My Sister’s Keeper

The screen version of Jodi Picoult’s novel poses the question: how much are we entitled to use each other?

The use and misuse of artificial reproductive technology (ART) is a subject that deserves more attention than it commonly gets. My Sister’s Keeper is a thought-provoking dramatization of one of the most troubling ethical issues of the ART industry: the creation of “savior siblings”.

The premise of the story is that one child in the family has a virulent form of leukemia. The mother devotes herself completely to saving the life of this daughter, Kate. The search for tissue donors fails. Their doctor suggests, strictly off the record of course, that they could have another child, designed to be a perfect donor match for the critically ill sister.

So, the movie begins with a voice-over flash-back from Anna, the savior sibling. She describes herself as a “designer baby”, but this is probably not exactly accurate. It suggests that the doctors were somehow able to manipulate her genes in order to make her the perfect match for her sister. More likely, the doctors would have created a number of embryos, tested them, and kept the one that matched. What happens to the others? They are discarded, of course. These discarded siblings are not part of the story. Somehow, they never are.

In any case, the tension begins when the girls are teens. Kate’s kidneys fail. The mother schedules an organ transplant. She takes for granted that Anna will donate one of her kidneys to her sister. Anna refuses.

She hires a lawyer to represent her in a suit against her mother. She declares that she wants the rights to her own body. The irony here is rich. Western societies have come to accept an unlimited abortion license, declaring that the woman has absolute autonomy over her own body, in spite of the distinct life growing within her. But the disregard for human life occasioned by the abortion license has led us to reduced regard for human life more generally, of which our willingness to create savior siblings is just one manifestation.

In My Sister’s Keeper , the adults — mother, father and doctor — convince themselves that it is morally licit to create a human being whose body would be available to serve the medical needs of another child. One need not be a religious believer to find this troubling. The Categorical Imperative of moral philosopher Immanuel Kant states clearly that we must always treat people as ends in themselves, not as means.

I have talked with people who were adults when Roe v Wade legalized abortion in the United States. These people will usually say they did not expect there would be so many abortions. They envisioned that women would only choose abortions in the “hard cases” of rape and incest, not to the tune of a million abortions per year. These same people also admit they would never have anticipated the moral callousness that society has developed around the sanctity of human life. They thought the predictions of euthanasia, assisted suicide, infanticide, and sex selection abortion were hysterical fantasies of religious fanatics. But those wild-eyed religious fanatics proved to be sober-minded prophets.

This back-story is worth keeping in mind as we think about the future of reproductive technology. Proponents of the unlimited use of ART dismiss the fears of excesses as over-wrought and hysterical. But once we decide that it is morally acceptable to do “selective reduction” of embryos, why isn’t it even more acceptable to eliminate non-useful embryos before implantation in the womb? We have allowed ourselves to do pre-implantation genetic diagnosis for the purpose of screening out embryos that have medical conditions we don’t want to deal with. What could possibly be the problem, then, with “screening in” for a baby that has the traits we positively want, for whatever reason.

In other words, given the things we already allow ourselves to do, we have no principled reason to oppose the creation of “savior siblings”.

As the story progresses, we see that the parents really do love Anna, the useful child. They do realize that she isn’t merely a bundle of spare parts, but a full human being. But the mother, in particular, really does believe she is entitled to direct the use of one daughter’s body for the benefit of the other daughter.

Only the sisters’ love for each other keeps the family from completely disintegrating. (The plot twist is the explanation of why Anna is so adamant that she will not donate her kidney.) While this is certainly uplifting and inspiring, the love of teenagers for their siblings is hardly a reliable barrier against moral excesses and medical abuses.

Some day, somewhere along the line, some adults are going to have to give serious thought to the question of how much we are entitled to use each other. In the meantime, we have to rely on fictional accounts like My Sister’s Keeper to keep this compelling moral question before our eyes.

[This article is published by Jennifer Roback Morse, and under a Creative Commons license. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact for permission and fees.]

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  • Warren Jewell

    Well, you have hit upon the problem in one word: “adult”. How many among us are little more than grown-up (for size and demand) adolescents, just ripe with ‘entitlements’ that must be met, no matter who pays what price?

    We have supreme court ‘justices’ (for one more and more misused word) who demand to use just about anything but our national Constitution to adjudicate cases. They’ve got their feelings and ’empathy’; they have any other court anywhere for precedent for their choices of decisions.

    This same supreme court has ‘sicced’ humanity against itself in terms of marriage, family, right to life and even right to freedom, which we supposedly hold so sacrosanct as to warrant licemtiousness.

    “Pray unceasingly” would seem to barely cover our willingness to use anyone else for anything else. Moreover, a constant stream of “God, save us!” would seem to preclude other prayers altogether.

  • caporasa

    It seems that the right to life, liberty, and the pursuit of happiness has morphed over the centuries to a litany of subsequent so-called “rights” that trump any number of “wrongs” committed in their procurement. Things that were once considered privileges and were gratefully accepted as a gift or blessing are now looked upon as rights to which the individual is entitled. Examples abound and include the “right” to choose (of course this must trump the right to life of the unborn), the “right” to reproduce (regardless of the number of embryos destroyed in the process, committed fathers are strictly optional), the “right” to marry (matrimony of course has nothing to do with procreation or trinitarian family life), the “right” to free medical care (who cares if we have to sell our grandchildren down the road and betray the principle of subsidiarity to get it), etc.etc… We should pat ourselves on the back for all the enlightened progress we’ve made. May God forgive our folly.