FINAL: Interpersonal Communication Ethics in My Sister’s Keeper

Cacciatore_4.25.14-FINAL

Interpersonal Communication Ethics in My Sister’s Keeper

Stacy Cacciatore

Queens University

 Introduction

My Sister’s Keeper (Cassavetes, 2009)is a motion picture based on a novel by Jodi Picoult. This movie reveals 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 plot of My Sister’s Keeper centers on two sisters, Kate and Anna, 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 child, Anna, for the sole purpose of donating blood marrow to save Kate’s life. 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 finds out in the end, is that big-sister Kate has asked Anna to file for medical emancipation, so that she will not donate her kidney, and she will allow Kate to die. The context of Kate’s illness influences the interpersonal communications ethics between the two sisters. This paper evaluates the interpersonal communication ethics, specifically interpersonal responsibility, demand, and dialogic ethic, in three scenes in My Sister’s Keeper and analyzes how the relationship between the two sisters is influenced by the context of a chronic illness. I will use the contextual communication approach, which “justifies different communication standards for various audiences, cultures and relationships” (Arnett, Harden Fritz & Bell, 2009, p. 51), to analyze the sister’s relationship.

Literature Review

Several themes emerge through the evaluation of research conducted on contextual communications ethics. The first theme that emerges is the correlation between culture and contextual communications. Streed (as cited in Hall, 2013) found that culture plays a key role in communication ethics. A professor at a Moroccan university, Streed experienced an ethical dilemma concerning pressure to provide a student with a passing grade in a course, when he didn’t earn it. In Morocco, it was a common practice to pass a student of high socioeconomic status, regardless of his or her academic performance, due to their position of power. This would not have surfaced as an ethical dilemma in the United States, where the primary ethical cultural concern is fairness among students. Streed found herself positioned against two goods: that of her host culture and that of her home culture. To her, the ultimate “good” was respecting 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 respecting all students. Hall (2013) found that the application of the Golden Rule –“Do to others as you would have them do to you,” (Luke: 6:31 New International Version) is a good standard for enacting communication ethics across the two cultures, because it is an excellent place to start with morality according to many religious traditions. It is a commonality between the Muslim traditions of the host country and the Christian traditions that Streed held. According to the American Heritage® Dictionary of Idioms, the phrase “do unto others as you would have them do unto you,” is stated in many ancient books, including the New Testament, Talmud, Koran and the Analects of Confucius (Ammer, 1997). By moving to a higher level of abstraction, the Golden Rule allows one to ethically regardless of the culture involved.

The second theme in the literature 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 they each felt. 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.

The third theme that emerges is the importance of open communication with those suffering from a terminal illness. Clayton, Dudley and Musters (2008) found that communication is one of the most important variables in the patient-medical provider relationship. A patient-centered style of communications, in which medical providers respond attentively to patient concerns, can influence the patient’s uncertainty, mood and perception of communication. The communication between the health care provider and patient predicts his or her perception of the 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 show that the discussion about symptoms was the most influential in predicting a patient’s mood and perception of their symptoms.

The fourth theme is the correlation of context with communication ethics in organizations. Ardichvili, Mitchell and Jondle (2008) conducted a study of the characteristics that contribute to ethical business culture. They found that organizational culture is one of the most important influences in communication ethics within an organization. Ardichvili et al. (2008) defined an ethical business culture as one in which the organization’s environment is guided by shared values and beliefs. Employees not only know the difference between right from wrong, but also go beyond the minimum ethical expectations. Their research found that one of the characteristics of a strong ethical business culture includes an emphasis on acting in the best interest of the customer. Employees also feel that leadership should “talk the talk” and “walk the walk” to lead by example (Ardichvili et al., 2008, p. 450). Ardichvili et al. (2008) found that employees feel that sustaining an ethical culture is a two-way street and that the responsibility not only resides with senior management in demanding ethical conduct, but by the frontline employee as well.

