My Sister's Keeper recap

Thirteen-year-old Anna Fitzgerald was conceived as a genetic match to save her older sister Kate, who has aggressive leukemia, and has spent her life donating blood, marrow, and cells. When Kate's kidneys fail and Anna is expected to give up one of hers, Anna hires a lawyer, Campbell Alexander, and sues her parents for medical emancipation, the right to control her own body. The lawsuit tears at the family, especially her mother Sara, who fights the case herself to keep Kate alive. As the trial unfolds through the family's shifting perspectives, the reason behind Anna's suit is revealed: Kate, exhausted by years of illness, secretly asked Anna to stop donating so that she could be allowed to die. The court grants Anna the right to decide for herself, and her lawyer is given medical power over her. Almost immediately, Anna is catastrophically injured in a car accident and left brain-dead. As her final act, her kidney is donated to Kate. Kate survives and, against all expectation, her cancer goes into remission, while Anna, the sister who kept her alive, is the one who dies.

The Fitzgerald family lives under the long shadow of a child's cancer. Their daughter Kate was diagnosed with a rare and aggressive leukemia as a toddler, and to give her a matched donor, her parents used genetic selection to conceive her younger sister, Anna. For all thirteen years of her life, Anna has been a source of blood, marrow, and cells to keep Kate alive, her own body treated as a medical resource. Now, faced with the demand that she donate a kidney, Anna makes a startling decision: she hires a lawyer and sues her parents for the legal right to make her own medical choices. Her petition throws the family into crisis, especially her mother, Sara, a former attorney wholly devoted to saving Kate, who resolves to fight the case herself. The story is told from many points of view within and around the family as the lawsuit forces them all to confront what they have asked of Anna and what it has cost each of them.

The novel's ending overturns everything the lawsuit seemed to be about. During the trial it emerges that Anna did not bring the suit purely for herself: her dying sister Kate, worn down by a lifetime of cancer and treatment, had begged Anna to refuse the kidney donation so that Kate would finally be allowed to die. Anna agreed and took the legal fight on her sister's behalf, unable to say so openly. The judge rules in Anna's favor, granting her medical emancipation and assigning her lawyer, Campbell Alexander, power of attorney over her medical decisions until she is older. The victory is immediately undone by tragedy: on the way from the courthouse, Campbell's car is struck by a truck, and Anna suffers a fatal brain injury. With Anna brain-dead, her family and Campbell make the decision to donate her organs, and her kidney goes to Kate. The bitter irony is complete. Kate, who wanted to die and whose survival the whole family had fought for, lives and recovers, her leukemia going into lasting remission, while Anna, the healthy sister created to save her, is the one who dies. Kate narrates the aftermath, carrying the guilt and grief of surviving because of her sister's death, and the family is left permanently marked by the loss.