Or just no exploitation period.

This week we read about the infamous case of Henrietta Lacks, a 31 year old cancer patient who upon passing away had her cells stolen from her without her consent or knowledge. In addition, her family was never informed that their beloved one’s cells were being used in research labs. Most importantly, after years of secretly conducting research on Henrietta’s cells, also known as HeLa cells, researchers have won numerous Nobel Peace Prizes and launched the multibillion dollar cell culture industry. Meanwhile, Henrietta Lacks family has never received any compensation for having their beloved ones cells exploited, nor have they seen a single cent of the profits earned from this research. No matter the amount of good things research on HeLa cells has done for the world, there is no excuse for why Henrietta’s family has not yet been compensation for this deception.

In the passage, “Vulnerability, Exploitation, and Discrimination in Research”, Beauchamp and Childress address three problems involved in enrolling the economically disadvantaged in research: 1) undue inducement, 2) undue profit, and 3) exploitation. Under inducements include monetary payments, shelter, and food and are considered unduly large and irresistible payments. In contrast, undue profits are when “subjects receive unfairly low payments, while the sponsor of the research gains more than is justified” (Beauchamp and Childress, 269). One could argue that it would be unethical for a researcher to approach a subject who is weak and constrained by their poverty, and thus more likely to be coerced into being a research subject with menial benefits. The compensation offered could be so little that it is viewed as exploitative. Contrastingly,  monetary payments could be unduly large and irresistible and be seen as coercive or as a form of bribery. Therefore, after reading this passage from Beauchamp and Childress, I have concluded that there is no real solution for how one can determine a method of payment or reimbursement that is nonexploitative.

One simple solution could just be to not exploit subjects in the first place; the Lacks’ doctors could have just informed the Lacks family and received their consent. I think an even better solution would be to ask research subjects how they would like to be compensated. Obviously the subject would not be allowed to make an outrageous request like ask for $1 million dollars. For example, say a homeless person was recruited for research, if the person requested 1 meal and shelter for a night, the researchers should ablige their request. Better yet, for low income subjects, researchers should say, ” Even if you decide you will not do this study, we will still offer you shelter, food, money, etc. just for your time.” This would show the subjects that the researchers are sincere in their endeavors. But I think the best solution would be to allocate more money to fix entire low-income communities so that the issue being an “economically disadvantaged” person is resolved completely.

Ultimately, in the case of Henrietta Lacks’ family, where billions of dollars has been raised off of the research done on Lacks’ cells, there is no reason why Lacks’ family should still be poverty stricken with no access to healthcare themselves. It is unfortunate that no justice has been served, and I am curious to know why no legal action has been taken against this case. Even if Lacks’ family cannot afford to finance a lawyer, it is appalling that no one, not even the many researchers who have profited from this deception nor a generous lawyer willing to offer their time to the case have come forth to at least help Lacks’ family gain the compensation they deserve.

Works Cited

Beauchamp, Tom L., and James F. Childress. Principles of Biomedical Ethics. 7th ed. New York: Oxford University Press, 2013. Print.

Thomas, John, Wilfrid J. Waluchow, and Elisabeth Gedge. Well and Good: A Case Study Approach to Health Care Ethics. 4th ed. Peterborough, Ontario: Broadview Press, 2014. Print.

There has been a large debate in Washington D.C. on how effective the Affordable Cares Act has been in revitalizing America’s healthcare ecosystem. There were many reasons to implement the ACA and one of the reasons that stood out to me the most was the idea that the United States placed dead last among developed countries in terms of mortality rate. The United States spends more than twice the amount than the rest of the world combined on healthcare but yet our nation still has a very low life expectancy. People generally come and think of America as the best place to get healthcare due to the technological advances our country has made in healthcare. However, to access these benefits, one would either have to shell out a lot of money or get lucky and have their provider give them the service that they were looking for. With the ACA, we move one step closer to a healthier society.

For example, before the ACA, hospitals were losing a lot of money because they had an overflow of emergency room patients and not enough people were making time to see their doctors regularly on a yearly basis. In addition, since the hospitals were not able to get money out of the emergency-room patients due to lack of financial status of the patient, hospitals would charge those who had insurances higher costs to balance the money being lost from the uninsured patients. That effect then raises the premium for the individual with the insurance and they end up having to pay for those without insurances.

