Dying in Vain

Eleven-year-old Anna Fitzgerald's parents didn't just plan for her — they customized her in utero, with the specific end of providing spare parts and infusions for her leukemia-sick older sister, Kate.

From a 2004 Jodi Picoult best-seller, My Sister's Keeper mashes Death Be Not Proud with Irreconcilable Differences. When Kate (Sofia Vassilieva) relapses, experiencing renal failure, Anna (Abigail Breslin), after years of marrow harvesting, defies her birthright duty to play donor and cough up a kidney. She contracts TV-spot lawyer Campbell Alexander (Alec Baldwin, possibly the only actor who doesn't cry on-screen), who agrees to help her win medical emancipation. Before mom Sara (Cameron Diaz) took a solemn oath to keep Kate alive, quitting work to scrutinize her daughter's cell count, she was a lawyer herself, setting the stage for a family catharsis in the courtroom. (The film has an odd idea of law as group therapy.)

Screenwriter Jeremy Leven and director Nick Cassavetes, who previously jackpotted with The Notebook, reunite to adapt another heartstrings molester. Afraid to jettison subplot baggage, they make space instead with corner-cutting exposition techniques — consequently, too much is done in too little depth. Key narrative information is left to voice-over. Moments of bonding that should expand characters instead compress them, as cast members in music-video montage ham "happy" — photobooth high jinks, a beach idyll, Kate's dinner date with a fellow patient — to a soundtrack of Delilah After Dark requests. (It's interesting to contemplate that someone actually approved the inclusion of a draggy "Girls Just Want to Have Fun" cover, at a moment when the familiar lyrics could not possibly be any less applicable.)

The misty resignation is periodically sideswiped by Diaz, defiantly shrill as a woman incinerated by monomaniacal love, while the right thing to do is increasingly obvious to her husband (Jason Patric as Hunky Celt), to everyone else on-screen and to everyone in the theater. Cassavetes père might have approved. Meanwhile, Evan Ellingson, as the overlooked oldest Fitzgerald kid, is given little to do save look pained in the few digressive scenes he's the center of, as if holding in a big third-act revelation that will erase any last trace of moral ambiguity. (He's always taking the bus to Sunset Boulevard and wandering around neon after-hours; I thought the twist would be that he was hustling.)

My Sister's Keeper is extraordinarily explicit in showing the effects of disease and what is involved in caring for the sick. Screen time goes to gory hemorrhages, chemo-induced heavings and messed plastic sheets. As Kate weakens, her translucent skin darkens and discolors, and her teeth go brittle and loose. It's not exactly The Fly, but you don't usually see this unblinking attention to the progress of physical decay in a PG-13 wide-release movie, and to the degree that it represents a real aspect of human experience generally curtained out of sight, it is, in the language of movie people, a brave decision. But some of the most moving agonies in films have been accomplished through the phony shorthand of sweaty brow, hand dropped limp or a dribble of syrup from the corner of the mouth — which is to say, such makeup department realism alone can't redeem the dramatic fallacies surrounding it.

Cursed with the susceptible sentimentality common to drunks and childless Hummel collectors, I was unmoved by My Sister's Keeper. The subject is the saddest imaginable, a young girl letting go of everything — but for that to mean anything, the drama needs to suggest life beyond a scrapbook of misty water-colored memories, something to hint at Our Town's "Oh, earth, you're too wonderful for anybody to realize you." This may be asking a lot of a weepie, but this much less is emotional ipecac.