My Sister’s Keeper: Ethics in The Film

The parents of two children were placed in difficult situation and were given a choice that can be viewed as ambivalent by many. The decision made by these parents revolves around one of the many themes that the film My Sister’s Keeper portrays, and that is morality. My Sister’s Keeper is a drama film from 2009 where it involves every member of the family to choose from right or wrong. In this My Sister’s Keeper ethics essay, the summary of the film will be given, four main ethical principles will be defined and discussed how it relates to the film, and how these ethical issues effect the nursing profession today.

Film Summary

The film My Sister’s Keeper stems off from one point, and that is when Kate, a two-year-old girl, was diagnosed with a rare, and aggressive form of leukemia. The health care provider discussed with the parents, Brian and Sara Fitzgerald, that both themselves and their son were not a match for their daughter, and finding a non-related donor is both risky and time sensitive. Brian and Sara Fitzgerald were given an option that can be seen as completely unorthodox. The health care provider illegally discussed off the record with the parents of Kate, of having another child in vitro. Sara, without hesitation agreed to conceive another child in vitro, so that their daughter Kate would have someone who is a one hundred percent genetic match, or as Kate’s genetic savior.

From that point on, Anna, the child grown from in vitro, underwent countless procedures including bone marrow transplantation, without any say. The family’s main focus was to provide for Kate. Anna and Jesse, the older brother, continued to go unnoticed as years went by. Anna at age 11, wanted to give meaning to her life other than saving her sister or donating a kidney, and with that she met a lawyer who represented Anna in her case to fight for Anna’s medical emancipation. Kate has made it clear to the rest of the family that she wishes for quality of life, and while Anna fights for medical emancipation, Kate stops breathing one night in her mother’s arms.

My sister's keeper: ethical analysis

Autonomy

The main ethical principle that is depicted in this film is autonomy which is the right to self-determination and is the freedom of one to make decisions for their own life. Whether one is a child or an adult, everyone should have the right to autonomy and to take part of the decisions made about their health. The siblings Anna and Kate both had troubles exercising their right to autonomy. Anna being born in vitro, felt as if her sole purpose was to provide for her elder sibling and that she had no say due to her sister’s illness (Elfarra, 2018). Their mother Sara made it seen to the entire family that because Kate had a terminal illness, all actions were justifiable. Ever since Anna was a newborn, she was subjected to invasive procedures while being held down by other health care professionals. After their mother Sara was made aware of Anna suing for medical emancipation, Sara argued that no one has a choice in their situation, and that Anna is too young to make a decision of this size on her own.

The father Brian argued with Sara that it is erroneous to unwillingly make their child undergo anymore operations or procedures unless Anna agrees to them and understands. While being the center of attention, Kate, by the age of two, has been hospitalized and has gone through chemotherapy and radiation, which alone can put a toll on many people. For the sake of her family, especially her mother, she continued to fight for her life (Goldman et al., 2009). Due to her Sara’s inclination in keeping Kate alive, she was unable to voice her thoughts. Already made aware to her siblings and father, her mother was unable to see that Kate wanted to have a peaceful death and thus did not respect her autonomy as well. Both Anna and Kate fought for their right of independence, a right in which both are inclined to (Kling & Kruger, 2017).

Non-maleficence

In My Sister's Keeper ethical issues of non-maleficence were completely disregarded in Anna’s aspect. The duty to do no harm and reach a beneficial outcome for the patient was ignored ever since the health care provider offered the family to have a donor child. All operations and invasive procedures performed on Anna was out of Kate’s best interests. All potential side effects of medications or possible complications were laid out to the parents prior to every procedure or drug therapy, but even so, their main concern was keeping their other child alive. This had health care professionals and the parents picking at Anna like vultures, continuing to make her feel as if her value in life was much smaller compared to Kate’s (Goldman et al., 2009). As the physicians and nurses stood by and continued on with the procedures, they ignored the ethical principle of causing no harm towards the patient. Placing Anna at risk for complications, and resulting in hospitalizations for those risks, caused pain and harm towards Anna (Elfarra, 2018).

