Consider the alternative: Anna wins, doesn't donate, and Kate dies. That would be a straightforward 'right to bodily autonomy' triumph. Or, Anna loses, donates, and Kate lives—a 'familial duty' triumph. Picoult chose neither. She chose a third path where autonomy is legally affirmed but physically overturned by chaos, and duty is fulfilled through tragedy, not coercion. It's a narrative that rejects simplistic ideological victories. The real world is messy, and the ending forces that messiness upon the reader, denying the catharsis of a clear moral stance.