Bryan Djunaedi

December 8, 2012
HONORS 391
Final Paper

It isn't fair, it isn't right, Mrs. Hutchinson screamed, and then they were upon her.
-The Lottery, Shirley Jackson
At the beginning of Shirley Jacksons short story The Lottery, everything seems
stereotypically normal: in a setting reminiscent of an American summer in the early 1900s, the
townsfolk of a farming community gather in the village square to draw lots, just like any town
might for a prize drawing. Only at the very end does it become clear that the prize, drawn by an
innocent and defenseless woman, is death at the hands of her peers by stoning. This ghastly
ritual, taken in stride and for granted by the townsfolk, is a gross anachronism more akin to a
pagan sacrifice meant to bring good weather, or more recently, the Talibans enforcement of
radical Sharia law in Afghanistan, in which allegedly adulterous couples are stoned to death.
Though Americans may believe themselves past or above such obvious examples of injustice,
Jacksons tale may not be such a distant metaphor when applied to the case of Henrietta Lacks,
whose story is retold in Rebecca Skloots book The Immortal Life of Henrietta Lacks. The
treatment of Henrietta and her family illustrates the disconnect between modern medical and
research practices and the outdated legal framework in which they exist, serving as a valuable
lesson on how the clash between moral boundaries and the promise of (bio)technological
advancement is often won by the latter.
The comparison between Skloots and Jacksons stories will, and perhaps should,
immediately encounter opposition. Whereas the actions of the villagers are almost inarguably
unjust, the most pressing question about Henrietta Lacks story is if the treatment of her and
her family was in fact morally wrong. Reviews of Skloots book, and perhaps Skloot herself,
appear to align with the opinion that the Lackses were treated unjustly. However, a significant
portion of my colleagues in this class took the opposite stance when the question of right or
wrong arose. Like a scientist examining Henriettas cells under a microscope, I will dissect the
three main angles at which Henriettas story has been examined.
Scientific Practice
Staunch fans of competitive cyclists who have been accused or found guilty of doping
argue that their heroes can hardly be called cheaters when the whole field is using
performance-enhancing drugs; if everyone is doing it, how can you corner and prosecute a
select few? The actions of George Gey exist on even firmer ground. Whereas using steroids is
banned in the cycling world, there existed neither precedent nor binding code at the time that
he collected Henriettas cells besides that of patient confidentiality. Hence, Gey did not
explicitly break any rules. At the time it was standard practice to collect biopsies for cancer
treatment, especially with the National Foundation for Infantile Paralysis call for viable
alternatives to human tests in the fight against polio in 1951. Gey acted as many other doctors
did at the time; he just happened to be in the right place at the right time.
Perhaps, in the light of the Moore case, if Gey had performed such actions in the
modern day, he would have been slightly in the wrong; the Supreme Court ruled that David
Golde, Moores doctor, had taken advantage of his position a doctor and violated patient
trust (205). However, unlike Golde, Gey had no financial interest in Henriettas cells, so there
was no lack of informed consent according to the ruling. In any case, you cannot use modern
precedents to retroactively judge past actions without running into serious contradictions
(some of the American Founding Fathers were slave-owners).
In regards to the contribution of Henrietta to the creation of an immortal cell line whose
existence led to the discovery of not only the polio vaccine but the documentation of countless
cellular responses to environmental conditions, scientific consensus would regard Henriettas
relation to the cells as mere chance: an act of nature. Unlike Ananda Chakrabarty, whose
bioengineered, oil-eating bacteria was able to be patented in 1980 as a result of human
ingenuity, Henrietta did not use her intellect to alter her cells in a way that would make them
immortal (201). Not even Gey can lay claim to that dubious honor. However, after
Chakrabartys victory, Gey hypothetically could have at least patented the cell line, whereas
Henriettas kin would not have been able to. This presents an irony: it would seem that we are
willing to give economic imperative to those who discover properties of or alter nature but not
to those who enable the very physical manifestation of said properties. If you discover an
unknown of, or engineer a modification to, an existing system, you can claim it as intellectual
property, like in the case of 20% of human genes (323). For example, the ability for Myriad
Genetics to exert their rights as the intellectual owners of the BRCA1 and BRCA2 genes
responsible for most cases of hereditary breast and ovarian cancer ignores a fundamental
reality that every human biological system that contains these genes uses them without
Myriads consent (324). Without Henriettas life, the cell line, the research, the monetary gain
of certain parties, and all the other accompanying side effects of HeLas development would
not have occurred by simple cause and effect. In fact, Henriettas life created the HeLa cell
line, much as modern scientists engineer immortal cell lines today. Why we refuse to give credit
to that, even if it is just by unlucky coincidence, is a mystery to me.