All four themes show that contextual communication ethics plays an important role in interpersonal relationships, whether the context is an individual’s culture, illness, gender or relationship. Nevertheless, the literature exposes a lack of research to demonstrate how contextual communication ethics plays a role in a relationships that features two such contexts, family and illness, and how these may characterize a relationship 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 cancer patient and a care practitioner they do not evaluate the importance of communication between the patient and a family member in the health care context. While Hall (2013) found that the application of the Golden Rule is a good standard for communication ethics across the cultures, the study did not apply the Golden Rule across the context of illness and health. Schleien et al. (2010) characterize gender differences in sibling communication, did not explore the intersection of illness and gender would play a role in contextual communications. Ardichvili et al. (2009) thoroughly evaluate how business ethics are affected by the context of the organizational culture, but they do not extend this theory to family ethical relationships.

I address communication ethics at the intersection of gender, family and illness 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.

Methodology

Many ethical issues are raised in My Sister’s Keeper (Cassavetes, 2009), however I concentrate on the interpersonal communication ethics between the two sisters and apply contextual communication ethics to demonstrate how their relationship is shaded by Kate’s illness. I chose to study interpersonal communication ethics with regard to the relationships in this film because in interpersonal communication ethics, the relationship is the primary concern (Arnett et al., 2009). Further, all interpersonal relationships are shaped by doing what is necessary, not what feels “right” or “good,” with the “good” acting as the most important, valued and highest regarded (Arnett et al., 2009) element. In interpersonal communication ethics, the “good” of the relationship is primary, not the value of the “Other”. While the precise nature of the “good” can change over time, its importance rests in the fact that each individual should act on behalf of the relationship, not on behalf of the self or the “Other”. Three assumptions for interpersonal communication include; interpersonal responsibility is about not losing sight of the relational responsibly to the “Other”, one cannot demand a particular relationship and listening, attentiveness and negotiation shape the dialogic ethic.

I chose three specific scenes from My Sister’s Keeper (Cassavetes, 2009)because they demonstrate how the context of a chronic illness affects interpersonal communication ethics, specifically interpersonal responsibility, demand, and the dialogic ethic, between two sisters. All three of these scenes reinforce interpersonal communication ethics, specifically how interpersonal communication ethics guides the connection between two people when “the relationship becomes the heart of the exchange” (Arnett et al., 2009, p. 120). The two individuals care for their relationship, without the pursuit of career advancement or a political agenda. There is no better example of this type of connection than between the characters of the two sisters in the film.

First, to understand interpersonal responsibility, one must factor out the question of what is “right” or “wrong.” To demonstrate how interpersonal responsibility works, specifically between two sisters shaded by the context of chronic illness, I outline the data in scenes one and three in My Sister’s Keeper (Cassavetes, 2009). Interpersonal responsibility calls for individuals to recognize that the ethical choice does not concern doing what is best for them or even what is best for the other person; rather, it’s about the ethical choice of doing what’s best for the good of the relationship (Arnett et al., 2009).Interpersonal responsibility rests not in the individual’s hopes or wishes, or the hopes or wishes of the “Other”, but in the responsibility to the relationship. According to Arnett et al. (2009), one must abandon the “expectation of reciprocity for attentiveness to a call of responsibility with or without the approval of the Other,” (p. 121). This means that one must stop concerning themselves with what the “Other” thinks or wants, and instead act in the best interest of the relationship, without expecting anything in return.

Second, interpersonal communication ethics dictates that one individual cannot demand a particular type of relationship upon someone else. To demonstrate this concept, I pull data from scenes one and two in My Sister’s Keeper (Cassavetes, 2009). These scenes show how the release of demand can foster a relationship. Arnett et al. (2009) state “Relationship development in interpersonal communication requires attentive care without the specter of demand” (p. 128). One must care for the relationship, without demanding that a relationship exist, that the relationship take a certain form or that the “Other” fulfill a certain goal. One shouldn’t even demand that there be a lack of demand in a relationship. As Arnett et al. (2009) state, “to impose or to demand a particular type of relationship violates the spirit of interpersonal communication,” (p. 128). One should treat a relationship, as it’s own entity. Relationships change over time, and people can invite adjustments, but from an ethical perspective, no one can force or demand change. Demand can damage the fragility of a relationship. While constant demand certainly can damage a relationship, lack of demand stemming from a lack of desire for the relationship can cause equal strain in a relationship. When a relationship has repetitive demand, without receptive change from the “Other”, the relationship moves into an area of obsession and control.

