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Two Sides to Every Argument

As I was reading The Immortal Life of Henrietta Lacks, the questionable ethics of the doctors’ actions involving Henrietta’s cells repeatedly entered my mind. The family says that neither Henrietta nor they were ever notified about the plans for her cells and that the doctors did not have the right to take them in the first place. The doctors claim that they had informed both Henrietta and the family about their intention to use the cells. As Skloot writes the book, she researches the details of every event in relation to Henrietta’s cells and her family’s reactions to each new piece of information that they learn and these details supplement the arguments of both sides.

First, Henrietta’s family and friends believed the hospital and the doctors took advantage of them in order to keep Henrietta’s cells for their own personal gain. Henrietta’s friend visited her in the hospital a couple of times before she died and despite all of these visits she was never told anything about the cells. Due to doctor-patient confidentiality, it’s understandable that the doctors would not divulge to a friend of Henrietta the specifics of her case, but they are still allowed to tell a patient’s family what is happening if the patient is incapacitated. Still more pertinently, physicians are required to tell the patient herself. Yet, for some reason, the doctors never found it particularly pressing to tell Henrietta or her family, even after Henrietta had passed.

On the other hand, the doctors believed, and still do to this day, that they were following the protocol of the time and that they did what they deemed was best for medical and biological science. They had Henrietta sign a waiver saying that she gave the staff at John Hopkins consent to perform any surgical and operative procedures that they considered necessary. The doctors found it imperative to acquire some of the cells for further analysis, more than partially because they had an agreement with Gey to continuously supply him with cancerous cells. Also, I would guess that the doctors did not want to tell Day about the cells because he refused to permit them to perform an autopsy on Henrietta’s body upon their request. That refusal would have led them to believe that he would disallow the doctors to work with the cells in the future and then to fear the loss of potential progress that this would cause for science.

So, were the doctors in the wrong? Could it be said that they purposely took advantage of the Lacks family because they were not knowledgeable on the subject and were minorities in the community? Or were they really doing what they believed necessary to improve science and help save millions of lives?

That’s where I ask you to comment:
What do you think? Also, if you were in the doctors’ positions, what would you
have done?

  1. dj74
    September 9, 2011 at 8:12 pm

    While reading The Immortal Life of Henrietta Lacks, I became quite annoyed at each step of the way leading up to and during Henrietta’s death; thinking that the John Hopkins doctors were simply taking advantage of another minority patient who they considered too uneducated to understand anything within the medical world. I maintained this bias throughout the majority of the book until Skloot raised the very pertinent legal note midway through Part Two. Skloot reports that it wasn’t until after a series of uninformed patients became aware that their cells were being used for other purposes outside of their own treatment, that lawyers and judges fell out of their own ignorance to help the misinformed patients. The lawyers and judges eventually met with those in the medical field to develop a list/system of ethical laws that all doctors should abide by. This being said, Henrietta wasn’t the only patient to have her personal, however non-legal, personal rights violated.
    According to Skloot, in February 1954 a cancer researcher named Southam decided that he would test the immune systems of his patients by injecting HeLa cells into their forearms. Although he informed his patients that he was “testing their immune systems; he said nothing about injecting them with someone else’s malignant cells.” (p.128) This procedure was conducted on a dozen other cancer patients, none of who were informed that cancerous HeLa cells were being injected into their bodies for Southam’s personal research. It is fair to state that Southam was not even conducting experiments within the guidelines of Nuremberg Code—which was developed after a major lawsuit was filed against Nazi doctors in Nuremberg, Germany who conducted inhumane experiments on Jewish prisoners—but this Code was just that, a code that wasn’t a law. Therefore, at the time there was no law that could appeal Southam for his research, but that would not last long.
    The term informed consent didn’t even appear in court until 1957, when a patient named Martin Salgo sued his doctor for withholding information about the procedures’ risks (p.132). Salgo went under anesthesia and woke up permanently paralyzed from the waist down. It was after this suit that the judge said, “’A physician violates his duty to his patients and subjects himself to liability if he withholds any facts which are necessary to form the basis of an intelligent consent by the patient to the proposed treatment.’” (p. 132) Eventually Southam was put under this ruling as well and had his license suspended for a year. Succeeding the end of Southam’s suspension the NIH conducted an investigation of the research institutions that it was funding and found there to be numerous cases of researchers withholding information and not using proper informed consent forms.
    In my opinion, I do believe that Henrietta should have been informed of the total weight of risks she would encounter during her treatment, as well as have been informed of the removal and further experimentation of her cells. However ethically and morally wrong the doctors and researchers who worked on her cells were, they were not in the wrong legally speaking because the laws governing such practices were not even propagated and enforced until close to seventeen years later. Louis Lefkowitz, the New York State Attorney General who headed the suit against Southam, stated, “‘Every human being has an inalienable right to determine what shall be done with his own body. These patients then had a right to know…the contents of the syringe: and if this knowledge was to cause fear and anxiety or make them frightened, they had a right to be fearful and frightened and thus say NO to the experiment.’” (p. 134)

  2. September 10, 2011 at 12:51 am

    I would like to believe in my heart that the doctors who worked with Henrietta Lacks were not purposely taking advantage of the Lacks family because they were minorities. However, the Skoot does not specify in the novel whether or not all the cells Gey experimented with were from African American patients. I would rather not comment on whether or not the doctors were wrong. I would much rather say that they did what they thought was beneficial to science and their livelihood when they took Henrietta Lacks’ cells.

