Autonomy
Samples of Henrietta Lacks’ cancer cells were collected and used during diagnosis and treatment at Johns Hopkins Hospital and then transferred for research without her or her family’s informed consent, which was common practice. Scientists also began investigating Henrietta’s children, who thought they were being tested for cancer that killed her, but reporters claimed the Lacks family was being studied to learn more about Henrietta’s cells (Skloot, 2010). Henrietta Lacks or her family may not have suffered any physical harm as a result of these actions, but the fundamental ethical principle of autonomy has, therefore, not been respected.
Nonmaleficence
Henrietta was directly harmed because she was not fully informed about the risks and benefits of undergoing cancer treatments and participating in research and indirectly damaged due to the impact her treatment had on descendants. Neither she, nor her family, nor her descendants received any monetary compensation, although pharmaceutical companies have made huge profits from the drugs developed using her cells (Skloot, 2010). The lack of trust shown by Johns Hopkins in treatment continues to influence her descendants’ attitude towards healthcare; many of them had no health insurance to access medical procedures that HeLa cells allowed.
Beneficence
The medical providers did not warn Henrietta about her fertility loss before starting cancer treatment, although such practice existed. Towards the end of the course, she found out about it and said that she would not have agreed to undergo this course of treatment if she had been told about it earlier (Skloot, 2010). Thus, the medical providers did not act in the interests of her well-being.
Justice
The Lacks family’s poverty made it difficult for them to communicate with the predominantly white, wealthy, and educated medical and scientific community, who had a completely different socio-economic background. Henrietta did not have a choice of where to go for help, both for economic reasons, and because of racism, assistance was provided to her without much involvement (Skloot, 2010). At this time, she had to deal with the incredible cultural incompetence and insensitivity of the biomedical profession, in which some cruel therapies were applied to her.
Locus of Authority
Like many doctors of his time, Telind often used free hospital wards to research patients, usually without their knowledge, believing it was fair to use them as test subjects, as a form of payment. The lack of influence of such patients, including Henrietta and her family, on the use of their genetic data, highlights the issue of data privacy and ownership of their tissues (Skloot, 2010). Whereas the locus of authority in these cases should have belonged to the patients.
Consequentialist Theory (Utilitarianism and Hedonism)
Although the cells were taken without Henrietta’s informed consent, they were used in medical research to achieve significant scientific advances and have revolutionized medical science by making the process more efficient and humane. (Skloot, 2010). Henrietta’s sacrifice was not in vain, and this is a key criterion that makes her acceptable to utilitarianism. Despite the illness, Henrietta returned to her ordinary life, in which she revived everyone with her presence; she continued to enjoy life, thereby setting an example of hedonism.
Deontologist Theory
The doctors used Henrietta and her family as a means for their scientific research; in addition, her maintenance conditions in the special hospital were extremely harsh. Henrietta had to make her way from bed to window to look at the children; even when she was no longer able to rise, the children could not say goodbye to their mother (Skloot, 2010). It is no matter how many lives were saved by harming Henrietta, deontology claims that this sacrifice is unacceptable, whereas people should use others as an end, not a means.
Casuistry Theory
The history of HeLa cells has been a catalyst for policy change, including significant regulatory changes proposed in the United States to obtain informed consent for biological samples research. Regularly securing permission for residual clinical samples in the study was a substantial departure from past practice (Skloot, 2010). Many considerations that optimize the patient’s interests, including their access to research results, have been taken into account in developing biological specimen policy.
Feminist Theory (Ethics of Care)
Despite the initially cold attitude of the medical providers towards Henrietta and her condition, they tried to alleviate her suffering in her last days. Each day, Henrietta’s doctors increased the radiation dose, hoping it would help shrink the tumors and ease her pain before she died (Skloot, 2010). In the end, one of the doctors tried to inject pure alcohol directly into Henrietta’s spine.
Virtue Theory
According to the words of Laura Aurelien, George Guy visited Henrietta in the hospital, bent over her bed, and told her that her cells would bring her immortality and help save the lives of countless people (Skloot, 2010). Therefore, in this instance, despite further unethical actions, he made the right decision when faced with an ethical problem.
Argument supporting the decision of the medical providers
The medical providers’ decision to use biological samples from Henrietta Lacks has played a pivotal role in medical advancements, and their continued wide availability will be vital to realizing the goals of precision medicine. The discoveries from research on biological specimens have led to new understandings of human biology and targeted approaches to reducing the risk of future diseases. The use of such cells made it possible to reduce the cost of testing substances, making the process more efficient and humane.
In addition, in 1951, there was no law requiring physicians to inform patients that they were using their cells, and no informed consent was required to store blood and tissue for research purposes. At that time, none of the jurisprudence clarified whether a person owns his tissues and whether he has the right to control them. Further, this decision served as a policy change, including significant regulatory changes proposed in the United States regarding informed consent. Even currently, when people go to the doctor for a routine blood test or to remove a mole, they leave biological materials that are not always thrown away. Doctors, hospitals, and laboratories preserve them and often indefinitely.
Argument against the decision of the medical providers
However, according to ethical standards, the collection, storage, use of biological samples, large-scale data exchange in research, and commercialization require the owner’s informed consent, oversight, access to research results, and the possibility of rejection. In an atmosphere of secrecy, the researchers contacted Henrietta’s children. They brought the orphaned family to nervous breakdowns with innuendo and endless blood draws: they wanted to track down mutations in their DNA, but they never succeeded. According to ethical norms, the overall success of a decision is highly dependent on solving such problems in ways that are acceptable to patients and the public, and building and maintaining support, trust, and transparency.
Reference
Skloot, R. (2010). The immortal life of Henrietta Lacks. New York, NY: Random House.