Jodi Picoult's My Sister's Keeper (2004) explores the medical, legal, ethical, and moral issues related to long-term illness—a complicated subject in the contemporary world. In the book, thirteen-year-old Anna sues her parents for the right to control her body. Conceived as a sibling donor match for her sister Kate, who suffers from leukemia, Anna has undergone numerous procedures to provide Kate with whatever she needs to fight her disease, but when Anna learns she is to give up a kidney for her sister, Anna hires a lawyer and takes her parents to court.

Picoult's idea for My Sister's Keeper came while doing research for her novel Second Glance (2003), when she was intrigued by information about eugenics in the United States in the 1930s. Supporters of eugenics wanted to improve the human race by allowing only those with desirable genetic characteristics to reproduce. Picoult also learned about stem cell research and linked the ideas, wondering if stem cell research could become human genome research. The related issues are complex and emotional.

A news story about a mother in Colorado who conceived a child so that the baby could donate cord blood to save the life of his elder sister also captured Picoult's imagination. The author took the idea to the next level and added more invasive procedures to increase the story's drama and ethical dilemma.

Picoult's personal experience also shaped the plot. Her middle child, Jake, had ten surgeries in three years beginning when he was six years old. Picoult's son suffered from cholesteatoma—a benign but potentially fatal tumor that can grow into the brain—in both ears. Because of this experience, Picoult understands the lengths to which a mother will go to protect her child and also how needs of a sick child are demanding for the entire family.

My Sister's Keeper won a 2005 Alex Award from the Margaret Alexander Edwards Trust, and Booklist named it as one of the top ten adult books for teenagers. Reviewing the novel in Booklist, Kristine Huntley concluded, "This is a beautiful, heartbreaking, controversial, and honest book."