Cover of My Sister’s Keeper
    LiteraryLiterary FictionRelationshipYoung Adult

    My Sister’s Keeper

    by Picoult, Jodie
    “My Sister’s Keeper” by Jodie Picoult follows 13-year-old Anna Fitzgerald, who was conceived as a genetic match to donate organs and blood to her older sister Kate, who suffers from leukemia. When Anna is asked to donate a kidney, she sues her parents for medical emancipation, challenging the ethical boundaries of family obligation and bodily autonomy. The novel explores themes of sacrifice, moral dilemmas, and the complexities of love through multiple perspectives. Picoult’s narrative delves into the emotional and legal turmoil faced by the Fitzgerald family, raising profound questions about medical ethics and personal choice. The story is inspired by the real-life case of Anissa and Marissa Ayala.

    The chap­ter depicts a tense court­room scene where attor­ney Mr. Alexan­der cross-exam­ines Dr. Chance about the med­ical treat­ments involv­ing Anna Fitzger­ald, who was con­ceived as a genet­ic match to donate to her can­cer-strick­en sis­ter Kate. Dr. Chance, vis­i­bly impa­tient to return to his patients, defends the pro­ce­dures as med­ical­ly nec­es­sary, empha­siz­ing that Kate’s sur­vival to age six­teen is remark­able. The attor­ney high­lights the eth­i­cal dilem­ma of Anna being used as a life­long donor, ques­tion­ing whether the Fitzger­alds were ful­ly informed about the risks and long-term impli­ca­tions of these dona­tions.

    Mr. Alexan­der chal­lenges Dr. Chance’s asser­tion that Anna has suf­fered no sig­nif­i­cant harm, pre­sent­ing a con­sent form out­lin­ing seri­ous anes­the­sia risks. The doc­tor down­plays these risks as rare, but the attor­ney coun­ters by point­ing out Anna’s repeat­ed expo­sure to dan­ger­ous pro­ce­dures. The cross-exam­i­na­tion reveals gaps in the doc­tor’s mem­o­ry about Anna’s pain and recov­ery, sug­gest­ing a dis­re­gard for her expe­ri­ences. The ten­sion esca­lates as Mr. Alexan­der implies Anna’s auton­o­my has been over­looked in the pur­suit of sav­ing Kate.

    The dis­cus­sion shifts to the exper­i­men­tal nature of some treat­ments, par­tic­u­lar­ly growth fac­tor shots, which Dr. Chance admits have only been test­ed on ani­mals. Mr. Alexan­der draws par­al­lels to his­tor­i­cal med­ical dis­as­ters like thalido­mide, cast­ing doubt on the safe­ty of these pro­ce­dures. The attor­ney then focus­es on the pro­posed kid­ney dona­tion, ques­tion­ing its impact on Anna’s future health and activ­i­ties. Dr. Chance ini­tial­ly claims min­i­mal effects but is forced to acknowl­edge doc­u­ment­ed risks like hyper­ten­sion and preg­nan­cy com­pli­ca­tions when pre­sent­ed with evi­dence.

    In the final exchange, Mr. Alexan­der under­scores the hypocrisy of Dr. Chance’s position—claiming Anna faces no long-term harm while admit­ting the lack of human stud­ies on some treat­ments. The chap­ter ends with the attor­ney high­light­ing Anna’s pas­sion for hock­ey, a sport she may have to aban­don if she donates a kid­ney. This con­fronta­tion expos­es the moral com­plex­i­ties of using one child’s body to save anoth­er, leav­ing the read­er to pon­der the true cost of Kate’s sur­vival.

    FAQs

    • 1. What is the main ethical dilemma presented in this courtroom scene regarding Anna’s medical donations to Kate?

      Answer:
      The ethical dilemma centers on whether Anna’s repeated medical donations (bone marrow, stem cells, and a potential kidney) for her sister Kate constitute justified medical treatment or exploitation. While Dr. Chance argues the procedures were medically necessary and low-risk, the attorney highlights the lack of long-term research on effects (e.g., growth factor shots), the anesthesia risks, and lifestyle limitations (e.g., Anna’s hockey participation conflicting with kidney donation guidelines). The chapter questions whether consent—given by Sara Fitzgerald, not Anna—truly considers Anna’s autonomy and well-being, especially since she was conceived as a donor match.

      2. How does Dr. Chance justify the ongoing medical procedures involving Anna, and what counterarguments does the attorney present?

      Answer:
      Dr. Chance defends the procedures by emphasizing Kate’s survival against odds, Anna’s role as a “perfect match,” and the absence of “significant long-term harm” to Anna. He frames consent forms as protective and downplays risks (e.g., calling marrow donation “simple”). The attorney counters by citing anesthesia consent forms listing life-threatening risks, the theoretical nature of growth factor research, and documented post-donation health restrictions (e.g., hypertension, pregnancy complications). He also implies moral hypocrisy by comparing extreme hypotheticals (e.g., “cutting off Anna’s head”) to the cumulative burden of her donations.

