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A marrow transplant represents little risk to the donor: Marissa's health was never in danger, and she came out of last week's procedure with only an ache in the hip. In the words of Dr. Mark Siegler, a medical ethicist at the University of Chicago, "The morbidity rate for this operation is much less than for roller-skating."
What disturbed was the spectacle of a baby being brought into the world not, it seemed, as an end in herself, attended by all the sentiment and sanctity that people supposedly accord a new life. Rather the baby was ordered up to serve as a means, as a biological resupply vehicle.
The baby did not consent to be used. The parents created the new life, then used that life for their own purposes, however noble. Would the baby have agreed to the transplant if she had been able to make the choice? Metaphysics: Would the baby have endorsed her own conception for such a purpose?
People wanting a baby have many reasons -- reasons frivolous, sentimental, practical, emotional, biological. Farm families need children to work the fields. In much of the world, children are social security for old age. They are vanity items for many people, an extension of ego. Or a sometimes desperate measure to try to save a marriage that is failing. Says Dr. Rudolf Brutoco, Marissa Ayala's pediatrician: "Does it make sense to conceive a child so that little Johnny can have a sister, while it is not acceptable to conceive the same child so that Johnny can live?" In American society, procreation is a personal matter. Crack addicts or convicted child abusers are free to have children.
The Ayalas were surely procreating on the side of the angels. Considered on the family's own terms, their behavior is hard to fault. They acted from desperate first principles. Life wants to live. The first duty of parents is to protect their children. The Ayalas say they never considered aborting the fetus if its marrow did not match Anissa's. They will cherish both daughters in the context of a miracle that allowed the older to live on and the younger to be born. It was possible to see the drama as a visitation of grace.
But their case resonated with meanings and dilemmas larger than itself. The case opened out upon a prospect of medical-technological possibility and danger that was like a medieval navigator's map -- inscribed in blank mid- ocean, "Here there be monsters."
The monster possibility is this: in the past, it was mostly cadavers from which transplant organs were "harvested." Today, as with the Ayalas, life is being tapped to save life. This suggests in some cases the sort of moral trade-offs that were worked out in the blizzards of the Donner Pass in the winter of 1846-47. Is there a principle of cannibalism involved? Sometimes.