Here's a quintessentially American predicament: 11-year-old Anna (Abigail Breslin), sues for "medical emancipation" from her parents rather than go under the knife and donate a kidney to prolong her older sister's fight against leukaemia.
The girls' parents, Brian (Jason Patric) and Sara (Cameron Diaz) are appalled, angry and determined to fight the case - it turns out that Sara was a high-powered attorney before she decided to devote herself to caring for Kate (Sofia Vassilieva). We share their dismay, at first, but it quickly becomes clear that Anna has a point: in her short life she has already endured countless operations, donated blood and bone marrow. And, what's worse, she was born and bred for this purpose, designed in vitro to be her sister's perfect genetic complement. It is true that Anna can live with one kidney, but not in the same carefree manner that she could with two. Doesn't she deserve her own chance to live as others do?
Co-written and directed by Nick Cassavetes (The Notebook) from Jodi Picoult's best-selling novel, My Sister's Keeper takes an exotic situation and seeks to draw some universal truths, with some success. Structured as a series of subjective flashbacks from different family members' point of view, the film tracks the fissures that run through this family and traces them back to Sara's, in some ways admirably fierce, resolve to fight for her first-born. If she can't win this war at least she can delay defeat, and what mother would do less?
An actress who has always struggled to be taken seriously, Diaz doesn't usually get to play these kinds of meaty dramatic roles but she commits herself to it with real will and never sugar-coats a sometimes disagreeable but very tough, single-minded and utterly believable mum. It's probably the performance of her career and though an Oscar nomination is unlikely at this stage, it certainly merits consideration.
Opposite her, Jason Patric is a model of subtlety and economy, trusting the drama to carry the emotional weight of the scenes as Brian looks for the impossible middle ground between his wife's sense of mission and his younger daughter's declaration of independence. Then there is Vassilieva's Kate, her big, bright, brave smile muddying the waters still further. We see that the sisters love each other. How could Anna bring herself to seal Kate's death warrant?
Actually, you may be able to guess the answer to that question and quite some time before it is revealed in open court. Picoult's elaborate plot apparatus feels a bit too clever and contrived in the face of the film's relatively authentic account of illness and suffering. Which is not to say that the courtroom mechanics aren't entertaining - especially Alec Baldwin, bringing wit to the most flamboyant role: the big-money lawyer who takes Anna as a client for reasons of his own.
But between them Picoult and Cassavetes will keep poking and prodding at our tear ducts. Was it really necessary that the judge listening to the case (Joan Cusack) should be getting over the tragic loss of her own daughter? And wouldn't the story's ethics have been that much more challenging if Kate were not such a golden child? Certainly the movie might have been much improved with the excision of the syrupy muzak cover versions that Cassavetes spreads over artfully photographed montage sequences at 15-minute intervals.
Mind you, by the egregious standards of cancer movies - I think the last one was The Bucket List - at least My Sister's Keeper doesn't prettify terminal illness. At least, not as badly as most. Cassavetes' father - the actor and director John Cassavetes - died at the age of 59 after a long struggle with cirrhosis of the liver and Nick's daughter has also suffered from a heart condition. You sense, watching the movie, that he has spent time in hospital bedrooms, smelt the smells, known the frustrations. (He also made the medical drama, John Q, let's not forget.)
A potentially mawkish cancer-ward romance between Kate and another terminally ill teenager (Thomas Dekker) is played with such sensitivity that you might wish it lasted longer. On the other hand, the girls' older brother Jesse (Evan Ellingson) has such a crudely curtailed role he might better have been written out altogether. Fans of the book will also want to heed the warning that the ending has been changed. Not for the worse, to my mind, but even so the denouement cheapens the emotions the actors have worked so hard to make true.