Synopsis of the Film
Anna Fitzgerald was conceived by means of in vitro fertilization (IVF) to be her older sister’s genetic match and donor. The older sister, Kate, who is diagnosed with acute promyelocytic leukemia, is expected to undergo periodic medical procedures to remain alive, with Anna expected to be part of these medical procedures every time. When Kate turns 15, she experiences renal failure, and, as usual, the parents expect Anna to donate one of her kidneys. However, Anna realizes that she does not want to lead a life of a donor and tells her mother that she will not be donating her kidney. The obsession of the mother, Sara, to keep Kate alive, makes her discontented with Anna’s decision, which forces Anna to sue the parents for medical emancipation and the right to her body. With the assistance of attorney Campbell Alexander, the case goes to a hearing, where a judgement was to be made on Anna’s request for the partial termination of parental rights. Later into the film, it is disclosed that Anna was acting under the request of her sister Kate, who wanted to die but knew that her mother would not grant her wishes. Although Sara was reluctant to bend to Kate’s wishes, she was eventually convinced by the father, Brian, and the older brother, Jesse, that Kate had been striving to tell her for a while. Although Kate dies before the passing of the court ruling, Anna wins the cases.
Ethical Analysis
Utilitarianism is one of the commonly known moral theories. According to the theory, the morality of an action is determined by its effect; the only pertinent effects are the good and bad outcome these actions produce. Act utilitarian, on the one hand, focuses on the impact of individual actions, and rule utilitarian, on the other focuses on the impact of a type of action (Nathanson, 2020). According to utilitarianism, the role of morality is to improve life by facilitating the occurrence of good things in the world and decreasing the occurrences of bad things in the world (Nathanson, 2020). Therefore, moral codes or systems that incorporate commands or taboos that are built on customs, traditions, or rules are not important. Instead, a utilitarian, irrespective of whether he or she follows the set guidelines, will judge the true morality or justify an action based on its positive contribution to human beings. In the film My Sister’s Keeper , there are multiple instances of medical problems that can be justified by the utilitarian school of thought.
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Anna Fitzgerald is a genetically engineered child who was born with a sole purpose of being her older sister’s genetic match, and thus a donor. The advice by the doctor and the subsequent decision for Kate’s parents to give birth shows the value of one human life on one end and the lack of respect for another human life on the other. Be that as it may, genome editing for human embryos, as in the case of Anna, has raised multiple ethical questions in recent years. Genetic modification is an irreversible experiment that manipulates embryonic genes (Ishii, 2017). The genetic make-up of Anna was tampered without her consent to help another child, even though her life also has value. Besides, genetic modification has widely been accepted in incidences, where it will prevent children from being born with serious genetic diseases (Ishii, 2017). On the contrary, Anna did not have any genetic disease, and the interference with her genetic make-up was meant to benefit another person at the expense of the potential risks of the irreversible manipulation. However, based on the utilitarian theory, the parents’ actions were justified since their outcome was good. The birth of Anna gave rise to a donor match that Kate was missing and thus prolonging her life. Although the quality of Anna’s life was affected, the modification of the genes and her involvement in Kate’s medical procedures as donor gave rise to two lives.
The issue of informed consent between parent and minors is another medical moral problem that is depicted in the film. Anna is forced to donate marrow and an organ to her sister despite her unwillingness to do so. Children’s autonomy and right to give informed consent has gained popularity (Nepi, 2019). When a parent is involved in giving informed consent on behalf of her child, he or she is expected to exercise his or her right protect the child and thus putting the child’s interest first (Nepi, 2019). However, in the case of Anna, Sara was very obsessed with prolonging Kate’s life to the extend that she failed to protect the interests of Anna. Besides, throughout all the medical procedures, Anna had not granted informed consent. Although she had not given informed consent to her involvement in the medical procedures, Anna felt that she was being denied her right to her body to the extent that she had to sue her parents. While Sara’s actions were not legally right, they could be considered moral according to the utilitarian theory. The outcome of violating Anna’s right to issue informed consent was the prolongation of Kate’s life, which is a positive effect on human life, and thus moral.
The battle of the quality of life versus the quantity of life, which is another moral problem, was evident in the film through Sara wanting Kate to live longer against her will. The question of who should rightly decide quality versus quantity of life matters in the context of healthcare has attracted diverse arguments. Medical practitioners tend to support their paternalistic approach to healthcare issues, particularly when they feel that they are upholding a patient’s good, or protecting a patient from harm (Hamilton et al., 2016). However, based on the moral principles of autonomy, a patient has the right to make a decision on matters concerning healthcare and medical treatment (Hamilton et al., 2016). Besides, since moral decision should be made by those who are expected to bear the burden of the consequences, Kate should have a say in healthcare issues involving herself. While Sara valued the quantity of life and strived to ensure that her daughter lives as long as possible, Kate, who valued her life based on quality, wanted to die. Based on the guiding principles of utilitarianism, life is valuable and any action to prolong it is acceptable. Therefore, although Sara was going against Kate’s will, her actions can be considered to be morally correct.
The primary moral value in the film is the respect for life. Based on the film, the quantity of life is more valuable than its quality. Sara was willing for Anna and Kate to live on despite the poor quality of their lives. In the process of preserving life, the doctor and the parents were involved in activities that would be considered medically unethical, such as genome editing for human embryo, violation of informed consent, and the failure to give Kate her moral right to make the decision about the question of quality versus quantity of life. Conflicts are evident in the film, particularly when Sara obsessively values Kate’s life at the expense of Anna’s life, and the question of quality versus quantity of life. However, actions by Anna’s parents and the doctor, if based on the concept of utilitarianism, would pass for morally correct actions, since its effect is the prolongation of life.
References
Hamilton, D. W., Bins, J. E., McMeekin, P., Pedersen, A., Steen, N., De Soyza, A., ... & Wilson, J. A. (2016). Quality compared to quantity of life in laryngeal cancer: A time trade‐off study. Head & neck , 38 (S1), E631-E637.
Ishii, T. (2017). The ethics of creating genetically modified children using genome editing. Current Opinion in Endocrinology, Diabetes and Obesity , 24 (6), 418-423.
Nepi, L. (2019). Ethical Issues Concerning the Informed Consent Process in Paediatric Clinical Trials: European Guidelines and Recommendations on Minor’s Assent and Parental Permission. BioLaw Journal-Rivista di BioDiritto , 16 (1S), 53-63.
Nathanson, S. (2020). Utilitarianism, Act and Rule | Internet Encyclopedia of Philosophy. Retrieved 19 November 2020, from https://iep.utm.edu/util-a-r/
