"Almost Family strives to be a drama about a woman (Brittany Snow) who discovers as an adult that she has several half-siblings whom she has to build bonds with as an adult, and to investigate what the concept of family truly means," says Daniel D'Addario of the Fox drama from Jason Katims and Annie Weisman. "Glinting out from behind every moment of tentative connection is the gross fact that her siblings come from her father’s inseminating women, without their consent, with his own genetic material to create his own descendants, a decision that’s neither endorsed nor decried by the series." D'Addario adds: "It’s not that a man who deceived women into having his biological children when they’d intended otherwise couldn’t, possibly, eventually have real relationships with said children. But the show takes as a given that these relationships would flourish basically instantly and without any real work of restoration for what (Timothy Hutton's) Bechley had stolen (women’s free will and right to bodily autonomy, for one thing). No one is beyond redemption, but the show’s approach to Bechley suggests it believes that no character on the show is beyond mindless approval. A revelation that Bechley is being charged with sexual assault is treated as a startling setback for his newly united trio of daughters, rather than the obvious starting point towards forgiveness."
Almost Family is the next This Is Us, but with "medical rape": "Almost Family gets credit for taking the biggest swing at a premise, and for whiffing it with gusto: What if we did This Is Us, but with medical rape?" says Kevin Fallon. "Once you learn the plot of Almost Family... the tone it takes is patently outrageous. The only thing more surprising is that, when asked about the borderline insanity of the choice to take such a lighthearted, heartwarming hand with the grave subject matter, the show’s creators and producers seemed caught entirely off guard. At least that’s how it appeared at a press conference with TV critics this summer. You see, Almost Family is a series that attempts to explore unconventional family dynamics, raising questions of what connects us, and what constitutes a family. It is also a series about sperm."
Almost Family is a series in conflict with itself: "If you hear the premise, 'Very different women learn they're sisters when it's revealed that a famous fertility doctor has been impregnating clients with his own sperm without authorization' and go, 'Ha! What a silly and whimsical way to build an extended family!' then it's entirely possible you'll find enough charm in Almost Family to be amused," says Daniel Fienberg. "If you hear that same premise and go, 'Ew! That's absolutely horrible and as unforgivable a violation as I can imagine!' you'd best stay away, because that is not a sentiment that's compatible with the confusingly goofy way Almost Family is approaching this story."