d. Nick Cassavettes; pr. Stephen Furst, Scott Goldman, Mark Johnson, Chuck Pacheco, Mendel Tropper; scr. Nick Cassavettes, Jeremy Leven; novel. Jodi Picoult; ph. Caleb Deschanel; ed. Jim Flynn, Alan Heim; m. Aaron Zigman; cast. Cameron Diaz, Sofia Vassilieva, Abigail Breslin, Joan Cusack, Alec Baldwin, Jason Patric, Jeffrey Markle (109 mins)

MY SISTER'S KEEPER FACTS: FILM TALES - Picoult readers and fans of the novel were distraught that filmmakers changed the ending and wrote to Picoult who, on her website, claimed that she had no control over the script and encouraged those outraged over Hollywood's decision to write the studio; Dakota Fanning was originally to be cast as the sick daughter but refused to shave her head for the role and was replaced by Sofia Vassiliava, who reckoned that shaving her hair and eyebrows was the least she could do to understand the character; SPONSORS: This review of My Sister's Keeper is proudly sponsored by: INKSTONE DIGITAL - the latest e-books for as low as $8.95 with exclusive special offers not on Kindle (read more); NO LIMITS - Free weekly e-zine devoted to topics of personal growth and self-empowerment with contributions from best-selling authors and leaders in their field (try a free issue now); Scrolling News Ticker by Mioplanet;

Jodi Picoult is a masterful author of populist familial crises, usually driven by medical issues and their associated ethical-legal dilemmas.

Children struggling with fatal illnesses or permanent disabilities, their families torn over their proper treatment, struggling not just to do what is right but to keep their families alive with hope and love: such is Picoult’s world in successive best-sellers. Indeed her work has found that delicate balance of literary talent and commercial success that has made her one of America’s highest-profile authors. And such thus unexpectedly is also the case with the first of her books to see the big screen in a Hollywood adaptation – My Sister’s Keeper starring Cameron Diaz – although the film’s ending was substantially revised from that of the novel, much to the concern of the novel’s many fans. The film’s success, however, may owe less to Picault’s uniqueness than her ability to update what are trends that have existed in medical fiction and film for quite some time. In short, on seeing My Sister’s Keeper one is left wondering just what, if anything, new is really being added to American film here by adapting Picoult., except perhaps a timely sentiment.

With a premise that involves genetic engineering and the sanctity of the individual human body, My Sister’s Keeper brings a balance of weighty ethics and unashamed sentiment that restores to Hollywood the time-honoured tradition of the “weepie”.

The “weepie” or the “tearjerker” was the name given to melodramas made since the 1950s and aimed primarily for women, the presumption being that women reacted more to emotional heights on screen than men, who preferred physical feats in action, adventure and other such traditionally visual spectacles. Featuring strong female characters, stories of love, marriage and family tensions these films often alluded to physical suffering, disease or medical ailment as a means of generating sympathy for the characters and their situation: characters often had some ailment that affected their lives or those of their loved ones. Although feminism has re-arranged the priorities women face in their emotional lives, this form of medical drama remains a potent metaphor, and similar narratives of definition-by-medical-condition proliferate. Indeed, the success of such cancer-sufferer pictures as Griffin & Phoenix and The Doctor testify to the continued viability of what might best be considered the medical weepie.

Former medico turned author Michael Crichton in the 1970s revolutionized the medical drama by transforming it into the medical thriller with such as the hit Coma, made into a movie with Genevieve Bujold, Michael Douglas and a villainous Richard Widmark. While Crichton turned away from medical ethics in favour of science fiction, Jodi Picoult returns to the medical drama the full weight of contemporary ethics in her work, the mawkish nature of which is particularly evident in the screen adaptation My Sister’s Keeper, directed with an eye for the tear-ducts by Nick Cassavetes. Cameron Diaz plays the mother of a young girl (Sofia Vassilieva) diagnosed with leukaemia. On the unofficial advice of her doctor, she and her husband (Jason Patric) donate egg and sperm to create a genetically engineered sibling (Abigail Breslin) who, as a genetic match to the sick girl, will be able to donate healthy organs and save her sister’s life. However, when Breslin reaches eleven years old, she decides that her life should be her own choice and hires a lawyer (Alec Baldwin) to sue her parents for “medical emancipation”, in effect giving her the right to deny her sick sister the use of her body. Needless to say Diaz will have none of this as the matter draws to court (and rests before judge Joan Cusack, herself having recently lost her only daughter in a tragic accident).

