Introduction
For the book club assignment, I chose to read The Immortal Life of Henrietta Lacks by Rebecca Skloot. The book was originally published in 2010 by Crown Publishers. However, the copy of the book I read was published in 2011 by Broadway Books, a partner of Crown Publishers. The book is about an African-American woman named Henrietta Lacks. She was diagnosed with cervical cancer and when she went to John Hopkins to be diagnosed and receive treatment, her tumor was biopsied and cultured. Her cells were grown and led to an immortal cell line. George Gey, the scientist who grew these cells, was the director of the lab at Hopkins and it was his work that helped to create this immortal cell line. The book explains how this ability to grow cells led to many medical breakthroughs including the testing of the polio vaccine and research about cancer cells. Although these breakthroughs have saved numerous lives and advanced modern medicine, the ethics of it is called into question. Henrietta did not know her cells were taken from her and used for research. Neither she nor her family were ever compensated for their contribution to advancing medicine. Finally, there was no informed consent and therefore, her cells, known as HeLa cells, have become a giant for profit business that is of no benefit to her children, husband, or other family members. I chose to read this book because I had heard of HeLa cells during my undergraduate coursework. I took a cell biology course and we discussed the benefits of the cells. However, as it talks about in the book, the medical advances were celebrated in my class but how the cells were grown was completely left out. I was curious to learn more about the famous HeLa and so I chose to read this book.
Summary of Contents
In part 1, titled Life, the first unethical situation arises. Henrietta had just been diagnosed with cervical cancer. She had discovered the tumor herself shortly after giving birth to her daughter Debora. The tumor had grown so fast that it was not in her medical charts. The doctor who diagnosed the cancer noted that after delivering the baby 6 weeks earlier, there was no note “made in the history at the time, or at the six weeks’ return visit” that would indicate cancer.1
As she traveled to John’s Hopkins, the nearest hospital that could treat her and treat other people of colors, she went to the doctor, told him where to look for the tumor and sure enough, a mass was found on her cervix. It is not known for sure in her case, but many black people were treated poorly by the doctors at this time.2 However, what she wasn’t told was that the doctor biopsied her cancerous tumor and was going to attempt to grow them outside the human bodied. She left the doctor with her diagnosis and her treatment of radium being inserted into the cervix and went home happily and peacefully.
Meanwhile, at the Gey labs at John’s Hopkins, Mr. Gey began to grow and cultivate the cells. It became an incredible breakthrough that would eventually lead to other immortal cell lines being grown. The new cells, called HeLa cells in this case, we’re going to become essential in discovering advances to treat diseases. However, the question remains: Did the doctor have any right to remove the tumor, experiment with the cells, all without telling the patient? It would appear that from a public health standpoint, the greater statistical number, or the population, was benefitted by the doctors taking the cells. However, on an individual level, it is a terrible precedent and very unethical that they would take the cells without asking her, without compensating the family. I believe this is a very crucial philosophical argument: What is the price to benefit the greater good? Part of the issue here is also that not only did they not inform her what they were planning on doing, they did not acknowledge her real name until an article appeared in 1973 that mentioned her name could be Henrietta Lacks and not Helen Lane.3
Another example of the unethical behaviors in the book come from one of the researchers who benefitted from the HeLa cells. Dr. Southam, a physician studying cancer, wanted to know if the cells could grow inside another person’s body. Using his terminal patients as guinea pigs, Dr. Southam injected the HeLa cells into the patients under the cover up that the injections were testing the immune systems of the patients. As a result of his experiment, he saw that cancer did grow in the patients. The cost however was that 4 patients could not have the cancer removed completely and one of the patients had the cancer metatisize through their body.4
He did not stop at these patients. Once proven they could grow in terminal patients, he wanted to see the cell effects on healthy patients. So, he found a population which could be coerced into doing things against their will, a prison population in Ohio. Instead of educating and promoting good health to this population, Dr. Southam decided to inject all the inmates with the cells and observe their reaction.4 He did learn a lot about resistance to cancer from these healthy inmates. However, as a public health official, he was not actively promoting good health. Rather, he was endangering the health of the population he was studying. The fact that this endangerment was occurring shows the lack of ethics used in this time period. Although good did come of it, one has to wonder if there could have been a better way for the research advances to be made.
Conclusion
In conclusion, The Immortal Life of Henrietta Lacks was a very difficult read. Not difficult as in hard to understand the words and meaning. Rather, difficult as in thought provoking and leaving a general feeling of uneasiness. The underlying issue of the ethics of medical research as well as how Henrietta Lacks was treated is put side by side with the advances in medicine that came because of the ability to culture her cells. This leaves an uneasy feeling in the stomach as one tries to wrestle with what is more important, the individual or the “greater good”. Understanding that statistics can be changed to justify one’s actions, I feel that the action taken has benefited society as a whole. However, as someone who aspires to become a full-time physician, the practice is completely unethical. In a perfect world, I would like to see the family of Henrietta be compensated today for the enormous breakthrough courtesy of her cells, especially considering the cell industry is now a multimillion dollar industry.5 It is terrible to read of her family and learn that after the death of their mother, her children were abused, molested, and suffered into adulthood because of these traumas. In my opinion, you can not put a price on a life. However, financial compensation is the least that could be done to support her family and possibly improve their socioeconomic status. Supposing that they could be compensated fairly, I would also like them to continue supporting research using the advances that have occurred so that more diseases and issues can potentially be solved. The cells have led to numerous breakthroughs and who knows how many more will come because of it. Yes, it is a cop out answer of staying right on the fence, yet I believe it is the correct answer.
This research has benefited the world. Public health is about population. The population is the patient and it is the job of public health professionals to do all they can to implement practices and policies that promote and sustain healhy populations. Because of the HeLa cells, population health was improved. While the book illustrates the clear unethical decisions made with regard to the HeLa cells, the Lacks family, and the other experiments mentioned, the advances made from studying her cells have led to medical breakthroughs. Vaccines, treatments, knowledge about infectious diseases, all have been influenced by the culture of immortal cell lines. Were it not for the cell line, perhaps these advances would not have occurred.6 Therefore, I believe that while unethical, Henrietta Lacks unknowingly advanced the field of public health and has contributed to making our society a healthier environment for all people.