My Sister's Keeper is a tear-jerker with a really provocative theme running through it's veins. This film comes courtesy of Nick Cassavetes (son of John), and as was the case with his adaptation of The Notebook, this somewhat manipulative movie gets a major boost from sincere performances.

At the heart of My Sister's Keeper is the story of young Anna Fitzgerald (played by Abigail Breslin), an intelligent eleven year old who was, more or less, genetically engineered to be a blood type match for her cancer ridden sister. As the film opens, Anna pleads with an attorney (played by Alec Baldwin) to medically emancipate her from her parents so that she will no longer be forced to medically aid her dying sister. At the surface, that sounds like cruel subject matter for a film, but there's actually quite a bit more to it.

My Sister's Keeper works best when its delving into the dynamics of this intense but incredibly loving family relationship. There's plenty of honesty and truth seeping from this picture, but Cassavetes occasionally undercuts the harsh reality of the proceedings through poor directing choices and intrusive music cues.

Thankfully, the performances make the film well worth watching. Sofia Vassilieva is incredibly moving in the lead. As the sickly Kate, Vassilieva brings strength, vulnerability, and soul to this inspirational character. Abigail Breslin is warm and vibrant as the sensitive Anna. There are key moments between she and Kate that are positively heartbreaking. Jason Patric is terrific in an all too small role as Kate's understanding father Brian. Cameron Diaz goes out of her comfort zone a bit as Sara, a mother who'd do anything for her child. Try as she might, Diaz overplays some moments, but she's quite powerful in the film's final act, and she deserves added props for her courageous new hair style. Rounding out a stellar cast is Joan Cusack who breaks the heart as the emotionally worn judge who must oversee Anna's complicated case.

There are some tough issues raised in My Sister's Keeper, and while these particular issues are sometimes handled in an overly melodramatic way, the film works more often than not thanks to a terrific cast.

My Sister's Keeper isn't in the same league as the similarly themed Lorenzo's Oil or Philadelphia, but overall, I was affected by it. Quite clearly, the rest of the audience was affected too, because there wasn't a dry eye in the house.

Grade: B-