Original Publication
Open Access

Medical Ethics and Health Equity: The Henrietta Lacks Story

Published: November 23, 2015 | 10.15766/mep_2374-8265.10276

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  • Instructor's Guide.docx
  • PowerPoint Presentation.pptx

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Editor's Note: This publication predates our implementation of the Educational Summary Report in 2016 and thus displays a different format than newer publications.

Abstract

This is a team-based learning (TBL) module that is part of our Psychosocial Issues in Healthcare course for first-year medical students and also serves as a learning module for the University of Central Florida College of Medicine longitudinal curricular thread in Culture, Health, and Society. The Psychosocial Issues module is designed to prepare first-year medical students to address key issues that impact the provision of healthcare and the doctor-patient relationship. This is primarily behavioral science and focuses on how people’s thoughts, behavior, and social environment affect their health. These factors make up some of the art of practicing medicine and are key competencies to providing high-quality care to the diverse patients we serve. The Culture, Health, and Society longitudinal curricular thread is designed to meet the Liaison Committee on Medical Education cultural competency standards and has sessions in all four years of the MD curriculum.

The module was received very well by the students. Many expressed that this was the first time they were able to make the connection between medical ethics and health equity and understand the meaning of health equity. The students had an opportunity to acknowledge that intersecting social factors collectively impact a patient’s ability to receive equitable healthcare.

This TBL was implemented twice, in 2014 and in 2015. The mean Individual Readiness Assurance Test (IRAT) score in 2014 was 86.3%, with a standard deviation of 12.2%. The mean Group Readiness Assurance Test (GRAT) score was 98.9%. The mean Application Focused Exercise (AFE) score was 99%. The IRAT was revised, and in 2015, the median IRAT score was 75%, with a standard deviation of 1.22. The AFE was not graded in the second year as multiple responses can be correct and we wanted the students to share their different perspectives. The mean GRAT score was 96.3%. The increase in the GRAT score from the IRAT score demonstrates that student learning was occurring in the group discussions.

The qualitative outcomes are the key themes from the individual reflections. A main outcome was increased understanding of what health equity means, how it differs from equality, and how it impacts on health disparities. A key theme was an increased understanding of applied meaning of the four pillars of medical ethics through the lens of this historical narrative. Students were able to empathize with Ms. Henrietta Lacks’ beliefs and values and contrast these with the physician bias on what was best for her care. This awareness allowed students to reflect on how they wanted to interact with patients in the future. Other key themes were reinforcement of patient interviewing skills, acknowledgment of the propensity for medical student/physician unconscious biases and its overall impact on healthcare, and lessons learned from past historical treatment of socially constructed patients and the development of a physician’s integrity to enhance present-day doctor/patient encounters.

Educational Objectives

By the end of this module, the learner will be able to:

  1. Define medical ethical principles and health equity.
  2. Formulate, present, and discuss particular positions on beneficence, nonmaleficence, respect for patient autonomy, and justice and apply these to the narrative of the clinical case of Henrietta Lacks.
  3. Demonstrate the ability to define a moral/ethical conflict and develop a plan to address the conflict.

Author Information

  • Lisa Barkley, MD: University of Central Florida College of Medicine
  • Deleso Alford, JD, LLM: Florida A&M University College of Law

Disclosures
None to report.

Funding/Support
None to report.


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Citation

Barkley L, Alford D. Medical ethics and health equity: the Henrietta Lacks story. MedEdPORTAL. 2015;11:10276. https://doi.org/10.15766/mep_2374-8265.10276