DRAFT: Interpersonal Communication Ethics in My Sister’s Keeper

Interpersonal Communication Ethics in My Sister’s Keeper

Stacy Cacciatore

Queens University

Introduction

My Sister’s Keeper (Cassavetes, 2009)is a motion picture that originated from a novel by Jodi Picoult. This movie has a complex web of ethical dilemmas that each of the characters face. My paper will focus on the interpersonal communication ethics between the two sisters.The narrative of My Sister’s Keeper is centered on two sisters, whose relationship is defined by illness. Kate is diagnosed with leukemia at the age of two. Her only hope for survival is a bone marrow transplant, but neither her parents nor her older brother, Jesse, are a match. At the recommendation of their oncologist, Kate’s parents conceive a genetically engineered child, Anna, for the sole purpose of helping keep Kate alive. Over the years Anna experiences almost as many medical procedures as her sick sister, donating parts of herself piece-by-piece to save Kate. At the age of 13, when her mother asks her to donate a kidney, she hires a lawyer to file for medical emancipation to prevent her from being forced to go through with this procedure. The twist, which the viewer isn’t privy to until the end, is that Kate asks Anna to file for medical emancipation, not donate her kidney, and allow her die. I will evaluate the interpersonal communication ethics, specifically interpersonal responsibility, demand, and dialogic ethic, in three scenes in My Sister’s Keeperand analyze how the relationship between the two sisters is influenced by the context of a chronic illness.

Literature Review

Several themes emerge through the evaluation of research conducted on contextual communications ethics. The contextual communication approach “justifies different communication standards for various audiences, cultures and relationships” (Arnett, Harden Fritz & Bell, 2009, p. 51). I will evaluate four of these common themes. The first theme that emerged is the correlation between culture and contextual communications. Hall (2013) found that culture plays a key role in communication ethics. Sarah Streed (1997), a professor at a Moroccan university, experienced an ethical dilemma concerning providing a student with a passing grade in a course, when he didn’t earn it (as cited in Hall, 2013). In Morocco, where the course was taught, it was a common practice to pass a student of high stature, regardless of their academic performance, due to their position of power. This wouldn’t have been an ethical dilemma in the United States, as the primary ethical concern in the U.S. culture is fairness among students. Streed found herself positioned against two goods. The ultimate “good” was being respectful of all of her students. On one hand, she could uphold this good by treating them all equally, but on the other hand she could uphold this good by respecting the cultural traditions of the country. Hall (2013) found that the importance in this case was not determining what was right or wrong, but instead valuing the good. In this case the good was being respectful of all students. Hall (2013) found that the application of the Golden Rule, treat others as you would like to be treated, is a good standard for communication ethics across the cultures because many religious traditions indicate it’s an excellent place to start with morality. By moving to a higher level of abstraction, the Golden Rule allows one to act ethically regardless of the culture involved.

The second theme uncovered is the role that gender plays in contextual communications ethics. Schleien, Ross and Ross (2010) evaluated apologies between siblings and the level of interpersonal responsibility felt among the parties. They found that girls were far more likely to apologize to their sibling than boys. Children were also more likely to apologize for rights violations on their own than at their parents demand. This demonstrates that children are able to make sense of their own and others rights (Schleien et al., 2010).

The third theme that emerged was the importance of open communication with those suffering from cancer. Clayton, Dudley and Musters (2008) found that communication is one of the most important variables in the patient-provider relationship. A patient-centered style of communications, which is the degree to which providers respond to patient concerns, is associated with the patient’s uncertainty, mood and perception of communication (Clayton et al., 2008). The communication between the health care provider and the breast cancer patient predicts the patient’s satisfaction and symptoms, especially relating to their fatigue symptoms. Originally the responsibility of the communication was seen to be with the provider, but it’s now seen as both the provider and patient’s responsibility. Contrary to what the researchers expected, their findings showed that the discussion about symptoms was the most influential in predicting patient’s mood and perception of communication (Clayton et al., 2008).

The fourth theme is the correlation of context with communication ethics in organizations. Grunig and White (1992) point out that the ethics of an organization’s communication practices may be judged based on their relationships. However, since the quality of the relationship depends on two parties, Roloff (2012) asks, “Should the evaluation of ethics depend on the cooperation of the second party?” (as cited in Grunig and White, 1992, p. 218). This study evaluates the relationship between two individuals and their interpersonal responsibility to each other.

