You do understand that the use of methotraxate is geared to many serious medical problems, often problems that affect the elderly. Why are you so certain that MTX is used to abort?
Read the articles. It all started with the attempt to draw a thin distinction between salpingastomy and salpingectomy in treating ectopic pregnancies. In light of the Tribunal of the Holy Office’s response in 1902 (see the Catholic Encyclopedia entry on ‘Abortion’ for a basic overview) ‘thin’ is putting it mildly.
But, now we have earlier detection and intervention, combined with plasma and antibiotics. So we have the
possibility of tubal rupture, which, in turn, has the
possibility of death (but a relatively low probability outcome with medical treatment). So the old old ‘treating the tube isn’t direct abortion’ argument has migrated into ‘preventively treating the tube isn’t direct abortion’ (we can’t say ‘pre-emptive’ because we don’t know if the tube will actually rupture).
Further, we have pressure from secular medical standards. Treating an ectopic pregnancy with salpingastomy, salpingectomy, and MTX have the same prognosis for the fetus - certain death. But, one is least intrussive (no surgery) and one is most intrussive (surgery and partial sterility) from the perspective of the mother. It is becoming very difficult to get secular health insurance to pay for a procedure with higher risks and a less positive health outcome simply because some theologians argue that doing the abortion of medical necessity a certain way does not count under Catholic faith.
So, we are seeing some very innovative thinking when it comes to ‘obeying the directives’. CHA’s position paper on ectopic pregnancies suggests that the old ‘thin’ argument of ‘double effect’ might apply to all three treatments. But a lot of Catholic hospitals are using very different protocols and rationalizations. For example, if you search the link I gave you you will find a relatively recent article on a protocol for the use of MTX in the treatment of ectopic pregnancies. That protocol contends that they are not, in fact, pregnancies, but interrupted miscarriages. So, the fetus is already ‘dead or dying’. The later, of course, has implications with regards to euthanasia, but the article does not address them. Nonetheless, the protocol is in use in a group of Catholic hospitals.
In fact, you would be hard pressed to find a single Catholic hospital that would not readily offer and provide at least one of the three common treatments for ectopic pregnancy. Since the Church has never declared any of them licit, and secular society counts them as abortions of medical necessity, I stand by my statement.