Finally, a dialogic ethic distinguishes the way conversation between two individuals plays an ethical role in their relationship (Arnett et al., 2009). According to a dialogic ethic, attentiveness and negotiation play important roles in listening. Individuals must listen without demand and pay attention to what is transpiring in the moment. Individuals must practice attentiveness in the relationship by acknowledging the ground of self and “Other” and historical moment. The ground of self is the ethical narrative that guides our own interactions, while the ground of the “Other” is the ethical narrative guide that guides the “Other”. By acknowledging both our own, and the “Others”, ethical ground, we can establish a framework from which to negotiate. Ethical ground rules are the fundamentals for how we base our ethical decisions and they are the guiding principles for our actions. To provide an example, one individuals’ ethical “ground” may be that he/she doesn’t drink alcohol. The “Other” may come from an ethical ground that they are not opposed to drinking alcohol. Dialogic ethic calls for both parties in the relationship to understand and acknowledge the ground of self and “Other”, but it doesn’t mean that they have to agree. To attend to the relationship, they can agree to disagree on the ethical ground of drinking alcohol and not place “demand” on each other to convert to the “Other’s” ethical ground. The dialogic ethic also calls for negotiation and learning from the “Other.” Arnett et al. (2009) state that “the key is not to tell, but to learn from the Other”, the historical moment, and reflective understanding of communicative action,” (p.133). Using the same example as above, if two individuals disagree on the ethical ground of drinking alcohol, they can learn from the “Other” to enhance the understanding of the “Other” perspective. Perhaps one individual doesn’t drink because alcoholism runs in his/her family. Perhaps the “Other” drinks casually because it helps him/her relax after work. The key for the relationship is to not act on behalf of what “I” or the “Other” wants, but listen to what’s best for the relationship. Perhaps the best solution is a negotiation that the “Other” doesn’t drink alcohol around the individual who is opposed to drinking. It doesn’t mean that the “Other” shouldn’t drink at all, but rather, both parties can act in the best interest of the relationship. I evaluate scenes one and three in My Sister’s Keeper(Cassavetes, 2009)to demonstrate how dialogic ethic plays a role between the two sisters.

I apply the contextual communication ethics theory to the interpersonal communication ethics between the two sisters. Hall (2013) 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.

I will analyze My Sister’s Keeper (Cassavetes, 2009)using the interpersonal communication ethics concepts of interpersonal responsibility, demand, and the dialogic ethic.

Data

All of these scenes appear in My Sister’s Keeper (Cassavetes, 2009).

Scene one(Cassavetes, 2009)

This scene starts with Kate lying in her bed at home. Her head is shaved bald and blood is streaming from her nose down to her mouth as she lies on her side. She is covered in several blankets and has two mismatched, worn pillows under her head. Despite the dim light emitted from the small lamp on her nightstand, the room is dark. Her bedroom door is slightly ajar. She calls for Anna, saying “Sissy,” and Anna rushes in the room. She first notices that Kate has soiled herself in bed. She says, “Oh my God”. Then she notices that Kate has blood running from her nose. She says, “Oh my God” again. She quickly grabs a tissue and wipes Kate’s nose. Then begins quietly folding up the soiled bed linens while Kate remained in bed.

KATE: (Lying on her side facing away from Anna.) Don’t worry, it’s just the new medicine getting ready for the kidney.

ANNA: (In the bathroom located inside of the bedroom. Anna first disposes of the soiled bed linens and then turns the water on in the bathroom sink and begins to wet a washcloth.) Are you in pain?

KATE: Pain? My whole life is a pain.

(Anna turns off the water and comes back into the bedroom. She proceeds to clean Kate’s backside while Kate is still facing away from her.)

