Nursing's Social Contract and the Henrietta Lacks Story
This paper examines the nursing social contract as defined by the American Nurses Association's Social Policy Statement, applying its core principles—accountability, autonomy, and transparency—to the case of Henrietta Lacks. Drawing on Rebecca Skloot's The Immortal Life of Henrietta Lacks, the paper traces how medical professionals at Johns Hopkins Hospital in the 1950s violated their implicit obligations to Lacks by harvesting her cells without informed consent, withholding information from her and her family, and failing to prioritize her welfare over research interests. The paper also provides background on the social contract concept as it applies to healthcare and argues that race, poverty, and lax professional standards contributed to the ethical failures in her case.
- Introduction: Henrietta Lacks and the Nursing Profession: Background on Lacks, HeLa cells, and nursing policy
- What Does 'Social Contract' Mean?: Origins and obligations of the healthcare social contract
- The Social Contract in the Context of Henrietta Lacks: Autonomy, transparency, and accountability failures in Lacks's case
- Conclusion: Synthesis of ethical violations and broader lessons
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What makes this paper effective
- The paper grounds an abstract policy concept—the nursing social contract—in a concrete, well-known historical case, making the ethical principles immediately tangible for the reader.
- The three-part analysis (autonomy, transparency, accountability) provides a clear and logical organizational spine that maps directly onto the social contract framework being discussed.
- The introduction effectively contextualizes both the subject (Henrietta Lacks) and the analytical lens (Nursing's Social Policy Statement) before bringing them together, giving readers a clear roadmap.
Key academic technique demonstrated
This paper demonstrates applied ethical analysis: it takes a defined theoretical framework (the social contract as articulated in nursing and medical professionalism literature) and systematically tests each of its components against historical evidence. Rather than arguing whether the social contract is valid, the paper assumes its validity and uses it as a diagnostic tool to identify specific professional failures in a real case.
Structure breakdown
The paper opens with a narrative background section introducing both the nursing social policy statement and Henrietta Lacks's story. It then defines the social contract concept, tracing its origins in political science and its application to healthcare. The analytical core applies the contract's three pillars—autonomy, transparency, and accountability—to Lacks's case in sequence. A brief conclusion synthesizes the findings and reflects on possible causes of the ethical failures observed.
Introduction: Henrietta Lacks and the Nursing Profession
Nurses are widely regarded as compassionate helpers, and the nursing profession reflects this through its foundational documents. The Nursing's Social Policy Statement details the many ways in which nurses assist others and defines the relationship between nurses and society as a kind of social contract—one that carries expectations on both sides. This relationship allows nurses to carry out their professional duties in providing care to individual clients and to society at large. It also empowers nursing practitioners to engage in policymaking, legislative action, and political advocacy for the purposes of improving care delivery, nursing practice, nursing research, and nursing education. Additionally, it enables nurses to understand the concepts of justice and social ethics and the roles these play in individual and societal health (Fowler, 2015). This paper discusses the nursing social contract as it relates to the story of Henrietta Lacks, as detailed in Rebecca Skloot's The Immortal Life of Henrietta Lacks (Skloot, 2010).
Henrietta Lacks was a poor, undereducated African American woman living in Baltimore in the 1940s. She was married and had five children with her husband, David. For quite some time, she lived with unexplained abdominal pain. In 1950, she asked her husband to take her to Johns Hopkins Hospital—the only regional health facility where Black people could receive treatment for complicated conditions at the time (Skloot, 2010).
After undergoing tests at the hospital, she was diagnosed with cervical cancer in February 1951. She subsequently received radiation treatment under general anesthesia, which was the gold-standard intervention for the disease at that time. Ongoing research at the hospital by two physicians—George Gey and Richard TeLinde—plays an important role in Lacks's story. Gey was attempting to develop and grow immortal cell lines in the laboratory for research purposes, while TeLinde was a renowned cervical cancer physician investigating how different types of cervical cancer are related (Skloot, 2010; Stump, 2014).
Just 21 days into utilizing Lacks's cells for research, Gey made a breakthrough. Her cells were uniquely resilient and enabled him to create the first immortal human cell line. He named the cells HeLa cells, combining the first two letters of her first and last names (Stump, 2014). Since then, these cells have been used to develop cancer treatments, HPV vaccines, smallpox vaccines, and the polio vaccine. They have also been utilized in more than 80,000 studies and investigations. In October 1951, Mrs. Lacks died—never knowing the significant role she had played in advancing human medicine.
References
American Nurses Association. (2010). Nursing's social policy statement: The essence of the profession. Nursesbooks.org.
Cruess, R. L., & Cruess, S. R. (2008). Expectations and obligations: Professionalism and medicine's social contract with society. Perspectives in Biology and Medicine, 51(4), 579–598.
Fowler, M. D. M. (2015). Guide to nursing's social policy statement: Understanding the profession from social contract to social covenant. American Nurses Association.
Palmd. (2010). More on Lacks ethics. Science Blogs. Retrieved from https://scienceblogs.com/whitecoatunderground/2010/02/03/more-on-lacks-ethics
Quinlan, C. (2018). Trust in medical research: The legacy of Henrietta Lacks, Part 1. Science 37 Trial Mix. Retrieved from
Reeves, S., van Soeren, M., MacMillan, K., & Zwarenstein, M. (2013). Medicine and nursing: A social contract to improve collaboration and patient-centred care. Journal of Interprofessional Care, 27(6), 441–442.
Skloot, R. (2010). The immortal life of Henrietta Lacks. Broadway Books.
Stump, J. L. (2014). Henrietta Lacks and the HeLa cell: Rights of patients and responsibilities of medical researchers. The History Teacher, 48(1), 127–180.
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