      3. Analyze the power dynamics in this scene. How do the characters’ motivations (Dr. Chance, Sara, the attorney) reflect their roles?

      Answer:
      Dr. Chance represents medical authority, prioritizing Kate’s survival and institutional protocols (e.g., consent forms) while dismissing broader ethical concerns. Sara’s urgency to expedite testimony underscores her focus on Kate’s immediate needs, sidelining Anna’s perspective. The attorney, acting as Anna’s advocate, weaponizes medical jargon and consent documents to expose systemic flaws—highlighting how Sara’s decisions and Dr. Chance’s recommendations may overlook Anna’s rights. The judge’s silence hints at judicial scrutiny of these dynamics. Power shifts as the attorney forces Dr. Chance to confront contradictions (e.g., downplaying risks while admitting lack of human studies).

      4. What literary devices or rhetorical strategies does the attorney use to challenge Dr. Chance’s testimony?

      Answer:
      The attorney employs:

      • Sarcasm (“How comforting”) to mock Dr. Chance’s reliance on theoretical safety.
      • Hypothetical extremes (e.g., “cutting off Anna’s head”) to reductio ad absurdum the ethics of incremental donations.
      • Documentary evidence (consent forms, hospital flyers) to contradict Dr. Chance’s assurances.
      • Pacing (deliberate pauses, slow questioning) to mirror the tension and force reflection.
      • Historical allusion (thalidomide) to warn of unforeseen consequences. These strategies undermine Dr. Chance’s credibility and reframe Anna’s donations as systemic exploitation.

      5. How does the chapter’s opening paragraph set the tone for the courtroom confrontation?

      Answer:
      The narrator’s disdain for doctors resentful of subpoenas establishes a combative tone, foreshadowing the attorney’s adversarial stance. By describing his deliberate delays (“retie my shoe,” “pregnant pauses”), he mirrors the power struggle in the testimony—where time wasted symbolizes resistance to medical authority. This framing primes readers to view Dr. Chance’s impatience as paternalistic, contrasting with the attorney’s calculated scrutiny of medical ethics. The heat metaphor (“Anna’s body throws heat”) further intensifies the emotional stakes.

    Quotes

    • 1. “DOCTORS HAVE THIS THING about being subpoenaed: they let you know, with every syllable of every word, that no moment of this testimony will make up for the fact that while they were sitting on the witness stand under duress, patients were waiting, people were dying.”

      This opening quote sets the tone for the adversarial dynamic between medical professionals and legal proceedings, highlighting the tension between clinical urgency and judicial process. It introduces the theme of conflicting priorities that runs through the chapter.

      2. “Nothing in cancer is a sure thing, Mr. Alexander.”

      Dr. Chance’s blunt admission underscores the fundamental uncertainty in medical treatment, particularly in oncology. This quote becomes a pivotal point in the cross-examination, challenging assumptions about guaranteed outcomes in Anna’s donations to Kate.

      3. “We were talking about a single cord blood treatment at the time… Subsequent donations came about because Kate didn’t respond to the first one. And because they offered more promising results.”

      This revelation exposes the slippery slope of medical interventions, showing how initial limited procedures expanded into ongoing demands on Anna’s body. It raises ethical questions about consent and the boundaries of medical treatment.

      4. “Increased chance of hypertension. Possible complications during pregnancy. Donors are advised to refrain from contact sports to eliminate the risk of harming their remaining kidney.”

      The highlighted medical flyer contradicts Dr. Chance’s earlier minimization of risks, revealing the significant lifelong impacts kidney donation could have on Anna. This evidentiary moment dramatically shifts the power dynamic in the courtroom.

      5. “Physicians don’t tend to prescribe drugs that have the potential to wreak havoc… Have you ever heard of thalidomide, Doctor?”

      This exchange encapsulates the chapter’s central conflict about medical ethics and risk assessment. The reference to thalidomide serves as a powerful historical reminder of medical overconfidence and its consequences.

    Quotes

    1. “DOCTORS HAVE THIS THING about being subpoenaed: they let you know, with every syllable of every word, that no moment of this testimony will make up for the fact that while they were sitting on the witness stand under duress, patients were waiting, people were dying.”

    This opening quote sets the tone for the adversarial dynamic between medical professionals and legal proceedings, highlighting the tension between clinical urgency and judicial process. It introduces the theme of conflicting priorities that runs through the chapter.

    2. “Nothing in cancer is a sure thing, Mr. Alexander.”

