YMMV / My Sister's Keeper

• Broken Base: Whether the book or the film's ending is better is a massive point of contention. The book ends with Anna suddenly dying in a car accident, and Kate receiving her kidney. The film avoids this, so Kate dies and Anna lives. Fans of the book's ending typically appreciate its themes about fragility and the randomness of life, as well as the fact that Anna does end up saving Kate's life after all. This disappears in the film's ending. Detractors typically hate the book's ending for coming out of nowhere, being a Writer Cop Out to avoid answering the moral dilemma the book presents, rendering a big portion of the book, namely the entire main plot pointless (especially after many of Jodi Picoult's later novels followed the exact same "introduce a thorny ethical issue and cop out of solving it in the last few pages" structure, showing this wasn't just a one-off), while the film's ending has none of the aforementioned problems. Chances are that whatever side a person is on, they'll think one of the endings is great and the other ruins the story.
• Fridge Brilliance: We assume that Anna is the narrator in the prologue and it is Anna who tried to kill her sister Kate when she was three years old. It is actually Kate. The only other time she narrates is at the end. Note the use of the italics.
• Jerkass Woobie: In the movie adaptation, even the wangsting Sara gets her sympathetic moments when she breaks down by Kate's side as her dying daughter in her deathbed slowly passes away in the same night. Even in the novel, there are glimmers of her showing remorse and awareness of the pain and estrangement she's caused her family, but she is too egomaniacal and adamant in her goal (which, in fairness, is to save her cancer-ridden daughter). The novel also ends with Anna dying instead of Kate, which emotionally wrecks Sara.
• Narm: The frequent usage of light-hearted pop songs on the soundtrack.
• Rescued from the Scrappy Heap: Sara in the film is shown to be far more sympathetic, some of her abuse being toned down and ultimately getting a Heel–Face Turn having to come to terms with Kate's death.
• Romantic Plot Tumor: Campbell and Julia's relationship takes up a lot of pages for something that isn't really related to the more compelling main plot and could be removed or edited down without any real effect on the story, at times taking up the brunt of a chapter to explain their history when Anna's situation always feels far more critical. Notably, the film streamlines the plot by completely removing Julia's character.
• Wangst: Following her daughter's diagnosis, Sara's entire life and identity revolve around it, to the point of neglecting her other children. Lampshaded when her sister Zanne says, "You can't be a martyr all the time," and Sara mistakes her for saying "You can't be a mother all the time." Although Sara acknowledges it at times, such as when Zanne tells her she's spending her whole life waiting for Kate to die, she falls back into the habit time and again.
• The Woobie:
  • Kate herself, through and through. She's spend her entire life terminally ill, bouncing in and out of hospitals, constantly sick and in pain, and self-conscious of her appearance because of it. She has no friends, and finds it difficult to get excited about anything since she's unsure if she'll even live to see it. The one time she falls in love with a boy, he's also sick, and dies the day after they kiss. At the end of the book, it's revealed that she's so tired of living that she has tried to commit suicide before—Anna only started the lawsuit as a means of helping her.
  • Anna's identity has always revolved around being Kate's donor. Her feelings of frustration and anger towards her sister and her family are only made worse by how much she does love Kate. Even when she finally takes a stand for herself by filing the petition for medical emancipation, it's basically to assist in Kate's suicide (which breaks her heart), and tears her family apart. When she does win the petition, she dies on the very same day in an abrupt car accident, after which her kidney is donated to Kate anyway. Anna never grows up, and never gets to see a life that doesn't revolve around Kate.
  • Jesse. Unlike Anna, who is admired by her mother and father for always being "happy" despite everything going on, years and years of being neglected and ignored by his parents have turned him into a delinquent who sets fires just to get attention. When he's finally caught, he breaks down crying, admitting that he hates himself for not being a match for Kate.