With universal healthcare, the predicament listed above ends. Everyone will be mandated to have health insurance and hospitals will be able to save generate more money from patients. I do not believe that the quality of healthcare would go down in this world but rather everyone would have access to the healthcare technologies that currently exist. Healthcare should not be limited to one socioeconomic group because all people should have equal rights in terms of care in my opinion.

Another major part of the new healthcare reform is a greater emphasis on preventative care. Great Britain has less than half the U.S. budget on healthcare but they do not focus on spending money to develop drugs. Britain focuses their money on developing preventative medicine policies so that they can stop disease earlier in its cycle in order to prevent spread of the disease. I believe that U.S. can be smarter with how it utilizes its funds and continue to build upon the foundation the new healthcare reform has set up.

Works Cited

Beauchamp, Tom L., and James F. Childress. Principles of Biomedical Ethics. New York: Oxford UP, 2009. Print.

Brody and T. Engelhard, “Access to Health Care,” Bioethics: Readings and Cases

Background

There are many ethical problems posed in the case regarding Henrietta Lacks. Unfortunately, her case occurred during a time where black individuals did not have the same rights as white individuals. This discrimination lead to black patients being treated only under the condition that it was then appropriate for medical research to be conducted on them. The two ethical issues I will tackle in this blog are should patients give consent to having their cells researched? Furthermore, to what extent should we violate autonomy to advance science?

Dilemma

Lack’s cells were special as they were the first successfully grown human cells. Her cells led to many advances in the scientific community such as leading to the eradication of polio, a disease that plagued many. When Lack’s tumor cells were taken after her death from cervical cancer, “no one asked her permission to take the cells” (p. 254). However, the case did state “it was considered fair for medical researchers to conduct research on patients because they were being treated free of charge” (p. 254). Operating under this principle, which I believe violates autonomy of black individuals, I will evaluate whether the principle of autonomy was violating regarding Lack’s cell collection. It is clear that the racism at the time was unethical for a multitude of reasons and the case does not make it clear whether Lacks was aware that by receiving medical attention free of charge she was giving herself to research. If she was unaware of the extent to which research would occur on her, than this would violate the principle of autonomy because she did not give consent to the researchers. I believe that it is easy to agree that patients should consent to any research that might be conducted on them as without consent autonomy is violated.

However, if upon entering the hospital Lacks was informed that they would treat her only under the circumstance that her cells would be used for research later, than I do not believe her autonomy was violated past the violation of autonomy as a result of racism. Beauchamp and Childress state, “nothing about economically disadvantaged persons justifies their exclusion, as a group, from participation in research, just as it does not follow from their status as disadvantaged that they should be excluded from any legal activity” (p. 268). Since Lacks was financially disadvantaged, one could argue that she is being exploited by receiving medical attention from this hospital. However, if one were to continue down this path then in an attempt to “eliminate the problem of unjust exploitation” society would have to “deprive these individuals of the freedom to chose [to engage in research]” which “would often be harmful to their financial interests” (p. 268).

Reflection

One of the conditions of the principle of justice is allocation of resources. Allocation of resources implies that if “there is not enough to go around, [then] some fair means of allocating scarce resources must be determined” (principle of bioethics online website). What if we could make the resource less scarce? Then issues surrounding justice and prioritizing distribution would be less of a concern. In Lack’s case researchers utilized her cells after her death, and advanced science exponentially as her cells were the first “ever successfully grown human cells in a lab” (p. 254). In regard to organs, after individuals are deceased and are not organ donors, their organs decay, providing no advancements or cures for live individuals suffering medical conditions. Does it seem logical to allow all the organs or people who are not organ donors to go to waste after death? Should we as a society utilize the bodies of not only donors, but also individuals who are not labeled donors after their death for the advancement of science? Many would argue strongly against this, expressing concern that this blatantly violates the person’s autonomy and free will. However, currently arguable greater ethical violations are occurring due to the lack of available organs. Individuals might contemplate having another child for the primary purpose of providing one of their current children an organ necessary to live. Is this a greater violation of autonomy than taking the organs of someone who has lived a full life and now has died? The person who is dead would be unaware their autonomy is being violated unlike the child who will later realize that their autonomy was violated from a young age. In Lack’s case, her cells were taken after her death. Looking back, knowing all the amazing advancements that occurred as a result of her cells, it is difficult to imagine where we would be today without her cells. Nobel prizes, the treatment of polio, and cell culture industries all resulted from Lack’s cells. It is fascinating to imagine the advancement that could result from having access to organs after individuals are deceased. An average of 21 people die a day waiting for an organ transplant (http://www.organdonor.gov/about/data.html), it is interesting to think about how many lives we could save by implementing a policy regarding organ donation of the deceased. Furthermore, if we had an ample supply of organs, researchers would have more material to investigate and try treatments on, which could lead to eradications of other diseases and conditions. Although this notion seems far fetched, I think it is an interesting idea to consider in the light of Lack’s case. While Lacks was alive she was provided with medical attention and treatment she would not have received without the possibility of research on her cells after her death. If Lacks gave consent to the researchers allowing them to conduct research on her after her death, even though there is the concern of exploitation, I do not feel it was wrong to utilize her cell’s after her death. The main moral issue I found with this case was the lack of acknowledgement and compensation her family received after the success of her cells. The case states, “Henrietta’s family remain[ed] in poverty and have never received any benefit or recognition for their mother or grandmother’s contribution to science” (p. 254).

