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Health communication has become an accepted tool for promoting public health. Health communication principles are often used today for various disease prevention and control strategies including advocacy for health issues, marketing health plans and products. (Thomas, 2006) Numerous media outlets exist through which a health message can be delivered, including billboards, television, radio, print and film. This research paper consists of an in depth analysis pertaining to a film titled, My Sister’s Keeper, which includes a focal point from a health communication perspective, while amplifying relevant messages of communication in health and healing. We will present a short synopsis of the movie, followed by a discussion of the main themes of the film, and elaborate on how they relate to the field of health communication. The specific themes being explored are the following: doctor-patient relationship, patient/family communication, support & conflict, medical ethics, patient’s right/medical emancipation.
My Sister’s Keeper is a film about a couple whose lives are centered around their daughter Kate. From a young age, Kate was diagnosed with leukemia and doctors gave her little time to live. Her parents undertake a decision to duplicate Kate’s chromosomes by genetically conceiving another child, Anna, in order to use her anatomy to save Kate’s life. As the film progresses, Kate’s sister, Anna (the newly genetically created child), finds out about her conception, and later files a lawsuit against her own parents. Anna claims the lawsuit is for her ‘right to life’ and to grant her the decision-making privilege regarding what to do with her own body. This is what she has viewers believing until we later find out that the actual motivation behind the lawsuit was because Kate decides to end her life and put an end to her suffering. The family becomes torn between the tension of the lawsuit and struggling to keep Kate ‘happy’ and alive.
The relationship between a patient and his/her doctor is a prominent concern in the health industry. (Berry 2007) In the review titled, ‘Effective Physician-Patient Communication and Health Outcomes: A Review’, Moira Stewart states that physicians interrupt patients an average of 18 seconds into the patient’s description of presenting their health problem, and that there exists a major lack of patient involvement during discussion. Effectively communicating one’s well being is an extremely important aspect of health. In ‘Communication Between Patients and Health Professionals’, Berry explains the several types of doctor-patient communication models. For example, in ‘My Sister’s Keeper’, the relationship between Kate and her doctor is considered to be ‘mutualistic’. This is portrayed when the doctor takes Kate’s emotional needs and distress into consideration, while Kate reciprocates by respecting her doctor and his medical expertise. In another scene, the doctor is explaining to Kate’s mother that Kate’s situation is worsening and that she has little time to live. Kate witnesses this through a hospital glass window, while analyzing the non-verbal communication between her mother and her doctor. (See Appendix, Fig. 1) The non-verbal communication between her mother and the doctor give Kate the impression that her situation is not well. Kate then asks her doctor, “Doc, no good, huh?”. The doctor then bluntly replies, “No, (…)”. Their interpersonal relationship is one that is open and honest, with no jargon and no sugarcoating.
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| Kate's mother - Family Support |
The notion of ‘family’ serves as a crucial factor when faced with health issues. In ‘Communication Between Patients and Health Professionals’, Berry discusses the family also being a patient, as they are the mediator to the patients’ life stresses and serious illnesses. The challenges facing chronically ill patients, their families and their clinical teams are enormous. For many patients 'self' management’ is a misnomer, since their disease care is actually shared by their family and broader social network. This is portrayed when Kate’s mother shaves her head in order to make her daughter feel ‘pretty’.
Certain families are very closely bonded and others are broken apart. The family portrayed in this film is both. They need each other desperately, but are also disconnected from one another. Anna and Kate need one another and live for one another, but one of them has to go. Each family member’s needs are compromised in order to satisfy Kate’s needs. The turning point of the film is portrayed in the relationship between the brother, Jesse, and Anna. Jesse’s frustration in dealing with the family struggles, i.e. the lawsuit and Kate’s medical condition, and lying about why Anna is suing her parents causes him to uncontrollably admit to the judge in court the real reason as to why Anna is suing her mother. Throughout the film, we witness the genuine support given to the family by the mother and fathers’ extended family. This is especially illustrated by Kate’s aunt, who is by her side throughout all events taking place in the movie, as well as other extended family being present during hospital visits and family diners. These examples portray the importance of effective interpersonal interactions between family members, and how they serve as contributing factors for the greatest possible outcome for Kate, as well as her whole family.
