My Sister’s Keeper is about 13-year-old Anna Fitzgerald’s fight for the right to decide for herself if her body should be used to heal her sister, Kate, who suffers from acute promyelocytic leukemia (APL). Jodi Picoult writes a majority of the novel from Anna’s perspective, exploring the ways in which the circumstances of her birth and frequent medical donations have forever altered her childhood. At the same time, Picoult inserts chapters from the perspectives of others, such as Anna and Kate’s mother, Sara, whose grief in dealing with Kate’s diagnosis and treatments are shown firsthand. The novel’s structure—caught between alternating, almost competing, styles—allows for a more thorough exploration of bodily autonomy and choice.

Sara is presented as a mother who is determined to save her elder daughter at all costs. She is single-minded to a fault; while this mindset has contributed to Kate’s survival, it also causes Sara to lash out at her younger daughter when she files a petition for medical emancipation. Sara believes Kate will survive as long as the family doesn’t give up. Anna, on the other hand, requests the right to make her own medical choices. Since the moment she was born, Anna has been pushed to donate blood and bone marrow to Kate without explicit permission.