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The Immortal Life of Henrietta Lacks

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on 26 November 2013

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Transcript of The Immortal Life of Henrietta Lacks

Nuremberg Code
During WWII, the Nazis conducted research and experiments with Jews without their consent. These actions led to a US led international war tribunal that was held in Nuremberg, Germany in 1947. This created a ten-point code of ethics to govern all human experimentation worldwide (Skloot 131).
Martin Salgo
A man named Martin Salgo went under anesthesia for what he thought was a routine procedure and woke up permanently paralyzed from the waist down. In court, the judge ruled against the doctor saying, "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 patients to the proposed treatment." There needed to be "full disclosure of fact necessary to an informed consent" (Skloot 132)
Prisoner Research
In May of 1956, Chester Southam placed an ad in the Ohio State Penitentirary asking for 25 volunteers for cancer research. He began injecting prisoners with HeLa cells in June 1956 to see if the HeLa cells would produce cancer in healthy patients. The prisoners fought off the cancer completely (Skloot 129).
William Hyman and the Three Jewish Doctors
During Southam's research on subjects without their consent, three Jewish doctors refused to help. The did not want to be part of the research that injected cancer cells into a person who did not give consent because that would be a clear violation of human rights and of the Nuremberg Code. On August 27, 1963, the doctors resigned and wrote a letter, citing unethical practice. They then sent this letter to at least on reporter. Upon seeing the letter, one of the hospital's board of directors, a lawyer named William Hyman, gained interest in the story. He compared Southam's study to Nazi research got affidavits from the three Jewish doctors. They then got a fourth doctor to give an affidavit, explaining that the patients in the study were not physically or mentally able to give consent. It seemed as though the Nuremberg Code did not apply to the US and that there were no laws protecting research subject. Hyman accused Southam and Mandel (who worked with Southam) of fraud and unprofessional conduct, and demanded that the Board of Regents of the University of the State of New York revoke their medical licenses. On June 10, 1965, the Board of Regents found them guilty of "fraud or deceit and unprofessional conduct in the practice of medicine" and recommended that their medical licenses be suspended for one year" (Skloot 132, 133, 134).
National Health Institute (NIH)
The negative press and media from the Southam/Hyman story got the attention of the NIH.The NIH funded Southam's research but required its investigators to get consent for all studies involving humans. The NIH then investigated all of its grantee institutions and found that only 9 of the 52 had any policy in place to protect the rights of research subjects and only 16 had used consent forms (Skloot 135)
The Immortal Life of