Work Cited

“African American Trailblazers in Virginia History.” N.p., n.d. Web.

Thomas, John E., Wilfrid J. Waluchow, and Elisabeth Gedge. “Case 7.3: Who Owns the Research? The Case of the HeLa Cells.” Well and Good: A Case Study Approach to Health Care Ethics. 4th ed. N.p.: n.p., n.d. 254-55. Print.

Principles of Bioethics. Thomas R. McCormick, D.Min., Senior Lecturer Emeritus, Dept. Bioethics and Humanities, School of Medicine, University of Washington, n.d. Web. <https://depts.washington.edu/bioethx/tools/princpl.html>.

Background

Although it is more than 60 years later, most people have never heard of Henrietta Lacks – whose cells have been used to save the lives of countless people. 31 year-old Henrietta was an African American woman living in the early-mid 1900’s. After being diagnosed with cervical cancer, Henrietta died in 1951 at Johns Hopkins Hospital. Due to the fact that research on such patient’s was very limited at the time, a biopsy of her tumor was taken for research purposes without ever asking her permission (Thomas, 254). What happened next changed the lives of many people – the cells reproduced and never stopped reproducing, essentially becoming “the first immortal cells ever grown in a laboratory” (Thomas, 254). These cells became famous not only in the medical field but also worldwide after being mass-produced. It is here we begin to see how the principles of ethics are being violated.

Dilemma

Within this case, the main dilemma that stands out to me revolves around the violation of Henrietta and her family’s autonomy. Henrietta and her family not only suffered considerable amounts of injustices during this time but continue to suffer through today’s time. It is noted that although Henrietta’s cells were taken without informed consent when she died in 1951, it wasn’t until 1971 that her family first became aware of the fact that her cells existed (Ethics of Informed Consent).

There were several opportunities before/during treatment that Henrietta was competent enough for physicians to ask for her consent in regards to taking her cells. What boggles me even more is the fact that her family members were also present and willing to speak their minds throughout this entire process. This is where we see the complete disregard of the ethical principle of autonomy. From an opposing viewpoint, one may argue that Henrietta’s status in society (an uneducated black woman) made it very difficult for physicians to communicate to her the details of her care. However, I would argue that a simple explanation and inquiry as to her feelings in regards to such a situation would have benefited all parties involved.

Additionally, one may present the argument that the physicians measured the principles of beneficence and non-maleficence and came to the conclusion that helping Henrietta and attempting not to harm her outweighed her autonomous rights. Although it is unclear in the reading, the physicians acquired the cells as leftovers done from a surgery intended to help Henrietta (scienceblogs). While the doctors felt as though their actions were benefiting Henrietta and the researchers felt as though they were benefiting the good of a greater number of people (mankind), it is evident that Lacks’ family did not share such sentiments. Although the outcomes proved to provide good to the greater number of people, something that falls along the lines of utilitarianism, I truly believe that the physicians failed to assess the situation properly.

