Symbolism, Imagery, Allegory
Paternalism was one philosophy about the doctor-patient relationship. It meant that the doctor always—always—knew what was best for the patient. This meant that he (and it was usually a "he"; paternalism, after all) could make decisions about treatment without taking the patient into account. He could withhold information if he thought it wouldn't make a difference to the patient or if would be upsetting or if would just make things more complicated for the doctor. This idea of paternalism, in both medical and research contexts, is an important motif in the book.
Today, we're getting cramps in our hands from signing so many HIPAA privacy forms. Our heads spin reading the warnings on prescription labels and the endless consent forms we have to sign before surgery. But back then, the idea that patients had a right to privacy or to honest and complete info about their condition wasn't even on the radar. Even educated patients who could afford excellent medical care were subject to this; patients might not be told they had cancer, or weren't told about possible side effects of a medication or surgical procedure. And this was for their own good; at least that was the thinking at the time.
When this philosophy was applied to uneducated, poor, and powerless people, it could become even more destructive. When racism was injected into the mix, it was even easier to dehumanize and abuse people in the name of science. Skloot recounts the worst of these dark moments in science: the Tuskegee experiments, Chester Southam, forced hysterectomies for poor black women, those horrific experiments on the residents of Crownsville, the Kennedy Krieger experiments.
Henrietta's doctors didn't kill her for her cells, but she was part of this story of science and medicine ignoring the autonomy of individuals—their right to have a say about what happens to their own bodies. Doctor knows best.