Content Warning: This section of the guide discusses pedophilia, rape, child sexual abuse and violence, possible incest, suicide ideation, and death by suicide.

Ethical dilemmas and impossible choices form one of the most significant motifs of Saving Noah. Choices such as whether Adrianne should resist Lucas’s decree against Noah’s return to their home not only propel the novel forward but also highlight key themes, such as The Search for Redemption and The Complexities of Mental Health and Human Nature. Impossible choices also deepen the metaphysical and philosophical elements of the narrative. As in real life, characters have no way of exactly predicting the outcome of their actions: They have to simply roll the dice and hope for the best. This dilemma of choice is especially amplified in stressful, unusual, and unimaginable situations, such as the one the Coates family faces. For instance, a desperate Adrianne asks Lucas to speak to Noah, hoping Lucas will be able to break through to their son. Her choice backfires, and Lucas’s harsh advice ends up triggering Noah into further self-harm.

Further, author Lucinda Berry presents impossible choices not only to test the characters but also to provide thought experiments.