"My Sister's Keeper"

[K9_Trainer]

For those who haven't seen the movie, it presents a rather interesting moral dilemma.

To summarize, a couple has a child with Leukemia. Treatments for this often deadly disease require blood/organ/bone marrow transplants and in order for the transplant to be successful, the donation must come from a perfect match. Thats often the difficult part, finding a donor that is willing and matches in time.

The parents decide to have another child, a designer baby genetically engineered to be that perfect match, to essentially be a "spare parts" child. They consciously brought the child into existence so they could use her blood and organs for her sister. She was forced to donate blood and bone marrow and was unnecessarily exposed to hospitals, needles and risks of infection since a young age.

At age 11, she ended up suing her parents for rights to her own body, and she won. She received medical emancipation, so from that point on, any decisions regarding her health were in her hands.

So topic is, was this ethical? How much authority should children have over their own health/medical needs? What age is appropriate for "medical emancipation"? Should parents be prevented from making decisions like the parents in this movie chose to make? What responsibility do doctors play in this?

Personally, I don't believe it was ethical. I would never bring a child into the world to be "spare parts" for another child, nor would I ever force one of my kids to donate to a sibling against their will. And I also believe the doctor in the movie was out of line in his suggestion to the parents to create the second child.

I always thought this was common sense, but apparently there are some people who would do such a thing (some other people I've talked to the movie about).

EDIT: Just wanted to add that the movie was not based on a true story, but the events that occured in it are still capable of happening.

 

[Lange]

Hello,

Is this movie based on real-life events?

- Peace Love and Chicken Grease​

 

[K9_Trainer]

No, its all hypothetical

 

[Mling]

I don't know the movie, but I know this has happened, and was the subject of a fair bit of ethical debate in the medical community maybe....5 to 10 years ago? Not sure on the time frame.

One the one hand, the idea sounds....appalling to me. I'm squarely in the camp that says children should never be a means to an end. You don't have a child in order to serve a goal. You have a child because you want and can care for a child. There should not be an ulterior motive. And you should certainly never have one child for the specific purpose of "serving" the other--not as a domestic servant, not as a "whipping boy" and not as a source of medicine.

On the other, if the child was already alive when the older sibling got sick, and the parents wanted to do blood transfusions from her, would I be offended? I'd hope that they would talk over the situation with the kid, but it wouldn't be as bad, I think.

In general, I think kids should have a say in their medical lives as soon as they're mature enough to articulate meaningful, well thought out opinion on the subject. I'd expect that age to come around 16 or so, but in this case, I can see why it would come sooner, and I would fully support the right of a child in this position to be a person, and not a bucket of blood and marrow. I doubt their parents actually see them that way, but there's no question in my mind that that's how they're treating them, and that that's how the kid would answer the question, "How do your parents think of you?"

That said, I would hope that a 'medically emancipated' child would make the choice to continue helping their sibling. Having it be of their own free will should make some difference, and I'd hate to see that child's life being sacrificed, either.

 

[K9_Trainer]

Oh so it HAS actually happened? Thats....Sick

But yes, I can totally understand it if the matching child is already in existence, as long as its the child's will to donate. The child shouldn't be forced though. Is there anything in existence that protects the child's right to refuse to donate though? Most of the time the parents are in charge of the child's medical needs/health because a child cannot be trusted to make wise decisions. A necessary surgery is much different than having a kidney taken out for a sibling.

 

[Lange]

Hey all,

I think that this is completely unethical. It's absolutely despicable. The only way I could possibly see it as being okay is if the child was born brain-dead and incapable of conscious thought.

- Rolling​

 

[Mling]

Oh so it HAS actually happened? Thats....Sick

But yes, I can totally understand it if the matching child is already in existence, as long as its the child's will to donate. The child shouldn't be forced though. Is there anything in existence that protects the child's right to refuse to donate though? Most of the time the parents are in charge of the child's medical needs/health because a child cannot be trusted to make wise decisions. A necessary surgery is much different than having a kidney taken out for a sibling.

