marcela Rodriguez-Alanis(Mexico), Angeles Tan Alora (Philippines), Atsushi Asai
(Japan), Alireza Bagheri (Iran), Gerhold Becker(Germany), Rhyddhi Chakraborty (India/UK), Shamima
Lasker (Bangladesh), Minakshi Bhardwaj (UK),
Christian Byk (IALES; France), Ken Daniels (New
Zealand), Ole Doering (Germany), Amarbayasgalan
Dorjderem (Mongolia), Hasan Erbay (Turkey), Soraj
Hongladarom (Thailand), Dena Hsin (Taiwan), Rihito
Kimura (Japan), Abby Lippman (Canada), Umar Jenie(Indonesia), Nobuko Yasuhara Macer (Japan), Masahiro
Morioka (Japan), Anwar Nasim (Pakistan), Jing-Bao Nie(China, New Zealand), Pinit Ratanakul (Thailand), Qiu
Ren Zong (China), Hyakudai Sakamoto (Japan), Sangyong Song (Republic of Korea), Takao Takahashi( J a p a n ) , N o r i t o s h i Ta n i d a ( J a p a n ) , A n a nya
Tritipthumrongchok (Thailand), Yanguang Wang
(China), Daniel Wikler (USA), Jeong Ro Yoon (Republicof Korea).

Conclusion
The Universal Declaration of Human Rights stated thatmales and females should have equal opportunities in law
and social situations, and should not be discriminated forequal treatment, health, and education. The scenario
introduced us to the unfortunate, neglected, not spoken,
hidden yet bitter realities and vulnerabilities of society.
Therefore, it is acceptable to make a sound stance by the
discussion that sex victims should be embraced by society
with the same respect and honor they deserve just likeany other member of society and live life productively.

f

f

f

f

f

f

f

f

f

f

References

EJAIB adopts and complies with the Committee on
Publication Ethics (COPE) Publication ethics andmalpractice policy. Our policy is on the EJAIB website.
All potential authors should have read these guidelines
and by submission of an article for publication you
acknowledge that you have complied with this policy.
Violations will be handled in proportion to the intention
and seriousness of the violation. Registered address of
EJAIB: P.O. Box 16 329, Hornby, Christchurch 8441,
New Zealand
Editorial address, and all correspondence to:Prof. Darryl Macer, Ph.D., Hon.D.
President, American University of Sovereign Nations(AUSN), https://www.ausovereignnations.org
Email: darryl@eubios.info

Eubios Journal of Asian and International Bioethics 31(5) (July 2021)

301

ASIAN BIOETHICS ASSOCIATION MEMBERSHIP 2021
and 2021 subscription to Eubios Journal of Asian & International Bioethics (EJAIB)____ I wish to pay my annual membership fees of Asian Bioethics Association (ABA), and receive the2021 issues of Eubios Journal of Asian and International Bioethics (EJAIB) (The Of icial Journal).
Regular Price: US$120 Euro 100 ¥14000 (=Credit card price NZ$180)____ I do not require the hard copy of Eubios Journal of Asian and International Bioethics (EJAIB).
____ I wish to make a reduced contribution and register as a member of Asian Bioethics Association I
understand that I should be satis ied with Internet access to Eubios Journal of Asian and International
Bioethics (EJAIB)<http://eubios.info/EJAIB.htm>.
____ I wish to make a donation to Eubios Ethics Institute of ____________ Exchange subscription with journal, newsletter, etc.
(Name________________________________________________ )____ I agree / ____ do not agree to my name being listed on the ABA www site. List Research Interests
to be included:
Send an E-mail with your address to: E-mail: asianbioethics@yahoo.co.nz
Please charge my VISA / MASTERCARD card (circle) for NZ$________
Account #Expiry Date
Signature
Name:
Mailing address:
E-mail:f

f

Web site: <http://eubios.info/ABA.htm>