It's beautifully shot and skillfully acted, but My Sister's Keeper, an earnest family-faces-cancer drama, is a bit like a real-world horror film with "heart," right down to the trick ending.
To its credit, it contains unblinking depictions of the retching, bleeding and scarring that come with extreme medication. (That's the most original thing about it.) But even if you judge it by the rules and standards of horror movies instead of family dramas, My Sister's Keeper flunks some basic tests.
Work backward from the tear-jerking climax, and you realize that the film has pulled cheat after cheat. The movie pivots on the story of Anna Fitzgerald (Abigail Breslin), a "designer baby" programmed to be a perfect genetic match and thus a bone marrow and organ donor for her leukemia-ridden older sister Kate (Sofia Vassillieva). At age 11, Anna approaches lawyer Campbell Alexander (Alec Baldwin) to sue her parents for medical emancipation. Fed up with doctors farming her for body parts, she wants to decide for herself whether to donate a kidney to her sibling.
My Sister's Keeper sets out to bring the mental toughness of a legal drama to a tale fraught with pathos. The potential for crackling poignancy is huge - especially since Anna's mom, Sara (Cameron Diaz), was a formidable lawyer herself before she quit her practice to care for Kate full time. (Her husband, Brian, played by Jason Patric, is a firefighter.)
Director Nick Cassavetes and his co-writer, Jeremy Leven, don't make good on the movie's promise. Too often, they sink into soap opera, using devices taken from Jodi Picoult's novel and broad strokes all their own, like the final narrative turnaround. Like desperate thriller writers, they withhold information to bring off their uplifting version of a feel-bad finale. They also practice the magician's trick of misdirection: drawing the audience's attention to one place while the real story builds to a climax somewhere else.
At the same time, they allow each major character, including Anna's troubled, elusive elder brother Jesse (Evan Ellingson), to present what amounts to partial testimony straight to the audience, in voice-over narration. And everyone, including Baldwin's lawyer and the key supporting character of Judge De Salvo (Joan Cusack), comes conveniently equipped with a back story that echoes the Fitzgeralds' calamities.
