The Immortal Cell Line, Henrietta Lacks and the Ethics of Continued Use

Before you can see why HeLa mattered, you need the problem it solved. For the first half of the twentieth century, researchers who wanted to study human cells had a miserable time. You could take cells from a patient, keep them warm and fed, and watch them divide, and then after a few weeks they would slow, stop and die. Every experiment started again from a new donor, which meant no two laboratories were ever working on the same material.

The reason is at the ends of the chromosomes. Every time a cell copies its DNA before dividing, the copying machinery cannot quite finish the very end of each strand, so a small amount is lost each time. Chromosomes carry a protective, repetitive cap at each end called a telomere, and that cap is what gets shortened instead of the genes. But the cap is finite. After roughly forty to sixty divisions the telomeres are worn down far enough that the cell detects the damage and permanently stops dividing. Leonard Hayflick measured this limit in 1961, a decade after the events in this lesson, which is why nobody in 1951 could explain what they were seeing.

So an "immortal" cell line is not a cell that has been made to live longer. It is a cell in which the counting mechanism itself has been broken.

Henrietta Lacks was a thirty-one-year-old African-American woman, a tobacco farmer and mother of five, who went to Johns Hopkins Hospital in Baltimore in early 1951 because she was bleeding and knew something was wrong. She was diagnosed with cervical cancer. Johns Hopkins was one of very few hospitals in the region that would treat Black patients at the time, and she was treated in a segregated ward.

During a treatment procedure a surgeon removed two small samples of tissue from her cervix, one cancerous and one healthy, and sent them to the laboratory of Dr George Gey, who had spent years trying and failing to grow a human cell line. Henrietta Lacks was not asked, and was not told. She died on 4 October 1951, aged thirty-one.

Her cancer cells did not die. They divided, and kept dividing, faster than anything Gey's laboratory had handled before. He labelled the culture HeLa, from the first two letters of each of her names, and began sending samples free of charge to any researcher who asked. Within a few years HeLa was growing in laboratories around the world.

HeLa cells keep their telomeres long, so the counter never runs down. They do it by switching on telomerase, the enzyme that rebuilds telomere caps. Most adult body cells keep the telomerase gene switched off; egg and sperm precursor cells and some stem cells keep it on. In HeLa it is on, so every division rebuilds what the copying lost, and the cell never reaches the point where it would normally stop.

Why it is switched on in these particular cells traces back to a virus. Henrietta Lacks's tumour was caused by human papillomavirus type 18. HPV inserted its DNA into a chromosome in one of her cervical cells, and the viral genes it brought with it disable the cell's normal brakes, the proteins whose job is to halt division when DNA is damaged. With the brakes disabled and telomerase running, the cell had no reason left to stop. That is the combination: damage that would normally trigger a halt, in a cell that can no longer call the halt.

This is why the line is described as immortal rather than merely long-lived, and it is also why it is a cancer cell line. The property that makes HeLa useful in the laboratory is the same property that killed the woman it came from.

A reliable, shareable human cell line changed what experiments were possible. Because every laboratory could work on the same cells, results could be compared and repeated rather than argued about. HeLa was used to grow and test poliovirus during the development and testing of the Salk polio vaccine in the early 1950s, work that needed human cells in quantities nobody had been able to produce before.

Since then HeLa has been used in research on cancer, radiation, viruses including HIV, the effects of spaceflight, and the testing of countless drugs. It has appeared in well over one hundred thousand published scientific papers. The line is also sold commercially by companies that supply laboratories.

Hold this card and the previous one side by side. The benefit is real and enormous, and it was obtained without asking. Neither fact cancels the other, and an argument that mentions only one of them is incomplete rather than simply one-sided.

It is tempting to settle this by saying "it was legal then", and that is worth examining rather than accepting. In 1951 there was no law in the United States requiring a hospital to seek permission before keeping and using tissue removed during treatment, and the phrase "informed consent" had barely entered medical practice. In that narrow sense the taking of the sample broke no rule.

But "no rule existed" is not the same as "no one objected". The Nuremberg Code, written in 1947 after the trials of doctors who experimented on prisoners, had already stated that voluntary consent of the human subject is absolutely essential. It was four years old when Henrietta Lacks was admitted. The standard existed; it simply was not yet binding on an American hospital taking tissue from a patient it was treating.

Today the rule is different, in Australia and elsewhere. Research using human tissue requires approval from a Human Research Ethics Committee and, in almost all cases, the informed consent of the person it came from. That change did not happen on its own. It happened partly because cases like this one became public.

The Lacks family did not know the cells existed until 1973, twenty-two years after Henrietta Lacks died, when researchers contacted relatives asking for blood samples in order to sort out HeLa contamination in other cultures. Several family members had limited access to health care themselves while cells taken from their mother were being sold to laboratories worldwide.

In 2013 a research group published the complete HeLa genome sequence online without consulting the family. Because a genome is inherited, publishing hers also published information about her living descendants. After the family objected, the sequence was withdrawn from open access, and the United States National Institutes of Health reached an agreement giving the family a say: access to the HeLa genome data is now decided by a working group that includes members of the Lacks family.

Notice what changed and what did not. The family gained a say over future access to the genetic data. They did not gain ownership of the cells, and the commercial sale of HeLa continues. In 2023 the family settled a legal case against one company that had sold the cells; the terms were not made public.

In Lesson 10 you met three principles. Applied to this case they do not all point the same way, and that is what makes it a real ethical problem rather than an exercise.

Beneficence, doing good, points clearly towards continued use. The cells exist, the harm of taking them cannot be undone, and destroying them would end research that saves lives while helping nobody. Autonomy, the right to choose, points the other way: Henrietta Lacks was never given the choice, and her descendants carry genetic information that has been made public without them choosing it either. Justice, fair distribution, is the sharpest of the three here: the benefits flowed to researchers, companies and patients worldwide, while the family whose mother made it possible received nothing for decades and were not even informed.

An argument that only uses beneficence concludes "keep using them, obviously". An argument that only uses autonomy concludes "stop". The useful arguments are the ones that say which principle they are giving priority to, and why, on this case.

Almost everyone agrees that what happened in 1951 would be wrong today. That agreement does not answer the question you are asked to argue. The question is about continued use: given that the cells exist, given how they were obtained, and given what they have produced, what should happen now?

These are genuinely different questions because the available options are different. Nothing done in 2026 can restore Henrietta Lacks's choice in 1951. What can be decided now is whether the line keeps being used, whether the family has a say over the genetic data, whether companies selling HeLa should share revenue, and whether her name is attached to the work. Each of those is answerable, and each one is a claim you could defend with evidence.

That is why "it was wrong, therefore stop using them" is a weak argument, and so is "it did a lot of good, therefore it was fine". The first treats an unfixable past wrong as if it could be fixed by discarding a present benefit. The second uses the outcome to excuse an act that was judged by a standard already written down in 1947. A strong response separates the judgement about 1951 from the decision about now, and says something specific about the second.