Ethics, Morality, & Medicine in My Sister's Keeper
Ethics & Morality
Ethics, Morality, & Medicine in My Sister's Keeper
Ethics, Morality, & Medicine in My Sister's Keeper
Both ethics are morality of topics of philosophical discourse. Ethics is sometimes also referred to as moral philosophy. Moral philosophy or ethics may defend, recommend, and/or systematize behaviors that are right and wrong. Morality could be explained as the context within which ethics are codified. Morality is a code; it is the system that stratifies and codifies intentions, decisions, and actions, good (right) or bad (wrong). Ethics and morality are ever-present in the novel and film My Sister's Keeper. The ethics and morality of the Fitzgerald family as well as the ethics and morality of the lawyers (Campbell and Sara), and furthermore, the ethics of the hospital staff are at the center of the narrative. Arguably, the novel is the narrative of a family, each member operating upon individual morality and ethics; the plot stems from the tensions that play out among the family as a result of their differing senses of ethics and codes of morality. In this paper, close attention will be paid to the ethics and morality of the medicinal practices in the novel, specifically, the medical practices Anna endured, and attempt to describe the affects of ethics in medicine upon the characters Anna & Kate.
Anna's existence is ethically and morally questionable. The entire idea and concept of a savior sibling is questionable, too. One of the morals of this story is that sometimes, a person's life does not belong to that person. Anna's parents conceived her to help Kate live. Anna's primary function is to be an extension of life support for Kate. Anna does not live for her own sake; Anna lives for the sake of her sister. If Kate had never contracted leukemia, it is dubious as to whether Anna would have existed at all. What are the ethics and morality of the decision by the Fitzgerald parents to conceive another child primarily for the sake of another? This question is not fully addressed by the novel, yet it is a question the novel raises directly and indirectly. How is Anna wrong to litigate against her parents for the power of medical attorney over her own body? It is believed in western culture that children do not choose to be born. If children do not choose to be born, it is far more unlikely that children would choose, if they could, not only to be born, but also to be born and live only in service to another sibling. It is possible that at least some children would make that choice, yet it is highly unlikely. Therefore, Anna did not choose to be born. Anna, further, did not choose to live to supply her sister, Kate, with various bodily tissues and organs to sustain her. Kate did not choose to get leukemia. Who is "right" and who is "wrong"? The answers depend on the situation as well as the ethical and moral perspective of the reader as My Sister's Keeper is a dynamic, layered text that asks many questions and answers only some of them.
The experience of a medical trauma such as a serious or fatal disease like leukemia is traumatic. This is Kate's trauma. It is also traumatic to experience constant medical testing. Medical testing can be painful, awkward, anxiety-inducing, and seemingly endless. This is Anna's trauma. That is a bond the sisters share -- besides sharing a kidney, as they do after Anna dies in the car accident near the close of the novel. Kate must endure medical tests because of her pre-existing medical condition, leukemia. Because Anna is a savior sibling, she must endure numerous tests for her fluids, tissues, and organs to help Kate stay alive and perhaps make her leukemia go into remission. Where and what were the ethics that made Anna be subjected to so many tests? The ethics in that case are consistent with the ethics that support savior siblings. If a family believes in bringing another life into the world to help one life in this world keep going, then that same family will likely experience hesitation in subjecting that new life to the tests required to extract whatever materials necessary to keep that other life going. There is a "proverb" within the world of team sports: "Go hard or go home." The parents who went through all the time and trouble to get pregnant and birth a child for the sake of another better have the follow through to do the tests necessary to see if the new baby is a compatible donor for the older child, or else, why have the child at all? That...
Arras argues that not only is there on inherent morality or ethics in medicine, but also when there is any ethics or morality in place, it is relatively arbitrary, or capitalistic at best, and changes with the times:
"The very idea of an unchanging essence of medical practice unaffected by the vagaries of history and culture as it meanders through the ages is, to modern sensibilities at least, rather implausible on its face. Miller and Brody's (2001) evolutionary account embraces the idea that the morality of medicine is always forged in a dialectical relationship with the surrounding (external) worlds of common morality, law, commerce, technology, and so on. This concession to the claims of externalist morality permits a much more satisfying explanation of the gradual development of various medical norms, such as the duty to treat dangerous or contagious patients. Whereas the essentialist account would have us believe, implausibly, that a timeless 'duty to treat' derives entirely from reflection on the goals of medicine, this evolutionary approach would be much more sensitive both to historical accounts of physicians' behavior in time of plague and to the changing social expectations of physicians. It would note, for example, that in many previous historical epochs physicians basically served rich patrons. Should the plague strike a city, physicians (like Sydenham) would traditionally decamp to the countryside with their patrons, leaving their ordinary patients behind. Some- times citizens would be highly critical of physicians who abandoned their posts, but there was by no means a single, unitary norm governing the behavior of physicians through the ages (Arras, 1988)." (Arras, 2001,-Page 649)
Basically, as cultures adapt, evolve, and change in general, so do the ethics by which doctors practice medicine. There has been no longstanding rule or governance to doctors in regard to their treatment of patients. It is both surprising and not surprising that in the above quotation there is mention of doctors only serving the rich. In the modern age, we like to believe that doctors are noble civil servants, listening and following a higher caller to help those who need treatment. The above statement shows that for most of modern medical history in the west, medicine was a business just like any other. The business followed the money because money keeps the business going. Thus, doctors served the rich and left the poor to die. This ethical precedent is interesting when considering the medical tests Anna had to take. Pellegrino stresses the vulnerability of illness and medical treatment.
Vulnerability is a familiar trait in My Sister's Keeper. Pellegrino explains:
"The underlying thought in illness for most persons, even with trivial and certainly with important symptoms, is: Is this the beginning of the end of my existence? The fragility of our human existence comes be- fore us bluntly when we experience illness. We have therefore, in the fact of illness, a wounded state of humanity. We haven't changed human nature ontologically, but the operations we usually regard as human are impaired." (Pellegrino, 2006,-Page 67)
Were the tests performed purely to save Kate's life? Were the tests performed because of a combination of the Fitzgerald parents urge to keep Kate alive and the costs of the tests, which were constant? Those who agree with the statement by Arras would state that the ethics to test Anna had little to do with life and death, and more to do with dollars and cents.
Pellegrino further agrees that historical precedents of ethics & morality in medicine as well as the noble archetypes of the dutiful physician have dramatically deteriorated in modern times. He writes:
"Today the traditional image is being fractured. It is being challenged and drastically revised in some of the more recently proposed professional codes. That great canon of medical morality, the Hippocratic Oath, is being honored more in the breach than in the observance. Each one of its prescriptions has been questioned by some physicians and violated by others. Thus, it is…
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