Reflection

In this case, the dilemma revolves around the basic ethical principle of autonomy and its disregard. Considering Henrietta’s situation, I believe that paternalism played a role in the disregard of autonomy – as a black woman in the 1950’s Henrietta did not have the option to question her doctor’s choices even is she was presented with such an opportunity. Such a situation could be termed “benevolent deception” meaning that the physicians believe they were doing Henrietta a favor in not taking the time to explicitly state what was wrong with her and the extent of her diagnoses. I’m not saying that if such a case was presented today that the patient would 100% agree with the physicians or 100% disagree with the physicians, but at least the patient would be given the choice. While some may put more emphasis on the effects that Henrietta’s cell have had, I would put the emphasis on the lack of information and choices presented to Henrietta.

Works Cited

Ethics of Informed Consent . N.p., n.d. Web. 8 Apr. 2015. <http://rabinmartin.com/insight/ethics-of-informed-consent-and-the-legacy-of-henrietta-lacks/>.

N.p., n.d. Web. 10 Apr. 2015. <https://hawaiiesquire.files.wordpress.com/2012/05/informed-consent-consideration.jpg>.

Thomas, John and Wilfrid Waluchow. Well and Good: A Case Study Approach to Biomedical Ethics. 3rd ed. Broadview Press Ltd., n.d. Print.

In this reading, the authors start off by discussing how different countries deal with healthcare, and ultimately ask to what extent, and at what cost ought a society to provide equal healthcare for all.

Healthcare in America accounts for around 18% of the total GDP, comparatively lying around 7% for the United Kingdom. On top of that, it was also discussed in this reading that while over 95% of the UK’s population has access to health care (99% in Germany), only 90% of US citizens have that same access. In regards to portion of GDP and percentage of the population accounted for, the score currently sits at 2-0, and it is not in America’s favor. However, while it is a widely accepted fact that the United States is still lagging in terms of Healthcare when compared to Europe, this does not necessarily mean that us American’s are losing on all fronts.

A piece of evidence presented that elaborates on why Europe is not “all that” is the example regarding how the United Kingdom went about balancing costs and healthcare. While the United Kingdom may spend less on healthcare than the United States or Germany, it comes at the cost of quality of care, and the UK essentially reduced these costs by “erecting barriers” to their citizens in regards to higher technology treatment. Not only that, but patients are often discouraged from certain “high cost or higher technology interventions” that clearly would provide the patient with greater benefits. So why does America pay so much for healthcare? Simply put, it is because America wants to provide their citizens with the opportunity for the best healthcare possible. While there are less people who have access to these opportunities when compared to the United Kingdom, those that do have more doors open to them. Unfortunately the comparison between the two is not black and white, and the question now is whether or not it is ethical for the United States to turn their back on 8-11% of Americans in the hopes of providing the majority with better, and higher quality healthcare.

While I believe that every person should have the right to healthcare, I feel that the benefit outweighs the costs when said benefit is better all around healthcare. The United States relatively speaking provides a slightly lower number of people with a high level of healthcare, and I feel that that triumphs over providing a slightly higher number of people with lower quality health care.

Also I would like to mention a common counterargument that can be made to support the superiority of healthcare in Europe (or rather the inferiority of American healthcare) in that American’s are not healthier, and do not live longer than Europeans. Even this statement, while statistically supported, cannot truly determine the quality of American or European healthcare systems because that point relies on the assumption that healthcare is the only determinant of a person’s health. In reality healthcare provides a long list of benefits for any person that qualifies, but the health of an individual at the end of the day is heavily reliant on genetics, diet, violence, and the list goes on. That being said, healthcare can only do so much, and ultimately there are a lot of health determinants that are well outside anyone’s control.

Below is an image which further proves my point that American offers a higher level of health care treatment

Below is another statistical analysis that shows that there are many different determinants of health that are not reliant on healthcare

Works Cited:

Brody and T. Engelhard, “Access to Health Care,” Bioethics: Readings and Cases

http://b-i.forbesimg.com/theapothecary/files/2013/11/CONCORD-table12.jpg (image1)

http://media.economist.com/sites/default/files/imagecache/full-width/images/2012/04/blogs/graphic-detail/20120428_WOC086.png (image 2)

Background

Henrietta Lacks was a poor African American woman who died of cervical cancer in the 1950s at the age of 31. She was married and had five children. Following her death, a biopsy of her tumor was taken for research. She was given treatment for free at a public hospital and in return, samples of her cells were taken for research purposes. This was a common way in those days to obtain research. The cells that were acquired from Henrietta kept reproducing. They became the first cells to reproduce in a laboratory setting. Henrietta’s cells were used in varied ways including finding a vaccine to help prevent diseases such as polio. Scientists continued using these cells for different purposes and many businesses profited greatly from them as well.

