My Sister's Keeper, director Nick Cassavetes' (The Notebook) new weeper film starring Cameron Diaz and Abigail Breslin, releases today.

Fans of the original 2004 Jodi Picoult novel may be expecting a cinematic exploration of the ethical ramifications of PIDG (pre-implantation genetic diagnosis), the medical practice of engineering and selecting embryos for specific medical reasons.

After all, in both the novel and the movie, the drama centers on a cancer-stricken teenager and the younger sister who was engineered in a test tube to be an ideal donor of blood and bone marrow. (USA Today's Cathy Lynn Grossman, a fan of the novel, offers a succinct summary of the issue and its implications on her Faith and Reason blog.)

Although the film is faithful to the book in a number of ways, a significantly altered ending and a shift in emphasis make PIDG more of a plot point than a central theme. Intriguingly, a different, but closely related issue, bubbles up in its place.

Kate, the film's sister-with-cancer, has battled serious illness for 12 of her 14 years. Although she needs a kidney transplant, she has become convinced that death is imminent and does not want any more invasive treatments. Her desire to "die with dignity" (to use a politically charged term that the film does not employ) places the people around her in painful quagmires. Her mother has been fighting for her daughter's life so long she cannot even apprehend or acknowledge what Kate actually wants. Her sister, who is in a position to donate a perfectly matched kidney, is the only person who can save Kate's life and, conversely, the only one who can make sure her wishes are respected.

As Grossman points out, the story points to a possible "tension between the value of preserving life and the costs of the quality of life." Although ostensibly the film is about the tension between preserving one child's life at the cost of another child's quality of life, it also asks questions about the validity of preserving a life against its owner's wishes.

The Christian belief that each person is crafted in God's image makes most believers staunch defenders of the sanctity of life. Conversely, the conviction that earthly death is not an end but a beginning (1 Thess. 4:13-18, Phil. 1:21-23) allows for the possibility of a peace-graced acceptance of death at the appropriate time. Ecclesiastes tells us there is a time to live, and a time to die (3:2). As medical science continues to advance and offer extraordinary ways to prolong life, how do we keep track of which season we're in - particularly in the case of terminal illness?

Is life worth fighting for to the - well, death? What do you think? When a terminally ill patient feels ready to let go, should medical interventions cease? How much is our desire for the patient to continue fighting a part of our own fear of death? On the other hand, how much do we need to safeguard ourselves against materialist and utilitarian notions about what makes a life worth living? In the tension between preservation of life and quality of life, on which side should we err?

See Carolyn's full review of My Sister's Keeper at, one of our sister sites.