KATE: This is the end, Sissy. It just gets scarier from here on out. Mom’s going to chop me and cut me ‘til I’m a vegetable. Two cells in a petri dish that she shocks with an electric cord.

ANNA: (Anna finishes cleaning up Kate and sits on the bed.) You’ll be alright.

KATE: (Turns over to face Anna, who is still sitting on the bed. She has a smile on her face and tears in her eyes.) It’s over. Time to go. I need you to do me a favor, Sissy.

ANNA: (Sniffling and holding back tears.) What favor?

KATE: You can release me.

ANNA: (Looks Kate into the eyes, now crying. Does not respond verbally.)

(Transition to courtroom scene. The judge is at the bench and turns to Anna, who is sitting in the witness stand to the left of the judge.)

JUDGE: So Anna, for the record, did you tell Kate you would stop being a donor so that she could die?

ANNA: Yeah.

JUDGE: So what did she say?

(Anna looks down at her hands as the flashback sequence begins. The movie then transitions to Kate and Anna sitting on a blanket in the warm sun. There is a house in the background, several tall trees, two wooden adirondack chairs and a trampoline. Kate braids Anna’s hair.)

ANNA: Mom and Dad are going to kill me. What am I supposed to tell them?

KATE: Tell them you’re important too. Tell them you want to play soccer. Tell them you want to cheerlead.

ANNA: They’ll never believe me.

KATE: Yeah, they will. And you wanna know why? Because it’s the truth.

(Kate stops braiding Anna’s hair and lies down on the blanket next to her.)

ANNA: You scared?

KATE: No, I know I’ll be OK.

ANNA: What do you think happens? I mean, where do you go?

KATE: I don’t know baby. But who knows, wherever it is, maybe I’ll run into Taylor

ANNA: (Sitting up straight and looking at Kate) Will you wait for me?

KATE: What?

ANNA: If you go anywhere crazy, will you wait?

KATE: If you’re ever lost or scared go to Montana.

ANNA: Montana?

KATE: Yeah, that’s where I’ll be.

Scene two(Cassavetes, 2009)

(Note that there is no dialog in this scene and the entire scene is set to the song, “Feels Like Home” performed by Chantal Kreviazuk and written by Randy Newman (1999).

The scene opens with Jesse and Anna running on the sand next to the ocean throwing birdseed to the seagulls. The seagulls fly overhead and swoop down to nibble the food. Kate is sitting with her father on the sand with a scarf covering her hairless head and a plaid flannel blanket draping her shoulders. Kate is wearing a nasal cannula, which is the device used to deliver supplemental oxygen to a patient in need of respiratory help (Nasal cannula, n.d.). Kate takes a deep sniff of the ocean air. She looks at her father and he smiles at her and then points to his nose, asking her to kiss him. Her mother then arrives with her sister. The mother, wearing a pair of jeans, a sweater and heavy winter boots, then walks up to the blanket that Kate and her father are lying on. She looks at her husband and then grabs his face and kisses him passionately. Kate begins clapping as she looks on. The mother then hugs Kate and wraps her up further in the blanket. Kate slowly gets up from the blanket as dusk falls and she walks towards the ocean with her flannel blanket still wrapped around her shoulders. She smiles broadly and her eyes, shadowed by dark circles, glisten with tears. She stares off across the ocean and watches the sun set. The scene then transitions to the family brining Kate back to the hospital. Kate curls up in the wheel chair with a huge smile on her face as they wheel her back to her room.

Scene three (Cassavetes, 2009)

Kate created a memory scrapbook of her life with pictures of her family, her boyfriend Taylor and friends. She is flipping through the pages of the book as she sits alone in her hospital bed. As she looks at the page with Anna’s pictures, she speaks into the book, “To my baby sis, I’m sorry I let them hurt you. I’m sorry I didn’t take care of you. It was supposed to be the other way around.”