Dilemma

There are two important ethical dilemmas presented in Henrietta’s case. The first dilemma involves whether a patient should give consent for their cells to be used for research and at the same time remain anonymous as to whose cells they are. In this situation from the 1950s, Henrietta was not asked for consent. However, today if the patient is competent, they are required to give informed consent. If they are not competent, the family of the patient is usually asked to give consent on their behalf. Therefore, consent should not be an issue today. Also, in this case, there was no anonymity. The public found out that the cells came from Henrietta Lacks and they were labeled HeLa cells. The ethical question of keeping a person’s identity anonymous is also usually not an issue today. Respect is given to a person’s privacy and people contribute their cells without labeling whom they came from. Another ethical dilemma in this case involves whether patients should be compensated for being a part of research. In this case, there was no compensation given to Henrietta or her family for using her cells in research. Today, patients are encouraged to participate in studies and are given a compensation for their time. Although some patients are offered compensation, many voluntarily donate their cells for scientific research.

Reflection

In my opinion, Henrietta Lacks’ family should have been given some compensation. Her cells went on to provide many scientific benefits in research as well as a profitable industry. One form of compensation that I feel is appropriate in this case could possibly be in the form of healthcare. Henrietta’s family was poor and their daughter stated that they couldn’t even afford to visit doctors when needed. I find this situation unfair, especially since many businesses received a profit from her cells. It was publicly known that they were Henrietta’s cells and thus, it only seems justifiable that they should at least receive something in return. Therefore, I agree with how society handles donations today in keeping them anonymous. Donors do not typically find out about findings from their specific donations. This way, scientists can objectively research and use the information to advance cures for the wellbeing of society. These donations help medicine advance to find new treatments and cures for future generations.

 Works Cited

Beauchamp, Tom L., and James F. Childress. Principles of Biomedical Ethics. New York: Oxford UP, 2009. Print.

Skloot, Rebecca. The Immortal Life of Henrietta Lacks. New York: Crown, 2010. Print.

Thomas, John, Wilfrid J. Waluchow, and Elisabeth Gedge. Well and Good: A Case Study Approach to Health Care Ethics. 4th ed. N.p.: Broadview, 2014. Print.

The world is unfair. The diversity through our city, state, country, and world require that there are differences in people’s life experiences. As a human race we should work to ensure that every person has the basic necessities to life a good life, however defining what a necessity is a very difficult task. Those living in different areas of the world view what is necessary and what is not differently. This discrepancy makes us ask what the difference is between something that is unfair and we need to live to learn with and what is unjust and we need to fight against to rectify in our world.

Beauchamp and Childress sate that “Properties distributed by the lotteries of social and biological life do not provide ground for morally acceptable discrimination between persons in social allocations if people do not have a fair chance to acquire or overcome these properties” But What properties create an injustice to require some form of assistance? Is it unfortunate or unfair? The example stated in Principles of Biomedical Ethics is the disparities have persisted in the management of acute myocardial infarction and acute coronary syndromes and that the End-stage renal disease Program pays in full for the kidney transplant but does not pay for the post-transplantation requirements such as immunosuppressant mendication needed for the rest of life. The denial of treatment due to the socioeconomic status of individuals is an injustice. While the programing are helping individuals and diagnosing illness to work to correct something that is unfair, they are also making it more of an injustice. It is not morally just to provide a service for a citizen that is not sustainable for their socioeconomic status. If you do not provide a service that will help them patient through their lifetime, and you know that they will be harmed in the future either emotionally or physically because of the stop to treatment, it is an injustice.

This makes me think of similar situation in New York. Froma Walsh discusses the case of Post Traumatic Stress Disorder (TSD) in New York neighborhoods. There are great discrepancies between the rates of symptoms and diagnosis of PTSD. There are higher rates of symptoms of PTSD, but there are higher rates of diagnoses of PTSD in upper middle class neighborhoods. While these disparities exist and it is unfair that mental health professionals take into account the socioeconomic background of a client before diagnosing them with something that may require expensive therapy and drugs that they cannot afford. Instead these clinicians provide ways to self regulate their symptoms for their PTSD that do not require diagnosing them with the disorder.

While it is important to work to fight injustices, it is important to accept that unfairness does exist. The same health conditions in different people may require different and more effective treatment based on their socioeconomic status and life experiences.

