In part three of The Immortal Life of Henrietta Lacks one of the pertinent ethical problems exemplified through events in the book is the problem of ownership and commercialization of biological material. Henrietta’s family comes to find out that their mother’s/wife’s/sister’s cells are being sold for $25 a vial and thus were making a very large profit for those selling them. However, the Lacks’ had not seen any form of compensation from the profits of Henrietta’s cells and struggled to even afford medical insurance to seek care for themselves. In addition to this, Skloot explains the story of the Mo cell line in which John Moore’s spleen cells were taken by his doctor and sold to biomedical companies, without his consent, to result in an industry worth $3.5 billion. Moore sued his doctor for lack of informed consent and stealing his cells, but ultimately the case was dismissed with the Supreme Court of California declaring that once your tissues are out of your body, they are not yours. In addition, they were now deemed an “inventive effort” due to the fact that Moore’s doctor had “transformed” them through his research.
In both of these examples, there is a very blatant and clear violation of Kantian autonomy principles which state that the demands of treating people as autonomous will dictate the extent to which you can treat people as means. The doctors have been placed in a position of power over patients and research subjects, and have taken advantage of their privilege to exploit the people they are supposed to be helping and instead used their cells for financial gain. Both Henrietta and John did not have the power to determine what happened with their cells, but instead had to yield the doctors decisions who were really supposed to be caregivers to their patients, not business people. They were used as means and not ends in and of themselves, and their stories serve to highlight the inherent inequalities that arise between people’s statuses as either patient or physician.This leads me to question, can a doctor ever be entirely invested in seeking to help their patients in the most beneficial way if they also have coinciding monetary, research, or career incentives to treat, cure, or operate in a certain way?
The idea of turning “bodies into businesses” is seen multiple times throughout part three. Americans, including Henrietta’s own son Zakariyya, enroll in various scientific studies because of the financial compensation that is offered to participants. Roughly two million Americans regularly and willingly sell their blood plasma. The individuals themselves, not just researchers, see their body tissues as a potential profit maker. During these instances, the participants are able to have control over their bodies and can freely choose which studies to participate in or how often they donate, so they are acting as autonomous beings. They are voluntarily allowing themselves to serve as means to an end, which is an interesting twist to Kant’s principle. While these participants are allowing their bodies to be studied, both John Moore and Henrietta Lacks did not. I completely agree with your argument about the blatant exploitation of power and lack of patient autonomy that is seen in these cases. Instead of getting personal financial compensation, Moore’s doctors and researchers were able to patent and profit off of his bodily tissues. With this constant possibility for career-altering discoveries or huge financial pay-outs, I do not think that research physicians can ever be entirely invested in finding ways to help their patients in the most beneficial way possible. Though they take the Hippocratic Oath, swearing to do no harm and ensure patient’s privacy, Skloot herself points out that this Oath is not an actual law, so constantly catering only to the patients’ best interest seems nearly impossible. Would completely separating biomedical researchers and physicians potentially remedy this problem? Or would this only lead to a lack of communication between discoveries and treatments, which could potentially endanger patients’ health even more?
I found this perspective on the events that transpired with Ms. Lacks and Mr. Moore to be very engaging. The healthy speculation on whether or not doctors have the capability of being solely caregivers when the role of physicians is so closely intertwined with monetary incentives. Working in a clinical setting on the administrative side of healthcare really opened my eyes to the true functionality of conducting procedures and how the nature of the role becomes convoluted with ulterior motivations. In the reading, we realized how Mr. Moore’s and Ms. Lacks interactions with their physicians were dominated by the influence of scientific and monetary progression. If healthcare remains as a for profit entity, it will become increasingly difficult to divest the aim of making money from the psyche of the caregiver. Contemporarily, we see patients treated with lesser care if they have insurance that doesn’t compensate the physician or hospital as well as a private insurance policy would. The character of a for profit healthcare system carries its implications all the way through to the hearts and minds of the physicians and nurses who provide direct care to patients, which inherently allows for a level of bias to affect the standard of care that patients receive
Kaeli did a great job explaining the abuse of power demonstrated by physicians in Henrietta’s case, as well as in the case of John Moore. In both situations, the patients were used as a means for the doctors to benefit financially instead of being treated as ends, which is a tremendous ethical issue. Kaeli raises an important question: how pure can doctors’ intentions truly be when they can potentially act with other interests in mind, such as monetary or career rewards?
This question is part of a much bigger question involving the effectiveness of a for-profit healthcare system. Clearly such a system has major flaws, but can these other incentives ever truly be removed? Doctors will always need to be paid, and it only makes sense that those who make groundbreaking medical discoveries should experience a successful career. These motives can never be removed from the system, but even if they somehow were, how would the healthcare system function? Would people still want to enter the field without a monetary incentive, and even if they did, would they be more reckless on the job as a result?
How can we regulate this field to ensure patients’ autonomy and best interests are always considered, when the incentives that could potentially coincide with these values can never be truly removed? Is the best solution to implement stricter laws regulating the healthcare system, or do physicians just need more thorough morality training before entering the field?