Imperatives of love


YOUR CHILD is dying. This is the most important thing. The doctors say there may be a way to save her life. It is relatively simple and will also, in the long run, be satisfying and enjoyable. The question is whether you are willing to do it or not.

The answer seems to me rather obvious.

This was the case with Abe and Mary Ayala, whose younger daughter was born a little over a year ago and whose elder one may have been born again this week. Anissa Ayala, who is 19, has leukemia, and her only hope was a bone marrow transplant from a compatible donor.

To find one, her parents looked within, and conceived Marissa. On Tuesday morning, some of the baby's marrow was given to her big sister. Doctors say that other families are quietly having children for just such a purpose.

A medical, ethical and philosophical debate has ensued, and interesting as it may be, it does not seem to me that it can ever be the last word on the subject. The last word comes, as it did for these parents, from within.

If one of my children were dying of leukemia and needed marrow that none of the rest of us were able to provide, there is one condition in which I would hope to find myself. And that condition is pregnant.

People wonder if that is the right way to look at this issue. I wonder if there is any more meaningful way. People have children for a variety of foolish or ill-advised reasons, from wanting to please their own parents to trying to cement a crumbling marriage to feeling that they want to give an older child a sibling, as though a sibling were a pound puppy.

Anyone who has two sons knows that there is a long and dreadful tradition of "trying for the girl." No one except teen-age girls is likely to admit this, but some women have babies because being pregnant makes them feel important; no one admits it anymore, but people once had babies to someday care for them in their old age.

Having a child to save a child certainly seems more laudable than any of these.

But most people have children for inchoate reasons that defy definition -- some amalgam of curiosity, warmth, mortality, timing and love that becomes an internal imperative.

It is only afterward, when the bond between parent and child becomes so strong, that we elevate the initial impulse, which may have come from something as humdrum as a small straw boater in a shop window. "The heart has its reasons which reason knows nothing of," wrote Pascal.

Reason will have to join emotion in the development of these issues, to define the permissible limits of one of our most powerful instincts, the one that leads us to fight for the lives of our children.

Once we said we would do whatever could be done, but the definition of what can be done has grown by leaps and bounds. The Ayalas' case is straightforward, but more problematic issues are ahead. If testing showed that the fetus would not make a suitable donor, are there parents who would abort and start over again? Will we sacrifice the children we have not yet borne, and do not know, for the ones we have, and do?

The truth is that some parents already do this, in an active way -- aborting a fetus with handicaps because they are convinced that its care would imperil the rest of their family -- and a passive one, too. There are as many reasons for not having children as for having them, but chief among them is a feeling that to add one more would subtract time, attention and energy from the others.

When technology raises its inventive head, we invest these things with a deceptive sense of newness. Actually this case is about ageless issues, less "Brave New World" than Old Testament: How far would any of us go to save that person who may be the most fiercely beloved of our lives?

Is it possible for us to feel that any measure goes too far in the face of our overwhelming urge to protect our children from death?

The Ayalas' story is not one of science but of love. They may now find themselves with two healthy daughters who share a special lifelong bond. They could still lose the elder, but would be left with the younger daughter.

Their hearts had reasons. For anyone who has ever looked at a child and thought, "I would do anything for you," those reasons should be obvious.

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