My Sister's Keeper- Ethical and Legal Landscapes and Questions of Healing

Within the last few months, I have been incredibly busy......

• Synthesizing field research and practice
• Exploring the chasm between health and healing
• The 'unknowns' patients and their families face in the wake of illness especially chronic and difficult ones

and exploring the inevitable questions that arise regarding choices,

• midst unprecedented levels of medical tourism
• the era of the WHO 2008 Beijing Declaration contending that traditional medicine should be primary care in every nation
• and the consequent backlash of medical information imperialism.

Yet, nothing touched me more deeply or inspired more thought than Jodi Picoult's 2004 My Sister's Keeper. If you haven't read the book, I'd highly encourage you to do so. It's beautifully, eloquently written and emotionally driven! Utilizing pivotal vantage points, Picoult almost instantaneously initiates her readers into the Fitzgerald family, revealing each member's vantage point, affectations and realizations.

Synopsis

The Fitzgeralds, a white, upper middle class family with two children faces seemingly insurmountable challenges when their daughter, Sara, is diagnosed with acute promyelocytic leukemia and none of them are donor compatible. Because of this, the Fitzgeralds choose to genetically engineer a child serve as spare parts for their daughter. More than a decade later, after numerous donations, operations, and procedures, their youngest daughter sues them for medical emancipation.

Obviously, this dilemma, the subsequent choices made and the consequences thereof elucidate several ethical, medical and legal questions. For this reason, I will pose them in parts.

Scenario

The most fundamental premises rest within the following scenario:

When Sara is diagnosed, her mother, father and her four-year-old brother are tested for donor compatibility. Devoid of a match, the Fitzgeralds' family doctor, Dr. Chance tells them a story about a family with a parallel circumstance. Notably, that family's later offspring matched the older sibling affected. While that family's child was naturally conceived for no particular purpose, that child 'solved' their donor problem.

The Fitzgeralds, on the other hand, took Dr. Chance's story one step further and genetically engineered Anna for the sole purpose of sustaining their other daughter's life. Accordingly, she was predefined and existed as 'an extra' or supplementary extension of Sara. While the initial donation merely entailed the cord blood cells, the probability existed for many more invasive donations. Therefore, it begs several questions from different intersecting arenas.

Questions

Unescapably, the society in which this scenario occurs dramatically alters its effects. Nevertheless, I listed a few select thoughts to consider.......

• Does this reason for Anna's existence violate the most fundamental rights for life and/or ethical principles?


• What should be considered? All vantage points welcome--Family nursing, social work, ethics review boards, legal representation, etc.


• What are the possible consequences of the Fitzgeralds' choice, even unintended ones?


• Should Dr. Chance have offered additional options, even if he were not qualified to deliver that modality of care?