"The voluntary consent of the human subject is absolutely essential" (Skloot 131).
The Nuremberg Code is supporting Skloot's claim because it is recognizing that humans need to give voluntary consent before they are used in experimentation or research. It is also recognizing that humans have rights to what is done to their bodies.
Central Claim
Scientists and doctors need to have patients' consent before experimenting and/or researching with their cells or tissue and patient's deserve recognition for their contribution to science.
The prisoners were all told what Southam would be doing and what the possible outcomes were. Because of this, the prisoner research is supporting Skloot's claim.
This is significant because it is the first time that rules existed for human consent and experimentation
The case of Martin Salgo is supporting Skloot's argument because it is the first time that "informed consent" appeared in court documents. This is significant because it is the government recognizing that patients not only need to give consent, but they also need to fully understand what they are giving consent to; doctors and researchers were no longer allowed to leave out any vital information that would change a patient's response.
The case of Hyman and the three Jewish doctors is supporting Skloot's claim because the doctors who violated patients' rights and used them without their consent were punished. The hospital recognized that they were wrong in what they did and fixed the situation. This supports Skloot's claim because the doctors were punished for not having the patients' consent.
George Gey
George Gey is the reason that HeLa cells came to be. He biopsied them when he was treating her cancer and began growing them in culture. However, "Henrietta knew nothing about her cells growing in a laboratory" (Skloot 42). The cells in the lab grew by the billions and soon formed a multi-million dollar industry- without Henrietta's consent or knowledge. She never signed a consent form and had no idea that the doctor had taken her cells
Injecting HeLa cells
In February 1954, Southam believed that either a virus or an immune system deficiency caused cancer, so Southam decided to test his theory. He mixed five million HeLa cells with saline solution and put them into a woman's arm who had been hospitalized with leukemia. He then tattooed a speck of India ink next to the small bump that formed next at the injection site. He repeated this process with 12 other patients. He told them that he was testing the immune systems- he never said anything about injecting them with someone else's malignant cells. In 4 of the patients, the HeLa cells produced cancer in their bodies (Skloot 128).
Southam's experiment of injecting patients with HeLa cells is negating the argument because he was doing it for the "good of science." To him, it was okay to inject the patients with HeLa cells even if he did not have their consent.
The NIH then concluded that, "In the setting in which the patient is involved in an experimental effort the judgment of the investigator is not sufficient as a basis for reaching a conclusion concerning the ethical and moral set of questions in that relationship" (Skloot 135).As a result, the NIH said that to qualify for funding, all proposals for research on human subjects had to be approved by review boards to make sure that they are ethical (Skloot 135).
The NIH is supporting Skloot's claim because it is requiring human consent for research in order for people to receive grant money. This way, the experimenters will have to get patient consent because they need money to fund their projects.
George Gey is negating Skloot's claim because he did what most doctors did at the time- he took Henrietta's cells without permission. Because it was not unusual, his actions are justified in his mind (if everyone else was doing it, why was it so bad that he did too?)
Henry Beecher
In response to the NIH required consent for everything, scientists said that medical research was doomed and that "when we are prevented from attempting seemingly innocuous studies of cancer behavior in humans...we may mark 1966 as the year in which all medical progress ceased" (Skloot 136). Later that year, Henry Beecher (Harvard anesthesiologist) published a study in the New England Journal of Medicine that showed that Southam's research was only one of hundreds similarly unethical studies (Skloot 136).
This is negating Skloot's argument because it is stating that in order for any progress to be made in science, patients should not have the option to give consent because if consent is required for everything, then no patients will be available for testing.
Hippocratic Oath
The Hippocratic Oath is historically taken by physicians and other healthcare professionals swearing to practice medicine with integrity.It was written in the fourth century BC and did not require doctors to have patient consent (Skloot 131).
The Hippocratic Oath negates the argument because it says that physicians can practice medicine ethically without patient consent. Nowhere in the oath does it mention a doctor needing to have patient consent in order to be a good doctor.
John Moore's Spleen
In 1976, John Moore was told that he had to have his spleen removed. He was referred to David Golde, a cancer researcher at UCLA. Before the surgery, he signed a consent form saying that the hospital could "dispose of any severed tissue or member by cremation" (Skloot 199). Seven years after his surgery, he was still flying to L.A. for follow up exams. A nurse handed him a consent form about cell lines and the potential product. Moore circled yes at first and on the second one he circled no. It turns out that Golde had devoted much of the seven years since Moore's surgery to develop a market cell line called Mo. Golde had filed for a patent on Moore's cells, and seveal extremely valuable proteins those cells produced (Skloot 203).
Seven years after Moore filed a lawsuit, the Supreme Court of California ruled against more: "When tissues are removed from your body, with or without your consent, any claim you might have had to owning them vanishes. When you leave tissues in a doctor's office or lab, you abandon them as waste, and anyone an take your garbage and sell it. Since Moore had abandoned his cells, they were no longer a product of his body. They have been transformed into an invention and were now the product of Golde's human ingenuity and inventive effort" (Skloot 205).
The Supreme Court of California's ruling is negating Skloot's argument because it states that the person does not have rights to their cells or tissues after they abandon them. This negates the argument because it would imply that the person should not receive any credit for their biological contribution, or that the patient does not need to give consent to the doctor or researcher for the use of his or her cells or tissues.
Work Cited
Skloot, Rebecca.
The Immortal Life of Henrietta Lacks
.New York:Crown, 2010. Print.
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