    Dr. Chance’s blunt admission underscores the fundamental uncertainty in medical treatment, particularly in oncology. This quote becomes a pivotal point in the cross-examination, challenging assumptions about guaranteed outcomes in Anna’s donations to Kate.

    3. “We were talking about a single cord blood treatment at the time… Subsequent donations came about because Kate didn’t respond to the first one. And because they offered more promising results.”

    This revelation exposes the slippery slope of medical interventions, showing how initial limited procedures expanded into ongoing demands on Anna’s body. It raises ethical questions about consent and the boundaries of medical treatment.

    4. “Increased chance of hypertension. Possible complications during pregnancy. Donors are advised to refrain from contact sports to eliminate the risk of harming their remaining kidney.”

    The highlighted medical flyer contradicts Dr. Chance’s earlier minimization of risks, revealing the significant lifelong impacts kidney donation could have on Anna. This evidentiary moment dramatically shifts the power dynamic in the courtroom.

    5. “Physicians don’t tend to prescribe drugs that have the potential to wreak havoc… Have you ever heard of thalidomide, Doctor?”

    This exchange encapsulates the chapter’s central conflict about medical ethics and risk assessment. The reference to thalidomide serves as a powerful historical reminder of medical overconfidence and its consequences.

    FAQs

    1. What is the main ethical dilemma presented in this courtroom scene regarding Anna’s medical donations to Kate?

    Answer:
    The ethical dilemma centers on whether Anna’s repeated medical donations (bone marrow, stem cells, and a potential kidney) for her sister Kate constitute justified medical treatment or exploitation. While Dr. Chance argues the procedures were medically necessary and low-risk, the attorney highlights the lack of long-term research on effects (e.g., growth factor shots), the anesthesia risks, and lifestyle limitations (e.g., Anna’s hockey participation conflicting with kidney donation guidelines). The chapter questions whether consent—given by Sara Fitzgerald, not Anna—truly considers Anna’s autonomy and well-being, especially since she was conceived as a donor match.

    2. How does Dr. Chance justify the ongoing medical procedures involving Anna, and what counterarguments does the attorney present?

    Answer:
    Dr. Chance defends the procedures by emphasizing Kate’s survival against odds, Anna’s role as a “perfect match,” and the absence of “significant long-term harm” to Anna. He frames consent forms as protective and downplays risks (e.g., calling marrow donation “simple”). The attorney counters by citing anesthesia consent forms listing life-threatening risks, the theoretical nature of growth factor research, and documented post-donation health restrictions (e.g., hypertension, pregnancy complications). He also implies moral hypocrisy by comparing extreme hypotheticals (e.g., “cutting off Anna’s head”) to the cumulative burden of her donations.

    3. Analyze the power dynamics in this scene. How do the characters’ motivations (Dr. Chance, Sara, the attorney) reflect their roles?

    Answer:
    Dr. Chance represents medical authority, prioritizing Kate’s survival and institutional protocols (e.g., consent forms) while dismissing broader ethical concerns. Sara’s urgency to expedite testimony underscores her focus on Kate’s immediate needs, sidelining Anna’s perspective. The attorney, acting as Anna’s advocate, weaponizes medical jargon and consent documents to expose systemic flaws—highlighting how Sara’s decisions and Dr. Chance’s recommendations may overlook Anna’s rights. The judge’s silence hints at judicial scrutiny of these dynamics. Power shifts as the attorney forces Dr. Chance to confront contradictions (e.g., downplaying risks while admitting lack of human studies).

    4. What literary devices or rhetorical strategies does the attorney use to challenge Dr. Chance’s testimony?

    Answer:
    The attorney employs:

    • Sarcasm (“How comforting”) to mock Dr. Chance’s reliance on theoretical safety.
    • Hypothetical extremes (e.g., “cutting off Anna’s head”) to reductio ad absurdum the ethics of incremental donations.
    • Documentary evidence (consent forms, hospital flyers) to contradict Dr. Chance’s assurances.
    • Pacing (deliberate pauses, slow questioning) to mirror the tension and force reflection.
    • Historical allusion (thalidomide) to warn of unforeseen consequences. These strategies undermine Dr. Chance’s credibility and reframe Anna’s donations as systemic exploitation.

    5. How does the chapter’s opening paragraph set the tone for the courtroom confrontation?

    Answer:
    The narrator’s disdain for doctors resentful of subpoenas establishes a combative tone, foreshadowing the attorney’s adversarial stance. By describing his deliberate delays (“retie my shoe,” “pregnant pauses”), he mirrors the power struggle in the testimony—where time wasted symbolizes resistance to medical authority. This framing primes readers to view Dr. Chance’s impatience as paternalistic, contrasting with the attorney’s calculated scrutiny of medical ethics. The heat metaphor (“Anna’s body throws heat”) further intensifies the emotional stakes.

    Note