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.

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