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

Analysis: Applying Method to Data

In My Sister’s Keeper (Cassavetes, 2009), younger sister Anna honors her relationship with her older sister, Kate, no matter what the consequences, and the consequences are literally life and death. Anna faces an ethical quandary: Should she do what she thinks is “right” and donate her kidney? Should she do what her sister wants and file for medical emancipation? Should she do what is best for the relationship? What is the best solution to honor the relationship? Finding the best answer from the perspective of interpersonal ethics requires her to find the best solution to foster the relationship. I analyze three specific scenes from My Sister’s Keeper (Cassavetes, 2009)to demonstrate how the context of a chronic illness can affect the interpersonal communication ethics, specifically interpersonal responsibility, demand, and dialogic ethic, between two sisters.

In a relationship, one should understand the responsibility to one another. This can be explored through interpersonal communications. In interpersonal communication ethics, the relationship is the primary concern (Arnett et al., 2009).Arnett et al. (2009) say 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 one we see Kate, bedridden, unable to control her bowels, with blood streaming down her face. She calls her sister, Anna, into the room to help clean her after she’s soiled herself. Anna rushes in and immediately takes charge, wiping the blood from her sister’s face, disposing of the soiled sheets and wiping her sister’s bottom. This scene displays the interpersonal responsibility that Anna has for Kate, which is influenced by the context of Kate’s illness. Interpersonal responsibility calls for individuals to recognize that the ethical choice does not concern doing what is best for them or even what is best for the other person; rather, it’s about the ethical choice of doing what’s best for the good of the relationship (Arnett et al., 2009). Kate and Anna fulfill the expectations of interpersonal responsibility, as demonstrated in this scene. Both of the sister’s are acting in the best interest of the relationship, not what is best for herself or the “Other”. We see this as Anna tends to her bedridden sister. Anna doesn’t take care of Kate for her “self” or “Other”, she takes care of Kate to foster the relationship. We know that Anna doesn’t tend to her sister to fulfill her sister’s desires, because of the dialogue that occurs in scene one. Kate asks Anna to request medical emancipation so that she won’t have to donate her kidney. This, in turn, will allow Kate to die and be released from her pain. When Kate requests the “favor” from Anna, to “release her”, Anna just looks at Kate with tears in her eyes. Anna is concerned at first that her parents won’t believe her when she says she doesn’t want to donate her kidney, as her parents know how much she values her relationship with her sister, but Kate says, “Tell them you’re important too. Tell them you want to play soccer. Tell them you want to cheerlead.” When Anna expresses that she doesn’t think that her parents will believe her, Kate says, “Yeah they will, because it’s true,” (Cassavetes, 2009). At this moment it is clear that both of the sister’s are acting in the best interest of the relationship. Anna still wants to donate her kidney, but interpersonal responsibility rests not in the individual’s hopes or wishes, or the hopes or wishes of the “Other”, but in the responsibility to the relationship. Anna is acting in the best interest of the relationship by not donating her kidney. Kate is acting in the best interest of the relationship by asking Anna to not donate her kidney. Both of the sister’s are acting on behalf of the relationship and are not losing sight of the relational responsibly to the “Other”. They both realize that their relationship is affected by the context of Kate’s illness and the best solution to value the “good” of the relationship is to discontinue their medicinal reliance on each other and instead act on behalf of the relationship.One could argue that Anna is doing what Kate “wishes” by not donating her kidney, but I argue against this point because of the last line of the scene in which Anna asks Kate, “will you wait for me?” referring to the afterlife. Kate replies, “If you’re ever lost or scared go to Montana,” (Cassavetes, 2009). This demonstrates that both Kate and Anna are acting with interpersonal ethical responsibility, because it then doesn’t become about what either sister wants, but about the relationship they’ll cherish in this life and beyond.

Another example of the sister’s honoring their interpersonal responsibility is in scene three. Kate, doesn’t want to have to ask Anna for a donation of organs or medical caretaking. Anna is Kate’s younger sister and Kate feels that she should take care of Anna, not the other way around. This is demonstrated in scene three when Kate says, “To my baby sis, I’m sorry I let them hurt you. I’m sorry I didn’t take care of you. It was supposed to be the other way around”(Cassavetes, 2009). This demonstrates that Kate doesn’t want Anna taking care of her for her “self”. 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 feels interpersonal responsibility for Anna, and Anna feels interpersonal responsibility for Kate. This interpersonal responsibility reliance is influenced by the context of Kate’s terminal illness. Arnett et al. (2009) state that interpersonal responsibility is about not losing sight of the relational responsibly to the “Other”. The sister’s do not lose sight of this relationship responsibility, it remains at the forefront of their relationship.

