Can parents force a reluctant child to become an organ donor for a fatally ill sibling? And if they can, should they? These are the questions powering Jodi Picoult's characteristically provocative, topical, and slightly bloated new novel, My Sister's Keeper -- a tense, high-concept piece of women's fiction in the tradition of Anna Quindlen and Rosellen Brown.
The melodrama begins when 13-year-old Anna Fitzgerald walks into a lawyer's office with $136.87, her life's savings, asking to be medically emancipated from her parents. Brian and Sara Fitzgerald designed Anna to be the perfect biological donor for her sister Kate, now 16, who was diagnosed with leukemia at age 2. As Anna puts it, ''I wasn't the result of a cheap bottle of wine or a full moon or the heat of the moment. I was born because a scientist managed to hook up my mother's eggs and my father's sperm to create a specific combination of precious genetic material.''
Over the years, each time Kate relapses, Anna is dragged to the hospital to give her blood, lymphocytes, granulocytes, and bone marrow. Now, as Kate lies on her deathbed, Sara expects Anna to pony up a kidney. Anna, however, has decided that she's through. ''Nobody ever asked,'' she tells her lawyer.
''My Sister's Keeper'' crackles when the characters wrestle with unanswerable moral questions. The Fitzgeralds divide into opposing camps on the subject of Anna's lawsuit, and each has a compelling argument. Brian, who has long privately disapproved of the painful measures used to keep Kate alive, supports Anna's right to control her body. But Sara, who loves both of her daughters passionately, flies into a rage. ''I have one child who's just signed her sister's death sentence,'' she tells her husband, ''and I'm supposed to cool off?'' As the two sides square off, a new question arises: Whatever the official courtroom verdict, how will this ravaged family ever repair itself?
Unfortunately, Picoult has overburdened an elegant and riveting premise with irrelevant sentimental subplots. Told from seven different points of view -- at least three too many -- the book plumbs the dreary inner life of Kate and Anna's troubled older brother, a budding arsonist whose complaints can't compete with the courtroom drama. The novel goes into even greater detail about the personal history of Anna's attorney and his reunion with a high school love. Soapy discursions like this dilute the effect of Picoult's sharp central narrative.
A taut, issue-driven novel can't support many extraneous players. And in Picoult's hands, even the people crucial to the case-study plot -- all of them nice, generic middle-class types -- quickly lose their substance when you close the book. Like the B actors on Lifetime, Picoult's characters get the message across, but you won't remember them in a year, a month, or even a week.