Health Ethics (3 examples)

Three health ethic issue. One from Nazi Germany and others from USA. (MSY)

 Josef Rudolf Mengele

(16 March 1911 – 7 February 1979) was a German SS officer and a physician in the Nazi concentration camp Auschwitz. He earned doctorates in anthropology from Munich University and in medicine from Frankfurt University. He initially gained notoriety for being one of the SS physicians who supervised the selection of arriving transports of prisoners, determining who was to be killed and who was to become a forced laborer, but is far more infamous for performing human experiments on camp inmates, including children, for which Mengele was called the “Angel of Death”.

In 1940, he was placed in the reserve medical corps, after which he served with the 5th SS Panzergrenadier Division Wiking in the Eastern Front. In 1942, he was wounded at the Soviet front and was pronounced medically unfit for combat. He was then promoted to the rank of SS-Hauptsturmführer (Captain) for saving the lives of three German soldiers. He survived the war and, after a period of living incognito in Germany, he fled to South America, where he evaded capture for the rest of his life, despite being hunted as a Nazi war criminal.

https://en.wikipedia.org/wiki/Josef_Mengele

 

Henrietta Lacks

On January 29, 1951, Henrietta went to Johns Hopkins Hospital because she felt a knot inside her. It all started when she asked her cousins to feel her belly, asking if they felt the lump that she did. Her cousins assumed correctly that she was pregnant. But, after giving birth to her fifth child, Joseph, Henrietta started bleeding abnormally and profusely. Her local doctor tested her for syphilis, which came back negative, and referred her to Johns Hopkins.

Johns Hopkins was their only choice for a hospital, since it was the only one in proximity to them that treated black patients. Howard Jones, her new doctor, examined Henrietta and the lump in her cervix. It was like nothing he had ever seen before. He cut off a small part of the tumor and sent it to the pathology lab. Soon after, Jones discovered she had a malignant epidermoid carcinoma of the cervix Stage 1 (cervical cancer).

Lacks was treated with radium tube inserts, which were sewn in place. After several days in place, the tubes were removed and she was released from Johns Hopkins with instructions to return for X-ray treatments as a follow-up. During her radiation treatments for the tumor, two samples of Henrietta’s cervix were removed—a healthy part and a cancerous part—without her permission.[10] The cells from her cervix were given to Dr. George Otto Gey. These cells would eventually become the HeLa immortal cell line, a commonly used cell line in biomedical research.[1]

In significant pain and without improvement, Lacks returned to Hopkins on August 8 for a treatment session, but asked to be admitted. She remained at the hospital until the day of her death.[1] Though she received treatment and blood transfusions, she died of uremic poisoning on October 4, 1951 at the age of thirty-one.[11] A subsequent partial autopsy showed that the cancer had metastasized throughout her entire body.[1]

Henrietta Lacks was buried without a tombstone in a family cemetery in Lackstown, a part of Clover in Halifax County, Virginia. Her exact burial location is not known, although the family believes it is within feet of her mother’s gravesite.[1] Lackstown is the name of the land that has been held by the (black) Lacks family since they received it from the (white) Lacks family, who had owned the ancestors of the black Lackses when slavery was legal. Many members of the black Lacks family were also descended from the white Lacks family. A row of boxwoods separates the graves of whites from those of the blacks buried in the family cemetery.[1] For decades, Henrietta Lacks’ mother had the only tombstone of the five graves in the family cemetery in Lackstown, and Henrietta’s own grave was unmarked. [11][12] In 2010, however, Dr. Roland Pattillo of the Morehouse School of Medicine donated a headstone for Lacks after reading The Immortal Life of Henrietta Lacks. [13] The headstone, which is shaped like a book, reads:

Henrietta Lacks, August 01, 1920-October 04, 1951.
In loving memory of a phenomenal woman, wife and mother who touched the lives of many.
Here lies Henrietta Lacks (HeLa). Her immortal cells will continue to help mankind forever.
Eternal Love and Admiration, From Your Family[14][13]

For Turkish review: http://biyorss.com/2010/02/olumsuz-kadin-henrietta-lacks-nam-i-diger-hela

Tuskegee syphilis experiment

The Tuskegee syphilis experiment[1] was an infamous clinical study conducted between 1932 and 1972 by the U.S. Public Health Service to study the natural progression of untreated syphilis in rural African American men who thought they were receiving free health care from the U.S. government.[1]

The Public Health Service, working with the Tuskegee Institute, began the study in 1932. Investigators enrolled in the study a total of 600 impoverished sharecroppers from Macon County, Alabama; 399 who had previously contracted syphilis before the study began, and 201[2] without the disease. For participating in the study, the men were given free medical care, meals, and free burial insurance. They were never told they had syphilis, nor were they ever treated for it. According to the Centers for Disease Control, the men were told they were being treated for “bad blood”, a local term for various illnesses that include syphilis, anemia, and fatigue.

The 40-year study was controversial for reasons related to ethical standards; primarily because researchers knowingly failed to treat patients appropriately after the 1940s validation of penicillin as an effective cure for the disease they were studying. Revelation of study failures by a whistleblower led to major changes in U.S. law and regulation on the protection of participants in clinical studies. Now studies require informed consent (with exceptions possible for U.S. Federal agencies which can be kept secret by Executive Order),[3][not in citation given] communication of diagnosis, and accurate reporting of test results.[4]

By 1947, penicillin had become the standard treatment for syphilis. Choices available to the doctors involved in the study might have included treating all syphilitic subjects and closing the study, or splitting off a control group for testing with penicillin. Instead, the Tuskegee scientists continued the study without treating any participants and withholding penicillin and information about it from the patients. In addition, scientists prevented participants from accessing syphilis treatment programs available to others in the area.[5] The study continued, under numerous US Public Health Service supervisors, until 1972, when a leak to the press eventually resulted in its termination on November 16.[6] The victims of the study included numerous men who died of syphilis, wives who contracted the disease, and children born with congenital syphilis.[7]

The Tuskegee Syphilis Study, cited as “arguably the most infamous biomedical research study in U.S. history,”[8] led to the 1979 Belmont Report and the establishment of the Office for Human Research Protections (OHRP).[9] It also led to federal laws and regulations requiring Institutional Review Boards for the protection of human subjects in studies involving human subjects. The Office for Human Research Protections (OHRP) manages this responsibility within the US Department of Health and Human Services (HHS).[10]

http://en.wikipedia.org/wiki/Tuskegee_syphilis_experiment

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