Throughout the film, Kate’s doctor displays no sign of distress and takes the necessary time to effectively communicate with the family. We notice the doctor giving the family adequate help and support in order to sustain emotional balance, which often results in obvious signs of empathy. However, despite his positive and supportive behavior, he also makes noticeable unethical medical suggestions, potentially violating medical laws. The issue of ethics relating to My Sister’s Keeper stems from the initial decision to genetically conceive Anna in hopes of using her body parts to replace those of Kate’s. The doctor suggests engineering a baby with the necessary chromosomes to be utilized for Kate’s medical care throughout her rigorous journey as a patient. Another example of medical ethics pertains to the scene where Brian, Kate’s father, decides to take Kate out to the beach while she’s in critical condition in her hospital bed. The doctor admits to legally (and for insurance purposes), not being able to permit her discharge for the day, however allows them to proceed regardless of his protocol and recommends ‘faking’ an emergency entrance upon their return. In reality, the doctor is essentially attempting to maintain his medical reputation, but at the same time, he demonstrates sincere signs of empathy towards Kate and her family. This amplifies his character as a human and not as a doctor, but also inspires the question of medical ethics.
Throughout the film, Kate’s doctor displays no sign of distress and takes the necessary time to effectively communicate with the family. We notice the doctor giving the family adequate help and support in order to sustain emotional balance, which often results in obvious signs of empathy. However, despite his positive and supportive behavior, he also makes noticeable unethical medical suggestions, potentially violating medical laws. The issue of ethics relating to My Sister’s Keeper stems from the initial decision to genetically conceive Anna in hopes of using her body parts to replace those of Kate’s. The doctor suggests engineering a baby with the necessary chromosomes to be utilized for Kate’s medical care throughout her rigorous journey as a patient. Another example of medical ethics pertains to the scene where Brian, Kate’s father, decides to take Kate out to the beach while she’s in critical condition in her hospital bed. The doctor admits to legally (and for insurance purposes), not being able to permit her discharge for the day, however allows them to proceed regardless of his protocol and recommends ‘faking’ an emergency entrance upon their return. In reality, the doctor is essentially attempting to maintain his medical reputation, but at the same time, he demonstrates sincere signs of empathy towards Kate and her family. This amplifies his character as a human and not as a doctor, but also inspires the question of medical ethics.
In addition to the issue of ethics, the issue of patients’ rights is at the core of the movie’s messages. As a patient, Kate should be able to choose which treatment to follow and when to stop. This can be compared to the essential topic of euthanasia. If a patient chooses to die, should we let them? If a patient is not capable to speak for him/herself, can we make that decision for them? These questions are at the root of Kate, the patients’ rights.
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| In Court - Medical Emancipation |
References
Berry, D. (2007). Health Communication: Theory and Practice. Maidenhead and New York: Open University Press.
Cassavetes, N. (Director). (2009). My Sister's Keeper [Motion picture]. USA: Warner.
Kuther, Tara D. (2003). Medical Decision-Making and Minors: Issues of Consent and Assent. Adolescence, 38. Retrieved from http://www.questia.com/googleScholar.qst;jsessionid=3CFDEA1F4877F4B7DB9729144909A234.inst1_3b?docId=5002025192
Stewart, M. (1995). Effective Physician-Patient Communication and Health Outcomes: A
Review. CMAJ, 152(9), 1423-1433.
Wadlington, Walter. (1994). Medical Decision Making for and by Children: Tensions between Parent, State, and Child. HeinOnline's Law Journal Library, III(331). Retrieved from http://heinonline.org/HOL/LandingPage?collection=journals&handle=hein.journals/unilllr1994&div=16&id=&page=