 

    Demand also plays a role inMy Sister’s Keeper (Cassavetes, 2009). Interpersonal communication ethics states that one cannot demand a particular type of relationship upon someone. Arnett et al. (2009) say, “Relationship development in interpersonal communication requires attentive care without the specter of demand,” (p. 128). In the 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. Demand can damage the fragility of a relationship. Arnett et al. (2009) state, “to impose or to demand a particular type of relationship violates the spirit of interpersonal communication,” (p. 128). This demonstrates that the interpersonal relationships among the family are negatively influenced by this demand.

However, during scene two of My Sister’s Keeper (Cassavetes, 2009) 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, there isn’t demand is being placed from anyone on their relationships. 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 running on the sand with her brother Jesse. Kate is sitting with her father and gives him a kiss on the nose. The mother and father kiss passionately for the first time during the movie. The reason they are the happiest at this moment is because 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.

    In My Sister’s Keeper (Cassavetes, 2009) the communicative lives change over time, as no relationship is static. Throughout Kate’s entire life, all of her decisions had been made for her, due to the context of her illness. When Anna was young, she had no communicative voice regarding the donation of her bone marrow. Kate had no dialogic voice to express her wishes about receiving cancer treatment. Over time their communicative lives shifted. Kate wanted to have a commutative voice and to have her own wishes to be respected in regards to her cancer treatment. This is demonstrated through the expression of the dialogic ethic.

In My Sister’s Keeper (Cassavetes, 2009)we see the dialogic ethic among the interpersonal communication between the two sisters. Kate did not feel as her mother, father or older brother listened to her concerns about wanting to discontinue treatment. However, in scene one in My Sister’s Keeper we see that Anna listens to Kate and gives her a dialogic voice. Dialogic ethic calls for both parties in the relationship to understand and acknowledge the ground of self and “Other”, but it doesn’t mean that they have to agree. Anna doesn’t want Kate to die and she also wants to continue to donate her kidney to save her sister’s life, but she provides an ethical ground for Kate. While they may not agree, they both learn from each other. Arnett et al. (2009) state that “the key is not to tell, but to learn from the “Other”, the historical moment, and reflective understanding of communicative action,” (p.133). Anna listens to Kate express her desires and she learns from the interaction. Kate and Anna had an open dialogue, as Anna listened to Kate’s wishes.

 

 

According to Arnett et al. (2009), one must abandon the “expectation of reciprocity for attentiveness to a call of responsibility with or without the approval of the “Other,” (p. 121). This means that one must stop concerning themselves with what the “Other” thinks or wants, and instead act in the best interest of the relationship, without expecting anything in return. Because of Kate’s illness, her parents, doctors, sister and brother all acted in response to what they felt was best for the relationship without considering what the “Other” (Kate) wanted. While they felt they were valuing the relationship, from an interpersonal communications ethics perspective, they were not providing Kate with a dialogic voice. Dialogic ethic distinguishes the way conversation between two individuals plays an ethical role in their relationship (Arnett et al., 2009). Both attentiveness and negotiation play important roles in dialogic ethics, as people must listen without demand and pay attention to what is being said in the moment. By acknowledging both our own, and the “Other’s”, ethical ground, we can establish the ethical narrative guide from which to negotiate.

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 is 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 discussed Kate’s wish to discontinue treatment and Anna’s concern about her parent’s reaction. 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 die. 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.”

Hall (2013) 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. Kate wanted the Golden Rule to apply to her with the interpersonal communication ethics between herself and her sister. She wanted to have a dialogic voice in having her wishes respected. Anna enables Kate’s dialogic voice and 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 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. The interpersonal communications ethic between the two sisters shows interpersonal responsibility, freedom of demand and encouragement of an open dialogic ethic, demonstrating how the context of illness influences their relationship.