Whether the context is ones’ culture, illness, gender or relationship, context plays a role in communication ethics. The gaps that I’ve uncovered include a lack of research in demonstrating how contextual communication ethics plays a role between two sisters when one is suffering from a life threatening illness. While Clayton et al. (2008) explore the importance of open-honest dialogue between a breast cancer patient and the care practitioner; this study does not evaluate the importance of communication between the patient and a family member. Hall (2013) found that the application of the Golden Rule, treat others as you would like to be treated, is a good standard for communication ethics across the cultures. However, this study did not look the application of the Golden Rule in a family setting. Schleien et al. (2010) evaluate gender as a factor in contextual communication ethics, and note that an older sister is more inclined to accept the interpersonal responsibility for issuing an apology (Schleien et al., 2010). However, this study did not explore how both illness and gender would play a role in contextual communications. Grunig and White (1992) thoroughly evaluate how relationships among colleagues in an organization affect interpersonal communication ethics; however, this research doesn’t evaluate the relationships among sisters.

I address these gaps through my research in this paper. My research evaluates the contextual communication ethics influence in a sister-to-sister relationship when one sister is diagnosed with a terminal illness. I evaluate each of these studies as it pertains to contextual communications and apply their role to interpersonal communication ethics.

Methodology

I chose to evaluate My Sister’s Keeper (Cassavetes, 2009)because many ethical issues are raised in this movie. This paper concentrates on the interpersonal communication ethics between the two sisters. Interpersonal communication ethics varies from other forms of communication ethics because the relationship is the primary concern (Arnett et al., 2009). Interpersonal communication ethics guides the connection when the relationship is first and foremost with no political agenda (Arnett et al., 2009). There is no better example of this type of connection than between two sisters.

An interpersonal relationship is shaped by doing what is necessary, not what feels “right” or “good”. In communication ethics the “good” is what is the most important, valued and highest regarded (Arnett et al., 2009). The “good” of the relationship, not what you or the “Other” desires, it’s what is called for in interpersonal communication ethics. While this “good” can change over time, the importance resides in the fact that one is acting on behalf of the relationship, not the individual. Interpersonal communication ethics rest not in our hopes or wishes, or those of another, but in something that we invite and can never create alone, a relationship that calls us to responsibility,” (Arnett et al., 2009, p. 126). I will evaluate interpersonal responsibility, demand, and dialogic ethcs within interpersonal communication ethics in My Sister’s Keeper (Cassavetes, 2009).

Interpersonal responsibility is not about doing what’s right” or “wrong”. Interpersonal responsibility calls for one to recognize that it’s not about doing what is best for them or what is best for the other person, it’s about acting on behalf of the good in the relationship (Arnett et al., 2009). Did Anna value the relationship with her sister, Kate, more than doing what is “right”? Did Anna value what the “Other” wanted more than the relationship?

Interpersonal communication ethics dictates that one cannot demand a particular type of relationship upon someone. Arnett et al. say that “Relationship development in interpersonal communication requires attentive care without the specter of demand,” (Arnett et al., 2009, p. 128). Relationships change over time and we can invite adjustments, but we can’t force or demand change. Demand can damage the fragility of a relationship. While constant demand can damage a relationship, lack of demand from a lack of desire for the relationship can also cause strain in a relationship.

Dialogic ethic is the way a conversation between two individuals plays an ethical role in their relationship (Arnett et al., 2009). In dialogic ethics listening, attentiveness and negotiation play roles. One must listen without demand and pay attention to what is transpiring in the moment. One must also provide attentiveness to the relationship by acknowledging the ground of self and “Other” and historical moment. Dialogic ethic also calls for negotiation and learning from the “Other”. One should listen to the “ground” of the “Other” and connect what “I” want with what the “Other” wants to find the “we” common ground for the relationship (Arnett et al., 2009, p.133). I analyze My Sister’s Keeper (Cassavetes, 2009)using interpersonal communication ethics and the concepts of demand, interpersonal responsibility, demand, and dialogic ethic.

Data

I explore the following scenes from My Sister’s Keeper (Cassavetes, 2009)in detail:

Scene one(Cassavetes, 2009)

