Double Effect, Methotrexate, and Ectopic Pregnancy

[fix]

And again, MTX isn’t intended to kill the baby(no woman in this situation intends to kill her baby any more then a F-18 pilot intends to kill the hostages)

Now, this is almost disingenuous. Simply claiming one’s intent is not to kill even if one’s actions are the opposite does not fulfill double effect.

only it’s trophoplast which will not serve to provide nutrtion to the embryo for long because of its circumstance which also presents a grave threat to the mother.

The trophoblast is in the wrong place. Ending that ends the baby’s life.

I repeat:

… Its primary effect is on the trophoblast (the precursor of the placenta). Clearly, this is not a cancer case, the point and purpose of MTX here is to shut down (stop) the life support system of the developing child (death-dealing).

… when you do directly remove the embryo from the site, what you do (finis operis) is destroy it in situ. Neither trophoblast nor its activity is in any sense “diseased,” and thus the salpingostomy or MTX is in no sense therapeutic for or to the embryo, it is, rather, a death-dealing procedure meant to improve mother’s health and life. This violates the double effect condition (re causality) that the good effect not be caused by, not come through the evil effect. As mentioned above, tubal pregnancies don’t happen because tiny embryos do what they naturally do; almost always there is a preexisting problem in the endosalpinx from whatever cause…

 

[VARC]

We’ll just have agree to disagree about the usefullness of a trophoplast in a tube. If the trophoplast is of no use to the embryo then the double effect principle can apply. Your not going to find a doctor that will tell you that the trophoplast is “not a problem”.

Anyway you say that you do not demand a a woman who can’t afford the surgery risk death. Well I’ll come right out and ask. What should a woman do in the circumstance? I know that this has happened before.

 

[fix]

We’ll just have agree to disagree about the usefullness of a trophoplast in a tube. If the trophoplast is of no use to the embryo then the double effect principle can apply. Your not going to find a doctor that will tell you that the trophoplast is “not a problem”.

Morality is not determined exclusively by medical opinion. If it were the Church would accept contraception, direct abortion, and much else.

Anyway you say that you do not demand a a woman who can’t afford the surgery risk death. Well I’ll come right out and ask. What should a woman do in the circumstance? I know that this has happened before.

That bad things happen does not mean choosing wrongly is acceptable. It is almost a Hobson’s choice. If there are truly only two alternatives presented then depending on time available the patient and her family need to speak with social services.

Why must you narrow this issue to one particular circumstance as if such a circumstance will change what is morally right?

 

[Seatuck]

We’ll just have agree to disagree about the usefullness of a trophoplast in a tube. If the trophoplast is of no use to the embryo then the double effect principle can apply. Your not going to find a doctor that will tell you that the trophoplast is “not a problem”.

Anyway you say that you do not demand a a woman who can’t afford the surgery risk death. Well I’ll come right out and ask. What should a woman do in the circumstance? I know that this has happened before.

Why do you seem to deny that the drug acts on the baby? Methotrexate causes death to the fetal cells. This kills the baby.

Methotrexate (MTX) is a chemotherapy agent that has been used for many years in the treatment of cancer because it affects cells that are rapidly dividing. In a Methotrexate (MTX) Abortion, it stops embryonic cells from dividing and multiplying and is a non-surgical method of ending pregnancy in its early stages.

The placenta is not the only tissue that is attacked. I wish you would say placenta because saying trophoblast is a lot like when the abortionists switched to “fetus” instead of baby to desenstitize the death.

Methotrexate attacks all rapidly dividing cells. This is why mouth sores are common after its use in cancer treatment. Epithelial cells are rapidly replaced and the drug interferes in this.

fwhc.org/abortion/mtxinfo.htm

 

[manualman]

It appears from the previous poster that the criteria I understood you to be stating (the drug doesn’t directly kill the embryo) is not true. Therefore, I can’t agree with your argument.