    On a different note, I do believe it was wrong of the hospital, the doctors, and all the legal council involved to continue to not only use the cells but to distribute the cells without the Lacks family’s permission. Mrs. Lacks did not acknowledge that she had given her body to science. Once that idea was realized it was the responsibility of the hospital and the doctors as well as their respective legal counsel to offer the family a stipend or health care in exchange for her huge donation to science. To be truthful, I have not actually finished the book yet. Therefore, I do not know if a settlement was ever made with the Lacks family but I know that they deserve health care especially after their mother contributed so greatly to science, health care, and our society.

    Honestly, as a doctor at the time I am unsure what I would have done in regards to the situation. I like other doctors would probably have assumed that Mrs. Lacks understood the paperwork and was acknowledging her agreement to participate in whatever procedure. Morally and as a woman I would have felt compelled to discuss the effects of her treatment as regards to her inability to bear children after its completion. I would assume that my openness who have then allowed Mrs. Lacks to ask any questions she had in regards to her time in the hospital. If she did not bring up the paperwork I would never have assumed that she was unsure about giving her cells to science.

  3. September 10, 2011 at 6:44 pm

    I believe that they should have told Henrietta what they were doing with her cells. The doctors were taking samples from her for research while she believed they were trying to cure her. She was not educated enough to know what questions to ask, or to know what the treatments would do to her body. She trusted the doctors completely and she shouldn’t have.

    As bad as it was that the doctors and surgeons kept Henrietta in the dark about what they were really doing to her cells it was worse to inject other patients with possibly cancerous cells without informing them. While the idea of informed consent did not appear until 1957 doctors were well aware of the Nuremberg trials since 1946 that held the doctors that preformed human experiments during World War II responsible for their actions.

    The doctors took this one step farther by testing on Henrietta’s family when they thought they were being checked for Henrietta’s disease. They treated generations of the Lack’s the same showing that even through the years the doctors were more focused on the cells than the health and rights of the patients.

  4. September 11, 2011 at 2:28 am

    While I read The Immortal Life of Henrietta Lacks, I was disgusted with the way her check ups were carried out. The doctor would simply jot down something along the lines of “patient complains about pain, told to return in two weeks.” I was upset because I wasn’t sure if thats just how they took notes back then or if the doctors just weren’t putting forth their best efforts because she was a colored woman. My take on doctors using taking her cells without her permission is a completely different story. I do believe Gey should have asked, but after understanding the potential lifesaver her cells could become to society, I do not think Henrietta should have had the right to oppose the use of them for medical advancement.

    It was revealed later in the book that multiple patients, not just colored ones, found out that their cells were being used for other medical research, proving that the doctors were not taking advantage of Henrietta because she was black, in the doctors eyes she and all the other people they saw were just patients (aka experiments) who they were trying to cure as well as using to try to cure others. Though some may think its not right, I honestly think that the doctors were just doing their job. Their job is to cure and prevent sickness, and thats what they were trying to do with Henrietta’s cells and the cells of the other patients.

    I understand that sometimes doctors can get detached from common curtseys because of their focus on the scientific aspect of everything, but that doesn’t mean they don’t care about people. Its like assuming that all doctors are atheists, which isn’t true at all. However, a legal process still took place to make doctors abide by laws and codes in their medical practice. Now, I’m all for laws, rules and regulations for any field of business and I believe that the patients had the right to no what would be done with their cells but I don’t believe that the doctors shouldn’t be looked at as monsters as a lot of us are basically characterizing them to be. Like I said before, in the end they were doing there job.

    Even if she had been asked permission, I don’t think that Henrietta would have refused knowing it would help others. Skloot described her as a caring and gentle woman. I just can’t see her saying no. We’re concentrating too much on how everything was carried out and what a toll it took on the Lacks family, and less about Henrietta and what her cells, whether she knew or not, did for the progression of society. Yes, Henrietta should have been asked. Yes, the Lacks family should have been compensated. Yes, doctors should have been more open and honest about exactly what they were doing. However, either way I believe that the doctors did the right thing by using her cells.

  5. September 11, 2011 at 2:03 pm

    As a libertarian, I believe that individual rights are the most important thing in a person’s life, sometimes even more so than security or the “public good”. Those cells belonged to Henrietta and the doctors should have asked her for permission to use those cells, even if it means risking the chance to uncover all the new discoveries that the HeLa cells have allowed for.

    However, although the doctor did not ask for permission, as I have said in an earlier comment, Henrietta was content after she was informed by Gey that her cells are being used to cure diseases for future generations.