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Between the ironic co-incidences (or dramatic contrivances) here is an intriguing dilemma: can a genetically engineered sibling assert an individuality which in effect refuses her parents the right to use her body to save her sick sister? At what age is a child considered able to understand the consequences of her actions and be responsible for the use of her own body? Indeed, in using her engineered daughter’s body to treat the sick girl for many years (often to the detriment of the healthy sibling) has Diaz been a cruel mother?

The intersection of medical technology and humanist responsibility is the premise underlying director Cassavetes’ vision in My Sister’s Keeper, even though the film is reassuringly theist in its look at the dignity (as well as the indignity) of suffering. However, the focus is less on any legal issues involved – which are dealt with quickly and succinctly even in the film’s courtroom scenes – than on the familial costs and their specifically maternal basis in what might be termed medical trauma. In this case, the film offers a cross-section of noble sufferers, all family members doing their best under the circumstances but – with the exception of Diaz – increasingly aware of the cost on their individuality and their family even though these are revealed in narration more so than in actual family discussion until the film’s second half.

Here, the film’s title is telling: the central characters are not the two daughters, who nevertheless dominate the film emotionally, but their mother, Diaz, who dominates the film dramatically in what is her finest work to date, the experience on her face almost as revealing as that on Cusack’s – the two of them paralleled as mothers facing the loss of a beloved daughter.

Hence the film’s most telling moment goes unanswered: judge Cusack has asked to see Breslin to determine if she is of sound mind only to have the little girl ask her what it is like to lose a daughter, the child desperate to understand the effect of her actions on her mother and struggling to express her concern: the question goes unanswered. As her own sister intuits, Diaz has defined herself as a woman in her role of “hero-mother” – prolonging her daughter’s life above all costs even though it has an arguably horrid toll on Breslin whose assertion of independence is met with disbelief and resentment by Diaz. Once a successful lawyer – and representing herself in this case – Diaz has given away whatever career or other individuality she had as an independent woman to define herself simply in reaction to her daughter’s medical ailment: she has allowed it to dominate her life and her outlook to the point where she has nothing else to define her; and, nothing else to live for.

It’s an assessment of motherhood which is intriguing – and one which even Vassilieva knows all too well is occurring, hence a telling moment between them about the need to let go and move on – albeit culturally conservative: the maternal bond as the surrender of the mother’s individuality to the sole purpose of the furtherance of the daughter’s life at the expense of the second daughter’s complete health, an individual to her mother only insofar as she too has a function to serve in the life of the sick child. In that, Diaz’s dilemma is both familiar and monstrous: after all, this culture makes much out of such notions as the nobility of suffering so much so that it is easy to empathize with Diaz’s self-sacrifice, another traditional (and religious) virtue which this film calls into question without really offering a point of view about in its mounting sentiment. Combined with the film’s subtle stress on notions of heaven in a repeated song and Breslin’s pseudo-spiritual voice-over opening and closing the film, this suggests the film is constructed to examine the cultural connotations of “suffering”, a spiritual affliction to some who seek solace in such matters. Suffering determines status – the ability to confront death with hope, resolve and love in the face of seeming despair.

However, Diaz’s single-minded determination to save her daughter suggests that her self-sacrifice is far less noble than it seems. It is on this note that My Sister’s Keeper strikes its potential note of psychological complexity, sadly to gloss over it in the film’s concluding moments.

Diaz has simply lost sight of just how pathological her maternal dedication to her daughter has become, although lawyer Baldwin sees it all too clearly. In that, her histrionics in certain scenes recall the melodramatic moments in films of a generation ago and she seems what director Cassavetes intends as a modernization of the traditional melodramatic heroine – the hysterical, obsessed woman, here a mother who was once a successful career woman and has transplanted her ability onto the quest to see her daughter survive – but now re-oriented towards a new and more contemporary set of ethical dilemmas posed by medical science. Despite the novelty of the premise, everyone here is otherwise a familiar character type in American film. Thus, although its medical ethical dilemmas may be especially resonant, the formula surrounding its depiction in this film adaptation is well-established – My Sister’s Keeper is, for all the novelty of its legal-medical premise, an old-fashioned weepie about the nobility of suffering and the seemingly tragic inevitability of death. Though extremely well-made and dramatically effective, it offers little if anything new to an existing body of work dealing with terminal illness except perhaps in the effectiveness of its appeal to emotional – as a modern tearjerker, it works to perfection.