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Just to clear some things up (clearly watch out for spoilers if you haven't seen it yet): I think the uncle wanted to send the older sister because he didn't understand the medical procedure and thought she would be strong enough to be able to donate an organ and keep living, while the younger sister would die either way because she's already so weak. The movie implies that she's going to have her heart forcefully removed to be given to Barbie's sister. They called it "Barbie" because she's a symbol of America: all smiles on the outside, but not actually representative of the people. Also, it's a Korean-written script so things like the American father sleeping with his daughter and several phrasings make more sense from the Korean side than the Western side. Kim Sae Ron did an incredible job, and I think there were good things in the script, but it played out a bit too melodramatically for me.