If the role of a physician is to first do no harm, why in 1951, was harm done to Mrs. Henrietta Lacks, of Roanoke, Virginia? Her poignant case, regarding the use of her HeLa cells, unbeknownst to her, which were named in her honor, was immortalized in the story, The Immortal Life of Henrietta Lacks, by Rebecca Skloot. This story enumerated the several reasons why Mrs. Lacks was exploited, against her and her family’s knowledge. It explains the ethics case which led to her family, ultimately, earning the rights to Lacks’s cells.
The HeLa cells, which is the term scientists use to refer to the cells grown from Henrietta Lacks’s cervix (Skloot xiv), are responsible for countless medical advances in our nation’s history: “for the past 60 years Lacks’s cells have been cultured and used in experiments ranging from determining the long-term effects of radiation to testing the live polio vaccine. Her cells were commercialized and have generated millions of dollars in profit for the medical researchers who patented her tissue, (“’Henrietta Lacks’: A Donor’s Immortal Legacy“2).
For over 60 years, scientists from Johns Hopkins and abroad, used the now known HeLa cells for research after Dr. George Gey snipped cells from her cervix without telling her. Dr. Gey discovered that Lacks’s cells could not only be kept alive, but would also grow indefinitely (“’Henrietta Lacks’: A Donor’s Immortal Legacy“2).
According, to this section of the Hippocratic Oath, “…I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice…” (“The Hippocratic Oath Today“). It became apparent that the once hailed, oath of physicians the Hippocratic Oath, did not apply to this African- American woman as an injustice was committed upon her. The issue of her rights as a patient came to light in 2013 at which time Lacks’s family gained the ethical rights to give permission for the use of her cells in scientific research. According to the National Institutes of Health (NIH), “The NIH agreement…will now restrict the distribution and access to complete DNA sequences from Henrietta’s cancer cells to scientific researchers funded by U.S. government grants. Researcher requests will now be reviewed by a six-person panel that includes two Lacks family representatives. Furthermore, publications resulting from such work will now be accompanied by an acknowledgement of Henrietta Lacks as the source of the cells, (“NIH, Lacks family reach understanding to share genomic data of HeLa cells” 2).
As a future physician, I have two issues with this matter. First, why did it take over 50 years for scientists to realize the injustices committed by Dr. Gey, of Johns Hopkins, on Mrs. Lacks and second, why does the NIH feel no compensation, but only ethical permission to use the cells, is warranted for the family of Mrs. Lacks?
Firstly, I believe that it is unethical to use any part of a patient without his or her permission. If a patient is incapacitated, as Mrs. Lacks was, when she was admitted to Johns Hopkins in September of 1950, for hemorrhaging, just three weeks following the birth of her third child, (Skloot 17), her family should have been contacted. Mrs. Lacks’s rights were violated as a patient, as she was used as an experiment for the scientific gains of our nation. However, her family did not received acknowledgement that this was unethical until 50 years after the fact.
If I were in a position where I had a patient, who exhibited a clinical pathology, which I felt could be further studied, or if I found clinical and scientific significance to his or her disorder, then I would notify the patient, if possible or otherwise, inform the family of what I wish to do. This is the respectable and ethical thing to do; giving patients informed consent. This practice of using informed consent, is defined as being, “… more than simply getting a patient to sign a written consent form. It is a process of communication between a patient and physician that results in the patient’s authorization or agreement to undergo a specific medical intervention…” (“Opinion 8.08 – Informed Consent” 2). In addition, as a clinician I must explain how the patient will benefit from this science, and how I will uphold the ethics of the information I aim to use from the patient. In the case of Mrs. Lacks, this was very sensitive biological information. Her family should have been apprised. It should not have taken Ms. Skloot’s biography to bring ethical justice to the family.
Secondly, the lack of compensation for the use of the HeLa cells to Mrs. Lacks’s family is an injustice. With all of the clinical and pharmaceutical benefits from the usage of Mrs. Lacks’s cells, compensation for Lacks’s family is imperative given the decades that her family lived in abject poverty! [“The Immortal Life of Henrietta Lacks”]
Patients should be compensated for their role in any clinical situation of which they are a part. This is the case with the clinical trials nowadays, which is just. In my opinion, Mrs. Lacks was a victim of a 50-year clinical trial. During those years, several advances were made which helped to advance the medical community.
Overall, the case of Mrs. Henrietta Lacks, raised two salient points. First, a using patient’s DNA without permission, and second, not compensating the patient’s family for the financial gains made from the use of her cells: in 1953, they were used to make chromosomes visible for study in genetic typing; in 1954 scientists were able to use them to develop successful cloning methods, due to the longevity of the HeLa Cells; and, in 1989 they were used to discover the enzyme telomerase, which scientists now understand is present to prevent cellular death, (“Henrietta Everlasting: 1950s Cells Still Alive, Helping Science” 1).
As doctors we must first do no harm. And, to explore that option, we must treat all citizens as patients when they come before us in our clinical work. No patient should be violated, and uninformed, when being tested. If we do that, then the Hippocratic Oath is for naught.
1. ‘Henrietta Lacks’: A Donor’s Immortal Legacy, 15 Jul. 2011. Web. 2 Dec. 2015
2. NIH, Lacks family reach understanding to share genomic data of HeLa cells, 7 Aug. 2013. Web. 2. Dec. 2015.
3. Opinion 8.08 – Informed Consent, American Medical Association, 1 Nov. 2006. Web. 2 Dec. 2015
4. Skloot, Rebecca. The Immortal Life of Henrietta Lacks. New York: Broadway Paperbacks, 2011. Print.
5. The Hippocratic Oath Today. Tyson, Peter 27 Mar. 2001. Web. 2 Dec. 2015
6. The Immortal Life of Henrietta Lacks, 1 Jan. 2011. Web. 2 Dec. 2015