In Part II of The Immortal Life of Henrietta Lacks, Skloot dives deeper into the issues of unethical medical paternalism to provide a thrilling narrative about the theft and exploitation of Henrietta’s cells, focusing special attention on on the divergences between these two entities: 1) the person, who experienced tragic treatment and suffered from institutional poverty, and 2) the cells themselves, which to this day remain very much alive and well. The narrative begins with Gey requesting an autopsy, and the author here draws a clear distinction by mentioning that Gey had to get consent from Henrietta’s family in order to conduct the procedure. Here Skloot begins to introduce the theme that as a corpse, as a piece of biomedical material, Henrietta’s body is seen from an economic standpoint, which makes it easier to treat it as a commodity. This theme runs throughout this entire section of the novel. The story then details Henrietta’s funeral, and the author is sure to include another philosophical symbol, the storm. Henrietta’s cells are used to test the polio vaccine, and are vastly effective in developing it. HeLa grows in popularity soon after, but Dey, specifically, is hesitant to take credit. Three doctors then grossly misuse HeLa cells in their own practice through human experimentation, but nevertheless, HeLa cells become ubiquitous in the medical landscape. Meanwhile, Henrietta’s family suffers crippling hardship and destitution. Henrietta’s cells were being used to save lives, but her own family could not afford health insurance.
Within Part II, numerous moral and bioethical issues are expressed, but the one I found most salient and profound was the distinct shift in focus from the issue of informed consent to that of ownership. While Henrietta was alive, doctors could exercise medical dominion over her under the guise of treatment and paternalism. The taking of tissue from Henrietta did not require consent, but the autopsy specifically did. This shifted the discussion from informed consent, which heavily relates to the living, to ownership, which largely dictates inanimate objects. This made me ponder the language surrounding the deceased and, more specifically, autonomy itself. Autonomy should refer to the living, but this societal reverence we place on the dead has highly autonomous language. I began to investigate the steps within the narrative to examine this unique relationship. Part of the reason for this difference, is that while she is alive, her cells are taken under the guise of curing and treating her, but after she has died, exploiting her body would specifically be for other reasons. They would be more directly “using her.” This significantly crosses the lines laid by Kantian ethics, which while allowing for people to be used as means, also dictates that those people are also the ends of the use. As a response to this however, Henrietta’s tissue becomes a medical commodity, transforming the issue into an economic consideration; once the issue becomes economic, it becomes easier to view her body and her tissue as biomedical material, and largely becomes an issue of ownership. I believe these ethical considerations to be well founded and strong arguments that build the subtext of the story. However, I do indeed pose some questions regarding their scope. If we abandon the Kantian interpretation and work within a utilitarian framework, I question if it can also be argued that since so many lives were positively impacted, the harmful actions of consent-overreach are negated or at least diminished in their immorality. I also question if Gey was genuinely trying to protect Henrietta’s privacy or if it was a matter of pride, guilt, and ownership.
This theme once again appears in the narrative during the discussion of the historical significance of “Night Doctors,” but this issue can be considered using other moral and ethical prescriptions as well. The narrative reveals that the practice and legacy of night doctors extends all the way back to slavery. This practice saw the commodification of black bodies and these entities were considered to be raw material. Once again this pulls on the notion of ownership and commodification, in that when viewing a patient or even a dead body as biomaterial instead of giving due reverence, it becomes vastly easier to view these issues through an economical sense, and treat these entities how we would treat any other economic commodity. Numerous ethical principles advise against such thinking, such as virtue ethics, which emphasizes the character, honesty, and individuality of the human form to be the most principled approach to ethics. I personally considered a philosophical theory I have been investigating independently to understand these issues: decadence. Decadence, from a societal and philosophical standpoint, largely refers to a perceived decay in standards, morals, honor, and discipline at the higher echelons of a state, and I believe this perspective can be a vital tool to understand the ethical dilemmas in this novel. I consider the systemic and institutionalized practice of these “night doctors” during the time of slavery, the subjugation of people of color described in the novel during the time of Henrietta Lacks, and the discussion in the novel of the current systemic practices in healthcare that disproportionately affect Black Americans to be emblematic of individual decay in cultural values and societal morals in the lack of reverence we award to people of color.
However, this unique perspective also poses some interesting questions. If these practices are so systemic and institutionalized, how do we begin to ethically and fairly dismantle systems of marginalization? If we only view these issues from a perspective of decadence, how do we account for the progress that society has made in the realm of race relations? These two realities are not mutually exclusive. We can accept that we live in an institutionally racist society without discrediting the progress that we have made. In my opinion, this duality can be extrapolated to once again represent Aristotelian ethics, in that as a society, our habits are warring with our experiences, battling for the soul of our character. Through gradual changes in cultural attitudes, we are pursuing perfection in egalitarianism, and in that pursuit itself, I believe we are intrinsically good.