*nods to the first one* I remember reading about it, many years ago. My mother worked in a pediatric nursing home at the time. They didn't have any cases of this happening where she worked, but when it came to light that people were doing it *anywhere,* they started discussing it.

Some places do have regulations regarding emotionally mature children. One issue I remember my mom's hospital *did* deal with was a 14 year old with sickle-cell anemia (very painful, treated with blood transfusions), whose parents were Jehovah's Witnesses (don't believe in blood transfusions). She didn't believe her parents religion, though, and was able to articulate that well, and explained that she intended to leave the church as soon as she was old enough to.

I *think,* in response to that case, they developed a procedure that allowed children to override their parents wishes, in similar cases. So I don't know how common it is, but I know it can be done. Probably depends on the state and the hospital, though.

Hey all,

I think that this is completely unethical. It's absolutely despicable. The only way I could possibly see it as being okay is if the child was born brain-dead and incapable of conscious thought.

- Rolling​

I get where you're going with that but....that makes it worse in my mind.

 

[K9_Trainer]

Some places do have regulations regarding emotionally mature children. One issue I remember my mom's hospital *did* deal with was a 14 year old with sickle-cell anemia (very painful, treated with blood transfusions), whose parents were Jehovah's Witnesses (don't believe in blood transfusions). She didn't believe her parents religion, though, and was able to articulate that well, and explained that she intended to leave the church as soon as she was old enough to.

Thats interesting. Leads me to think of many other moral dilemmas when it comes to children and medicine. Like, had that child agreed with her parents religion and they'd refused blood transfusions, would she have died? I typically don't like the idea of the government having control over things such as the health of an individual, but situations like that make me wonder sometimes. The dilemma is purely religiously based. Should the government be morally obligated to step in when a child and the child's parents are both refusing treatment because of religion and the child could die as a result?

 

[RealityPixie]

Bringing a child into the world to act as spare parts is an outrage, no matter how sick the sibling is. Children are people, and have emotional as well as physical needs, and constantly donating and the knowlege of the reason for their existance would take a huge toll on such a child.

Whne it comes down to censent though, this is a tricky one. I think it should be reviewed on a case by case basis so the the maturity of the child can be evaluated. They should definantly not be forced to undergo procedures they don't want to do, or to reject procedure they want just beuas eof the will of the parents.

 

[Robbie_James_Francis]

I'm going to have to play devil's advocate here...I'd say if the parents explicitly didn't want another child anyway, it would be wrong to have one just for the transplant. But if they did want a child or were ambivalent and this was one of the motivating causes for having that child, then it's not the case that they are simply using (or rather abusing) the child.

In fact, in a world of suffering, I think this is one of the few occasions (assuming the parents already wanted a child and would love her and care for her properly) when reproducing is acceptable. I still cannot understand why people can happily bring hungry mouths into a world full of starvation. When the orphanages are empty, then we can have kids. Until that day, it's morally wrong to do so IMO.

I also think that medical consent should be considered case-by-case. But, realistically, an 11 yr old should never be given full medical emancipation. Of course, if the parents are medically abusive (and I would certainly include the sickening human beings who object to blood transfusions on religious grounds), then the child should no longer be subject to their medical choices. But that child does not then become the sole agent of her medical choices, she ought to become the responsibility of the State.

 

[Cognitive]

Bringing a child into the world to act as spare parts is an outrage, no matter how sick the sibling is. Children are people, and have emotional as well as physical needs, and constantly donating and the knowlege of the reason for their existance would take a huge toll on such a child.

Whne it comes down to censent though, this is a tricky one. I think it should be reviewed on a case by case basis so the the maturity of the child can be evaluated. They should definantly not be forced to undergo procedures they don't want to do, or to reject procedure they want just beuas eof the will of the parents.

I tend to feel this is the best answer.

