The following student paper, shared with permission, was created in the Engineering Professional Development 155 class taught by George Johnson.
“In the chapter, Illegal, Immoral, and Deplorable, it talks about a virologist named Dr. Chester Southam, and his use of the HeLa cells in testing for cancer. Southam was concerned that use of the HeLa cells could cause cancer. The book says, “…some rats grew tumors when injected…” And the scientists who used them were exposed to them at all times, “Researchers were in the air around the HeLa cells, touching them, even eating lunch at the tables beside them,” the book explains. So with this problem Southam started to inject people with the HeLa cells without there consent, and observe what happened. He injected patients who already had cancer at first, and then moved on to healthy humans. He found that the healthy humans rejected the cells much faster than subjects who already had cancer. With this fact, Southam “checked” people for cancer. The book says, “Southam thought that by timing the rejections rate, he might be able to find undiagnosed cases of cancer.” All of this testing came to an abrupt stop when three Jewish doctors refused to inject patients without the patients consent. They claimed that this was the same thing the Nazis did to their ancestors; they were following the Nuremberg Code. The Nuremberg Code states, the voluntary consent of the human subject is absolutely essential. When they three doctors resigned because of this incident, it caused suspicion and an investigation was done on Southam. When it was all said and done Southam’s license was suspended for a year.
In the afterword chapter the author, Rebecca Skloot, address the tissue sample issue. The tissue issue centers on doctors and scientists taking tissue samples from patients without their consent. The book says, “The samples come from routine medical procedures…They sit in freezers, shelves, and vats of liquid nitrogen.” Right now there is no law against taking tissue samples without consent, but some people are trying to change this. Scientists explain that if we do pass a bill to make them ask for tissues the research growth would drop drastically. In the end I am not sure which way this will end.
These parts of the book are very interesting to me. The chapter, Illegal, Immoral, and Deplorable, surprised me. I didn’t realize that Dr. Southam did all of those experiments, like injecting them with cancer, on patients without them having any knowledge about it at all. I would have to side with the doctors who refused to do so. I feel if you are going to do test on a human, they should definitely know about it. The Nuremburg Code should have been enforced more strictly and Southam shouldn’t have just had his licenses suspended for a year. He should have had it taken away in my opinion. As far and the afterword part of the book, that was a real shocker. I had no idea that the medical community kept everyone’s tissues like that. The book explains, “…more than 307 million tissue samples from more than 178 million people are being stored in the United States.” This is madness. I never had any idea that there were this many tissue samples floating around behind the scenes of today’s medical community. I personally feel that I would like to know if the doctors took my tissue. What they test on it I don’t really care, but I would definitely like to know what they took.”
Engineering Professional Development 155
George Roesch Johnson, Instructor
The following post, shared with permission, was written in the Engineering Professional Development class taught by George Johnson.
“In the chapter “Illegal, Immoral and Deplorable” Rebecca Skloot points out many of the secrets that were kept during the growth and research of the HeLa cells. Dr. Chester Southam, a cancer researcher, proposed the thought, what if Henrietta’s cancer cells could infect the scientists working on them. He tested this theory using HeLa cells and injecting them into patients that were diagnosed with cancer and recorded the results. Southam simply told the patients that he was testing their immune systems. Within hours the patient’s arms were red and swollen, and days later nodules began to grow near the injection site. He removed some of the lumps to determine if they were cancerous, but also left a few to see if immune systems would reject them or if it would spread. He also injected prisoners to better understand how the cancer cells affected healthy people. The inmates showed the same symptoms, but the men fought off the cancer completely, and with each new injection their bodies responded faster, so the injections were creating immunity to cancer.
Southam stated, “The only drawback to the use of cancer cells is the phobia and ignorance that surrounds the word cancer.” This is proof that patients were never told what their injection truly consisted of because he didn’t want to scare them. Chester Southam’s case relates directly to the Nuremberg Trials from World War II. “The voluntary consent of the human subject is absolutely essential.” A judge once stated, “A physician violates his duty to his patient and subjects himself to liability if he withholds any facts which are necessary to form the basis of an intelligent consent by the patient to the proposed treatment.” This is not always true in such a case as Southam in which the subjects were not his patients. Southam’s lawyer argued, “If the whole profession is doing it, how can you call it unprofessional conduct?” Southam was found guilty of fraud or deceit and unprofessional conduct in the practice of medicine. Another issue today is the argument on whether tissues and cells are still property of the donor after the cells and tissues have been removed from the body. Many tissues and cells are saved and stored from diagnostic procedures and do not require patient consent. Some people argue that donors should have the right to determine what their tissues are used for, but consent diminishes the value of tissue. “You can’t ignore this issue of who gets the money and what the money is used for,” says Ellen Clayton. “I’m not sure what to do about it, but I’m pretty sure it’s weird to say everybody gets money except the people providing the raw material.” But experts do not want to create profit-seekers toying with science and research. Blumberg believes researchers are entrepreneurs and says, “Whether you think the commercialization of medical research is good or bad depends on how into capitalism you are.” Lori Andrews counters this statement by arguing, “The fundamental problem here isn’t the money; it’s the notion that the people these tissues come from don’t matter.” The research Southam conducted was wrong because he lied and kept important information from the patients about the injections they were receiving. I believe that many of the people would have terminated the process if they found out he was injecting cancerous cells into their arms. Southam never had approval from any patients and I think it’s interesting that when asked why he didn’t inject himself with the cells, he simply stated that there was no need for any risk to a person of great importance to cancer research. He knew these injections could possibly be fatal and he didn’t care about anyone but his own work and progress. I think patient consent should be required in all cases, even after procedures because the patient should know that their cells or tissues could possibly be used for research. I don’t think it’s necessary for patients to specify preferences on how they want their cells to be used because then it gets unorganized and complicated. The money that is rewarded for research and development should be returned to science to enhance studies.”
Engineering Professional Development 155
George Roesch Johnson, Instructor
The EPD 155 class is part of the Com A requirements and is attended primarily by students who are considering careers in one of the STEM disciplines. The class begins with a chapter from Henry Petroski’s book The Role of Failure in Successful Design (1985) to expand our understanding of how engineers use hypothesis and the scientific approach in planning and design. The class continues to explore current issues in technology including the use of social media, alternative sources of energy, stem cell development and of course cell tissue experimentation and use as described by Skloot. The first issue was to understand Henrietta Lacks and George Gey in their historical setting, which meant touching on the issues of Jim Crow laws, and northern migration patterns referenced in the book. While we looked at how Lacks was positioned without power to question authority, I also wanted the class to consider the traits that made George Gey a successful researcher, who in his time thought he was acting ethically. In many ways Gey’s characteristic are the same that the students will need to develop.
Next we focused on the ethical issues raised by Dr. Southam’s research. This lead to a discussion of the Tuskegee Syphilis Experiment, as well as Stanly Milgram’s experiment in Obedience to Authority, which we begin to frame using the Nuremberg Code and tutorials required for human subject research. A number of students became interested in bio/ethics and decided to do more research on the topic. All the students were required to write a reflection/reaction paper after each reading where they summed up the material and then ventured their opinion. For the most part the students were glad the book was chosen.
George Roesch Johnson
Associate Faculty Associate
Engineering Professional Development
Technical Communication Program