My Sister's Keeper - Jodi Picoult (2004)

Do children have the legal right to determine their own destiny without parental consent? Jodi Picoult embraces this controversial question with boldness and grace as her novel examines the ethical and moral consequences that arise from genetic engineering, an unnatural process of genetic modification for creating babies.  Anna Fitzgerald, the most conflicting character, defines herself as a “designer baby”, conceived merely in order to provide a perfect donor match for her sister, Kate, to undergo a bone marrow transplant.  The ambiguous boundary between what is morally right and wrong is fiercely debated by each family member’s struggle with the tragedy of having to deal with Kate’s Acute Promyelocytic leukemia, a rare form of cancer.

In keeping with the pattern of the vast majority of Picoult’s works (The Pact, Perfect Match) a substantial portion of the novel is written from a single viewpoint, in this instance Sara Fitzgerald, the former attorney and present stay-at-home Mother. The first person narrative enables the reader to have an increased emotional appreciation of her obsessed focus on keeping Kate alive. However, the authoress’s extended use of flashbacks depicts varied viewpoints of each family member, which adds further dimensions to the novel.  Although the present day events, surrounding the trial for Anna’s medical emancipation from her parents, take place within two weeks, the flashbacks reveal the most pivotal moments of the last thirteen years, showing the deterioration of Kate’s health and its subsequent affects on family dynamics. The use of a legal dispute is another one of Picoult’s commonly used themes. Unfortunately, the pace of the novel is dramatically slowed by the implementation of the court scenes, which are necessary but dull at times. Nonetheless, Picoult’s unconventional writing style is a refreshing change because it adds a realistic tone to the novel.  This reality is enhanced by the knowledge that the authoress’ own child suffered from a tumour as a young boy and that she no doubt drew upon the emotions she felt during this period.  Consequently, her pain is reflected in the extreme actions that Sara takes.

Central to the novel is the debate between science and humanity; the perception of what is right and what is wrong, both morally and legally. I found it difficult to be entirely sympathetic towards Sara because I struggle to comprehend the situation in which she finds herself. It is conceivable to argue that without experiencing the bond between a Mother and her daughter from the converse viewpoint, it is unfathomable to appreciate why she places Anna’s quality of life at stake for the sake of Kate’s survival. Her lack of empathy towards the struggles of her youngest daughter for undergoing painful procedures and blood transfusions is harrowing. Picoult explores the respective rights of Anna’s appeal for medical emancipation in order to have control over her own body and the counter-arguments of Sara. The argument is made more complex by the fact that Anna is still a minor and that Kate has secretly asked her sister to claim emancipation to help end her suffering, as she is tired of waiting for her inevitable death. Picoult successfully attempts to discuss the rights of the terminally ill through the medium of the court case and the use of medical witnesses. This is best surmised by Judge DeSalvo’s following speech: ‘The answer is that there is no good answer. So as parents, as doctors, as judges, and as a society, we fumble through and make decisions that allow us to sleep at night—because morals are more important than ethics, and love is more important than law’. The court case further highlights the question of whether keeping Kate alive justifies the pain that Anna subsequently suffers.

The novel’s conclusion offers an unexpected twist that entitles the reader to feel almost betrayed. There is an upsetting irony that having won the lawsuit and thus been granted the medical emancipation she sought, Anna dies in a car crash before she is able to fulfil her sister’s wish. Ironically, Anna’s kidney is then given to Kate who begins to regain her health.   Although the majority of the novel’s conflict surrounds Kate’s terminal illness, she remains silent in the background until her prominent first-person narration of the epilogue, which is set six years in the future.  Overall, Picoult convincingly illustrates the delicate nature of human life whilst demonstrating the lack of control we have over our fates. 

Brittany Ray