Lena Luthor & Medical Ethics

Lena Luthor is fascinating. So many of her actions have good intentions but are morally dubious, and this episode, which focused on Lena’s scientific endeavors, was no different.

Lena believes in the power of her personal actions. When she tells the story of her mother’s death, she makes it clear that she believes she would have saved her mother’s life by calling out or running to her mother, even if there actually is absolutely zero guarantee screaming or shouting or running would have saved her. This idea that she alone has the power to change the world is mirrored in the God-complex seen in many doctors and scientists. It’s the same complex that drives Lena to “cure all diseases” and give humans superpowers. But just because Lena can, doesn’t mean that Lena should.

Ethics exist because it is easy to make little steps and push boundaries that you don’t see yourself, until suddenly you’ve gone too far. And make no mistake, experimenting on an otherwise healthy human without previous data of success in cell lines or animal trials, without proper disclosure of what the experiment entails, and in clear violation of “do no harm” is too far.

“Doctor K,” as Adam calls Lena, seriously violates the four main pillars of medical ethics (beneficence, non-maleficence, autonomy, and justice).

When doing complex medical research, almost no one besides the primary scientists or doctors understand what is going on. And so, it would be impossible to make a fully informed decision without being told what the risks are. Adam voluntarily signs (or thumbprints) a consent form, but that is not true autonomy. There is a difference between saying, “yes” and understanding what “yes” means. Lena’s role as the expert automatically gives her the power to sway Adam’s decision because she gets to decides what to tell him (framing bias).

In other words, for Adam to have autonomy and provide informed consent, Lena has to tell him what she is planning on doing. But instead, she just hands him a consent form, doesn’t go through the process of explaining it to him, and uses unclear terminology in the document (see, “expires” as a covert way of implying death). She doesn’t tell him what he’s consenting for or what kind of procedure she is going to perform. When she finally does explain a little of what may happen, she selects what information to tell him. She reports only her ideal outcomes and only one potential effect (though arguably the most important, death) without explaining the other possibilities as well. Adam never had enough information to be able to act with autonomy.

Furthermore, even if Adam was fully educated, signing a consent form doesn’t actually make the experiment okay. Apart from ethics, even the law says no (Grimes v Kennedy Krieger). Consent in and of itself does not mean that the excessive risk and burden of Lena’s experiment is acceptable.

But isn’t Lena trying to do something good? Is it acceptable if it’s going to cure humans of all disease? It’s a noble cause. But something that is good for society is not necessarily good for the person who it’s being tested on. Look at the atrocities of Nazi scientists who performed experiments on concentration camp victims for the “benefit” of society. So it’s important to consider if Lena’s experiment will actually be good for Adam? This is the concept of beneficence.

Adam is currently healthy, and he doesn’t need anything to be healed now. It also isn’t clear that Adam would even benefit from having superpowers. We don’t know what powers he would get and we even saw that when Lena told him he might get powers, Adam freaked out and indicated that he may not even want them. There have also been numerous examples of people who have struggled with having powers (see, Kara when she first lands on Earth, Jennifer Pierce in Black Lightning, Rogue in X-Men). There are unintended consequences that Lena, despite her spider talk, hasn’t really considered yet, and these are just the potential beneficial consequences of Lena’s harun-el treatment.

Lena’s experiment has the potential outcome of death. Of course, people have different values, and have different thresholds for what they believe to be acceptable risk. However, there are limits to the risks and burdens a person can consent to carry for others.

In research, a high risk of death is in the realm of 1 in 1000 or 0.01%. Lena cites that her experiment has a 15% mortality rate or a risk of 1 in 6-7. This is RIDICULOUSLY high. It is, in fact, the same mortality rate as actually having cancer, the thing Lena is trying to cure. For further comparison, the risk of dying from a gun assault is 1 in 315. Doctors make an oath to “do no harm” (non-maleficence), but a 15% mortality rate? Clearly harmful.

Other issues aside, let’s say Lena’s experiment worked and Adam and other test subjects don’t die. You’ve got a treatment, but does everyone have the opportunity to benefit? Is this going to be accessible to everyone? Justice is the idea that the benefits (and burdens) of medicine should be distributed equally among all groups in society.

As Alex brings up in the episode before, who is going to be the one who decides who gets to be “cured of all disease” and get superpowers? In this episode, Lena specifically emphasizes that she chose only Adam, implying that Lena will be the one who chooses who gets her treatment, and who does not. That would obviously not be accessible to everyone, and would therefore be unjust. But even if Lena decided to let every human have her treatment (especially given her vocalized desire to “level the playing field” for humans), it would still be unjust to only give humans the opportunity. Aliens get sick too, and just as there are aliens stronger than humans, there are probably aliens weaker than humans. (Regardless, humans already do have advantages. Humans certainly have the political and social advantage, even if they do not have the advantage of brute strength.)

I’m not trying to say that Lena is a villain. She has good intentions, but is making very, very poor decisions. It’s part of what makes her such a great character. And at the end of the day, Supergirl is a show of hope. I still have faith that Lena will become the good person she strives to be, but to become that good person, she needs to learn from her mistakes. Lena is acting without oversight and without feedback, and as James has also shown us this season, there are consequences to our actions — good intentions are not enough. Stronger together, not stronger alone.