This scene starts with a demonstration of Anna taking care of her sister Kate, as she lays in bed, unable to control her bodily functions due to the medication she’s on in preparation to receive the kidney transplant. Anna rushes in to clean her sister up and asks if Kate is in pain. Kate says, “My whole life is a pain. This is the end, sissy. It just gets scarier from here on out. Mom’s going to chop me and cut me, till I’m a vegetable” (Cassavetes, 2009). Kate is referring to the fact that her mother is continuing to fight for Kate’s life, even though it seems that none of the treatments are working. Not only has her cancer returned, but she’s now in kidney failure. Kate then says, “I need you to do me a favor, sissy. You can release me” (Cassavetes, 2009). We see the visible pain in Anna’s reaction. We understand that she does not want her sister to die, and she wants to donate her kidney. Kate reassures Anna that she is ready to be released and die. This is the climax of the movie, as this scene depicts the moment we find out that the reason Anna is filing for medical emancipation is because her sister asked her to do this for her. The scene then moves to Kate and Anna lying on a blanket in the warm sun and while Kate braids Anna’s hair. Kate tells Anna that she should file for medical emancipation so that she won’t have to donate a kidney. Kate says, “Tell them you want to play soccer. Tell them you want to cheerlead.” Anna says, “They’ll never believe me”. “Yeah, they will. And you wanna know why? Because it’s true,” says Kate. Anna then sits up straight and looks at Kate and asks, “Will you wait for me?” (Cassavetes, 2009) referring to the afterlife.

Scene two(Cassavetes, 2009)

During this scene of the movie, which is referred to as, “Feels Like Home”, Kate is allowed her dying wish, which is to visit the ocean. This is the one moment in which all of the characters seem the happiest. They are simply living in the moment, enjoying the view of the crashing waves, spending time with each other and releasing all expectations and demands. The mother kisses the father passionately, Anna and her brother Jesse frolic in the sand and Kate gives her father a kiss on the nose. Kate smiles broadly and her eyes glisten with tears as she watches the sunset. She is wearing a quilted blanket over her shoulders, demonstrating that she is still sick, and she walks in the ocean with the blanket on and a smile on her face.

Scene three (Cassavetes, 2009)

As Kate is dying she confesses to Anna, “I’m sorry I let them hurt you… I was supposed to protect you.”

I outline how these scenes tie into my analysis using the contextual communication ethics and interpersonal communication ethics approaches.

Analysis: Applying Method to Data

In My Sister’s Keeper (Cassavetes, 2009), Anna works to honor her relationship to her sister no matter what the consequences. In this movie, the consequences were literally life or death. Anna faces an ethical-decision making quandary and needs to explore the following questions; should she do what she thinks is “right” and donate her kidney? Should she do what her sister wants and file for medical emancipation? What is the best solution to foster the relationship? Does she do what’s “right” for the relationship?

In order to answer these questions this paper builds upon established research on ethics in contextual communications ethics. I analyze My Sister’s Keeper (Cassavetes, 2009)using the interpersonal communication ethics approach. In this section I evaluate the research and apply what I’ve learned in my literature review, using the methodology outlined to analyze the scenes from My Sister’s Keeper. I evaluate if this ethical issue is resolved today and propose an alternative resolution to this ethical dilemma.

We can apply the contextual communication ethics explored by Hall (2013), as he found that the application of the Golden Rule, which is treat others as you would like to be treated, is a good standard for communication ethics and is an excellent place to start with morality. While Hall (2013) applied this to various cultures, I extend this application to the context of the relationship with one with a terminal illness. As Kate suffered from a life-long battle with leukemia, she wanted her own wishes to be respected. The Golden Rule could be applied as Anna could treat Kate as she wanted to be treated and give her a voice.

In a relationship, one should understand the responsibility to one another. This can be explored through interpersonal communications. Arnett et al. (2009) said that interpersonal relationship calls for us to do what is necessary, not what we want for ourselves or the “Other”. This responsibility plays out perfectly in My Sister’s Keeper (Cassavetes, 2009).

In scene three, when Kate is dying she confesses to Anna, “I’m sorry I let them hurt you… I was supposed to protect you” (Cassavetes, 2009). This ties directly into what Schleien et al. (2010) discovered in their research on the level of interpersonal responsibility felt among siblings. Schleien et al. (2010) found that older sisters were far more likely to apologize to a sibling for perceived wrongdoing than boys. Schleien et al. (2010) also found that older sister’s were far more likely to apologize on their own than apologize at their parent’s request. Through their analysis they found that this occurred because the level of interpersonal responsibility that the older sister’s felt to their siblings. Kate feels responsibility for the interpersonal relationship between her and Anna. She apologizes because she feels that she was unable to uphold this level of responsibility because of her illness. When Kate says, “I was supposed to protect you,” she is speaking to the level of responsibility she felt for protecting Anna, as her older sister. I extend Schleien’ et al. (2010) theory regarding interpersonal responsibility to apply with the context of suffering from a chronic illness. Because of Kate’s lifelong battle with leukemia, she and Anna didn’t have a typical sibling relationship. Anna often took care of Kate, which we can see in scene one where Anna is cleaning Kate after she soiled herself. Kate felt guilty for not upholding her perceived level of interpersonal responsibility. Kate and Anna also have an older brother, Jesse. We don’t see this level of interpersonal responsibility between Jesse and either of his siblings. While he loves his sister, he does not know where he fits into the context of the family, given his sister’s terminal illness.