Conclusion

My Sister’s Keeper (Cassavetes, 2009)demonstrates 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 interpersonal communications ethics and contextual communications theories, we are able to see how the sister’s relationship was influenced by the context of terminal illness.

While My Sister’s Keeper (Cassavetes, 2009) is fiction, the story is similar to the real life story of the Ayala sisters. Anissa Ayala was diagnosed at age 16 with leukemia and the doctors said her only hope was a bone marrow transplant. Her parent’s frantically searched for a match to no avail. Since no donor match was available, her parents decided to conceive another baby against all odds in hopes that s/he would provide a match. The odds were slim, not only that the Ayala’s could conceive, as the mother was 42 and the father previously had a vasectomy reversed, but even if they did coneive they only had a one in four chance that the baby would be a match. But they miraculously got pregnant. At 14 months old, Anissa’s sister Marissa provided her with a life-saving bone marrow donation (Vieira, 2011). Anissa’s medical condition improved quickly and she is still cancer-free today.

While the Ayala family is completely comfortable with their decision, the same can’t be said for the rest of the world. The family received national medical attention, which focused on the fact that Marissa was too young to give her consent to being a donor for a family member. Dr. Nancy Snyderman, a medical correspondent for TODAY, responded to the Ayala family’s situation by saying that “It crossed so many medical ethical lines,” (Vieira, 2011). However, the situation worked out well for all of the members of the Ayala family. Anissa was thrilled when she learned her parents were bringing a baby girl into the world, not only for saving her own life, but to give them something to focus on during that time of darkness. Marissa is happy that she was brought into this world to save her sister’s life. And both parents are not only thrilled that Anissa is cancer-free, but they grew their family in the process.

According to Be The Match® (n.d.), a national bone marrow registry organization, “Each hour more than six people die from blood cancer. While a bone marrow transplant can save the lives of people battling leukemia, lymphoma, and other blood cancers, 70 percent of patients in need of a bone marrow transplant do not have a matching donor in their family. Individuals can sign up on the Be The Match Registry® to register to donate bone marrow. However, 60 percent of patients never receive a transplant from a non-family member (DoSomething.org, n.d.).

Given the current state of the environment, I believe that the issue of conceiving a child for the purpose of donating blood marrow could continue to occur. 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. With the context of a terminal illness, it’s important to ensure that the interpersonal relationship allows for both parties to have a level of interpersonal responsibility for the relationship, allow both parties to have a dialogic voice and relieve the relationship of demand. While there is no “right” answer, communication ethics states that there is no right or wrong, only what works for the relationship in that moment of historical time. Based on the conclusions drawn in this paper, I believe that 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

Ammer, C. (1997). The American Heritage® Dictionary of Idioms. Boston, MA: Houghton Mifflin.

Ardichvili, A., Mitchell, J.A., Jondle, D. (2009). Characteristics of Ethical Business Cultures. Journal of Business Ethics, 85(5), 445-451.

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

Be The Match® (n.d.) How we help patients. Retrieved from http://bethematch.org/About-Us/How-we-help-patients

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

DoSomething.org (n.d.) 11 Facts about Bone Marrow Donation. Retrieved from https://www.dosomething.org/tipsandtools/11-facts-about-bone-marrow-donation

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.

Nasal cannula (n.d.) Wikipedia. Retrieved from http://en.wikipedia.org/wiki/Nasal_cannula

Newman, R. (1999). Feels Like Home [Recorded by Chantal Kreviazuk]. On Songs from Dawson’s Creek Soundtrack [Audio CD]. New York: Sony. (April 27, 1999)

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

Vieira, M. (Interviewer) & Ayala, A., Ayala, M., Ayala, M. & Ayala, A. (Interviewees). (2011, June 3). Born to save sister’s life she’s ‘glad I am in this family’ [Interview Transcript]. Retrieved from http://www.today.com/id/43265160/ns/today-today_news/t/born-save-sisters-life-shes-glad-i-am-family/#.U1h4fl4ipuY

 

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