U.S. American Health Issues, Health care system
"My Sister's Keeper" by Jodi Picoult is a novel about the family of Fitzgerald. At a tender age of two, Kate is diagnosed with leukemia and she urgently requires a donor in order to save her life. However, there are many attempts to find her a suitable donor, but all this is in vain. The novel is set in a span of two weeks where the author divides the scenes according to the day of the week. The story that happens within the two weeks gives a flashback from the points of views of the main characters in the novel who are Anna the sister to Kate, Sarah Kate’s mother, Brian who is Kate’s father, Jesse who is Kate’s brother, Campbell serving as Ann’s attorney and Julia acting as the GED. However, it is interesting that there is no flashback on points of view of Kate who is the victim of Leukemia and one who needs a donation. The doctors tell Sara and Brian that the only remaining option to save Kate’s life is to design a scientifically modified genetic child to suit the requirements of Kate so that the child can donate his or her organs to her sister. This is where Ann comes in and she is three years younger than Kate who is sixteen years.
The story is about a mother having to make a choice on creating a child and giving birth to her only to have her sacrifice her organs in an effort to save another child. From Ann’s point of view, one may see that Sara is so inhumane for allowing such a thing to happen and then forcing Anna to sacrifice her kidney for the sake of her sister. The problem sets in when Anna decides to file for a medical emancipation protecting her from donating her kidney to her sister who needs it in order to continue living. Anna wants to sue her parents because she believes they are infringing on her rights to her own body by making her donate to her sister any time she has an attack. The story provides a different view for all the characters where the reader gets to understand how the family works and why Kate’s problems seems to be the driving force behind all the decisions made by the family members.
Anna is so bent on defining her personality and identity and she narrates how she is the peacekeeper in her family according to Jesse. The role of Anna in the novel is to be there to donate anything her sister needs. However, it reaches a time when she decides to search for an attorney to help her file a case against her donating her kidney for her sister. She seeks medical emancipation with the help of Campbell Alexander.
She is a mother interested in keeping Kate alive and she put Kate’s interests as her utmost priority. The motherly instinct of Sara is directed majorly to Kate and in the process she neglects her roles as a mother to her other children. This comes out clearly in the way she disregards Jesse wayward behavior, which he uses to seek for attention. She does not consider Anna part and point of view when she file the lawsuit as she only thinks that Anna has an obligation to save her sister. She is so engrossed with Kate that she does not realize that she has strained relationships with her husband, sister and Jesse and Anna. She is also so focused on the physical health of Kate that she forgets to talk to her about her emotions ad this leaves her doubting Anna when she reveals that Kate want to die.
At the begging on the novel, he is portrayed as a sarcastic and lone person who only trusts his dog Judge. He is epileptic, but he is also a very trusting a caring person who has a keen interest in Anna’s family. He bonds with Anna because he feels a strong connection because of their health issues and lack of control over their bodies.
He is Kate and Anna’s brother and he is a loner who keeps to himself. He is involved in the arson, but he hides this because he is a delinquent who hates talking to others. He is 17 years and he feels guilty because he cannot do anything to help his sister.
He is a fire fighter and the husband to Sara and the father to Jesse, Kate and Anna. Through his flashback one gets to understand how hard it is for a father to have a child who is dying of a terminal illness like cancer and the conflicting decisions he has to make over time.
The novel has many conflicting themes that one gets to explore while reading the book. The first major theme that portrays conflict is on deciding what is right and what is wrong. This is evident from the vague line between Right and Wrong. This comes from the beginning when parents had to make a decision to design a scientifically modified child that has genetic make-up matching that of Kate to have a suitable donor. The other conflict seen between making a decision between a right and wrong action comes from Anna who wants to lead an independent life where she is not bound to be donating her organs to her sister Kate. However, it is clear that she loves her sister and wants to continue providing for her so that he continues fighting her illness. Throughout the novel, one struggles to decide what is the right and the wrong action considering that Anna’s decision to deny her sister her kidney will lead to the death of her sister who cannot do without the kidney yet Anna can live without it. The decision is further complicated when one considers the health risks associated with the surgery to transfer the kidney.
The other conflicting theme in the novel is that of appearance and reality. This is evident in the way characters have secrets they hide from others. One of the people who hide behind a facade is Campbell who does not want people to know he is epileptic and he does not want anyone to know why he broke his relationship with Julia. He is trying to avoid people having pity and seeing him a s a vulnerable being. Another conflict between appearance and reality is in how and why Anna decides to file a lawsuit to emancipate her from donating her kidney. The reader does not understand the reasons and at one point one believes that she is doing this for her own selfish reasons. The reality however, is that she is using the lawsuit to hide the fact that Kate wants to die. Jesse, on the other hand is hiding his act of arson because he does not want to discuss about his delinquency with anyone and he feels that it will only add to the family problems. Each character in the novel tries to hide the real motives of their actions leading the reader and other characters to believe the opposite of what the matter is actually.
The book relates to health issues and the importance of communication as seen in the Fitzgerald family. This is a family full of conflicting interests with the health of Kate being the center of interest for all the family members. Communication is an important aspect in any setting and this is the case with family where the doctors had to be frankly and tell Sara and Brian that the only option to save Kate was to create another child with the same genetic make-up as Kate who will act as a donor. Anna knows her role is to donate her organs and blood to Kate every now and then. Health focuses on keeping a patient safe and this issue comes up when Sara decides to have Anna donate her organs at a tender age even though she is not aware of what is happening to her. This brings out the issue of infringement of another person’s rights to their body and this issue is resolved later on in the book when she goes to court to seek emancipation. Kate wants to die, but the only person who knows about this is Anna and she does not want to expose this. This is why she goes to court. However, she later on confesses this while on the stand and helps solve the dilemma.
