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In 1951, a woman named Henrietta Lacks unknowingly became one of medical history's most important sources of information about cancer. She also became one of biomedical ethics' most controversial figures--both celebrated and reviled, through no fault of her own.
Lacks went into the hospital in February of that year complaining of a vaginal discharge with spotting and was diagnosed with cervical cancer the same day.
She immediately began receiving treatment for her cancer, which doctors noticed was unusually aggressive. Lacks' cancer had metastasized rather quickly and in October, just eight months after her diagnosis, Lacks died at the young age of 31, leaving behind a husband and five young children.
The bioethical dilemma in this story does not arise because Lacks was treated in a segregated ward; that portion of the story is more of a civil rights dilemma, which was largely ignored at the time given the widespread presence of segregated facilities for blacks and whites most everywhere throughout the nation. The nascent civil rights movement would not reach its peak until the sixties, with Martin Luther King as its spokesman.
The bioethical dilemma here was curiously hidden (whether by omission or by sheer forgetfulness) for years: the Lacks family did not know that some of Henrietta's cancer cells had been taken and cultured for future study. Mr. Lacks, Henrietta's widower, was told after her death that some of his wife's cells were taken for study but was not really informed as to the exact type and scope of the research that would be done with her cells. Back then, it was not necessary to inform patients or their families about such things, so the doctors working on her case did not notify Mr. Lacks about their taking some of her cervical cells.
The doctor in charge of culturing the cells, George Gey, took the cells and cultured them, naming them HeLa in an attempt to preserve Lacks' anonymity. The HeLa cell line is said to be immortal, meaning that as long as the cell culture has optimum growing conditions, the cells continue to grow and undergo mitosis. Trillions upon trillions of HeLa cells have been descended from the original cells, which were removed from cervical lesions discovered during Lacks' treatment.
HeLa cells have since been cultured millions of times over and used in countless research studies, ranging from cancer studies to the development of the polio vaccine by Jonas Salk.
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Herein lies the dilemma: was it right for Dr. Gey to remove the cells from Henrietta Lacks without her consent? Remember that the doctors noted the cells' unusual aggressive growth and figured they might be of value for study. Should Mr. Lacks have been notified prior to his wife's passing that some of her cells would be removed for study? Should her family have benefitted financially, since her cells have undoubtedly generated millions in research funds that have likely propagated millions of dollars in profits from various chemotherapy agents and treatments produced by companies all over the world?
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Currently, doctors and researchers must obtain consent from patients before using them or any bodily part of them for research purposes. If a person were to be admitted to hospital with an unusual form of cancer whose cells might be valuable research subjects but who would not (or could not) consent to their being used for that purpose, what's to keep an unscrupulous doctor from seizing them for something that could potentially benefit many others?
Posted by scienceguru on December 5, 2007
Tags bioethics, cancer, cell division, dilemmas dilemmas!, discuss
, you have to obtain consent if at all possible or assume it before you render aid in order to, ahem, C.Y.A., in today’s circus of lawsuits. Though medical treatment and medical research are somewhat different in scope, the point I think is that we seem to have moved on the issue of ethics in science away from the “common good” (whichever definition you choose), and towards the “individual good” (looking out for yourself first). Shall we call it social evolution or backtracking?
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