The town of Upper Darby embodies the typical American suburb, serving as a microcosm for the broader societal debates around medical emancipation and genetic engineering. This setting is crucial as it amplifies the normalcy of the family's life amidst their extraordinary circumstances. Rhode Island, with its quaintness and proximity to major medical hubs in the United States, adds a layer of realism and accessibility to the story, making the unimaginable dilemma of the Fitzgerald family something that could happen in any town.

Characters

• Kate Fitzgerald: A teenage girl suffering from promyelocytic leukemia. She is the motivation behind Anna's conception as a "savior sibling."

• Andromeda "Anna" Fitzgerald: Conceived to be a donor for her sister, Kate. At 13, she seeks medical emancipation to gain control over her own body and medical decisions.

• Jesse Fitzgerald: The oldest Fitzgerald child, who turns to delinquency as a way of coping with his family's situation.

• Sara Fitzgerald: The mother of Anna, Kate, and Jesse. Obsessed with saving Kate, she overlooks the needs and well-being of her other children.

• Brian Fitzgerald: Father to Anna, Kate, and Jesse. An astronomer who is torn between supporting his wife's fight to save Kate and understanding Anna's desire for independence.

• Julia Romano: Appointed as Anna's guardian ad litem to represent her best interests. She has a romantic history with Anna's lawyer, Campbell.

• Campbell Alexander: Anna's attorney in her quest for medical emancipation. He has a hidden personal condition that impacts his life and choices.

• Suzanne: The wealthy aunt of Jesse, Kate, and Anna, and Brian's sister-in-law. She shows more support for Anna's situation.

• Dr. Harrison Chance: Kate's dedicated oncologist.

• Judge DeSalvo: Presides over Anna's medical emancipation case.

• Isobel "Izzy" Romano: Julia's sister and roommate, a jewelry designer who dislikes Campbell for breaking her sister's heart.

• Taylor Ambrose: Kate's boyfriend, who also suffers from leukemia. He shares a profound connection with Kate during their time together.

FAQs

What is the book about?

My Sister's Keeper revolves around the complexities of familial obligations, the ethics of medical decisions, and the quest for individual identity within a family dynamic, particularly when one child's life consistently overshadows another's.

What ethical questions does Jodi Picoult raise in her novel?

In My Sister's Keeper, Picoult raises ethical questions about the extent to which parents can decide medical treatments for their children, the morality of conceiving a child to save another, and the rights of minors in making life-altering medical decisions.

How does the book explore the concept of being a "savior sibling"?

Through Anna's story, the novel delves into the emotional and physical toll of being conceived as a "savior sibling," designed to donate organs and tissues to her critically ill sister, exploring themes of autonomy, sacrifice, and identity.

What are the main conflicts in the novel?

My Sister's Keeper centers on the conflict between parental rights and the medical needs of a child versus the rights of another child to control her own body. This is compounded by internal family struggles, ethical dilemmas surrounding medical consent, and the quest for individual identity.

What is the significance of the court case in the novel?

The court case serves as the climax of My Sister's Keeper, bringing to the forefront the ethical and moral debates surrounding medical emancipation, the rights of individuals, and the role of the judiciary in resolving deeply personal and contentious family matters.

How do the characters evolve over the course of the story?

Characters evolve significantly throughout My Sister's Keeper, confronting their own beliefs, fears, and desires. This evolution is marked by a deeper understanding of love, sacrifice, and the complexities of ethical dilemmas, resulting in altered perspectives and, for some, a change in behavior and beliefs.

What role does the concept of medical emancipation play in the novel?

Medical emancipation is central to the plot of My Sister's Keeper, acting as Anna's aim to gain autonomy over her own body decisions, challenging her parents' choices, and sparking a wider debate on the rights of minors and the ethical implications of parental consent for medical procedures on children.

How was the novel received by readers and critics?

While readers generally laud My Sister's Keeper for its compelling narrative and ethical quandaries, critics have both praised Picoult's storytelling and depth of character development and noted potential weaknesses in character believability. The book's controversial topics have also led to it being challenged in some educational and library settings.