Walsh, F. (2003). Normal family processes: Growing diversity and complexity.

New York: Guilford Press.

Tom L. Beauchamp and James F. Childress, Principles of Biomedical Ethics. New York: Oxford   UP, 2009. Print.

As is the case in many developed nations in the world, it is a generally accepted concept that all people should have equal opportunities to succeed. In the paradigm of health, it is often intuitively assumed that in order to achieve equal opportunities amongst all people, there must be universal healthcare offered to everyone as well (Sreenivasan 21). However, Sreenivasan works to challenge this intuitive connection we often make. He analyzes the argument for universal healthcare being a necessity for justice by looking at two primary connections that must be accepted in order to make the conclusion true. The first premise is that we must accept that fair health is needed in order to get a fair share in a certain population (Sreenivasan 22). The author is careful to note the parameters for this assertion in saying that fair share is relative based on the population you are looking at. The second connection that must be made is that healthcare must be equated to health (Sreenivasan 22). The author mentions this in his argument, but the problem is not so much the first premise. In fact, he argues that the argument falls apart with the second premise.

When asserting the intuitive statement that better healthcare leads to better health outcomes, the assumption is made based on the idea that healthcare is the only socially controllable factor (not biology or random chance) that can account for a lack of equality in health outcomes, and therefore in opportunities (Sreenivasan 23). On paper this may be true, but it would be foolish to believe that healthcare is the sole social determinant in health outcomes. A perspective that is more and more on the rise in recent years is the role of socioeconomic stress in health. In a study done by Whitehall, it was shown that socioeconomic stress was a greater determinant in health outcomes compared to healthcare availability. Whitehall looked at a population that was consistent in living environment and other potential confounding factors. He then looked at the mortality rates of people in certain defined employment grades. It was shown that, despite everyone having free healthcare, there was a graded mortality rate as employment status went down (Sreenivasan 24). In another study, it was shown that it is not so much the actual value of the income for a given group or the actual job that makes a difference. It is actually the disparity in the income levels and employment grades present in a given population (Adler 62). Sreenivasan alluded to this when he talked about the relative nature necessary for the first premise to hold true.

The purpose behind Sreenivasan’s argument was to show that the commonly accepted justification for universal healthcare as a form of justice is flawed. He makes it clear that he still supports universal healthcare, but thinks there needs to be a better justification for it (Sreenivasan 21). I would argue that his argument is enough of a support to say that universal healthcare is not where resources need to be allocated. Socioeconomic stress is a huge source of chronic stress for populations across the world and if our aim is to seek justice through the provision of equal opportunity, then socioeconomic stress needs to be what we as a society are working to ameliorate. It has been shown that in nations (even with a low GDP compared to the US) that have a smaller disparity between high and low income groups tend to have better health outcomes (Adler 62). Closing an income gap is by no means easy, but it is arguably one of the best ways to ensure better health outcomes for all members of a population. Therefore, by the premises established by Sreenivasan, seeking to ameliorate socioeconomic stress is the best way to provide justice, not universal healthcare.

Works Cited

Adler, N. E., and K. Newman. “Socioeconomic Disparities In Health: Pathways And Policies.” Health Affairs 21.2 (2002): 60-76. Web. 9 Apr. 2015.

Sreenivasan, Gopal. “Health Care and Equality of Opportunity.” Hastings Center Report 37.2 (2007): 21-31. Web. 8 Apr. 2015.

“Equals must be treated equally, and unequals must be treated unequally.”