Beneficence

As Kate’s mother, beneficence, or the act of promoting good, was her priority in terms of health. Sara left her practice as a lawyer and committed to Kate’s health fulltime by staying at home for her care. Sara cooked healthy foods that would minimize any complications that may arise from Kate’s health, and did everything possible to prolong her life. Sara made it possible for Kate to receive all necessary chemotherapy and radiation, and to remain hospitalized as needed. Sara’s number one priority was to keep Kate safe, even though Kate had accepted death, and viewed death as inevitable.

This in hand results in Sara not respecting her autonomy. Although it may be seen as trying to prolong her life, may be doing more harm than good, Sara was blinded with parental love and in her eyes, was trying to do the best she can in any possible way as a mother to maintain a healthy life for her child Kate. Anna, and the others although, promoted good by respecting Kate’s wishes in promoting quality of life by allowing a last memorable moment at the beach and allowing a peaceful death (Goldman et al., 2009).

In healthcare, the health care provider, including nurses, should place the patient’s best interests first. Physicians have been in conflict at times where it is in the patient’s best interests to continue with the plan of care, while the patient refuses treatment (Kling & Kruger, 2017). This is not the case in this film. Anna refuses to donate her kidney or refuses further treatment without her permission, for her own benefits. These invasive procedures only put her health at risk. These providers are only promoting good for the sake of Kate and her rare illness but disregard the health of her sister Anna.

Justice

The ethical principle of being fair can be depicted throughout the film. Anna had to fight for medical emancipation in the courtroom because of her parents’ lack of equality. Anna believes it was not fair that she was brought in vitro, for the benefit of another child, even being her sister. Anna should be able to make decisions, whether drastic or not, for herself. Her mother did not illustrate fairness for her children but showed favoritism towards Kate due to her illness. It was not equitable of the parents to shift their focus to only on Kate, while Anna and Jesse struggled alone. In this film, health care professionals were not given much of a role, but the nurses should have advocated in Anna’s behalf. Being a professional nurse means advocating for your patient and fighting for their rights. While the family and health care professionals fought for Kate, no one stood up for Anna (Goldman et al., 2009).

Relation and Impact to the Nursing Profession Today

The film My Sister’s Keeper involves a family conceiving a child through in vitro fertilization. Although there are many controversies on the use of in vitro fertilization, the main ethical issue presented throughout the film is the right of a child to exercise autonomy. There are cases where the patient or an individual may not be able to exercise this right, mostly involving the person being mentally incapacitated, either by mental immaturity or insanity (Grootens-Wiegers, Hein, van de Broek, & de Vries, 2017). To possess appropriate capability for decision making is not a simple answer and continues to raise controversy today. Minors were viewed as incompetent due to their age and were not allowed in making their own medical decisions. Health care professionals in pediatrics including nurses, are faced with numerous difficulties concerning parenteral participation in medical decision making (Parsapoor, A., Parsapoor, M. B., Rezaei, & Asghari, 2014). Decision making capacities have been recognized by early childhood, middle childhood, and adolescence. This is a broad way of viewing a child’s age and their right to decide for themselves medically. In cases where the child may not make their own decisions, what is to happen when the parent does not make a decision based solely off the patient’s best interests? These ethical issues continue to bring up questions today and is a concept that cannot be depicted as clearly as black and white.

Conclusion

In conclusion, Kate’s condition has always been the priority in the family. Each member including Kate has been affected by the leukemia, whether directly or indirectly. The siblings had to fight for a voice and their independence, while the parents fought for the life of their child. Many ethical principles have been illustrated throughout the film, and these ethical controversies continue to affect healthcare on a day to day basis. Nurses and other healthcare orof4essionals encounter difficulties with autonomy for medical decision making in children, and nurses especially are in contact with the patient and families more often than not. These ethical issues continue to bring up conflict due to morality not being so clearly defined in difficult situations.

References

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