The airplane analogy is faulty. It might be acceptable to shoot down the airplane because it is the only way to repel the unjust aggressor if it is reasonable to expect that doing nothing will lead to more deaths. The deaths of the passengers is an unintended and unavoidable side effect. Double effect is satisfied.

A more appropriate analogy is this: A terrorist penetrates the White House and somehow gets to the Oval Office and the President. He has no weapon except a large amount of explosive packed around his body with nails/shrapnel. He calls for everyone to freeze or he will blow up the WH. Next he states that unless the President is shot, he will detonate his bomb. The Secret Service somehow determines that the bomb is very real and the threat 100% credible. (forget how unlikely it is for us to get this far for discussion). NOW we have a similar situation. If you are the Vice President in another building, do you order the President to be shot or accept the loss of the White House and all the staffers present? THAT is the choice you are presenting with your ectopic pregnancy drug.

 

[Seatuck]

Why do you seem to deny that the drug acts on the baby? Methotrexate causes death to the fetal cells. This kills the baby.

The placenta is not the only tissue that is attacked. I wish you would say early or pre placenta because saying trophoblast is a lot like when the abortionists switched to “fetus” instead of baby to desenstitize the death.

Methotrexate attacks all rapidly dividing cells. This is why mouth sores are common after its use in cancer treatment. Epithelial cells are rapidly replaced and the drug interferes in this.

fwhc.org/abortion/mtxinfo.htm

 

[VARC]

I apologize for the length of this post in advance. I intend to wrap this up as concisely as possible.

This situation happens quite often in this country so it needs to be addressed. When you say that she should talk to social services, you are answering that she should risk death or be excommunicated. People in these circumstances don’t have a whole lot time to go back and forth with social service agencies (assuming they could find one that would help) when time is of the essence.

In bringing up this case, I’m trying to make people see the tree(the totality of the circumstance) from the leaves (the individual details). The terrible truth is that in an ectopic pregnancy, the baby is lost no matter what you do or don’t do. Nothing is going to change that. The only varible is the condition of the mother.

To other very staunch pro-life christians(protestant and orthodox), the use of MTX is morally justified becuse they regonize the intent is not for a mother to kill her baby but rather to treat a grave threat to her life and health. They regonize that the spirit of the law against abortion is not violated in this case and accept the loss of a tubal ectopic pregnancy as a forgone conclusion of the condition not the treatment. They don’t demand that she risk her life as well because there simply would be no reason to do that. I hope that those who disagree with them would at least admit that it is truly the pro-life position not to needlessly endanger the mother’s life as well.

Unfortunately we catholics demand the application of the double effect principle. By regonizing a few details, the double effect priciple can apply to this circumstance as well. I will list them:

1. The trophoplast is distinct from the embryo and it is not a human life.
2. If the trophoplast cannot serve to nuture an embryo to term its destruction is a morally neutral act
3. The destruction of said trophoplast is a morally good act when it is a danger to the mother’s life

It is a very legalistic way to justify what is common sense to all other christians of good conscience.

My point in starting this thread isn’t to convince those who are determined to believe otherwise. Rather, the purpose is to demonstrate that:

A) this matter is not settled by the church’s Magesterium
B) that there is a reasonable argument for the use of MTX and
C) that, although a minority, there are reputable catholic bioethicists who hold this view.

All three points above are undisputedly true. so women should make thier descision based on thier conscience without fear of latiae excommunication.

 

[SaintRose83]

VARC,
I couldn't agree more with your stand on Methotrexate and Ectopic pregnancies. Catholics who are against MTX need to be careful about things they say and stands they take concerning this issue, especially when the pope has not even offically ruled in this matter. The woman feels bad enough that she lost her baby, and now she has Catholic's telling her that she has to put her life in danger, for what?? To take a pro-life stand? There is no life to save, except the mothers at this point. I could see if there was any chance for the baby to survive, but it is impossible for a tubal pregnancy to brought to term. Please stop telling us that this is what the Catholic Church teaches, because you may just be pushing someone out of the church, or keeping someone from entering it.

