[Editorial] Henrietta Lacks and Biomedical Ethics

Who was Henrietta Lacks?

  • Henrietta Lacks was a Black tobacco farmer. She lived in the USA.
  • She is known for being the source of the HeLa cells.
  • She died of cervical cancer when she was 31 years old.

What are HeLa cells?

  • Researchers had been faced with miserable failures when it came to growing human cells in petri dishes. These cells failed to divide and multiply for long.
  • In 1951, the cells of Henrietta Lacks were found to possess a remarkable property. They were capable of growing outside her body and dividing rapidly. Their numbers doubled nearly every day.
  • Eventually, her cells were used for developing an ‘immortal cell line’ i.e. cells capable of dividing indefinitely, outside the human body. These came to be called ‘HeLa cells’.

How were these cells used?

  • The cells have played a crucial role in many biomedical breakthroughs:
    • Jonas Salk used the HeLa cells for developing the polio vaccine, identifying the HIV (the virus) and for developing cervical cancer vaccine.
    • More recently, the cells have been used for understanding how SARS CoV 2 infects people. This has helped in COVID vaccine development.
  • The cells have been sent on space missions to develop an understanding of the biological impacts of environmental stress.

What is the significance of these cells?

  • The HeLa cells enabled experiments that aren’t possible in living persons.
  • These cells have featured in more than 80,000 published biomedical research studies.
  • More than 50,000 metric tonnes of these cells have been grown and distributed worldwide. They are still used in labs across the world.
  • The biotechnology industry was built on the use of these cells.

More recently:

  • Lacks’ birth centenary was celebrated on August 1st, 2020. The WHO commemorated it by launching a global strategy for eliminating cervical cancer expeditiously.
  • October 4th 2021 marked her 70th death anniversary. This was marked with the installation of a bronze statue in the University of Bristol. WHO conferred her with a posthumous award.

What are the concerns?

  • A key problem is that her family knew nothing about the use of her cells. Lacks’ cancer surgeon took a portion of her tumour and gave it away to a researcher without her knowledge or consent.
  • This was legal at the time. However, it was unjust and unethical.
  • The cell lines were commercially cultivated and marketed by Thermo Fisher Scientific, the pharmaceutical MNC. Profits from its sale ran into several million dollars.
  • The Lacks family has sued the company and has been asking the court to order Thermo Fisher to disgorge its net profits from the cell line’s commercialization to the estate of Henrietta Lacks.

What are its implications for ethics in biomedical research?

How did biomedical ethics originate?

  • Biomedical research on human beings is governed by ethical codes that have evolved over the years.
  • Their origin can be traced to 1929 when the National Socialist Physicians’ League was established in Nazi Germany. Unethical and outright murderous experiments were undertaken on the people in concentration camps.
  • The “Doctors’ Trial” was conducted in August 1947. This trial, in Nuremberg, tried 20 physicians who were accused of human experimentation.
  • The trial gave birth to the Nuremberg Code– a code of ethics. The code established obtaining voluntary consent as the most fundamental requirement for collecting biospecimens and for enrolling people into research studies.

What is the current status?

  • However, wrongdoings continue to occur:
    • The editor-in-chief of Annals of Human Genetics, the oldest human genetics journal, resigned last year after citing discomfort in having to consider submissions from China- a country where scientists and doctors, evidently, are involved in human rights abuses.
    • The Chinese authorities, as part of its surveillance program and criminal control program, have been collecting blood samples from the people of Xinjiang province, without consent. In addition to this, their genetic profiles, along with identifiable information, are being stored for later use.
    • 8 members of the editorial board of Molecular Genetics & Genomic Medicine journal resigned after the journal published papers on forensic genetics that were based on blood sample data in 2019. These papers provided no documented evidence of taking consent from the test subjects.
    • Chinese authors recently reported the results of blood sample analysis in 2 papers in the International Journal of Legal Medicine, without the consent of the test subjects- people of Tibetan, Uyghur and Hui origin. These papers were retracted.
  • Retraction of scientific papers have become the hallmark of scientific misconduct– a scar on the integrity of its authors and on the system itself.
  • Several issues have become common:
    • plagiarism
    • data-doctoring
    • image manipulation

In India:

  • Retractions are increasing alarmingly in India too. Since 2010, some 1,000 reports have been retracted. This is according to Retraction Watch, the online database.

Why is this happening and what is the way ahead?

  • This increase in scientific misconduct is associated with certain modalities of professional recognition such as awards, medals, election to science academies, etc.
  • Misconduct is being encouraged by promotions based on publications in “high-impact” journals. Professional recognition is a precondition for selection as directors, vice-chancellors, secretaries of agencies, etc. of various institutions and universities.
  • This has led to a pressure to publish more and publish rapidly. This unrealistic aspiration is a key reason for the erosion of scientific integrity.
  • Offending scientists should be stripped of their promotions and accolades. This should be especially applied to repeat offenders.
  • While considering persons for an award or for appointment as an institution’s head, background checks for fraudulent practices must be carried out to the extent possible.

Conclusion:

Inaction against misconduct tends to demoralize the honest and tarnish science in the public eye. It is true that past wrongdoings can’t be undone. However, “the time is always right to do what’s right”, as said by Martin Luther King, Jr.

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8 months ago

Very good editorial , need such editorial more

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