Cruelly inspired, perhaps, by the weeping induced by the ravages of dementia he portrayed in his adaptation of Nicholas Spark's novel The Notebook, director Nick Cassavetes apparently set out to make another tear-jerker with a subject even more traumatic. What, he must have wondered, can I do to make audiences cry even harder?

The answer is My Sister's Keeper, a no-holds-barred weeper that makes The Notebook resemble an episode of How I Met Your Mother. Based on Jodi Picoult's bestseller, the film reveals the private agonies of the Fitzgerald family, in particular of teenage daughter Kate (Sofia Vassilieva of TV's Medium), who has leukemia, and her younger sister Anna (Abigail Breslin, Little Miss Sunshine). There's a brother, too, but aside from a couple of scenes indicating that (1.) he's dyslexic and (2.) he's upset, he's more or less expendable, which is sort of odd in this movie about how children are anything but.

Anna tells us over the opening credits that she was engineered in vitro by her parents to be a sort of medical clearinghouse for her dying sister. Blood, platelets, bone marrow -- you name it, and Anna has provided it to keep Kate alive. But now Anna says she's tired of being poked and prodded and cut open, even though Kate needs a kidney, or she'll die. The intrepid little sister hires an attorney (Alec Baldwin) to plead her case.

Profoundly and understandably enraged is Anna's mother (a surprisingly good Cameron Diaz, still looking a bit young to be a lawyer with all these teenagers), who has abandoned her career and devoted herself to keeping her eldest child alive. Anna's father (Jason Patric), a firefighter, is more sympathetic.

Shot in a series of nonchronological vignettes more confusing than artful, My Sister's Keeper is not a courtroom drama, though the legal challenge looms from time to time as its framework. It's a family melodrama that never misses the opportunity for a heartbreaking, acoustic musical montage that brims with portent, as if we could forget that losing a child is hard and terrible. Happy times, in usual Cassavetes fashion, are indicated in the most obvious ways: As the actors jump on a trampoline or pile into a photo booth or frolic on a beach, to slightly more upbeat music.

You might call My Sister's Keeper manipulative, and you would not be inaccurate. But if you know what you're heading into, you have nobody to blame but yourself when you emerge from the theater red-eyed and sniffling.

Cast: Cameron Diaz, Abigail Breslin, Jason Patric, Sofia Vassilieva, Alec Baldwin.

Director: Nick Cassavetes.

Screenwriters: Jeremy Leven, Nick Cassavetes. Based on the novel by Jodi Picoult.

Producers: Stephen Furst, Scott Goldman, Mark Johnson, Chuck Pacheco, Mendel Tropper.

A New Line Cinema release. Running time: 106 minutes. Mature thematic content, some disturbing images, sensuality, language, brief teen drinking. Playing at area theaters.

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