In "My Sister's Keeper," Abigail Breslin ("Kit Kittredge: An American Girl," "Nim's Island") leads an ensemble cast in an examination of death, what it means and the effects of hanging on to life too tightly.

Breslin stars as Anna, the 11-year-old sister to 14-year-old Kate (Sofia Vassilieva, TV's "Medium"). Anna was planned and engineered when Kate's parents, Sara (Cameron Diaz, "What Happens in Vegas") and Brian (Jason Patric, "In the Valley of Elah"), discovered Kate had leukemia when she was 2. In the years after her birth, Sarah and Brian farmed Anna for cord blood, bone marrow and a whole host of other bodily components Kate needed to stave off her disease. In most cases, the farming procedures were painful and frightening, and some were so brutal, they required hospital recovery time afterward.

While Anna's past sacrifices put Kate into remission and kept her alive long after the doctors' original predictions, the leukemia has returned. Kate's kidneys have failed, and Anna is expected to give up one of hers.

Rather than submit, Anna turns to Campbell Alexander (Alec Baldwin, TV's "30 Rock"), a locally famous lawyer. The plan is to sue Anna's parents and obtain "medical emancipation," which would allow her to refuse the kidney transplant.

LAWSUIT
The announcement of the lawsuit throws Anna's already fragile family into disarray. Sarah, who gave up her law practice to take care of Kate, goes to court against Anna. When they're not in the courtroom, Sarah takes Anna on some epic guilt trips. In the background is Anna's brother, Jesse (Evan Ellingson, TV's "24"), who has his own problems with dyslexia and general emotional neglect.

After many flashbacks, fights, monologues and musings, we learn that the situation with Anna and Kate isn't exactly what we thought.

Based on the best-selling novel by Jodi Picoult, "My Sister's Keeper" suffers from the usual adaptation problems that come with satisfying fans of the original book and making a logical movie. While some book fans may be on the message-board warpath over changes to the ending, director and co-screenwriter Nick Cassavetes ("Alpha Dog") makes a wise choice shifting the story's focus.

Although the book focused more on Anna's unique legal situation, the movie is more interested in exploring the underlying message that even in the worst of circumstances, life continues to happen to us up until the moment we die. Sarah, who doesn't understand that no-holds-barred war on her daughter's illness may not win her the battle at hand, and may actually destroy the rest of her family in the process, is the slowest to learn this lesson.

While the casting, acting and general production are excellent, adherence to the source material causes some hiccups. The book has up to six narrators, which Cassavetes tries to emulate here. That sort of narrative device works well in novels, but in movies, it becomes confusing and fragmented, because there simply isn't enough time to get to know each narrator's voice and understand their unique points of view. Jesse is especially underrepresented, and Brian, despite some nice moments, never quite takes shape.

Overall, "My Sister's Keeper" is very sad, but generally worthwhile.

"”Mike Robertson