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 ...

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