It’s not slick, it’s not easy and it’s aimed squarely at your tear ducts.

Yet the punch that “My Sister’s Keeper” packs is an emotional wallop that can’t be denied.

Directed by Nick Cassavetes from a script he adapted from Jodi Picoult’s novel, “My Sister’s Keeper” could easily have had the disease-of-the-week feel of a TV movie. But Cassavetes isn’t afraid to tackle stories in which feelings trump ideas, something most audiences can relate to.

Here, the feelings are the full Kubler-Ross gamut: denial, anger, bargaining, depression, acceptance. At heart, “My Sister’s Keeper” is about coming to terms with death at a young age, even as the characters battle for life.

Cameron Diaz and Jason Patric play Sara and Brian Fitzgerald, parents of three children. But their middle child, Kate (Sofia Vassilieva), is diagnosed at a young age with a rare form of leukemia. When tests show that none of her immediate family is a match for bone-marrow transplants, the doctor suggests that the technology exists to create a match through in vitro fertilization and genetic manipulation. In essence, Brian and Sara would engineer a child as a live-in donor for their sick child.

That child is younger daughter Anna (Abigail Breslin), who, when she reaches the age of 11, rebels against further medical procedures. Specifically, her parents are planning a kidney transplant to her sister – which would saddle Anna with a single kidney and a lifetime of caution that would exclude sports, cheerleading, even childbearing. It’s a lot to ask of a prepubescent girl.

So Anna hires an attorney (Alec Baldwin, looking like the cat that ate the canary) to argue her case in court. She wants to become medically emancipated from her family, so she won’t be forced to give up a kidney for her sister.

Yet the lawsuit is not the focus of the story. The film bounces around in time, offering backstory on Kate’s illness, telling the tale through interior monologues by each of the characters. We get Kate’s illness, from onset to her current 14-year-old state: bald from chemotherapy, relapsing, nearing kidney failure.

The doctors are suggesting hospice treatment but Sara, who has fought this thing for all of Kate’s life, won’t hear of it. She’ll win the lawsuit, force Anna to surrender her kidney and Kate will survive after all.

It’s a provocative set-up, yet one in which the central arguments seldom get hashed out. Does a sister have an obligation to save her sibling, even if it compromises her own life? How much can a parent demand of one child to save another?

Rather, the script – by Cassavetes and Jeremy Leven – focuses on the shifting alliances within the family. It pulls the audience into the fiery blast-furnace of emotions that makes straight thinking almost impossible.

That’s captured well by Cameron Diaz as Sara, a bulldog who gave up her legal career to care for – and be a tenacious advocate for – her daughter. Her single-minded focus obscures all else, keeping her from seeing the effect her crusade is having on the rest of her family. Diaz is like a laser: focused, almost blindingly so, on a single goal that seems impossible to everyone else.

Patric complements her as the firefighter husband who does see that there is more at stake than the survival of one child, that the health of the entire family unit is being put at risk. It’s a relaxed, empathetic performance that builds in power.

Breslin has grown into a resourceful young actress, capable of playing a variety of emotions without losing her essential kid-ness. Vassilieva gives a performance that shines through the layers of make-up: the pallor, the bald pate, the angelic quality with which the movie sometimes tries to saddle her. Thomas Dekker, so good as John Connor on “Terminator: The Sarah Connor Chronicles,” does a nice job as a cancer patient who befriends – and ultimately romances – Kate in the hospital.

“My Sister’s Keeper” seems like a preprogrammed weepie, yet there’s more going on here. It’s the kind of movie that critics seem to dismiss – Feelings? How common – but which audiences will embrace.

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