.Where do medical ethics fit into Henrietta Lacks’ story? During her first treatment for cancer, her physician made an unethical decision regarding informed consent. This doctor's decision led to the creation of a multi-billion dollar industry. Before dissecting the ethical dilemma, we must first understand what actually happened to Henrietta during treatment.
The Cells
Henrietta was diagnosed with stage II cervical cancer and was prescribed a radiation treatment to kill the cancer cells. On the day of her first treatment, Dr. Lawrence Wharton Jr was the physician who gave her the radium inserts to treat the cancer. While Henrietta was unconscious for the procedure, Dr. Wharton removed two small samples of her cervix. One sample was cancerous and the other was normal. Both were labeled and sent to fellow physician and researcher, Dr. George Gey (Skloot, 2010).
Dr. Gey had been studying cells for a number of years and was determined to grow malignant cells in a culture outside of the human body. The goal was to create an “immortal” line that constantly replicated from the initial sample and would not die. He took in whatever sample of cervical cells that was available to try and create an “immortal” line (Stump, 2014). When Henrietta’s cells came into his laboratory, Gey’s assistant labeled them HeLa and prepared the cells for study. Conducting experiments using human cells was a struggle. Until this point human cells only lasted a few days in a culture before dying. This made experiments very difficult to conduct.
Dr. Gey discovered that Henrietta’s cancer cells were unlike any other sample he had seen. Her regular cells died shortly after being brought into the lab, but her cancer cells replicated at an unstoppable rate. He began sending samples of the replicating cells to colleagues, researchers, and other scientists all over the country. Using HeLa cells, tests were conducted that would have been impossible with a live human or any other cell culture (Skloot, 2010).
The Ethical Dilemma of Informed Consent
All of this had happened without Henrietta Lacks’ consent or knowledge. She passed away in 1951 while her cancer cell samples continued to replicate and be distributed to scientists. Between 1951 and present day the HeLa cell industry has grown to have a net worth of over $2 billion. The Lacks family received no financial restitution for Henrietta's cells being taken and used (Stump,2014). . The issue of controversy is the idea of informed consent. Informed consent is a physician’s duty to assure that a patient fully understands a procedure as well as perform only under a patient’s consent (Du Pre, 2010). Henrietta was unconscious when the cells were removed from her body and in her lifetime was never aware of the HeLa cell line. Because of the Henrietta's race and the time period, doctors felt as though black patients consent was unnecessary because they were lesser than white patients (Redman, 2004).
Although there were no laws in place at this time to protect patients, there was still a code of ethics that physicians were expected to adhere to, In 1931, the Guidelines for Human Experimentation were enacted in Germany to guide physicians in ethical behavior (Beauchamp & Faden, 1986). These guidelines covered the issues of consent in human experimentation and performing unnecessary procedures. After the Nuremburg trials, the Nuremburg Code was developed in 1947 to address the war crimes committed during the Holocaust. Both the Guidelines for Human Experimentation and the Nuremburg Code state that without informed unambiguous consent a procedure may not be conducted (Pence, 2011). Nuremburg trials were reported worldwide and parts were even televised. The Nuremburg Code set the standard for medical ethics everywhere. To see the Guidelines for Human Experimentation compared to the Nuremburg Code, click here.
Despite an ethical standard being set, there were still medical professionals that failed to act ethically. Henrietta Lacks's physicians as well as Dr. George Gey failed to maintain ethical practices. As patients we expect our healthcare providers to adhere to ethical principles. We have learned from Henrietta's experience that not every healthcare provider adheres to ethical standards. Her experience also teaches us the importance of understanding informed consent. It is a necessity to become educated when seeking treatment. It is up to each and every patient to ask questions and to build strong communication with healthcare providers.
Background( Photo 7)
The Cells
Henrietta was diagnosed with stage II cervical cancer and was prescribed a radiation treatment to kill the cancer cells. On the day of her first treatment, Dr. Lawrence Wharton Jr was the physician who gave her the radium inserts to treat the cancer. While Henrietta was unconscious for the procedure, Dr. Wharton removed two small samples of her cervix. One sample was cancerous and the other was normal. Both were labeled and sent to fellow physician and researcher, Dr. George Gey (Skloot, 2010).
Dr. Gey had been studying cells for a number of years and was determined to grow malignant cells in a culture outside of the human body. The goal was to create an “immortal” line that constantly replicated from the initial sample and would not die. He took in whatever sample of cervical cells that was available to try and create an “immortal” line (Stump, 2014). When Henrietta’s cells came into his laboratory, Gey’s assistant labeled them HeLa and prepared the cells for study. Conducting experiments using human cells was a struggle. Until this point human cells only lasted a few days in a culture before dying. This made experiments very difficult to conduct.
Dr. Gey discovered that Henrietta’s cancer cells were unlike any other sample he had seen. Her regular cells died shortly after being brought into the lab, but her cancer cells replicated at an unstoppable rate. He began sending samples of the replicating cells to colleagues, researchers, and other scientists all over the country. Using HeLa cells, tests were conducted that would have been impossible with a live human or any other cell culture (Skloot, 2010).
The Ethical Dilemma of Informed Consent
All of this had happened without Henrietta Lacks’ consent or knowledge. She passed away in 1951 while her cancer cell samples continued to replicate and be distributed to scientists. Between 1951 and present day the HeLa cell industry has grown to have a net worth of over $2 billion. The Lacks family received no financial restitution for Henrietta's cells being taken and used (Stump,2014). . The issue of controversy is the idea of informed consent. Informed consent is a physician’s duty to assure that a patient fully understands a procedure as well as perform only under a patient’s consent (Du Pre, 2010). Henrietta was unconscious when the cells were removed from her body and in her lifetime was never aware of the HeLa cell line. Because of the Henrietta's race and the time period, doctors felt as though black patients consent was unnecessary because they were lesser than white patients (Redman, 2004).
Although there were no laws in place at this time to protect patients, there was still a code of ethics that physicians were expected to adhere to, In 1931, the Guidelines for Human Experimentation were enacted in Germany to guide physicians in ethical behavior (Beauchamp & Faden, 1986). These guidelines covered the issues of consent in human experimentation and performing unnecessary procedures. After the Nuremburg trials, the Nuremburg Code was developed in 1947 to address the war crimes committed during the Holocaust. Both the Guidelines for Human Experimentation and the Nuremburg Code state that without informed unambiguous consent a procedure may not be conducted (Pence, 2011). Nuremburg trials were reported worldwide and parts were even televised. The Nuremburg Code set the standard for medical ethics everywhere. To see the Guidelines for Human Experimentation compared to the Nuremburg Code, click here.
Despite an ethical standard being set, there were still medical professionals that failed to act ethically. Henrietta Lacks's physicians as well as Dr. George Gey failed to maintain ethical practices. As patients we expect our healthcare providers to adhere to ethical principles. We have learned from Henrietta's experience that not every healthcare provider adheres to ethical standards. Her experience also teaches us the importance of understanding informed consent. It is a necessity to become educated when seeking treatment. It is up to each and every patient to ask questions and to build strong communication with healthcare providers.
Background( Photo 7)