As a consequence of the emotional and physical rigor of medical training, particularly during internship and residency, it has been reported that doctors can come to view patients simply in terms of their disease rather than as whole people as a coping mechanism. In light of this thought process, I have chosen to reflect on one of the most personally thought-provoking papers I have encountered in my education: Screaming Yeast, by Sophia Roosth. I do not wish to address the paper’s contents but rather how the idea that a yeast cell screams and that it has likes and dislikes raises a number of interesting ethical quandaries. On the basis of such questions, Roosth’s findings have the potential to drastically shift our perceptions of the central ethical guidelines of research and clinical medicine.
Arguably the most important question raised when we anthropomorphize cells is what rights such agency allows them. In our present research framework, cellular studies differ from those on animals and humans in that the treatment of the research subject experientially is rarely considered. Even when granted the seal of ethical approval by the IRB, the suffering of model organisms bears heavily on scientist’s minds and, for this reason, are usually absent from professional and popular accounts of research. At least speaking from personal experience, this trepidation does not plaque cellular work. Within the laboratory, we grow and disregard cultures with relatively little thought, forcibly introduce foreign DNA and infectious agents, destroy the cells to extract their contents and expose them to chemicals of extreme toxicity as a matter of course. The granting of a greater degree of humanity and therefore dignity to cells would consequently produce enormous ripples throughout the research community. Within this new perceptional framework, it is quite likely the research community would be forced to elevate cells at least to the level of laboratory animals. While this would not preclude us from conducting the same experiments we do today, doing so would at a minimum require investing far greater thought into our cellular research protocols.
Still more interesting questions emerge when our thoughts transition to how the allotting of greater humanity to cells alters our ethical obligations to patients. These considerations are perhaps most pivotal when considering cytotoxic treatments such as chemotherapy. Even when considering a human patient, the brutality of chemotherapeutic treatments and the graveside effects they produce as a normal part of the course of treatment give doctors pause. In the present paradigm, we accept these grave consequences because our priority is to the patient; which we take to represent the individual as a whole. Cells coming to hold agency however drastically changes this relationship. As a consequence of such a perception shift, it could be argued that each one of the patient’s cells represents a patient in its own right. Taken from this perspective, a decision to pursue chemo is a coldly utilitarian bargain given that all rapidly dividing cells, not just those composing cancerous lesions, are driven to destruction. In a world in which cells have individual agency, we are therefore prioritizing one patient’s health at the cost of the likely death of countless others. If this is the case, where do, we stand in regards to beneficence arguably the central concept of medical ethics?
While the concept of cells having agency, of course, remains largely theoretical (the “screams” that resulted in the paper can be ascribed to the simple process of pumping out excess alcohol), the questions raised are no less valuable. In allowing cells to scream, we create a class of being that never before existed, opening the door to valuable insight. Those of us trained within the present biological paradigm very rarely question the assertions it presents us early on in our careers. Reflecting on these concepts allows us to regain a sense of critical evaluation in regards to the rights and moral duty and conduct we owe viruses, prions and of course patients.