"Moral Philosophy as a Subversive Activity"

In March 1990 a story appeared in the U.S. newspapers about a Los Angeles couple who had decided to have another child in the hope that the baby's bone marrow cells could be used to save the life of their teenage daughter. Abe and Mary Ayala, who are in their forties, had not intended to have an additional child; in fact, Abe Ayala had had a vasectomy. But their 17-year-old daughter, Anissa, was dying of leukemia, and a bone marrow transplant was her only hope. After two years of searching in vain for a suitable donor, they decided to have another child because there was a one-in-four chance that the new family member would be a suitable donor. So Abe Ayala had his vasectomy reversed and Mary Ayala became pregnant. The baby, a girl named Marissa, was born on April 6 and she was indeed a compatible donor. The transplant procedure, which was to be accomplished a few months later, would involve little risk for the baby, and Anissa's chance for survival would rise from zero to between 70 and 80 percent.

The Ayalas were understandably elated to learn that Anissa's life might be saved. However, the newspaper stories prominently featured quotations from medical ethicists who labeled their decision "troublesome" and even "outrageous": "The ideal reason for having a child," said a well-known figure in the field, "is associated with that child's own welfare--to bring a child into being and to nurture it. One of the fundamental precepts of ethics is that each person is an end in himself or herself, and it is never to be used solely as a means to another person's ends without the agreement of the person being used." The Ayalas' baby "is not seen as an end in itself, but as a means to another end. The fact that the other end is laudable doesn't change that." Another expert was quoted as saying that the Ayalas' decision means "we're willing to treat people like objects"--and, he added, "I don't think we ought to do that." Now the Ayalas are real people, not characters in a made-up classroom example, although their plight does sound like one of those fictional cases philosophers sometimes invent: "You say you don't want any more children? Well, would you have another baby if it were necessary to save the life of your teenage daughter?" The Ayalas were desperately trying to save the life of their teenage daughter, and they didn't much care for the ethicists' comments. Mrs. Ayala said that the ethicists ought to be worrying more about the shortage of marrow donors, and less about their decision. Anissa herself was asked what she thought about all of this, and she said that she was "sort of troubled" by the criticism, but added that "We're going to love our baby." If Anissa were trained in philosophy, she might have found the criticism less troubling. She might have observed that people have always had babies for all sorts of reasons other than the "ideal" one. Real life rarely lives up to philosophers' expectations. People have children so that the children can share in the family's work, to please grandparents, or just because it is expected of them. They sometimes have second children because they don't want the first to be an "only child." None of this is strange or unusual; it is just the way life is. What is important is, as Anissa insists, that once born the children are loved and nurtured within good families. Anissa might have also pointed out that her mother, in fact, had wanted another baby anyway--it was only her father's wish to have no more children. And finally, she...