The above quote is Aristotle’s view on justice.  It represents the principle of formal justice, that being the unspecified and unsubstantiated basic principle of justice. However there is a lot to be said for its simplicity. It lays a good groundwork for the original theories of justice. People who for whatever respects are considered equals must receive the same level of respect and in a medical sense treatment. It also allows for people who are not equals to be treat differently. Some would argue that this is grounds for the justification of discrimination. Which it could be, unless the terms are properly defined. It is stated in the Declaration of independence, one of the founding documents of the American government, that all men are created equal. Now this should clearly be expanded to include all women and everything in between, but it provides a definition of equality. The ideal of Justice as simply treating everyone equally sounds wonderful but is also kindergarten-ish in its simplicity and functionally impossible. The other option is to use some other definition of equality. And this is where the philosophy of this quote begins to seem barbaric. Say the equality was determined by intelligence, or success, or some other unequivocally good quality. There would always be people who did not possess such a quality merely because they were disadvantaged. This concept of being disadvantageous in the center point of the discussion of justice and equality. This is the idea that people are in fact perfectly equal but the circumstances of their life have the capability to render them unequal to others due to no fault of their own. This is perfectly true. There are certain external factors that can be very difficult or functionally impossible to overcome. This is being disadvantaged and in our ideals of equality society would bring these people up to whatever may be determined as a standard. This is sometimes referred to as the lottery of life. We attempt to help these people through genuine beneficence, sheer force of empathy, or the sense that if we had their place that we would want someone to help us.   However Aristotle would not have this happen. They are not under most senses equals. My other major concern with the philosophy of this quote is the use of the word must. On first reading it seems Aristotle would view programs and actions taken in an attempt to equalize the disadvantaged as unjust. Despite the random and blameless nature of their condition he holds that they must be treated differently. However this could possibly be interpreted that due to their unequal nature they must be given better treatment as it is not specified that unequals of a lower sense must be treating unequally in a lesser sense. This can in fact be interpreted as everyone must be treated as such that the outcome is equal for them. Thus this quote which at first seems barbaric may in fact provide a truly beneficent foundation of justice.

http://a57.foxnews.com/global.fncstatic.com/static/managed/img/Health/0/0/Henrietta%20Lacks_AP_Aug%207%202013.jpg

Henrietta Lacks was a woman age of thirty, living in the 1950’s as an African American woman. She was diagnosed with cervical cancer and died within a year of the diagnosis unfortunately. Before she passed away, physician in charge taking care of Henrietta took her tissue sample without her consent (The Immoral Life of Henrietta Lacks). It was discovered that cells from Henrietta (referred to as HeLa cells) continuously divided without dying, an optimal cell line that scientists were looking for. Previously, researchers had tried to keep the cancer cells alive to advance on with their research projects, but they were unsuccessful. The ethical issue kicks in here, the physician taking the cells without Henrietta or her family’s permission and not even providing them with any monetary compensation for the contribution of the cells.

Before determining whether the doctor’s decision to take the cells from Henrietta without her consent was just or not, I would like to take a look at the issue of autonomy. Whether it was before or during the chemotherapy treatment, she was competent to not only speak for herself but also consider medical treatment decisions. In addition, her family members were present right beside her to give inputs. Therefore, the physician obviously violated the patient’s autonomy when HeLa cells were extracted from Henrietta’s tissue. One defending view might present beneficence that would ultimately result in helping of others as the research in cancer advances. However, this view can’t justify the violation of autonomy that the physician didn’t tell the truth, respect the privacy, and obtain consent to Henrietta and her family (Principles of Bioethics).

Considering justice side of the issue, I want to ask a few questions. What happened to the societal strive to raise the issue of the need to protect subjects from exploitation when research offers no benefit to the patient (Principles of Bioethics)? Was it because Henrietta was an African American woman? Because she had a low social status? Would the physician have informed and gotten the consent had the patient been White? Regarding Henrietta’s race and economic status, it can be inferred that the physician’s action displayed disparities in providing fair opportunity. Beauchamp and Childress’s view on the material justice states that there should be maximum of liberty and property resulting from the exercise of liberty rights and participation in fair free-market exchanges (Principles of Bioethics). Strictly speaking, cells for research purposes should be bought for unless the patient voluntarily donates her cells. Cells are goods that have monetary values, having potential to contribute to great discoveries in the field of medicine. However, Henrietta and her family received nothing in return, not even a thank-you.

One other apparent issue here is the undue profit. I understand that she didn’t participate in a research project as a volunteer to receive monetary compensation but with her cells that would change the future of the research field, her family should have given a financial reward. This injustice of distributing too little, or in this case none, of a payment brings the argument back to implicit disparity possibly due to her race and economic stance in getting cells without Henrietta’s permission that violated her autonomy. In conclusion, Henrietta was the patient who was unjustifiably exploited in terms of autonomy and justice by the medical system of the era in 1950’s, although her cells still strive today contributing tremendously in the field of research.

References:

Beauchamp, Tom L., and James F. Childress. Principles of Biomedical Ethics. New York: Oxford UP, 2009. Print.

Skloot, Rebecca. The Immortal Life of Henrietta Lacks. New York: Crown, 2010. Print.