Ethical Dilemmas in Book my Sisters Keeper

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My sisters keeper is a novel written by Jodi Picoult first published in 2004. It is a story about a family almost torn apart by illness of one daughter and the intended medical emancipation of another daughter who is tired of being a donor to her sick sister. This book therefore presents several ethical dilemmas. It presents to the reader to distinguish between what is wrong or right or what is legal or not. It is about un endless love a mother has for her child and what lengths she would go to save her dying daughter.

Was it ethical for the doctor to suggest genetically engineering a baby for the purpose of donating?

Critics of genetic engineering do not support it because they feel like this is playing God. They believe it is morally impermissible to interfere with human nature.Many people believe it is unethical to create embryos and then destroy them in order to harvest the stem cells. As for Sarahs case, they had to destroy embryos that were not a genetic match to Kate ad only implant that which was a perfect match.

Human rights activists believe embryos are human beings and as such have the full moral right of an individual, and therefore they feel like destroying incompatible embryos as murder. Looking at the moral framework, ethicists believe that it is morally justified to genetically engineer a child if the intention was good. As seen in the case of Anna, the intention was to save her sister Kate who is dying of leukaemia and thus the intention was good.

Drawing back to the utilitarianism theory, Anna was genetically engineered to save her sister so that she can in the end provide happiness to the greater majority that is her parents, her brother and her dying sister.

Was it ethical for Sarah and Brian to conceive a child(Anna) for the purpose of saving another childs life(Kate)?
Most people have a child without thinking about why. People who are in support of having a child for the sole purpose of organ donation will argue that if a woman can have a child with no particular reason but as a result probably a fun night coupled with alcohol intoxication, then why not have a child with a purpose of saving another in the notion of altruism.

People who are against the notion of having a child for the sole purpose will argue that this is against the notion that people are to be treated as an end and never merely as a means to an end. When Sarah and Brian decided to have Anna for the sole purpose of organ donation, it seems that the Fitzgeralds were using Anna as a means to an end which raises an ethical issue.

Was it ethical for the parents to force Anna to donate to her dying sister?

Anna being a live donor to Kate violates the traditional rule of medicine that is primum non nocere (above all, do no harm) because it involves the removal of a healthy organ from one person for implantation into another person. The pain Anna had to go through while they harvested lymphocytes, bone marrow and other cell types clearly showed Anna was being subjected to harm and so some people will argue that it is only morally right and ethical to harvest tissues and organs from a donor who is already dead to avoid causing harm to them.

Anna being a child below 13 years of age, her parents had to consent for her to be organ/ tissue donor but the ethical dilemma here is, can we really know if the decisions made by Sarah and Brian to let Anna donate was in the best interest of Anna or not or they did it for their own benefit or for Kates benefit.

Anna was less than two years when she started donating tissues and cells to her sister. Her parents were consenting for her but still this goes against her autonomy, the right of self-determination.Even though she is young, at 13 she can either decline or accept any medical procedure to be performed on her and so it is seen as though her parents were going against her autonomy to choose what she would want to be done to her body by trying to force her to donate a kidney to her sister Kate.

Even if Anna was to willingly donate to her sister Kate, we cannot determine if her willingness was not out of coercion and out of being the feeling of being trapped because if she did not do as her mother wished, it would jeopardise her relationship with her mother.

Many hospitals and doctors believe that there is a conflict when a parent consents to an organ donation between two siblings, because it is hard for the parents to be impartial and make the best decision for the donor child(Mathew,2008). The critics argue that the parents are so concerned with the sick child that they are willing to sacrifice a well-child to get the sick child better.

Opponents of minor sibling donations believe that the long term effects of a child donating an organ to another is never taken as of great importance. They believe that there is a chance that the donor sibling might need the donated tissue or organ for their own use and it will not be available to them later in life because of a decision to donate made by their parents when they were younger(Mathews,2008). In Annas case, if she donated a kidney to Kate, she may never be able to play soccer and do all the other things she had always wanted to do in life.
Even though some critics believe that the parents are not in the best position to consent to sibling donors, courts have consistently allowed parents to make decisions concerning sibling donors.

Lastly but not least, Kate was terminally ill and even if Anna was to give her a kidney, her chances of surviving was still very minimal and so we ask, was it really beneficial to let Anna loose a kidney to a dying person who will never recover anyway? What is the cost verses the benefit? Secondly what would the consequences be if Anna donated to her sister or not. What would the consequences be to Anna, Kate, her parents and family at large?

Supporters of child organ donors believe if a sibling donated an organ to another and saved their lives, this will bring psychological satisfaction and more happiness to both the donor and her family as well.
Basing on the concept of beneficence, Anna donating tissues and organs to her sister was a pure act of beneficence that is the act of showing mercy, kindness and charity for the love of humanity.

Was it ethical for Sarah to keep Kate alive against her will?

Kate wanted to die, she was tired of being sick and having all these medical procedures performed on her and so she asked her donor, Anna to stop donating to her. The challenge was their mother Sarah would not accept this decision by Kate and thus Kate and Anna came up with a plan to sue her parents for medical emancipation.
John Stuart Mill advanced the principle that ?the only purpose for which power can be rightly exercised over any member of a civilised community, against his will, is to prevent harm to others. A terminally ill person is not harming anyone in the society and so why not let them exercise their will to withdraw treatment or refuse treatment and die just like in Kates scenario.

To deny terminally ill patients the right to deny treatment and thus quicken death is to condemn them to a miserable existence, contrary to their wishes. Issues as personal as ones own life and death are very personal decisions that an individual should make and to deny someone this decision is go against a persons autonomy and democracy and thus Sarah should have respected Kates decision to die.

For Sarah, it was hard for her to allow her daughter Kate to die without her intervening. She felt it was her duty as a mother to keep her daughter alive using all means possible (deontology). Nothing was going to come her way to stop her from keeping Kate alive.

Was it ethical for Sarah and Brian to switch off the life support machine for Anna?

People against life support point to situations where it is clear that there are no chances of recovery and life support only prolongs the dying process. that it is morally wrong to keep someone alive without their consent, possibly prolonging their suffering. This group compared the cost verses the benefit of keeping someone on life support and cost outweighed the benefit. This group will argue that it morally justifiable and ethical for Annas parents to turn off the life support machine since she was already declared brain dead.The other group of people who are in support of life support say that it is morally wrong to let someone die, that no one has a right to take a life and so turning off life support machine is violating the right to life.


My Sister's Keeper examines what it means to be a good parent, a good sister, a good person.
Sarah felt like whatever she did to save Kates life was morally right even if it meant putting Annas life at risk and causing harm to Anna. Anna knew her purpose in life was to save her sister Kate but when Kate asked her to stop donating, she respected her sisters wish and thus fought for medical emancipation from her parents, to her she felt this was the right thing to do. Kate was dying of renal failure but she did not want to have her sisters kidney, she was tired of living and undergoing lots of treatments and procedure and so when she asked her sister to let her, would it be wrong or right to grant her wishes?

This book presents you with a lot of ethical dilemmas that you would only find right answers to by applying ethical theories and principles. Depending on the different situations being presented in the book and with the application of the different theories of ethics, I would either agree or disagree with the authors position.


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Ethical Dilemmas In Book My Sisters Keeper. (2019, May 18). Retrieved February 22, 2024 , from

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