This is an Ian McEwan book, so you can almost bet on the fact that there is a morally complicated theme. This book focuses on the tension between the autonomy that families have in making decisions about the health care of their children and the state's right to intervene. The situation is this. An almost 18 year old has Acute Lymphocytic Leukemia and in order to treat the disease he will require blood transfusions as a result of the chemotherapy. The family and the child are refusing this because they are Jehovah's Witnesses. The case is brought before judge Fiona Maye, and she is tasked with deciding what to do.
The book handles this real life situation very well (there is a current case in the news about an almost adult who is refusing treatment for Hodgkin Disease), including the fallout that occurs when a child is forced to do something that their parents do not agree with. The legal system provides no support for that child who is now at odds with the beliefs of their family and can therefore no longer count on them, all the while they have a life threatening illness. The reader sees Fiona's dilemma in this, and sympathizes with her choices, but all does not end well, which is yet another realistic depiction.
The side bar to all of this is that Fiona's husband Jack is pursuing an affair with another woman, all the while telling her that he loves her and doesn't want anything to change with their relationship, which Jack describes as more like a relationship between siblings than a passionate one. The book does not deal deeply with the inevitable cooling of ardor over a decades long relationship, but does a good job of depicting Fiona's response to the situation put in front of her. All in all it is a compact book full of wit and insight.
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