Some day, when she is bigger, we hope that Marissa Ayala's parents and her big sister will be able to tell her the wonderful story of how Marissa was brought into the world to save her sister's life with a gift of bone marrow. Anissa, 19, was dying of leukemia, but her recovery prospects are better than 70 percent, thanks to the procedure last week by which marrow was withdrawn from the 14-month-old baby and transferred to Anissa.
Hearing the story of her wonderful birth will make Marissa know she was wanted and is loved. Yet ethicists are divided on the question of making one child to save another. "The ideals of our society are that we are to treat each person as an end and never merely as a means," commented Dr. Robert Levine, of Yale University's School of Medicine. "It seems to me that when a primary motive for conceiving a child is to produce tissue or an organ, we are getting very close to seeing this new being as a means to another end."
Children are conceived for all sorts of reasons, and for no reason. Some babies are born to please in-laws, or to bolster a shaky marriage, or because the father of daughters still hopes for a son. Surely these are not morally better reasons than Abe and Mary Ayala's reason for conceiving Marissa.
The difficulties come as the cases get harder. One couple conceived a child to donate a kidney to an elder sibling. Another inquired into tissue-typing a fetus with the object of aborting it if its bone marrow would be unsuitable for a transplant. Their obstetrician refused to perform the test, but Dr. Norman Fost, a pediatrician and ethicist at the University of Wisconsin School of Medicine, suggests that such an abortion would be acceptable, since women in other cases are not required to produce justifiable reasons for abortions.
Some months ago a woman spoke of the possibility of conceiving, then aborting a fetus so that its tissue might be used to relieve her father's Alzheimer's. It is not clear that such a thing actually occurred, but the speculation shows the vexing problems that will arise as society attempts to draw ethical lines.
The debate will give new rancor to the abortion issue, since it will touch again the question of the nature of life in the womb. Nevertheless, debate cannot be avoided so long as there are parents like the Ayalas who love their children and will take any step to save their lives.