Give filmmaker Nick Cassavetes some long-overdue credit. After more than 10 years of directing, he's clearly learned how to manipulate moviegoers.

His biggest hit to date was the 2004 adaptation of "The Notebook," which tried to pluck the heartstrings of its mostly female audience.

Cassavetes' latest, an adaptation of Jodi Picoult's best-selling novel "My Sister's Keeper," is similarly shameless and unapologetic about its intentions.

This ethical drama tries to make people think about medical and family dilemmas while wringing a few tears out of them along the way.

But surprisingly, it's a little more effective in that regard than "The Notebook" was. The talented and appealing cast is a big reason for that.

Abigail Breslin ("Little Miss Sunshine") stars as Anna Fitzgerald, a pre-teen who's suing her parents to gain "medical emancipation."

It turns out Anna's folks (Cameron Diaz and Jason Patric) have been using the supposed "designer baby" as an organ and blood donor to her older sister, Kate (Sofia Vassilieva), who's been living with leukemia for years.

And now Anna claims that she's grown tired of being used and of not having a say in the matter.

She's even hired a celebrity attorney, Campbell Alexander (Alec Baldwin), to help put a stop to this.

Of course, this puts a tremendous strain on the Fitzgerald family. And Anna's mother, Sara, used to be a lawyer herself and isn't about to let this go without a legal fight.

Co-screenwriter/director Cassavetes uses extensive flashbacks and pseudo-documentary elements to show us the complicated family history.

Those elements — and the story itself — might not work if he hadn't gotten these particular people to play the characters. Breslin continues to impress, and Diaz is playing someone who's not always likable.

Supporting cast members Baldwin, Joan Cusack, Emily Deschanel and David Thornton are all good as well.

But the real revelation here might be Vassilieva, from TV's "Medium." It's obviously the most physically demanding role of the bunch. Like her character, she's also asked to keep things together when they start splintering.

"My Sister's Keeper" is rated PG-13 and features occasional strong profanity (including one usage of the so-called "R-rated" curse word), drug content and references (medications, painkillers and hypodermic needles), some crude slang and suggestive language, a brief sex scene (implied), brief blood and gore, some derogatory language and slurs, brief violence (a destructive temper tantrum and some slapping), and glimpses of nude artwork. Running time: 109 minutes.

E-mail: jeff@desnews.com