Moral Philosophy
Using moral philosophy as grounds for judging the actions of those who dealt with
Henriettas cells is shaky at best to begin with; at its heart, every code of ethics contains
principles that have no infallible basis. Thus, it is flawed to believe that the decision of right
versus wrong can be made with morality as a framework. The only benefit of performing this
exercise is to gain understanding of how some people, including those involved with the cells,
might view their actions as ethically acceptable.
In the theories of both Immanuel Kant and John Stuart Mill, the moral decisions that
backed the exploitation of Henriettas cells are justified. Kants categorical imperative, which
demands a thought experiment in which all humans are subjected to the same moral decision
in question, holds Gey as a righteous man. After all, he subjected all his cancer patients to the
same procedure of collecting biopsies for study, with no harm done in excess of the treatment
or the illness itself. The fact that Henriettas family drew the winning ticket, as it were, does not
affect the Kantian view of Geys actions. In ultimate agreement with Kant, Mills classical
utilitarian view clearly favors the collection of Henriettas cells and their subsequent use in
research, since they contributed so much to the advancement of cellular science. This view
would even hold if Henriettas cells were taken from her with her objection; the ends justify the
means, and the research performed on the cells led to the greatest possible happiness for the
most people.
Both of these philosophical treatments cover the case broadly and ignore the basic
human needs of Henrietta and her immediate family. Though perhaps the results of the HeLa
experiments were unquestionably beneficial to society, the lack of communication to
Henriettas family about the processes behind HeLas usage in science was certainly unethical,
especially in the context of reinforcing existing racial and economic disparities at the time.
However, whom can we pin the blame upon? By the time HeLa had effected major scientific
advances, so many scientists were involved in the cell lines upkeep, distribution, and usage
that no one person could claim full responsibility for HeLas impact. It is a small mercy that
Skloot pursued her project to the degree that she did; without The Immortal Life, Deborah and
the rest of Henriettas family might have been left in the dark until their deaths.
Economic Theory
Economic analysis of Henriettas case results in conflicting judgments of HeLas
exploitation. If we treat the Gey Lab as a startup company whose ultimate goal is the creation
of an immortal cell line, then the seed investments are the biopsies collected from Geys
patients. The cumulative probability of dozens of cells possibly containing the necessary genes
for immortality, combined with Geys tireless efforts to enable such cells to survive in culture,
resulted in the eventual success of the Gey Lab. Likewise, a startups multiple backers may
eventually allow it to succeed, with no credit given to any particular backer. The success of the
company results in payoffs for the initial investors. However, it would be unrealistic for all of
Geys patients to be rewarded for contributing cells. What about just Henrietta? It wouldnt be
unexpected within the metaphor for a crucial early backer to gain favor in the eyes of a
company CEO, even if that particular contribution was made without the knowledge of its
eventual impact. Therefore, it seems that in this framework, Henrietta should be compensated
for her involvement with the success of the Gey Lab in creating an immortal cell line, as well as
Gey himself and his associates.
The major hole in the startup company metaphor is that the Gey Lab did not make any
money for all its efforts, so there would be no source for Henriettas compensation even if she
did merit it. Once HeLa left the lab, it was able to easily survive so long as it had culture
medium. In economic theory, supply and price are inversely proportional. With HeLas ability to
multiply rapidly and sustain its survival without intervention, supplies of HeLa exploded
(especially with the creation of the HeLa Distribution Center at Tuskegee and, later, the
Microbiological Associates Cell Factory in Bethesda, Maryland). If a scientist got his/her hands
on HeLa, they would feel no pressure to compensate Gey or Henrietta since they could keep
the cell line going on forever.
Conclusion
Clearly, deciding on the morality of Henriettas story is impossible; there exist too many
conflicting views. The positive impacts of Skloots work the financial gains of the Lackses due
to the books publication and the increase in their knowledge of what really happened to
Henrietta are fortunate impacts, but ones which are not the results of necessary systemic
changes. Perhaps the most beneficial outcome of Skloots book is the fostering of dialogue in
classrooms, political theaters, and policy-making circles. When awareness of issues becomes
mainstream, its ripples might just be enough to push the status quo over the brink of passive
acceptance into the crucible of change.