Tag Archive for: Medical ethics

Honoring Black History in Healthcare: Week 4 – Enslaved Women and Modern Gynecology

Throughout February, NOAH will share and honor Black History Month with snapshots of just a few of the important, impactful, and life-saving stories of Black history in healthcare in America. One of our primary goals at NOAH is ensure quality healthcare for every member of our community. To do that, we will look at where we have been, what we have accomplished, and how we will collectively achieve this goal.

Enslaved Women and Modern Gynecology

By By Jennifer Perry, MD, PGY-3

Dr. James Marion Sims has been named the “father of modern gynecology” for his contribution of tools, such as the speculum, and surgical techniques related to women’s health. He was named president of the American Medical Association in 1876 and president of the American Gynecological Society in 1880. However, Dr. Sims’ success has overshadowed the suffering of enslaved women that contributed to his work.

Seven women participated in Dr. Sims’ experimentation over a four-year period. Lucy, an 18-year-old who was unable to control her bladder after a traumatic birth, was his first subject. She had a vesicovaginal fistula, a connection between the bladder and uterus which wasn’t uncommon for women who endured traumatic deliveries in the 19th century. Dr. Sims placed naked Lucy on her knees and elbows with her head in her hands for the procedure while several male doctors watched. The entire surgery was conducted without anesthesia. As imagined, Lucy experienced extreme pain as Dr. Sims operated. A sponge was placed in Lucy’s bladder to drain the urine, which led to severe infection. Lucy almost lost her life, but this did not stop Dr. Sims from performing a similar procedure on six other enslaved women.

Enslaved women were considered property and did not need to give their consent for medical procedures. Dr. Sims performed more than 30 surgeries on one woman, Anarcha, without anesthesia. Despite reports of displayed agony, including screaming, it was believed that Black people did not experience pain like White people, so anesthesia was not utilized. However, once Dr. Sims perfected his technique, he performed surgery on White women under anesthesia.

Statues of Dr. Sims have been erected in Central Park and Philadelphia in dedication to his contribution to medicine. Those statues have sparked many protests because of the controversy of honoring a man who performed non-consensual medical experiments on Black women. The New York City statue was moved out of Central Park in 2018, and to Dr. Sims gravesite in Brooklyn, NY. In the same year, the monument in Philadelphia was removed and replaced by a plaque that educates the public of the origins of the monument and the Black females whose bodies were used for the advancement of medicine.

To learn more about the medical ethics involved with this story, read this article from the Journal of Medical Ethics.

Read our other Black History in Healthcare stories:

Week 1: The Innovations of Dr. Charles Richard Drew

Week 2: Understanding the Tuskegee Study

Week 3: The Lasting Impact of Henrietta Lacks

Honoring Black History in Healthcare: Week 3 – The Lasting Impact of Henrietta Lacks

Throughout February, NOAH will share and honor Black History Month with snapshots of just a few of the important, impactful, and life-saving stories of Black history and healthcare in America. One of our primary goals at NOAH is ensure quality healthcare for every member of our community. To do that, we will look at where we have been, what we have accomplished, and how we will collectively achieve this goal.

The Lasting Impact of Henrietta Lacks

By Monica Chaung, MD, PGY-3

In 1951, Henrietta Lacks, a young mother of five, was diagnosed with cervical cancer. Doctors at Johns Hopkins collected some of her cancer cells during her biopsy to diagnose the cancer. Some of these cells were sent to Dr. George Grey’s research lab, as was common with many other patients at this time.

The sample cells from other patients Dr. Grey collected and studied quickly died. Henrietta Lacks’ cells, however, were different. Instead of dying, Henrietta’s cells doubled every 20-24 hours. These remarkable cells, named “HeLa” cells after her first and last name, became the first immortal human cell line.  

To this day, researchers continue to use HeLa cells to make scientific and medical discoveries. They have allowed scientists to study the human genome, test the effects of drugs and toxins on human cells, learn more about cancer cells and viruses, and even create the Polio vaccine; all without having to experiment on humans. HeLa cells also have been used to improve our understanding of diseases like tuberculosis and HIV.

Despite her enormous contribution to medicine, however, the way in which Henrietta’s cells were used raised ethical questions. In the 1950s, it was common for extra biopsy samples to be shared and used for research without gaining consent from patients. Standardized informed consent was not common practice.

When Henrietta Lacks consented to the diagnosis and treatment of her cervical cancer, she was not informed that her cells could be collected and used for ongoing research. Additionally, there were no regulations on the use of human cells for research and patients did not have access to their medical records. The ethical concerns surrounding the use of Henrietta Lacks’ cell line have guided policies that now protect patients. These include informed consent, research approval through an Institutional Review Board (IRB) and improving patients’ access to their medical records. 

Henrietta Lacks died at the age of 31, within a short time of her cancer diagnosis. Although her life ended early, Henrietta Lacks’ legacy lives on through her HeLa cells, the impact of her story, and on research and medical ethics.

More on her story can be found in Rebecca Skloots’ book: The Immortal Life of Henrietta Lacks

Read our other Black History Month snapshots:

Week 1: The Innovations of Dr. Charles Richard Drew

Week 2: Understanding the Tuskegee Study

Week 4: Enslaved Women and Modern Gynecology