It had been
eighty-five years since the Civil War ended for American culture in
the 1950's. Society was rife with segregation and inequality as if
paying homage to a pre Emancipation Proclamation status quo. Slavery
had since been abolished, but not the idea that free black men and
women were any more their equals – evident by the treatment of
blacks across the country. In “The Immortal Life of Henrietta
Lacks”, Rebecca Skloot brings to life this world where black men
and women are kept separate from white society by telling the story
of Henrietta Lacks, a poor tobacco farmer whose cervical cancer
changed the face of science and medicine forever.
Henrietta's cells
being taken by Dr. Wesley TeLinde in the name of science without her
consent is analogous to a debate between John Stuart Mill and
Immanuel Kant – normative ethics versus absolute morality. Societal
norms stemming from segregation played a role in what constitutes
moral responsibilities in medical practice, however it is a more
complex issue. Although it is true that segregation and general
unequal treatment of the black community was inexcusable, the
decision to take the cells without consent is morally ambiguous. The
Hippocratic Oath, an oath taken by physicians provides guidelines to
follow when treating a patient, namely a that physician such as
TeLinde must act in accordance with the maxim that whatever his modus
operandi, it must be for the good of the patient. Furthermore, a
doctor must direct medical care such that a patient understand that a
“doctor knows best”, stemming from the Hippocratic concept that
a physician must follow a beneficence model of care so as not to
provide too much information to the patient because it is not to
their benefit.
Dr. TeLinde
regularly practiced taking cells from patients without consent. From
a utilitarian standpoint, the act of taking cells provided an end
that justified the means. Studying these cells catalyzed progress in
biomedical science for the benefit of all mankind regardless of race,
creed, or any factor eligible for discrimination. This, however,
ignores injustice at the individual level. A well intentioned act,
whether resulting in good or not, fails the test of morality by a
deontological standard. By acting on an exploitation such as not
being truthful about intention to a poor population, whether good
intentioned or not, it is a violation of Kant's categorical
imperative by not treating the act as an end and a means at the same
time. Concurrent inequality issues allows for moral absolutists to
rule that any act as a result of an injustice is ethically immoral.
From the book, it
it not clear to say how societal pressures affected Dr. TeLinde. The
exploitation of black patients certainly enabled his ability to take
cells without patient consent, but whether he did so on his
Hippocratic duties or a disregard for the merit of black humanity is
unclear. The effects of Henrietta's cells on science are
unquestionably beneficial to all mankind and it is likely that
Henrietta would have given consent, “...He Told Henrietta her cells
would help save the lives of countless people, and she smiled. She
told him she was glad her pain would come to some good for someone”
(Skloot, 66). Barring issues about legality and documentation of
consent, it would seem that Henrietta approved of a utilitarian
viewpoint. She likely found solace in her deathbed knowing that her
pain is not for naught, such that any grievances concerning the
maltreatment of her condition, if any, are justified by the result of
her pain.
The debate about
whether HeLa cells are justified injustices depends on which act is
perceived with greater importance. If absolute morality takes
precedent over the end result, deontological injustice trumps the
congregate good resulting from the discovery of HeLa. The issue with
the deontological standpoint, however, is that the greater benefit
cannot be disregarded. The lives saved and the intrinsic good
generated from the HeLa cells that changed the world must be forgone
- not an easy task. Likewise, no justifications can be provided for
the inequality Henrietta faced because treatment by society was
abhorrent. On the other hand, the ends cannot be whisked away by
subscribing to a deontological perspective and not acknowledging
benefits we would have never experienced. While her medical treatment
is morally ambiguous, other societal norms, even those than enabled
ethically ambiguous medical advances are clearly unethical. The issue
arises from the medical profession itself following beneficence with
patients and a general tendency to take the path of least resistance,
which unfortunately was an exploitation of poor uneducated blacks in
need of medical attention
