‘Sister’s Keeper’ raises tough questions

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“My Sister’s Keeper” is a shameless weepy, one of the most manipulative and fundamental of genres, but it also raises some surprisingly difficult and thought-provoking ethical questions.

Based on the Jodi Picoult best-seller, the drama focuses on the Fitzgerald family, and the drastic decision they made in medically engineering a child (Abigail Breslin) as a perfect genetic match to help save the life of their older daughter Kate (Sofia Vassilieva), who has leukemia.

Ordinarily, this sort of material would seem better suited for television, but there’s an artfulness to the storytelling that makes it work on the big screen.

For years, little Anna provided blood, bone marrow, whatever Kate needed. She did it because she loved her sister, and because it’s all she ever knew. Now at 11, with Kate needing a kidney, Anna says no for the first time – and beyond that, she files a lawsuit seeking medical emancipation from her parents to keep them from making further decisions about her body.

(Alec Baldwin provides a few welcome flashes of comic relief as the dryly arrogant lawyer she chooses from his TV commercials.)

Director Nick Cassavetes, who co-wrote the script with Jeremy Leven (writer of Cassavetes’ “The Notebook”), traces this conflict through flashbacks from various characters’ perspectives: Bulldog matriarch Sara (Cameron Diaz), whose priority is preserving Kate’s life at all costs; father Brian (Jason Patric), who is patient and supportive no matter what; only son Jesse (Evan Ellingson), who feels lost in the shuffle; and Kate and Anna themselves. He probably relies a bit too heavily on voiceover from them all explaining the obvious: That they’re a dysfunctional family but they still manage to stick by each other.

Cassavetes tugs at the heartstrings, which has become a trademark in much of his work, providing opportunities to yank out the hankies early and often. But he also wisely refrains from demonizing any of these characters for their choices and lets us draw our own conclusions.

Cinematographer Caleb Deschanel helps bring a gauzy melancholy to these heavy proceedings, especially during a pivotal scene at the beach toward the end.

On the flip side, some family members seem too good to be true – especially Brian, who happens to have chosen that most selfless of careers as a firefighter, and the saintly Kate herself, who loses it far less frequently than the average person might in her situation.

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