The little girl that on television that Shay spoke about is revealed to be the daughter of June and the late Kurt, Claire, who has a terminal heart condition.

Maggie, an attorney, begins the legal process to petition the commissioner of corrections to allow Shay to be hanged rather than executed by lethal injection, so he will be able to donate his heart to Claire.

Claire sees that her dog Dudley has died, but when she picks him up and holds him to her chest, his heart begins to beat again.

Change of Heart is written such that each chapter is from the point of view of one of the characters, either Maggie, Michael, Lucius, or June.

Picoult moves the story along with lively debates about prisoner rights and religion, while plumbing the depths of mother-daughter relationships and examining the literal and metaphorical meanings of having heart."

[1] Donna Seaman reviewing in Booklist writes, it is "a compulsively readable saga and dramatic critique of capital punishment".

Seaman compares Change of Heart to The Da Vinci Code by Dan Brown, describing the novel as, "Laced with intriguing musings on the Gnostic Gospels, Picoult's bold story of loss, justice, redemption, and faith reminds us how tragically truth can be concealed and denied.

Maslin asserts that June Nealon is "a wet hankie of a character, full of grief and anger, but otherwise lacking any distinguishing characteristics."

She felt that Picoult missed her own chance at redemption, "had Change of Heart culminated in revelations that were truly plausible or unexpected, its vapidity might have been transcended.

"[3] In terms of public reception, Change of Heart debuted as number one on The New York Times Fiction bestseller list.

Peter Jackson, the director of Alice Sebold's novel The Lovely Bones, is slated to direct the film adaption with Fran Walsh writing the screenplay.

On January 13, 2012 Paramount Pictures announced that the first actor to be cast was Sean Bean who will play the role of Shay Bourne.