What differentiates the film adaptation from the book?

The film version of My Sister's Keeper differs from the novel mainly in its ending and selective emphasis on certain subplots, decisions that author Jodi Picoult did not fully endorse. These changes significantly impacts the story's conclusion and messages.

Quotes

• “You don't love someone because they're perfect, you love them in spite of the fact that they're not.”

• “Let me tell you this: if you meet a loner, no matter what they tell you, it's not because they enjoy solitude. It's because they have tried to blend into the world before, and people continue to disappoint them.”

• “Maybe who we are isn't so much about what we do, but rather what we're capable of when we least expect it.”

• “If you have a sister and she dies, do you stop saying you have one? Or are you always a sister, even when the other half of the equation is gone?”

• “Extraordinary things are always hiding in places people never think to look.”

• “The bottom line is that we never fall for the people we're supposed to.”

• “It is the things you cannot see coming that are strong enough to kill you.”

• “Sometimes to get what you want the most, you have to do what you want the least.”

• “Here's my question: What age are you when you're in Heaven?”

Quick facts

• Although a work of fiction, My Sister's Keeper touches on real-world debates about the use of preimplantation genetic diagnosis (PGD) to conceive "savior siblings."

• My Sister's Keeper features multiple points of view, including those of Anna, Kate, their brother Jesse, and their parents, among others. This narrative structure provides a multi-dimensional perspective on the story's complex ethical questions.

• Jodi Picoult conducted extensive research into leukemia, "savior siblings," and the legal system to write the novel, which has been praised for its accurate depiction of these elements.

• In a significant plot twist, it is revealed that Kate actually wants to stop receiving medical treatments, leading Anna to sue her parents for medical emancipation—a revelation that challenges perceptions of self-sacrifice and familial obligations.

• The character of Campbell Alexander uses a service dog, which adds another layer to the story about dealing with disabilities and how they are perceived by others. It's later revealed that Campbell has epilepsy, a fact that even some of the other characters are unaware of until a dramatic turn in the story.

• In 2009, the American Library Association (ALA) and the office for Intellectual Freedom named My Sister's Keeper the seventh most frequently challenged book in the US due to its content.

• My Sister's Keeper was adapted into a major motion picture in 2009, directed by Nick Cassavetes. Interestingly, the movie features a significantly different ending from the book, a change that author Jodi Picoult has publicly expressed disappointment over.

About the author

Jodi Picoult is a prolific, popular, and acclaimed New York Times bestselling author of contemporary women's fiction. Beginning her writing career in 1992, she has published nearly 30 novels, including Wish You Were Here, Small Great Things, Leaving Time, My Sister’s Keeper, 19 Minutes, Between the Lines, and more recently, Mad Honey, co-written with Jennifer Finney Boylan. She also co-authored two young adult novels, Between the Lines and Off the Page, with her daughter, Samantha van Leer.

Born in 1966 in Nesconset, New York, Picoult attended Princeton University, where she studied creative writing. While in college, she published two short stories in Seventeen magazine. She later earned her master's degree in education from Harvard University. In her novels, Picoult frequently explores complex moral dilemmas and family dynamics, touching on controversial and pivotal issues such as abortion, race relations, LGBT rights, genetic engineering, and gun control. She invests meticulous research into writing about thought-provoking topics, yet embraces having her novels labeled "chick-lit." She has won several awards, including Cosmopolitan magazine's Fun Fearless Fiction award and the New England Bookseller Award.

Picoult is a vocal advocate for various social issues and has participated in numerous organizations and initiatives aimed at fostering inclusivity, literacy, and justice. She has also contributed to the DC Comics universe by writing several issues of Wonder Woman, engaging with an entirely different audience. In recent years, her advocacy has extended to challenging book bannings and supporting marginalized voices in literature. She lives in Hanover, New Hampshire, with her husband, Timothy Warren Van Leer, and their three children.