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Beyond the Ayala case, the ethics can become trickier. What if a couple conceives a baby in order to obtain matching marrow for another child; and what if amniocentesis shows that the tissue of the fetus is not compatible for transplant? Does the couple abort the fetus and then try again? Says Dr. Norman Fost, a pediatrician and ethicist at the University of Wisconsin: "If you believe that a woman is entitled to terminate a pregnancy for any reason at all, then it doesn't seem to me to make it any worse to terminate a pregnancy for this reason." But abortions are normally performed to end accidental pregnancies. What is the morality of ending a pregnancy that was very deliberately undertaken in the first place? The slippery slope becomes abruptly steeper.
In the world of advanced medical technology, the uses of living tissue have become very suddenly more complex and problematic. A newly born infant suffering from the fatal congenital malformation known as anencephaly will surely die within a few days of birth. Anencephaly means a partial or complete absence of the cerebrum, cerebellum and flat bones of the skull. Such babies could be an invaluable source for organs and tissues for other needy infants. Is that sort of "harvesting" all right?
Aborted fetal tissue has shown promise as a treatment for Parkinson's disease and Alzheimer's disease. But such experiments have mostly been blocked in the U.S. by a ban on federal funding for research using fetal tissue. Some antiabortion activists think that if the technique proves successful, it would encourage women to conceive just to provide material for relatives in need. A mother of a diabetic girl in Maryland gives credence to such fears: "If the technique were perfected today, I'd hop in bed right now. It's not an easy issue. But I'd kill an unborn sibling to improve my daughter's life."
Transplant technology is developing so rapidly that new practices are outpacing society's ability to explore their moral implications. The first kidney transplants were performed over 35 years ago and were greeted as the brave new world: an amazing novelty. Today the transplant is part of the culture -- conceptually dazzling, familiar in a weird way, but morally unassimilated. The number of organ transplants exceeds 15,000 a year and is growing at an annual clip of 15%. The variety of procedures is also expanding as surgeons experiment with transplanting parts of the pancreas, the lung and other organs. As of last week, 23,276 people were on the waiting list of the United Network for Organ Sharing, a national registry and tracking service.
A dire shortage of organs for these patients helps make the world of transplants an inherently bizarre one. Seat-belt and motorcycle-helmet laws are bad news for those waiting for a donor. The laws reduce fatalities and therefore reduce available cadavers, thus inviting the mordant thought that the speed limit should be raised when the donor-organ supply is low.