A hefty payment in the name of science Topic: What is the duty of a medical doctor/researcher to inform his/her subjects on the implications of their medical consent? Historically, how does social justice play a role in this relationship? Are doctors allowed to act unethically if their immoral research and inhumane actions are for the benefit of society? Is informed medical consent necessary if the lack of it does no harm to the patient? Does skin color correlate to medical bias?
Doctors have taken a Hippocratic Oath since the dawn of medicine which implies they are to act ethically as the healers of mankind; the reason why there is a large amount of trust placed by patients in their physicians. The concept of informed consent is relatively new; the legal duty of providing informed consent in layman terms was declared in 1972 by the California Supreme Court as a result of many unprofessional misconducts. The violation of this trust through time has been the cause of suffering and inhumane experiments.
In this paper, the effects of the violation by doctors will be addressed for the following: Nazi human experimentation, Tuskegee syphilis experiment, and Henrietta Lacks. Under the Nazi regime numerous Nazi doctors conducted human experiments ranging from live open brain surgery to the effects of infectious disease to poison all leading to torturous death. It must be noted that all the victims were not under anesthesia or pain killers, and most importantly it was not consensual.
The unwilling subjects were forced to suffer through inordinate amounts of pain, trauma, and death because the “doctors” failed to uphold ethical duties bestowed upon them. The Nazi believed that their research would be of benefit to them scientifically and in the military. Along with the firm belief of the Aryan race they conducted the heinous experiments. Therefore it can be deduced that social injustice (racism and political desires) led to one of the largest crimes against humanity. “Nazi Concentration Camp science is often branded as bad science” (poor and impractical methods) by professionals and it is morally tainted.
Assuming sound data it is extremely unethical to use the gathered data as it implies that the suffering of the victims was justified. A monumental document in ethical medical research that came about as a response was the Nuremberg Code; drafted at the end of the Nuremberg trials in 1947 as a response to the war crimes during World War 2 such as the aforementioned. In the trials plentiful doctors were given life sentences, death penalties while some walked free; professionals are still held accountable for their actions. The code is composed of ten ethical codes for human experimentation, not law thus it has no legal precedence.
It states that voluntary consent must be obtained: experiments must be for benefit of society and avoid unnecessary pain, death, and such. From 1932 to 1972, the researchers from U. S. Public Health Service began experimenting with three-hundredninety-nine African-American men at the Tuskegee Institute. Men opted in to be a part of a study testing for “bad blood”; the researchers deceived the men as the true objective of the study was to observe syphilis from contraction to death. These men were illiterate, poor, and most importantly unaware of their condition.
They were recruited in exchange for incentives such as free physical exams, meals, rides into town, and a fifty-dollar cash reward given to family upon death. In the book, The Immortal Life of Henrietta Lacks, it is rumored that many of these men were infected with syphilis by doctors. AfricanAmericans were believed to be “a notoriously syphilis-soaked race. ” Nearly ninety-eight percent of these men died a slow, excruciating, and horrendous death. As a matter of fact in 1939 it was demonstrated that penicillin was an effective antibiotic to treat syphilis and became a proven treatment by 1947; yet emained unoffered to the participants.
Doctors and parties that participated in this study demonstrated utter disregard of their moral responsibilities confirming the study was unethical, and traits of racial prejudice and narcissism were present. The study ended after it was declared “ethically unjustified” and a class action lawsuit of ten million dollars was won on behalf of victims; the parties responsible for the study left unscathed. The Tuskegee Syphilis study illustrates another situation where the researchers failed to get complete patient consent despite the fact the participants signed up at their own will.
Researchers falsified the objective thus rendering the experiment immoral. Rebecca Skloot identifies the aforementioned purpose of this essay in her book, The Immortal Life of Henrietta Lacks. Henrietta lacks, a 31 year old black woman who passed away from cervical cancer in Baltimore’s Johns Hopkins hospital. Her life was nothing but ordinary at the time yet she went on to be one of the most important people in our history. Henrietta was responsible for the development of numerous vaccines, treatments, careers, significant advancement of medical knowledge, and wealth for others.
Howard Jones, her doctor, had sent tissue samples of her carcinoma to Dr. Gey for unrelated testing for an experiment he was conducting without consent. Dr. Gey had been in search for cells that would grow and multiply inside a lab, outside of the body in hopes to find a cure for cancer; he had been taking samples from all his patients without consent in his pursuit. Her cells were taken and sold for large profits, as Hela, without her and her family’s knowledge while she was being treated and then by deception post mortem. In the book it is mentioned that her identity is kept hidden by Dr.
Gey for her safety and patient information confidentiality even though it was not law; publication of her name could have caused nuisance to the hospital. As a result she failed to get recognition in the field of medicine. Upon the discovery of her cells twenty-five years later after her death her family was in disbelief; her husband, David Lacks, “had not signed any paper. ” The Lacks received no financial benefit as the HeLa line made millions of dollars. They were unaware of the fact that genetic testing had been done on them and published; also didn’t have the means to contact a lawyer.
As a matter of fact a similar case in the name of John Moore v. Regents of the University of California was in trial for the same reasons. Dr. Golde chose to not get consent and used deception ion to obtain and then develop and patent the Mo cell line which is estimated to be worth three billion dollars. In short, this case was lost as the judge ruled that patients accept doctors using their cells for research and profit since the Lacks had not sued John Hopkins Hospital. The Lack’s did not resent that Henrietta’s cells had used to save millions of lives, rather they were ecstatic.
The Lacks lived in poverty while Henrietta was according to her daughter “the most important person in the world” while they couldn’t afford health insurance. Henrietta’s family was riddled in diseases such as nerve deafness, cancer, depression, and more. To put into perspective the implications of the discriminatory and immoral actions, the Lack’s family was unable to afford essential medicine that may have used Henrietta cells. It must be noted that the times were different, legal procedures, laws, and the doctor patient relationship.
Nonetheless, once the laws humanized in favor of confidentiality and privacy the Lacks should have been reimbursed. Doctors are thought of as healers yet have been responsible for many immoral acts towards their patients; failed to uphold the Hippocratic Oath as evident by the infamous Nazi medical experiments and the Tuskegee Syphilis study. In both events, the physicians either inflicted or allowed their patients to endure pain and die a torturous death in the name of science. Some doctors violated their patients trust without inflicting direct harm by the means of trickery and failing to get consent.
Dr. Golde went as far to patent the cell of his patient without his knowledge, implying that John Moore did not own his own biological cells. In the case of Henrietta Lacks, Dr. Gey published her DNA and allowed other associations (government and private) to reproduce the HeLa cell line that he developed without permission. The cell line was sourced from Henrietta Lacks and she deserved to be compensated for her contribution; racism may be the reason for the lack of compensation. Despite the obvious benefit to society, racism is evident by that fact that African-Americans were used as lab rats by doctors.
