MY SISTER'S KEEPER

The difficult choices a family must make when a child is diagnosed with a serious disease are explored with pathos and understanding in this 11th novel by Picoult (Second Glance , etc.). The author, who has taken on such controversial subjects as euthanasia (Mercy ), teen suicide (The Pact ) and sterilization laws (Second Glance ), turns her gaze on genetic planning, the prospect of creating babies for health purposes and the ethical and moral fallout that results. Kate Fitzgerald has a rare form of leukemia. Her sister, Anna, was conceived to provide a donor match for procedures that become increasingly invasive. At 13, Anna hires a lawyer so that she can sue her parents for the right to make her own decisions about how her body is used when a kidney transplant is planned. Meanwhile, Jesse, the neglected oldest child of the family, is out setting fires, which his firefighter father, Brian, inevitably puts out. Picoult uses multiple viewpoints to reveal each character's intentions and observations, but she doesn't manage her transitions as gracefully as usual; a series of flashbacks are abrupt. Nor is Sara, the children's mother, as well developed and three-dimensional as previous Picoult protagonists. Her devotion to Kate is understandable, but her complete lack of sympathy for Anna's predicament until the trial does not ring true, nor can we buy that Sara would dust off her law degree and represent herself in such a complicated case. Nevertheless, Picoult ably explores a complex subject with bravado and clarity, and comes up with a heart-wrenching, unexpected plot twist at the book's conclusion. (Apr.)