A VERY DIFFICULT PREGNANCY

IT IS AS IF A PARTICULARLY DIABOLICAL textbook problem for budding ethicists has been transposed to grim reality in upstate New York. In 1985 a highway accident smashed the promise of a 19-year-old Cornell University freshman, putting her into a coma-like state. Then in August someone at the Westfall Health Care Center in Brighton, N.Y., raped the helpless woman, a fact deduced last month when the woman, now 29, was found to be five months pregnant.

Police say they have several--unidentified--suspects; meanwhile, a Westfall aide stands accused in another sex-abuse case. The state Attorney General has dubbed the crime part of an unrecognized problem of abuse of nursing-home patients. But what has attracted the most attention is the decision by the woman's family that she should bear the child.

Women in comas have given birth before, usually to children conceived before the women were stricken. And by tradition, barring a living will, doctors honor a family's perception of a coma victim's wishes. The New York woman had been a devout Roman Catholic. Says Ellen Moskowitz, a lawyer and ethicist at the Hastings Center, "It seems reasonable to conclude this is the kind of decision she would have wanted."

Others disagree violently. George Annas, chairman of the Boston University School of Public Health's law department, points out that in the 1990 Cruzan case, the Supreme Court kept a comatose Nancy Cruzan on life support, though her parents protested that she would have opposed it. Annas recommends similar skepticism here: "Even people who are fervently pro-life," he says, "[sometimes] make exceptions for rape and incest." Since the pregnancy was "not her project," says Annas, making the woman give birth--which carries medical risks--constitutes an "abuse." Other experts worry about how such bizarre origins might affect a child.

For now, the mother-to-be lies in Rochester's Strong Memorial Hospital. She is said to be able to feel pain; her blue eyes sometimes follow visitors around her room, although apparently without comprehension. In fact, some situations defy comprehension even by the healthy.