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I have a well-documented fascination with extreme religions. I've written before about the dark, twisted world of Scientology, and I've also recommended a couple novels about children of religious extremists. There's just something about religion gone wrong that draws me in.

In The Children Act, it's more a case of religion against mainstream culture, but the interplay between believers and agents of the court is still riveting. Fiona Maye is a judge in family court, presiding over contentious divorces and embittered custody battles. One day an emergency case is added to her list: a seventeen-year-old boy named Adam is refusing on religious grounds a blood transfusion that would save his life. Fiona has to decide whether to respect Adam's wishes or to allow the hospital to intervene despite them.

In late middle age, Fiona is a highly professional and experienced judge. However, Adam's case may prove to be her undoing. Maybe her personal life clouds her judgment—her husband has just asked for her permission to have an affair, seemingly clueless as to why this would upset her—but whatever the reason, she handles Adam's case differently than perhaps she normally would. Instead of sending a social worker to interview Adam, Fiona suspends the court's activities and ventures to the hospital herself, believing that she should confront such a serious situation personally. Unfortunately, that fateful visit and Fiona's subsequent ruling have a far too personal effect on Adam, and Fiona may not be able to regain her professional distance ever again.

Although this is a fairly short book, clocking in under 250 pages, McEwan has packed in plenty of weighty ethical questions. At what age is a person truly able to make life-and-death decisions? How certain can we be that the views of the child are not just the views of the parents, reflected back in eager hope of approval? And the question most critical to Fiona's life and most interesting to me, where is the boundary between professional interest and personal responsibility?

An engaging medical and legal drama, The Children Act asks lots of uncomfortable questions. It's the kind of book you speed through, anxious to find out the ending, but the characters and their fraught lives linger in your head long after you've learned what becomes of them.