 

[fix]

This is a delicate topic, but that does not mean we should shut down discussion claiming discussing moral theology will turn off people from the faith. In fact, it may be a vehicle to show how deligent and caring the Church is.

And, no one has said the Church teaches a mother must place her life in danger. There is a lot of hyperbole going here.

I offer two more links:

Operations, treatments, and medications that have as their direct purpose the cure of a proportionately serious pathological condition of a pregnant woman are permitted when they cannot be safely postponed until the unborn child is viable, even if they will result in the death of the unborn child.

In case of extrauterine pregnancy, no intervention is morally licit which constitutes a direct abortion.31USCCB

And

What is the Church’s teaching on ectopic pregnancy?

 

[TAS2000]

I apologize for the length of this post in advance. I intend to wrap this up as concisely as possible.

This situation happens quite often in this country so it needs to be addressed. When you say that she should talk to social services, you are answering that she should risk death or be excommunicated. People in these circumstances don’t have a whole lot time to go back and forth with social service agencies (assuming they could find one that would help) when time is of the essence.

In bringing up this case, I’m trying to make people see the tree(the totality of the circumstance) from the leaves (the individual details). The terrible truth is that in an ectopic pregnancy, the baby is lost no matter what you do or don’t do. Nothing is going to change that. The only varible is the condition of the mother.

To other very staunch pro-life christians(protestant and orthodox), the use of MTX is morally justified becuse they regonize the intent is not for a mother to kill her baby but rather to treat a grave threat to her life and health. They regonize that the spirit of the law against abortion is not violated in this case and accept the loss of a tubal ectopic pregnancy as a forgone conclusion of the condition not the treatment. They don’t demand that she risk her life as well because there simply would be no reason to do that. I hope that those who disagree with them would at least admit that it is truly the pro-life position not to needlessly endanger the mother’s life as well.

Unfortunately we catholics demand the application of the double effect principle. By regonizing a few details, the double effect priciple can apply to this circumstance as well. I will list them:

1. The trophoplast is distinct from the embryo and it is not a human life.
2. If the trophoplast cannot serve to nuture an embryo to term its destruction is a morally neutral act
3. The destruction of said trophoplast is a morally good act when it is a danger to the mother’s life

It is a very legalistic way to justify what is common sense to all other christians of good conscience.

My point in starting this thread isn’t to convince those who are determined to believe otherwise. Rather, the purpose is to demonstrate that:

A) this matter is not settled by the church’s Magesterium
B) that there is a reasonable argument for the use of MTX and
C) that, although a minority, there are reputable catholic bioethicists who hold this view.

All three points above are undisputedly true. so women should make thier descision based on thier conscience without fear of latiae excommunication.

Your personnal opinions do not make it fact that ALL other good people (except of course those catholic whacko’s) hold these same ideas. They don’t so drop it!.

You keep throwing around words like Intent and spirt of the law. As was pointed out, to satisfy double effect the ACT as well as the INTENT must be good. You have not sufficiently proven that MTX meets the ACT portion of the requirement. If it directly effects the still living embryo, then it most likely does not meet the act part. You also say things like “unfortuinstly” we require that we meet moral standards. Apperently you would be happier if th emoral standards were flexible? today it is ok to knowingly and actively kill another person because it will do some good to another person? This is like saying we can kill terminally ill patients to harvest their organs for saving other lives. rather than say the church should lower it morals to prevent MONEY form stopping women from getting the moral care they need, maybe you should say the insurance and medical communities need to change to allow women better access to the care they need rather than prescribing babykilling abortion drugs under the guise of “helping” them. Then maybe those women wouldn’t have to face guil;t and remorse when they later learn they were LIED to and that they did in fact willing participate in the killing of their child when they were already under huge amounts of emotional stress at facing the possiblity of an ectopic.

