The premise of the two-hankie dying-daughter melodrama "My Sister's Keeper" is so preposterous that taking it seriously proves a difficult task. The gist: 11-year-old Anna Fitzgerald was conceived for the sole purpose of being a genetic match for her older sister, Kate, who has leukemia. All her life, Anna has been a donor of blood, marrow, and other necessities, and now Kate needs a kidney. But Anna has had enough of this and wants to sue her parents for "medical emancipation" -- the right to decide for herself whether she keeps donating things to her dying sister.

Clearly, this would have worked better as a dark comedy. As a drama, it's unspeakably ghoulish. The Fitzgeralds had another child not for any of the normal reasons, but to serve as spare parts for their cancer-stricken daughter? That's how Anna describes it when she approaches a lawyer about her rights: "I was made in a dish to be spare parts for Kate." And her lawyer says, "You're kidding, right?" Yeah, that was my reaction, too.

Insane though it may be, that is the movie's premise (it's based on a novel by Jodi Picoult, a regular pusher of hot buttons), and the frustrating thing is that it's not entirely implausible. Nothing about it blatantly contradicts science or the law. Theoretically, this could happen. I can't decide whether that makes me like it more or less.

This much I know: The film, directed by Nick Cassavetes ("The Notebook") and adapted by him and "Notebook" collaborator Jeremy Leven, is the unremarkable, broadly drawn weeper it sounds like it would be. Once the bizarre premise is established, all the movie can do is spin its wheels and wait for the story to play out -- it has a beginning and end, but no middle. In the meantime, we're saddled with characters who won't communicate with each other and whom the screenplay tries, ineffectually, to flesh out with backstories.

Feisty young Oscar nominee Abigail Breslin plays Anna, with Sofia Vassilieva (from TV's "Medium") as 15-year-old Kate, whose cancer has come out of remission when the film begins. Having seen super-lawyer Campbell Alexander (Alec Baldwin) in his TV commercials, Anna goes to him for help suing her parents for rights to her own body. Her parents, Sara (Cameron Diaz) and Brian (Jason Patric), are devastated, particularly Sara, who cannot fathom why Anna wouldn't want to donate a kidney to save her sister's life. In fact, Anna can't see anything past her dying daughter, believing Kate's needs come before everyone else's.

The issues here are indisputably thorny. Do parents have the right to force one child to donate life-saving organs to another? Was it unethical for them to conceive Anna in the first place, knowing they were doing it only to save Kate's life? (They have another child, Jesse, played by Evan Ellingson, but he's not a close enough match to be a donor.) If, as Sara insists, Anna isn't old enough to decide not to donate a kidney, isn't she too young to decide the other way, too?

But the movie (and presumably the book) sidesteps any real examination of these moral and legal quandaries, focusing instead on the shopworn family-in-crisis scenarios. In narration, Kate says, "I don't mind my disease killing me. But it's killing my family, too!" There's the obligatory scene where Sara shaves her head in solidarity with her chemo-sickened daughter, who is self-conscious about her baldness but has evidently never heard of the exciting new technology known as "wigs." Sara and Brian fight because he's never home and she has to take care of the kids herself, yada yada. Everyone is issued a problem: The judge in the case (Joan Cusack) lost a daughter to a drunk driver, and the lawyer has a "helper dog" for a medical reason he won't disclose.

All of this is unnecessary, though, since all the movie actually cares about is Kate the dying girl. We're told that her brother, Jesse, eventually "turned his life around," but evidence that his life was ever messed up is in short supply. At the trial, Sara says Anna has been acting quiet and evasive all week; did you want to show any of that to us, movie? Every character gets a turn narrating the film, ostensibly to help us know them better but really just a lazy screenwriting technique. (When you don't know how to show us, you give up and just tell us.) In one scene, the only line of narration is Jesse saying, "When I got home I wondered how much trouble I'd be in," and it's accompanied by a shot of him sneaking into the house late at night, making the narration redundant.

Jason Patric is given very little to do as the girls' father, while Cameron Diaz, even at 36 years old, comes off as remarkably immature as their mother. She strikes one note at the beginning -- shrill, strident, desperate -- and stays there the entire time. But Baldwin and Cusack, in their smaller roles, are characteristically understated, while Breslin and Vassilieva, in the leads, also do fine work. It would be hard not to be moved by a story of two young sisters dealing with death, no matter how maudlin or grotesque the story that surrounds them.

Grade: C

Rated PG-13, a little profanity, one F-word, some very mild sexuality

1 hr., 49 min.

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