Henrietta Lacks: Her Legacy in both Medicine and Bioethics
Image of Henrietta Lacks, Courtesy of CNN
If you’ve received the COVID-19 or polio vaccine, you’ve directly benefited from the life of Henrietta Lacks, a 31-year-old African-American mother from Baltimore.
Mrs. Lacks visited the Johns Hopkins Hospital in 1951 with complaints of vaginal bleeding. She was soon diagnosed with cervical cancer after a large and malignant tumor was found on her cervix. Unbeknownst to her, tissue samples from Mrs. Lacks’ cervix taken from a biopsy were sent to Dr. George Gey’s tissue lab for evaluation and research. Dr. Gey that Mrs. Lacks’ cancer cells were unlike other cells he’d sampled: Mrs. Lacks’ cells doubled every 20-24 hours, whereas cells from other people would die quickly. These cells, nicknamed “HeLa” cells after the first two letters of Mrs. Lacks’ first and last name, were the first human cell lines that successfully survived in vitro (in petri dishes). Not long after, HeLa cells were donated by Dr. Gey to many research labs around the world.
Months after her diagnosis, Mrs. Lacks died of cervical cancer at 31. While her life may have ended then, HeLa cells continue to pervade the scientific community and serve as one of the primary cell lines researchers use. Cell lines are cultures of cells, namely animal cells, developed for long periods in vitro. These cells are often immortalized and never stop dividing, lasting up to 50 years. But what makes the HeLa cells remarkable is that they’ve continued dividing for the past 70 years.
Scientific Impact of HeLa Cells
Image of HeLa cells, Courtesy of Tebu Bio
As stated by Professor Harry Mellor at the University of Bristol, their science department “publishes one research article each month that makes use of HeLa cells.” HeLa cells have been used for decades as the preferred cell line for biomedical research. By 2021, HeLa cells had contributed to nearly 75,000 biomedical studies.
HeLa cells have been used to identify the infectivity of the COVID-19 virus in humans, leading to the development of the COVID-19 vaccine. Because the virus did not infect HeLa cells well, the researchers searched for the “key to viral entry that was apparently missing on the HeLa cells.” After engineering the HeLa cells, researchers found that the protein ACE2 was used to enter cells–a key to finding the infectivity of COVID-19 virus in humans. While HeLa cells aren’t the only cell lines that have been used to develop the COVID-19 vaccine, they have played a significant role in enhancing our understanding of the virality and infection in humans, serving as the basis for the development of the vaccine.
HeLa cells have also aided in the development of the polio vaccine. Jonas Salk, a medical researcher, created a polio vaccine in the early 1950s and inoculated 161 people. The results were auspicious, and he was set to vaccinate hundreds of thousands of children. However, Salk wanted to be certain that his vaccine was the “safest and most certain” approach and see if the vaccine would trigger enough antibodies within the group to neutralize the virus and the outbreak. Not long before this, HeLa cells were widely distributed a few years earlier, serving as the perfect test subject for the vaccine. A couple of months later, the polio vaccine was ready for human trials, thanks to the help of HeLa cells.
HeLa cells have also been readily used in research on cancer, virology, gene mapping, Parkinson’s disease, and more. HeLa cells have even been sent to space to determine the long-term effects that space travel can have on living cells, discovering that HeLa cells divide quicker in zero gravity. HeLa cells have also won two Nobel Prizes. The work of three scientists who discovered the function of telomeres and telomerase enzymes won the Nobel Prize in Physiology or Medicine in 2009. HeLa cells were used to identify the presence of telomeres and telomerase in human cells, whereas prior knowledge limited the identification of telomeres to protozoans (single-celled eukaryotic organisms). The second Nobel Prize was for the “advancement in live viewing of cellular growth.” HeLa cells were used to develop and test a new microscope technique, resulting in the 2014 Nobel Prize in Chemistry.
HeLa Cells and Bioethics
HeLa cells and the life and legacy of Mrs. Lacks have also significantly impacted the study of bioethics, which is, according to the NIH, the study of “ethical, social, and legal issues that arise in biomedicine and biomedical research.”
The most significant ethical issue arising from using the HeLa cells is that Mrs. Lacks and her family never consented to use her cells in research. This is true for the first biopsy sample in 1951 and her subsequent death, when lab technicians continued to harvest the cells from her body without Mrs. Lacks' or her family's consent. Even worse, her family was never informed of the usage of her cells and wouldn’t be aware of it until 1975. While her name and history were never disclosed to researchers, the first 20 years or so of using her cells erased her history and her contribution to significant medical advancements. After Mrs. Lacks’ passing, no obituary was written for her, and she was buried in an unmarked grave. Mrs. Lacks remained forgotten for decades.
Although retrieving Mrs. Lacks’ cells for research without consent was legal back then, nowadays, scientists can look back at this practice in hindsight and state that harvesting Mrs.Lacks’ cells without consent is considered illegal and unethical by today’s standards. As stated by the Code of Medical Ethics of the American Medical Association, “human biological materials and their products may not be used for commercial purposes without the consent of the tissue donor.” Her story has been the catalyst for change in the ethics code when it comes to biomedical research, contributing to the revision of the ‘Common Rule,’ or the Federal Policy for the Protection of Human Subjects, in 2017 to require that informed consent paperwork given to patients receiving medical care is both clear and understandable to all.
Her Story Now
Mrs. Lacks’ story has been viewed as another case of a Black person’s body being exploited by white scientists, contributing to medical racism. Although the procurement of Mrs. Lacks’ cells without her consent was not inherently racist, as consent was not needed back then for tissue sampling, the commercialization and continuous usage of the HeLa cell line with no acknowledgment or compensation for the millions of dollars and substantial medical advancements that Henrietta Lacks has contributed to humanity is exploitation. Her family lived impoverished with little to no quality healthcare for decades, while scientists continued to use her cells to make money and contribute to research. Mrs. Lacks’ family has tried to make it right with lawsuits against large biotech companies like Thermo Fisher but chose to settle instead.
The bottom line is that Henrietta Lacks and the HeLa cells are the basis of modern medicine today. Without them, polio could still be around, the human genome wouldn’t be mapped, HIV could still be a large epidemic, and other heinous diseases would be less understood. Her unintentional contributions to science and bioethics have improved the quality of care and medicine worldwide.