To understand interpersonal responsibility, one must take out the factor of what is “right” or “wrong”. Interpersonal responsibility calls for one to recognize that it’s not about doing what is best for them or what is best for the other person, it’s about doing what is best for the good of the relationship. Since interpersonal communication ethics is about the relationship, not about what one or the “Other” wants, than Anna did not honor the “good”. She placed a higher value on doing what her sister wanted (the “Other”) than the relationship. If she valued the relationship more, then she would have not honored her sister’s wishes. In scene one, when Anna and Kate are discussing Kate’s wishes for Anna to request medical emancipation and to let her go, Anna asks if Kate will wait for her in the afterlife. This demonstrates that Anna is acting with interpersonal ethical responsibility, because it then doesn’t become about what her sister wants, or what she wants, but about the relationship that they cherish, both in this life and beyond.

Clayton et al. (2008) found that a patient’s mood and state of mind is highly influenced by an open dialogue. Kate and Anna had an open dialogue, as Anna listened to Kate’s wishes. Anna was engaged with the reality of Kate’s medical diagnosis and listened to her concerns. Kate did not feel as her mother, father or older brother listened to her concerns about wanting to discontinue treatment. This is seen in scene one when Anna says to Kate, “They’ll never believe me.” Both Anna and Kate feel as if their parents don’t allow for an open dialogue. Kate becomes depressed because she has tried to express to her mother on multiple occasions that she doesn’t want to go on with treatment. This speaks to what Clayton et al. (2008) found regarding the patient’s mood and state of mind being influenced by open dialogue. Kate feels as if she can have an open dialogue with Anna, which greatly improves her mood because she realizes that through Anna, she can be free.

Schleien et al. (2010) found that children are able to make sense of their own and others’ rights. This can be seen through the dialogic ethic between the two sisters. Dialogic ethic is the way a conversation between two individuals plays an ethical role in their relationship (Arnett et al., 2009). In My Sister’s Keeper (Cassavetes, 2009)we see the dialogic ethic among the interpersonal communication. The first concept of dialogic ethic is to listen without demand. Interpersonal communication ethics dictates that one cannot demand a particular type of relationship upon someone. Arnett et al. (2009) say that “Relationship development in interpersonal communication requires attentive care without the specter of demand,” (p. 128). In scene one when the sister’s are laying on the blanket outside, discussing Kate’s demand for Anna to request medical emancipation, it is clear that there is demand in the interpersonal relationship. There is demand from Kate to Anna, to not donate her kidney. Anna hires a lawyer to file for medical emancipation from her parents because of the demand her parents place on her to donate her kidney. Kate also has demand placed on her from her parents to receive the donated kidney and undergo the medial procedure. All of the relationships have a form of demand upon each other.

During the “Feels Like Home” scene of the movie the concept of demand in interpersonal communication ethics plays a role. In this scene, Kate is allowed her dying wish, which is to visit the ocean. This is the one moment in which all of the characters are the happiest. In that moment, no demand is being placed from anyone on the relationship. They are simply living in the moment, enjoying the view of the crashing waves, spending time with each other and releasing all expectations and demands. Anna is playing in the waves with her brother Jesse. Kate is sitting with her father and gives him a kiss on the nose. At this moment, they are not placing demand upon each other to be a mother, father, caretaker or sister of a sick sibling. The context of being a sister of a sibling with terminal illness shades their interpersonal relationship because of the demand, but in this moment they are free.

Grunig and White (1992) point out that the ethics of an organization’s communication practices may be judged based on their relationships and I extend this theory to apply to siblings, because being the sister of sibling with a terminal illness influences the communication ethics. Grunig and White (1992) say that the quality of a relationship depends on two parties. We can see in both scene one and scene three that the relationship between the two sisters depends on the interpersonal responsibility to each other. In scene one, Anna demonstrates responsibility to her sister because she expresses her desire to donate her kidney and save her sister’s life. In scene three, we see Kate’s responsibility expressed to Anna as she apologizes for not protecting her. Their relationship is strong because of the interpersonal responsibility felt towards each other, which depends on the two parties. This relationship is influenced by Kate’s diagnosis with a terminal illness, as this defines the responsibility they feel for each other.