There are many health principles that come out clearly in the novel. The first one is that of informed consent, where a patient has to give their consent before any medical procedure is conducted. In the case of conceiving Anna and the genetic modification that were needed to create her, Sara and Brian were informed of the health risks and all the other advantages and disadvantages as well as the options that existed in order to remedy the situation. This principle requires a patient to be informed of the procedures, the available options, the repercussions of the procedures and the risks involved. This principle also applies to Anna who is aware of the health risks associated with the surgery where she is at risk of many health problems (Picoult, 2004).
Health decisions need to be made with the principle of autonomy being the first and the utmost principle to be upheld. This principle of health provides that a person needs to make individual decisions when making up their mind n any medical procedures to be done on their bodies this is a very important principle where the patient or anyone who needs to undergo any medical procedure needs to be accorded. In the novel, this principle is not upheld as Anna keeps on donating her organs and blood to Kate even at a very tender age as it is clear form Sara’s flashback that Anna donated her blood through her umbilical cord when it was connected to Kate’s centerline. The principle upholds the rights of a person to their dignity. This does not seem to apply to Anna who was conceived for a purpose and is always defined in terms of her sister Kate. Anna does not enjoy this right, as she is obliged to donate her blood without a question. She has been comfortable with the way things were until she was asked to donate her kidney for her sister.
The principle of beneficence is a very important principle in any health procedure. This is what the doctors and Kate’s parents are trying to uphold as they make the critical decision to conceive Anna in order to help save Kate’s life. This principle demands that a person should be exempted from any preventable harm and doing well for the sake of the patient. In the case of the novel, My Sister's Keeper, this principle comes out clearly, as everyone is looking out for the well-being of Kate and everyone does everything in his or her power to ensure that she is always safe. The conception of Anna from a bone marrow that was a perfect match for Kate is one is a clear indication that the doctors were keen on ensuring that Kate was safe and that she had a perfect donor for her whenever her body was giving in to the terminal illness. The decision to create Anna with the prefect math of blood and bone marrows shows how important it was for the doctors to prevent any harm from reaching Kate.
The other principle is non-maleficence where every patient has a right to be prevented from any avoidable harm that may arise during any medical procedure. This is a principle that conflicts in the novel because making Anna go through the surgical transplant puts her in a risky situation yet she is not sick or requires the medical procedure. In this case, the decision to have Anna donates her kidney for her sister puts her in danger and this is something that can easily be prevented. This however, conflicts with the principle of beneficence where the interest of the patient is of utmost importance. The principle tries to protect Anna from the possible side effects of the medical procedures, but it is putting Kate’s life in danger.
Anna has a right to refuse the medical procedure and that is why she seeks emancipation from the surgery that puts her at risk. According the health law, a minor can be emancipated form any procedure that does not benefit him or her. In this case, Anna hopes the court can help give her back her rights to her body and her organs as she feels that she has always been used to keep her sister alive and this makes the situation complicated as she cares for her sister. With the help of the court, she can enjoy the rights to her body and prevent her parents form forcing her to undergo any medical transplant in future (Picoult, 2004).
The book is a perfect one for those who are interested in health issues. as one reads through the book, he or she cannot help wonder why Anna decides to go to court to prevent her parents form making her go through the surgery hat is so important in saving her sisters life. Anna makes it clear that she loves her sister and the bond they share is very string as they are like Siamese twins, just as Anna puts it at some point. The girls share a strong bond that make them feel as if they are one person especially with the fact that Anna’s blood flows through Kate’s body. The issue of personality and identify comes into play in the book as Anna tries to focus on identifying herself. Ever since she was a child, she has always lived under the definition of Kate who seems to be her role model. She does not seem to question this role and she willingly goes through the blood and marrow transfers without a question.
I applaud Picoult for tackling the issue so well because the issue of halt and the scientifically modified genetic children is not an easy issue to write about. However, she puts the issue in a very captivating way where she makes it clear that the decisions one makes has a motive and what people think is not always the case. This is evident in how the end of the book takes a twisting turn. It is heart and the reader cannot help, but feels betrayed by the writer. The characters are put in such a way that the reader feels connected and part of their lives and this makes one feel and understand their anguish and the reasons for the decisions they make. The health communication issues that come up in the novel are numerous. Some of the issues that come up is the infringements of the rights of one child in an effort to save the life of the other child. As one reads, the novel he or she wonders what will happen as the novels ends.
The issue of infringements of ones right is clear as Anna is conceived for the sole purpose of providing a reliable donor for her dying sister. The novel brings out the issue of love and the sacrifices associated with the feelings. Communication comes in handy is such situations especially when it comes to explaining to Anna why she was convinced and the role she plays in Kate’s life. In such a case, the doctors have to come out clearly and explain why they were recommending the genetic procedure that would help save the life of Kate. Communication is an important aspect and Sara does not focus on this part as she only cares about the physical health of Kate. She is therefore, not aware of Kate’s desire to die because she is tired of her life and wants to end it. The only person who knows about this is Anna and although she loves her sister, she decides to use the kidney transplant as an excuse. The other issue about health and communication comes out in Campbell’s part where he does not want to have people pitying him because he is epileptic. This shows how much people hide health related issues for fear of vulnerability and pity from those around them. However, one cannot help, but feel sad and mad about the way the novel ends with the death of Anna who seems like a sacrificial lamb in the family. It seems like the author created her solely for helping her sister survive with the blood and organs. It is also difficult to determine the writes’ stand in the whole issue. She keeps the reader on edge, keeps on shifting her focus from one character to the other, and this does not provide a clear picture on what she thinks is right.
Picoult, J. (2004). My Sister's Keeper. New York: Atria