 

[lawtonfogle]

Thats interesting. Leads me to think of many other moral dilemmas when it comes to children and medicine. Like, had that child agreed with her parents religion and they'd refused blood transfusions, would she have died? I typically don't like the idea of the government having control over things such as the health of an individual, but situations like that make me wonder sometimes. The dilemma is purely religiously based. Should the government be morally obligated to step in when a child and the child's parents are both refusing treatment because of religion and the child could die as a result?

The issue is not the government having control over our medical lives, but that in the end, each individual has their own control. But of course, our very law says this is not always true (and who disagrees, a new born cannot make any medical decisions), so the government (should) act on behalf of the child. Normally by leaving the decisions with the parents, except when the parents are not acting in the child's best interest. The problem arises when parents mistake this for some 'right to their child', but truth be told, a parent has as much right to make medical decisions against the well being of the child as they have the right to sell the child into slavery, NONE.

 

[Blackmarch]

For those who haven't seen the movie, it presents a rather interesting moral dilemma.

To summarize, a couple has a child with Leukemia. Treatments for this often deadly disease require blood/organ/bone marrow transplants and in order for the transplant to be successful, the donation must come from a perfect match. Thats often the difficult part, finding a donor that is willing and matches in time.

The parents decide to have another child, a designer baby genetically engineered to be that perfect match, to essentially be a "spare parts" child. They consciously brought the child into existence so they could use her blood and organs for her sister. She was forced to donate blood and bone marrow and was unnecessarily exposed to hospitals, needles and risks of infection since a young age.

EDIT: Just wanted to add that the movie was not based on a true story, but the events that occured in it are still capable of happening.

No it's not ethical. It creates an underclass of person that is exploited. IF the child consented their own will tho, then I don't see a problem (barring age sensibility debates).

And is also good reason to find out how to grow organs individually.

 

[Phylogeny]

I think posters here do not understand the complex emotions that comes into play to bring a child into this world as a 'spare part'. From what I gather, most of these parents DO NOT treat this late in life child as merely medicine for an older child.

I remember one interview where the mom gave birth to provide cord blood (which contained stem cells) to an older sibling who didn't have a match. She told her youngest child she was brought into this world b/c her sister needed her cord blood to live, and that she is a beloved member of the family for having brought this gift to her sister.

I don't recall a single case where parents openly abused the situation such as those that people state.

Look at it this way, people bring a child into the world for all kinds of reason. Most don't even have an articulate reason except that it is the 'thing' to do at that point in life. Plenty of parents bring a second child into this world because they want the older one to have a sibling. Heck, I've heard of parents who do this so the child can take care of a disabled sibling when the parents get old. How is that different than bringing a child into this world so they can harvest cord cells (which is in the umbilical cord I think) or do make ONE bone marrow donation (only once is needed usually). Neither procedure is risky and only needed once.

It is only when the second child's welfare or health is disregarded that it becomes unacceptable. Having a young child donate blood or bone marrow once or twice is acceptable b/c the dangers are nil but the potential for life saving is huge.

Having a young child donate an organ is NOT ALLOWED in most hospitals. Any procedure that endangers the healthy child should NEVER be allowed until the child is at least in their teens and can give proper consent. So my take is that no child's donation should be risky or bring possible harm to the child, nor should it disrupt the child unduly. The book "Sister's Keeper" is unrealistic in that it talks about the child feeling pressured to donate their kidney. In actuality, I've known of no hospitals that would allow such a child to do so. Even older children would be hard pressed to find a doctor to perform such a procedure on them. Many states won't even consider organ donation before the age of 18.

 

[wanderingone]

I don't think it ethical to assume any family member has a physical obligation to provide "spare" parts for another family member, regardless of their choosing to have an additional child or if a family member happens to be a "match" as a living donor. Any time a procedure is at all invasive I think the subject expected to "donate" needs to have a degree of control over the decision.

However, I think as phylogeny presents that in the cases where families have had children in hopes of having a match for transfusion there has not been any evidence that the children born were abused or treated badly in any way. This issue has been fodder for lifetime moves for a couple decades already.