In Jodi Picoult's My Sister's Keeper, Anna Fitzgerald is brought into the world by means of in vitro fertilization as "savior sister." Savior siblings are always in vitro because if the conception occurs outside the body, zygotes, or the initial cells, can be genetically tested. In this way, it will be known whether the savior sibling's organs and cells will be compatible with the sibling who will need them. With such a designed birth, there are social issues, of course.
- The Ethics of Breeding a child for design
Because Kate Fitzgerald, Anna's sister, suffers from promyelocytic leukemia, cancer of the blood and bone marrow, Kate's doctor makes an informal suggestion to Kate's mother about giving birth to another child who could be a savior sibling; this suggestion is made informally because a formal suggestion would constitute a violation of medical and legal ethics and the physician would lose his license to practice medicine.
On the parents' parts, there is the question of selective breeding. Since the baby is to be born so that it can be a "loaner" to the ailing sister, the implication is that zygotes are rejected if they fail the genetic match-up tests. Also, the savior sibling can become a mere "laboratory experiment."
- The Ethics of using a sibling's body as a supplier for another sibling
In both the book and the movie version, Anna learns that she is going to be asked to donate her kidney to her sister, and, in the book her sister requests that she not do so; in the movie, Anna does not want to donate any body part, so she hires an attorney to sue for partial termination of parental rights. Here the question arises if it is morally correct to make a child donate blood or body parts to a sibling. At one point, the justification for this type of operation is made for Kate Fitzgerald,
"It's about a girl who is on the cusp of becoming someone.. A girl who may not know what she wants right now, and she may not know who she is right now, but who deserves the chance to find out.”
- The dilemma of Genetic Engineering
If babies can be designed to fit the needs of siblings, what is to prevent further genetic engineering? Certainly, the potential for a Brave New World presents itself as one family proceeds to genetically reproduce a sister for Anna, a genetic copy for her business. What, then, is the next step?
- The rights of the "savior sibling"
Does the minor child have a right to deny the parents' argument that he/she donate cells or organs to the sibling? In the narrative of Picoult's Anna hires a lawyer to sue for partial termination of parental rights.
On the other hand, do the parents have a right to infringe upon other's lives for the sake of saving their child's life?