Jodi Picoult's book, My Sister's Keeper, illustrates the juxtaposition of family ethics and family communication by retelling Adam and Molly Nash's true story about the multiple ethical decisions that confront a family after a child is diagnosed with a rare medical disease. The book highlights each family member's struggle as the family attempts to grasp why one daughter wants freedom to make her own medical choices. Each family member's viewpoint on medical, family, social, and personal ethics is developed as the narrative unfolds. In so doing, Picoult provides insight into family decision making as well as into behavioral expectations family members have of each other.
My Sister's Keeper illustrates how family problems rarely have simple right or wrong solutions. Inquiries into what is right or wrong invoke questions of morality, and discussions of morality lead to grabbling with ethical quandaries. It zeros in on how families communicate about these problems and illustrates the differing dilemmas between spouses, between parents and children, and among families in general as they confront heart-wrenching medical decisions.
Although My Sister's Keeper is an extreme medical situation, families also confront similar ethical issues when dealing with more common medical dilemmas. For example, many families must manage a child's attention-deficit/hyperactivity disorder (ADHD). Imagine a family with an extremely hyperactive child. The parents complain constantly about the stress the child places upon the family. At home, constant bickering ensues over even the simplest of chores, such as cleaning the child's room. The family limits interactions with friends and more distance family members to forestall explanations and justifications for the child's behavior. After seeking professional help and trying several therapies, the family faces an ethical decision of whether or not to medicate the child. The mother favors medication as a means of reducing family stress. Less stress will translate into family members enjoying each other's company more. The father fears that medicating the child will result in others, particular teachers, perceiving the child as different in some way, not to mention his trepidation on how the medication may affect the child's brain or suppress the child's natural personality and spirit.
How does the family answer the question? Whose perspective should be most important? The mother's? The father's? Another family member's? A medical professional? Do family members exercise multiple perspectives or only their own? Do they consider the long-range effects on the family? How do families engage in the discussion without being judgmental? To whom or where can a family turn to resolve the dilemma?
Family ethics can be crucial in situations such as this one. When a crisis, such as making a major medical decision, arises within a family, an ethical lens emerges that provides a blueprint for behavior. How family members talk and react to another is guided by that lens. If that lens is cloudy the more uncertain and stressful those conversations will be. If the lens is clear, a better family dynamic will result. Investigations into family dynamics show that families who have positive interactions surrounding medical decisions usually have a solution prior to finding themselves in a predicament. These families talk about potential decisions that may have to be made, discuss the reasons why they should do this or that, and consider the implications of their actions. Slowly working through the intricacies of the issue allows each family member's voice to be heard. Everyone feels part of the solution. Waiting for a calamity to occur before expressing concerns results in unsupportive and difficult communication between family members at a time when cool heads and cooperation are essential. Scholars have shown that supportive families talk about issues and come to a decision together. These families also talk about the decision in such a way that it shows the affection and commitment they have for one another and the family unit.
However, sometimes that affection and commitment can be problematic if not handled properly. Because family members generally love each other, they sometimes turn to unhealthy coping strategies to maintain family stability during a crisis. One popular strategy is the partial truth. “Is it a lie if I don't tell all the truth?” is a common marital question. Some people hold that steadfast truthfulness is a universal marital law. After all, if one's partner feels otherwise, how can the relationship persist? Some spouses may expect a “no secrets,” totally transparent marriage. Research suggests that most people favor open and honest communication in their marriages, but does that require complete transparency? Marriage presents a classic catch-22: partners must disclose personal information to create intimacy, but too much disclosure can sabotage that intimacy. Much research touts self-disclosure as essential to marital relationships, but research also reveals a curvilinear relationship between satisfaction and self-disclosure. That is, a couple can reveal too much and hence decrease marital satisfaction. Spouses must make ethical choices when deciding what to disclose. The complexity of the interaction between disclosure and honesty grows when spouses disagree on something as basic as what is appropriate to disclose.
Self-disclosure between spouses is not the only type of disclosure within a family. Consider the communication dynamics between teenagers and parents. Teenagers sometimes lie about where they will be, who they are with, and what activities they are involved in. Parents judge children's behavior on perceived integrity or trustworthiness. Children, being a bit less sophisticated, may view parents as unfair and try to focus the conversation elsewhere, especially when there are other siblings. “How come he can do that and I can't?”This type of perceived inconsistency needs explanation; otherwise, children will feel less favored or will reinforce the perceived unfairness as fact. Explaining behavior increases mutual understanding and appreciation of another's perspective, so parents should seize any opportunity to explain why they behave as they do or why they expect children to behave a certain way. Explanations are ethical lessons. Routine communicative moments, such as putting away groceries, chatting over dinner, or watching TV, are excellent opportunities for parents to talk about their ethical values with their children. When parents talk about what happened at work that day, children learn to process information about work. These types of interactions help children create mental models for work, authority, and family communication. Family conversations—whether implicit or explicit--help shape children's views the world and how they behave in it.
All families have communication patterns, good or bad, and most families have standards of behavior. A focus on family ethics may make those standards manifest. The good news is that family members often think similarly, so different perspectives are not always so different. Nevertheless, having family conversations about what guides family members' behavior can be a positive exercise in getting family members to understand each other as well as themselves. Working out a family's ethics helps family communication become more effective and really helps when a crisis within the family arises and good communication becomes a necessity rather than a luxury. Good communication is always healthy and understanding what makes a family tick will always make for much better family experience.