Hazel McHaffie

Questions and challenges for “Listen”

DISCUSSION POINTS FOR BOOK CLUBS

• The narrator sets out with the intention to ‘murder’. Is the use of the word advisable? What is your opinion of such an act in such circumstances? Should it be treated as murder?
• Jocelyn is grappling with many different worries and responsibilities in relation to her own genetic inheritance and the wellbeing of her family. Is she justified in planning to evade the consequences of her biological legacy and actions by taking her own life?
• To what extent do you believe Jocelyn’s experience with her sister Morven is influencing her thinking about death now?
• Do you know in what ways your biological and genetic data could be used against you? Does this bother you?
• What do the various train conductors bring to the story?
• Which passengers resonated most with you?
• In Chapter 3 Jocelyn discovers things about a work colleague. She asks, if she knows shouldn’t the philandering Shaun’s wife know? What do you think?
• In Chapter 4 Jocelyn resolves to bring her mother’s phone away with her because it contains evidence of her pledge. What does this tell you about her thinking?
• Having read her reactions to many events and people, how would you describe Jocelyn Grammaticus?
• An old Spanish saying goes: An ounce of mother is worth a ton of priest. Do you agree? To what extent do you feel Jocelyn’s mother has influenced her?
• Jocelyn decides against using the illustration of the young woman seeking sterilisation in Chapter 7. Why do you think this one is too sensitive to include in her speech?
• If you were in Jocelyn’s shoes which alternative case would you go for: the sterilisation of the young woman with Aspergers’, or the girl with cancer and learning difficulties (Chapter 7)? Why?
• Have you made a living will? Why/why not?
• Have any of the passengers in this story challenged your own thinking? Have you changed your mind on anything?
• After all you’ve shared with her, what did you think about Professor Grammaticus’ speech to the conference?

QUESTIONS EXPLORING ETHICAL ISSUES RAISED IN THIS NOVEL

• During her journey Jocelyn is eavesdropping on many conversations. She plans to use them for her keynote address to a professional conference. Is this justifiable? What caveats would you set around doing so?
• To what extent do you feel the book about Henrietta Lacks’ immortal cells helps the exploration of ethical issues?
• Jocelyn challenges her students with ‘D’you know what happens to blood you give in your GP’s surgery? Or the appendix you leave behind in the operating room? Or fetuses left over from abortions? You may well have undisputed rights over your intact body, but what rights do you have over disembodied cells? What if bits of you were used in ways that generated stacks of money (like Henrietta’s)? What if they were part of research developments that established huge reputations (ditto)?’ How do you feel about these issues?
• Is there a place for ‘benevolent deception’ in medicine?
• What do you feel about the issues raised by the passengers in this story: The rights of families to sue when a child is damaged during the birthing process (Chapter 4)? Treating a mentally ill patient on death row until he’s sane enough to be executed (Chapter 6)? Covert surveillance in suspected cases of child abuse (Chapter 6)? Sterilisation on demand (Chapter 7)? Enforced treatment for mentally incompetent patients (Chapter 7)? Assisted conception for elderly women (Chapter 8)? Withholding of treatment unless life style changes are made (Chapter 9)?
• Jocelyn says: ‘I can’t help but think of the foreign doctors and nurses and carers who have helped look after both my parents at various points in their illnesses. So many of them were strangers to the English language, thick accents, convoluted sentences, alien cultures. I had difficulty understanding them; what chance the elderly, the hard of hearing, the demented? And yet these are the very people responsible for imparting vital information, life-or-death facts and figures. What price informed consent then?’ What do you think about this?
• Henrietta Lacks did not give consent – her cells were used; George Geys did give consent, even specific instructions – his cells were not used. What are your views on this?