And before you go on your horse about knowing someone who had this happen…I was rushed to the hospital in the middle of the night with and ectopic pregnancy and told later that i was about an hour away from bleeding to death internally without ever knowing it. So i HAVE experienced this. first hand.

 

[SaintRose83]

In fact, it may be a vehicle to show how deligent and caring the Church is.

And

Are you serious? How can you possibly be convinced that people would see the Church as deligent and caring in matters of an ectopic pregnancy if the Church forbid MTX. The only way they could be percived as caring, is if they allow the use of MTX to spare the mother from serious harm or death. I would be ashamed if more people knew that some Catholic’s actually believed this, and are telling mother’s who have already lost their baby, that they have to risk death just to prove some legalistic point. There is nothing wrong with the use of MTX to remove a pregnancy that has gone wrong, just as there is nothing wrong with removing the pregnancy in the tube. Its really the same thing and has the same end result. If a woman is still able in her pregnancy to get the MTX shot, she should do it without fear from Catholics who threaten her with excommunication. It can spare her unneccessary surgery, physical pain, her future fertility, and her life.

I’m sure that if there was something that could be done to give the child a chance at surviving, most mothers in that situation would do anything. Since there is no chance for survival (at this time) how is it pro-life to be against MTX. Your not being pro-life for the baby (its doomed either way) and your certainly not being pro-life for the mother, so who are you being pro-life for?

Also, yes the Church would be saying a mother must place her life in danger. By waiting to remove the tube, you are risking the tube rupturing, which does happen if you don’t get it cleared up right away. That is why when they discover you have an ectopic pregnancy the doctor will give you the MTX shot that day before you leave the office, waiting any longer then neccessary is reckless, and places your health in grave danger.

 

[SaintRose83]

Your personnal opinions do not make it fact that ALL other good people (except of course those catholic whacko’s) hold these same ideas. They don’t so drop it

I have talked about this issue with people of many other faiths and I have never encountered anyone that would say that it would be immoral. Not even a catholic. Even if I could find someone that would agree that it is immoral, I doubt they would think that it should carry the church’s highest penalty…automatic excommunication. It’s kind of our “forty lashes” for the teacher who names a teddy bear Muhammed. Embarassingly unjust.

 

[VARC]

Your personnal opinions do not make it fact that ALL other good people (except of course those catholic whacko’s) hold these same ideas. They don’t so drop it

I have talked about this issue with people of many other faiths and I have never encountered anyone that would say that it would be immoral. Not even a catholic. Even if I could find someone that would agree that it is immoral, I doubt they would think that it should carry the church’s highest penalty…automatic excommunication. It’s kind of our “forty lashes” for the teacher who names a teddy bear Muhammed. Embarassingly unjust.

 

[SaintRose83]

It’s kind of our “forty lashes” for the teacher who names a teddy bear Muhammed. Embarassingly unjust.

I would say its more like the Muslim woman who was raped and received the 200 lashes. She was a victim and was given an unjust punishment by her religion. I think getting 200 lashes is less cruel than being excommunicated.

 

[Listener]

I would like to quote a paragraph from the Catechism of the Catholic Church:

2263 The legitimate defense of persons and societies is not an exception to the prohibition against the murder of the innocent that constitutes intentional killing. "The act of self-defense can have a double effect: the preservation of one’s own life; and the killing of the aggressor. . . . The one is intended, the other is not."65

I still think that if a woman’s tube is removed, the baby is being killed just like it would be killed if she took Methotrexate. The baby is going to die anyway. I think that the least they can do is save the mother. I think this would be killing in self-defense, which is permitted by the Catholic Church.

Some say you could only kill a guilty person in self defense. However, a person with the mental capacity of a two-year-old (technically innocent) could attack you and try to kill you. I think you would have as much right to kill such a person in self-defense as you would have the right to kill a “guilty” person.

 

[fix]

Are you serious?

Very!

