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68 pages 2 hours read

Jodi Picoult

Handle With Care

Fiction | Novel | Adult | Published in 2009

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Background

Authorial Context: Jodi Picoult’s Novels

Jodi Picoult is a prolific American novelist best known for her 2004 novel My Sister’s Keeper, which was adapted into a movie. Her novels focus primarily on family, relationships, and women’s issues and rights. She does not shy away from controversial or difficult topics; her novels have explored suicide, school shootings, and medical ethical dilemmas. Many of her novels, like Handle with Care, also have a courtroom drama element. Additionally, Picoult is an avid baker and often includes baking in her novels, which is reflected in Handle with Care.

Because Picoult often chooses controversial topics, she prepares to write her novels by conducting extensive research. For Handle with Care, she spoke with Kara Sheridan, “a scholar studying body image and self-esteem for disabled teens” (x), who also has Type III OI. Despite her research, Picoult has received some criticism for her depictions of disabilities. She typically focuses on how a child’s disability affects their mother, which means that “the predominant perspectives of illness or disability—whether sociocultural, transgressive, or tragic—are tied to the respective mothers” (Jarman, Michelle. “Disability on Trial: Complex Realities Staged for Courtroom Drama—the Case of Jodi Picoult.” Journal of Literary & Cultural Disability Studies, 2012). As a result of this focus, characters with disabilities become tools or narrative tropes to further examine and develop maternal characters, stripping those characters with disabilities of agency and individuality.Jodi Picoult is a prolific American novelist best known for her 2004 novel My Sister’s Keeper, which was adapted into a movie. Her novels focus primarily on family, relationships, and women’s issues and rights. She does not shy away from controversial or difficult topics; her novels have explored suicide, school shootings, and medical ethical dilemmas. Many of her novels, like Handle with Care, also have a courtroom drama element. Additionally, Picoult is an avid baker and often includes baking in her novels, which is reflected in Handle with Care.

Because Picoult often chooses controversial topics, she prepares to write her novels by conducting extensive research. For Handle with Care, she spoke with Kara Sheridan, “a scholar studying body image and self-esteem for disabled teens” (x), who also has Type III OI. Despite her research, Picoult has received some criticism for her depictions of disabilities. She typically focuses on how a child’s disability affects their mother, which means that “the predominant perspectives of illness or disability—whether sociocultural, transgressive, or tragic—are tied to the respective mothers” (Jarman, Michelle. “Disability on Trial: Complex Realities Staged for Courtroom Drama—the Case of Jodi Picoult.” Journal of Literary & Cultural Disability Studies, 2012). As a result of this focus, characters with disabilities become tools or narrative tropes to further examine and develop maternal characters, stripping those characters with disabilities of agency and individuality.

Medical Context: Osteogenesis Imperfecta (OI)

OI is also known as brittle bone disease, and “[i]ts major feature is a fragile skeleton, but many other body systems are also affected” (“About OI.” Osteogenesis Imperfecta Foundation, 2024). The condition is caused by a gene mutation that affects bone strength and formation. It is a rare condition; only about 25,000 to 50,000 people have OI in the United States (“About OI”). With proactive medical care, individuals diagnosed with OI can live productive lives and have an average lifespan.

There are five types of OI, but Willow has Type III, which means she was born with fractures at birth. However, this is often considered a non-fatal form of OI, and people with Type III OI are often expected to have an average lifespan. Charlotte assumes that Willow will outlive her, which is partly why she wants to file a wrongful birth lawsuit; she wants to leave money to provide and care for Willow after her death.

Charlotte’s lawsuit hinges on how early Piper should have been able to diagnose Willow with OI. However, “even experienced professionals may not be able to pinpoint the type of OI or differentiate between OI Type II (lethal) or OI Type III (severe) or other conditions” if parents themselves do not have the condition and genetic testing has not been performed (“About OI”). Neither Charlotte nor Sean were carriers for OI; therefore, there was no reason for Piper to suspect OI at the first ultrasound appointment.

Legal Context: Wrongful Birth Lawsuits in the United States

Wrongful birth lawsuits are controversial and are not allowed in every state. A wrongful birth lawsuit is brought by the parents of a child with a disability against a medical professional and implies that the parents were denied the opportunity to consider terminating the pregnancy. As a result, parents can sue for damages to cover the emotional turmoil of having their agency withheld, the financial cost of raising a child with a disability, and “moral and psychological suffering” (Frati, Paola, et al. “Preimplantation and Prenatal Diagnosis, Wrongful Birth and Wrongful Life: A Global View of Bioethical and Legal Controversies.” Human Reproduction Update, 2017, pp. 338-357).

The first successful wrongful birth lawsuit was in Texas in 1975. A mother had the measles during her first trimester, and “[n]egligent conduct consisting of an incorrect diagnosis […] prevented the parent from terminating the pregnancy” (Frati et al. 344). New Hampshire, where the novel is set, is one of the states that allows wrongful birth lawsuits.

Critics of wrongful birth lawsuits equate these kinds of lawsuits to eugenics, arguing that wrongful birth lawsuits could create a world where doctors can decide which genetic attributes are unacceptable. Additionally, critics argue that these lawsuits imply that people have the “right to be born only if healthy,” which ignores the fact that many people with disabilities live fulfilling lives (Frati et al. 352). Many characters in the novel criticize Charlotte for filing a wrongful birth lawsuit because it invalidates Willow’s unique life and implies Willow should have never been born because she wasn’t the healthy baby Charlotte assumed she would birth.

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