Reproductive choice. Disabilities. Divorce. Cutting. Our tort-happy nation. Jodi Picoult has never been one to shy away from hot-button issues. But in her newest novel, Handle With Care, she out-Picoults herself by tackling all of the above-mentioned topics, and then some. In lesser hands, such an undertaking would be unwieldy at best, but Picoult delivers a deeply affecting story about one family struggling to do the right thing.

When Sean and Charlotte O'Keefe marry, he adopts her little girl, Amelia, and they immediately begin trying to conceive a second child. Charlotte is thrilled to get pregnant, but the fetus is diagnosed in utero with brittle bone syndrome. Even before birth, the fetus suffers numerous fractures, and doctors warn the O'Keefes that their baby will have a difficult, painful life.

And she does: Willow breaks bones in her sleep, while playing, even if her mother hits the brakes too hard while Willow is strapped into her car seat. The O'Keefes wouldn't trade their funny, smart daughter for anything, but they're consumed with worry and mounting debt. Charlotte thinks she's found the answer when a lawyer tells her that suing for medical malpractice could free them from their money problems. The only catch: Charlotte must sue her best friend and obstetrician, Piper Reece, on the grounds that if Piper had diagnosed their baby's condition earlier in the pregnancy, they could have chosen abortion.

Told alternatively from the points of view of Sean, Charlotte, Piper, Amelia and Charlotte's attorney, Marin—all of whom speak directly to Willow in their narration—Handle with Care is everything faithful readers would expect from Picoult, handled in her thoughtful, elegiac prose. The book doesn't spoon-feed all the right answers or lionize the characters. Charlotte is sometimes strong but often all-too-human, second-guessing and justifying her own choices.

Provocative and complex, Handle with Care explores what it means to do something in the name of love—and what those choices say about us.

Amy Scribner lives with her family in Olympia, Washington. Copyright 2009 BookPage Reviews.

Fans of popular author Picoult (My Sister's Keeper) won't be disappointed with her newest novel, which offers a glimpse into the life of a family whose daughter is born with a severe medical condition that could have been prevented, but at what cost? Sean and Charlotte O'Keefe's magical world is turned upside down when daughter Willow is born with brittle bone disease, a disease so severe that Charlotte is forced into the role of caretaker for Willow and emotionally abandoning older daughter Amelia. It's only when Charlotte decides to sue for wrongful death that the family begins to unravel—even if the reason for the lawsuit is for Willow's future. In order to win the lawsuit, Willow's parents have to claim that they would have aborted her if they had known about her condition, a claim that is so abhorrent that it literally fractures the family. Picoult's novels are like Russian nesting dolls, with each plot unveiling a subplot, leading to an ending that readers never see coming. Highly recommended for all public libraries. [See Prepub Alert, LJ 11/1/08.]—Marika Zemke, Commerce Twp. Community Lib., MI

Perennial bestseller Picoult (Change of Heart) delivers another engrossing family drama, spiced with her trademark blend of medicine, law and love. Charlotte and Sean O'Keefe's daughter, Willow, was born with brittle bone disease, a condition that requires Charlotte to act as full-time caregiver and has strained their emotional and financial limits. Willow's teenaged half-sister, Amelia, suffers as well, overshadowed by Willow's needs and lost in her own adolescent turmoil. When Charlotte decides to sue for wrongful birth in order to obtain a settlement to ensure Willow's future, the already strained family begins to implode. Not only is the defendant Charlotte's longtime friend, but the case requires Charlotte and Sean to claim that had they known of Willow's condition, they would have terminated the pregnancy, a statement that strikes at the core of their faith and family. Picoult individualizes the alternating voices of the narrators more believably than she has previously, and weaves in subplots to underscore the themes of hope, regret, identity and family, leading up to her signature closing twists. (Mar.)