    Her family should have been compensated because those cells belonged to Henrietta, and always will. The free market system only works when those who participate are ethical. In this case, they doctors and scientists are unethical because they did not give credit in the form of health insurance or even financial support to Henrietta’s descendants.

  6. September 12, 2011 at 12:29 am

    Yes, Doctors took Henrietta’s cells and used them to further the scientific community. Did they do her an injustice by today’s standards? Yes. But as a society we must recognize that values let alone medical ethics change. When Henrietta Lacks was being serviced at the John Hopkins hospital this was a time when African Americans were hard pressed to find decent medical treatment anywhere. She was very lucky to be getting the quality of treatment she had been receiving from John Hopkins.

    The doctors did a wrong by not informing Henrietta and her family that they had biopsied her cells and were planning on using them in research. This “wrong “is being determined by the standards we see and doctors today now adhere by. Back in the 1950s this was not the case. She signed a consent form and from the doctors point of view that gave them the freedom to use her cells. There are other documented cases where doctors of that time period executed the same executive decision not to tell the patients that their cells were being used. Henrietta’s is the most famous because her cells were unique and extraordinary. The Medical society later recognized that this was an extreme mal-practice and made changes to what is considered right and wrong. I think it is wrong to judge the doctors for preforming with the right intentions and preforming to the standard practice procedures of the time.

    Reflecting on history allows us as a society to recognize the wrongs and gives us a chance to learn from those mistakes, to do better today. This is why Henrietta’s story was so important and such a widespread success. It shows how the scientific society adjusts and improves upon itself. Ultimately I think the doctors were justified if not by anything, the time period, and the ethics associated with it.

  7. September 12, 2011 at 12:44 am

    I would like to say from the get-go that I am not supporting the actions of the doctors of Hopkins Hospital, merely attempting a justification and possible explanation for their actions.

    I think its very easy for us to criticize the doctors for taking Henrietta’s cells without her knowledge but I feel a lot can be said in their defense. First and most importantly we must look at the time period in which this occurred, a lot has changed since when these events occurred and it is very easy for us to forget just how differently things were back during this time. During this time, the medical world was much less regulated than it is today, it wasn’t uncommon for doctors of this time period to use their clinic patients as guinea pigs without their knowledge, not that this is acceptable but the doctors who were treating Henrietta weren’t one of a kind, the truth is she could have walked into any hospital in the country and there is a solid chance that the same situation would have occurred. This doesn’t make the actions of her doctors ethical, but I believe it is unfair of us to single out Henrietta’s doctors as unethical and corrupt professionals when in all reality a majority of their colleagues would have done the same thing. Personally I believe these doctors did not intend to directly exploit their patients for personal gain, after all they weren’t using these cells to kill babies for pleasure or something ridiculous, they were using them to advance the medical field, which has the potential to benefit the entire human population. It is also important to point out that Gey did not make a single cent off of the HeLa cells, he distributed them for the good of science, not for his own personal gain. Sadly this was common practice at the time, and while acting unethically, these doctors that we accuse of exploiting a dying woman were simply products of the time in which they lived.

  8. September 12, 2011 at 3:35 am

    One thing that came up for me while reading the book was the thought that the outcome would have been different if the culture that grew was from a person with a different socio-economic background. Would the family of my hypothetical person have demanded financial compensation just because they were better educated, white, and wealthier or would they have been kept in the dark as much as the Lacks family was? As much as I would like to hope that nothing would change with a different patient, I think that the outcome would have been much different.

    I compare the Lacks’ treatment by the medical community to many English as a Second Language patients at the hospital that I volunteer at in Hawaii. Because of the diverse population of the island and tourists who visited, the floor I worked on often would have patients speaking four or five different languages. The nurses and I would try to make outcomes and information as clear as possible, but many times it was simply impossible. It wasn’t that we were purposely taking advantage of these patients, it was that none of us spoke Swedish and we had four more patients to discharge in that hour. The English speaking patients had a better comprehension of what we were saying and often questioned us more, especially if the patient had a family member in the medical community. Because of this experience, I can sympathize with Drs. Christoph and the Chinese one who for some reason I can’t find to save my life. They didn’t mean to mistreat the Lacks family, but it still happened.

  9. September 12, 2011 at 4:13 am

    I don’t think that what the doctors did was that bad because during that time there was no regulation at the time. I think the excuse that “they were just going along with the ways of the time” is perfectly valid. It is extremely important that while judging history, you judge not on the current ways but by the mindset of the time.Things change, culture changes and with the culture practices change. Judging by the mindset of todays culture will get you no where in the exploration of the past. The doctors simply didn’t know better, they felt that it was perfectly reasonable to take them without notice because it may just help the persons treatment. And also the care that Henrietta was receiving was free of charge, so i believe the doctors are entitled to some her cells as a sort of repayment. So I don’t think the doctors were in the wrong in taking her cells. I hate to say it but I think if I was in the doctors positions that I would have done the same thing just because that’s what they did at the time.

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