Hall (2013) found that the application of the Golden Rule, treat others as you would like to be treated, is a good standard for communication ethics across the cultures because many religious traditions indicate it’s an excellent place to start with morality. I extend this to apply to communication ethics across time regarding the attentiveness of self and others. The attentiveness on the self, “Other” and moment in time play a role. The ground of “Other” is the ethical framework that shapes the communicative lives together. Over time this relationship can change. In My Sister’s Keeper (Cassavetes, 2009) the communicative lives change during the course of their lives, as no relationship is static. When Anna was young, she had no communicative voice regarding the donation of her bone marrow or blood. Kate had no dialogic voice to express her wishes about receiving cancer treatment. Over time their relationship shifted and the contextual communication ethics changed as well. Even though they came from different mindsets and situations, they both applied the Golden Rule “treat others as you would like to be treated,” in their relationship. This helped shaped their ethical ground.

This ties right into the third concept, which is negotiation. A relationship must be negotiated, and have consistency that “I” can’t control and “we” must negotiate. In My Sister’s Keeper(Cassavetes, 2009)there was negotiation between the sisters, based on the context of Kate’s terminal illness. Both Anna and Kate had to move from the place of being the “I” in control to the “we” that must negotiate together. We see this in scene one, when the sister’s sat on the blanket together and Kate expressed her wishes to die. Kate helped negotiate a solution that worked for both of the sisters without placing emphasis on either of them as individuals, but rather the “we” of their relationship.

The final pillar of dialogic ethic is the connection of “I”, one’s own interpersonal responsibility to the relationship. At first, Anna doesn’t want to admit that Kate wants to released from her pain. However, through self-reflection, time and learning from their relationship, Anna comes to link her responsibility to the relationship with Kate to finally let her sister go. This demonstrates the concept that knowledge is learning. We must learn from self-reflection and from the “Other”.

Conclusion

My Sister’s Keeper (Cassavetes, 2009)provides an excellent example of how the context of a terminal illness plays a role in the interpersonal communication ethics in a sister-sister relationship. Interpersonal responsibility calls for one to recognize that it’s not about doing what is best for them or what is best for the other person, it’s about doing what is best for the good of the relationship. While one may think of ethical responsibility as doing what is “right” that’s not the case. The guiding key in relationships is our responsibility to the other, not our own, or their, hopes and wishes. The contextual communication approach “justifies different communication standards for various audiences, cultures and relationships” (Arnett, Harden Fritz & Bell, 2009, p. 51). In My Sister’s Keeper the context of illness shades the sister’s relationship with each other. Through analyzing the interpersonal responsibility, demand and dialogic ethic of specific scenes in My Sister’s Keeper using established research in the field of contextual communications we are able to see how the sister’s relationship was influenced by the context of terminal illness. Through the application of contextual communication ethics, we can evaluate the interpersonal communication ethics in relationships and the responsibility to uphold the “good” in the relationship.

The issue of a conceiving a genetically engineered child for the purpose of donating blood marrow for their terminally ill sibling is still an issue today, and quite possibly will increase as technology evolves. Understanding the context of the situation and applying interpersonal communication ethics can help guide the sister-to-sister relationship in these instances and provide a moral compass for navigating the relationship. While there is no “right” answer, communication ethics states that there is no right or wrong, only what works for the relationship that moment of historical time. The best advice to provide in this situation is to understand the “good” of the relationship and always strive towards achieving that “good”. If one acts in the best interest of the relationship, then that will set them free.

 


 

References

Arnett, B.C., Harden Fritz, J.M. & Bell, L.M. (2009). Communication ethics Literacy: Dialogue and Difference. Los Angeles, California: SAGE Publications., Inc.

Clayton, M., Dudley, W. & Musters, A. (2008, May/June). Communication with Breast Cancer Survivors. Health Communication, 23(3), 207-221. doi: 10.1080/10410230701808376

Hall, B. J. (2013, April). Communication, Culture, and Ethics: Implications for Symbol-Uses and the Golden Rule. China Media Research, 9(3), 102-110.

Edwina Hayes – Feels Like Home (My Sister’s Keeper) [Video File] Retrieved from youtube.com/watch?v=Ym9wFydQFYc

Furst, S., Goldman, S., Johnson, Pacheco, C. & Tropper, M. (Producers) & Cassavetes, N. (Director). (2009). My Sister’s Keeper [Motion Picture]. United States: Curmudgeon Films.

My Sister’s Keeper Scene [Video File] Retrieved from youtube.com/watch?v=QYhC-qylIC0.

Picoult, J. (2004). My Sister’s Keeper. New York, New York: Atria.

Roloff, M. (2012). Communication Yearbook 21. New York, New York: Routledge.

Schleien, S., Ross, H. & Ross, M. (2010, February). Young Children’s Apologies to their Siblings. Social Department, 19(1), 170-186. doi: 10.1111/j.1467-9507.2008.00526.x

 

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