Anna’s motivation in filing her lawsuit still remains unclear. Anna’s decision will almost certainly lead to Kate’s death, but Anna obviously loves her sister and has always done all she can to make her feel better. Anna has been able to help Kate as no one else can, not only physically but emotionally as well. When Kate becomes upset as she, Anna, and Sara shop for a dress, Anna finds a way to cheer Kate up. In addition, Anna knows that Kate even saved her life once by stopping her walker from rolling into traffic. All of this evidence contrasts with Anna’s decision to stop being Kate’s donor. Furthermore, Anna does not deny that she lied when she told Campbell that she filed the lawsuit so she could finally be the focus of her family’s attention, indicating that the real reason Anna filed the lawsuit remains a secret.
Taylor’s introduction into the story allows Sara—and the reader—to see Kate as an average teenage girl, but his sudden death underscores the fact that, for Kate and the rest of the Fitzgerald family, any sense of normalcy is often fragile and temporary. So much of Kate’s presence in the story has been about her illness, but her relationship with Taylor reveals a different girl entirely. She falls in love and gushes about her first kiss. She goes to a dance. These events resemble the life of a typical adolescent girl, though reminders of Kate’s cancer persist. She and Taylor flirt during chemotherapy, she has no hair to style for the prom, and Kate and Taylor must remove their hospital masks to kiss. Even so, Kate finally has something to focus on other than her health, and Kate can bond with Taylor because he understands everything Kate endures as a patient since he has experienced it all himself. In fact, Taylor represents the only deep emotional connection Kate makes in the book with someone outside her family, making his sudden death extremely painful for Kate. In addition, his death forces Kate and Sara to recognize that Kate could die at any time, practically without notice.
Taylor’s death also serves as another reminder of the life Kate might have had if she didn’t have leukemia. After Taylor dies, Sara sees Kate looking at pictures of the family and herself when she was younger, before she had cancer. Kate speaks about the younger version of herself in the picture as though she were a stranger, and Sara thinks to herself that the girl in the picture represents someone they never got to know. In other words, the person Kate might have been if she were healthy has been lost to them, suggesting that cancer has not only made her sick but also transformed who she is as a person. Prior to this point, we have seen the devastating physical effects cancer has had on Kate, but now we see for the first time the full extent of the emotional distress Kate has experienced because of her cancer.
At the trial, Campbell and Sara represent the two sides of the novel’s main ethical debate about whether Anna has an obligation to give Kate a kidney. Campbell begins by emphasizing that what is moral differs from what is legal. As he argues, Brian and Sara may feel that Anna has a moral obligation to give Kate a kidney because Anna will suffer only some pain in exchange for Kate’s survival. But from a legal standpoint, Anna has no such obligation, and neither Brian, Sara, or the doctors involved have ever taken Anna’s legal rights into account. Therefore Anna should be medically emancipated and allowed to make her own decisions about her health. Sara, on the other hand, argues that she and Brian have not neglected Anna’s rights. They have not put Anna in any undue risk and have only followed the suggestions of the hospital’s ethics committee. They’ve considered the health of both daughters, where Campbell only has to consider Anna’s wellbeing.