Synopsis of the Fictional Piece
My Sister’s Keeper (2009) was my selected movie for analysis in this paper. It narrates the story of a young couple Sara and Brian, who once faced a difficult situation, seeing their daughter have leukemia and making questionable choices with grave ethical implications. For starters, realizing that they and their son, Jesse were not a match as donors for Kate, their ailing daughter, they decided to engineer another child genetically, Anna, who will be an allogeneic stem cell donor for Kate. From the moment she was born, Anna only served one purpose: to keep Kate alive. She was subjected to numerous hospitalizations and procedures, including growth hormone injections, all to enable her to keep Kate alive. By the time she turned eleven, her sister Kate had undergone kidney failure. Anna was expected to donate her kidney Kate to even her odds of surviving another complication of her medical condition. However, with her brother’s help, Anna sought legal services from an attorney Alexander Campbell with intentions of medical emancipation. She refused to donate her kidney to Kate, knowing how such a donation could impact her life.
At this point, her parents always believed that Anna had undergone all the medical procedures because she was willing to help her sister. Therefore, the news of emancipation came as a grave shock to her parents and created strife between Anna and her mother, Sara. Anna was eventually moved to a different temporary home by her father to keep the peace. The court proceedings in the court hearing of the case would reveal to Anna’s parents that Anna was acting according to Kate’s wishes, and this showed Kate’s acceptance of death as her sentence, for which she died the next day. News arrives from the court that Anna has won the case, and the family continues with life, with Anne revealing that the family commemorates Kate’s birthday by going to Montana, which was Kate’s favorite place.
Ethical Analysis – Ethical Theory
The story of Anna and her evolving strife with her parents reminds me of the saying – actions have grave consequences. Therefore, in light of such a revelation, a consequentialist view on morality would be the best ideological view to help makes sense of the ethical dilemma presented in the film. The theory of choice for this ethical analysis is utilitarian. The theory holds that the right action is the action that is expected to produce the greatest good (Savulescu et al., 2020; Kay, 2018). The theory emerged in the 19th Century when the majority of the population in the era suffered grave institutional discrimination (Savulescu et al., 2020). The theory emerged to emphasize the value of treating everyone equally and has been implicated in the progressive liberation of society from such vices as slavery and the improper treatment of animals (Savulescu et al., 2020). The theory works on the principle of beneficence, which supports doing what is suitable for all versus doing what is evil and, in this case, wrong (Savulescu et al., 2020; Kay, 2018). Therefore, utilitarianism aims to maximize utility or goodness for all as the most crucial measure of rightness or morality (Savulescu et al., 2020). However, the consequential approach assumed in this theory has received numerous criticisms citing overlooked principles like autonomy and just or fair distribution of goods (Savulescu et al., 2020; Kay, 2018). The theory does not pay attention to personal freedoms to choose or carry out an action because it is in itself just or right. It has been equated to using people as a means to an end which does not correspond well with other theories such as virtue ethics and social contract theory.
Ethical Analysis – Answering the Medical Ethical Dilemma
The ethical dilemma presented by the film revolves around three questions: Were Sara and Brain right to genetically engineer a savior sister for Kate and subject her to the various medication procedures without asking about what she wanted or wished for in her life? Was Anna right to follow Kate’s wishes to refuse to complete the kidney donation to save Kate’s life? Was Kate’s disposition to accept death as her sentence right, given her family’s struggles to keep her alive? These serious ethical considerations underpin the medical-ethical burden depicted in the film that a utilitarian approach will attempt to find solutions or recommend remedies.
To begin with, the moral value in the film, relating to the ethical theory, is that Kate’s parents seem to be working under one principle: keeping Kate alive by all means necessary. However, their choice is not a moral value that aligns with utilitarianism because it does not benefit all the members present. Sara and Brian emphasized Kate and forgot about their other children. It would follow that Jesse’s dyslexia was not picked until his grades dropped significantly. Also, Anna’s wishes since birth were not considered as she was turned into an object of organ donation for Kate, and that was to constitute her entire existence. The moral values in the film conflict with each other, including Anna’s freedom of choice of what should happen to her body versus her parents’ designation of her as her sister’s savior. Secondly, there is a lack of consideration of justice regarding how Sara and Brian’s focus solely on Kate impacted their other children. Thirdly, it is Anne’s choice to refuse organ donation informed by Kate’s wishes which goes against her parent’s wishes for Anna and Kate, Anna’s desires, and Kate’s wish to die. Lastly, there is the moral question of genetic engineering a donor through in vitro fertilization to save Kate despite society’s moral respite to genetic engineering offspring and the honest question of creation or playing God. Surprisingly, however, the utilitarian theory would not find fault with some of these actions and prove benefits to all concerned as evidence to support the moves made by the characters in the movies.
On the question of genetic engineering Anna to save Kate, the theory would argue that the consequences of saving a life would prove the maximum utility and, therefore, the right thing to do given the circumstances of Kate’s illness. Regarding Anna’s decision not to donate her kidney, the theory would applaud Anna for wanting to save herself and fulfill Kate’s dying wish. Kate’s decision to accept death and stop causing Anna and her family to suffer will be applauded as considering the welfare of the many with no harm done to the many and hence maximum benefits and good to her family. Therefore, by focusing on the circumstances surrounding the decisions made at each character’s critical point in life and the desired effect not to cause harm, the theory would render their actions right and justified. However, as the critics of the theory posit, the issue of using Anna as a means to an end to save Kate contradicts utilitarian beliefs since Anna’s freedoms and justice for Anna and Jesse were never actualized by their parents, who seemed more focused on Kate. Also, the subjection of Anna to the numerous procedures for Kate’s sake outweighs any benefit that the parents were seeking to manifest, making it an outright violation of Anna’s freedom of choice.
Reflection
In summary, the essay provides critical points regarding consequentialism achieved through applying utilitarian ethics to address a fictional medical ethical dilemma. The piece depicts utilitarian ethics as focusing on appraising actions that provide maximum good for all concerned. However, it demonstrates fallacies in the construction of the theory that tends to overlook autonomy or personal freedom of choice and actualization of justice for all concerned. Applied to the medical ethical dilemma in the film, it would recommend the actions taken by the characters based on the circumstances surrounding each action and the end goal to be morally right. However, it fails to protect Anna’s freedom of choice and protection from exploitation by her parents, who robbed her of her childhood by turning her into an organ dispensing object for Kate. Therefore, following the discussion in this essay, I have learned that actions have consequences, and sometimes, the best actions done with the purest intentions might not be right for all concerned. This is exemplified by Anna’s parents choosing to conceive her to save Kate but, in the process rendering Anna incapable of living as she would desire. The lessons learned from this piece can be applied to my personal and professional life by helping me develop ethical principles that would guide my practice and life. It specifically mandates me to recognize crucial aspects of autonomy and justice as I seek to serve a community or population in my profession and to question what is good for all if my actions infringe on some of their rights or cause inequality.
References
Kay, C. D. (2018). “Utilitarianism.” In: Farazmand, A. (ed.) Global Encyclopedia of Public Administration, Public Policy, and Governance. Springer, Cham. https://doi.org/10.1007/978-3-319-20928-9_2399
Savulescu, J., Persson, I., & Wilkinson, D. (2020). Utilitarianism and the pandemic. Bioethics, 34(6), 620-632. https://doi.org/10.1111%2Fbioe.12771
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