How can you possibly be convinced that people would see the Church as deligent and caring in matters of an ectopic pregnancy if the Church forbid MTX.

Because the Church preaches what is true.

The only way they could be percived as caring, is if they allow the use of MTX to spare the mother from serious harm or death.

The only way? In your opinion.

I would be ashamed if more people knew that some Catholic’s actually believed this,

Then that sense you would have would be illegitimate.

and are telling mother’s who have already lost their baby, that they have to risk death just to prove some legalistic point.

If the baby is dead then there is no debate because MTX would be licit in that case.

There is nothing wrong with the use of MTX to remove a pregnancy that has gone wrong, just as there is nothing wrong with removing the pregnancy in the tube.

Based on what do you assert this? The ends justify the means?

Its really the same thing and has the same end result. If a woman is still able in her pregnancy to get the MTX shot, she should do it without fear from Catholics who threaten her with excommunication. It can spare her unneccessary surgery, physical pain, her future fertility, and her life.

Again, your opinion.

Since there is no chance for survival (at this time) how is it pro-life to be against MTX. Your not being pro-life for the baby (its doomed either way) and your certainly not being pro-life for the mother, so who are you being pro-life for?

Do you claim direct abortion is licit simply because a life will end? You are saying because one’s life cannot be saved we are free to take it?

Also, yes the Church would be saying a mother must place her life in danger. By waiting to remove the tube, you are risking the tube rupturing, which does happen if you don’t get it cleared up right away.

You are limiting treatment to one drug under every scenario. The Church does not say that.

That is why when they discover you have an ectopic pregnancy the doctor will give you the MTX shot that day before you leave the office, waiting any longer then neccessary is reckless, and places your health in grave danger.

You have taken all of medicine and reduced it to a cookbook.

 

[fix]

I have talked about this issue with people of many other faiths and I have never encountered anyone that would say that it would be immoral. Not even a catholic. Even if I could find someone that would agree that it is immoral, I doubt they would think that it should carry the church’s highest penalty…automatic excommunication. It’s kind of our “forty lashes” for the teacher who names a teddy bear Muhammed. Embarassingly unjust.

I posted links from two separate priests who say it is wrong.

And, the hyperbole is uncalled for.

 

[TAS2000]

Can you people NOT understand this concept??? The Church does NOT demand that ANYONE “risk death”. What it does say is that you can not knowingly commit murder, which will damn you to hell for all eternity, for the sake of your convieneince. To say any less or change positions on the matter is to crumble the fabric of our belief in the Chrch as God’s infallable representative on earth. So the church is not cruel, unfeeling, driving people away etc., unless those people refuse to accept obvious TRUTH.

The real and ONLY question involved is does using MTX to “treat” an ectopic pregnancy consist of murder of an innocent, or a valid medical treatment of a medical condition. The church position cannot change. IF it can be proved that MTX does not knowingly destroy the embryo directly, then it meets the moral standards of not being murder. I don’t think it has been proven yet. Bully for all those how say it is so much easier and faster and cheaper and less invasive, but that still doesn’t make it automatically RIGHT. It is the difference between earning money and stealing it. One is right, the other isn’t though both have the same end. The MEANS matters to the church just as much.

Yes the baby will die anyway with today’s medical knowledge. But that doesn’t justify murdering it before hand to make it more convienient fo rthe mother. The baby is an innocent, not an agressor, so self defense doesn’t apply.

Again, the only valid arguement here is whether or not MTX directly kills the baby (chemical abortion) which would be wrong, or if it treats another medical condition, thus making it acceptable.

 

[VARC]

I posted links from two separate priests who say it is wrong.

And, the hyperbole is uncalled for.

I am well aware that there are Roman Catholic priests that believe what you are proposing. But I seriously doubt that a cleric from any other religion whatsoever would even entertain the idea. And if 9 of 10 catholics disagree with the church’s teaching on contraception, it’s probably a fair bet that 99 out of 100 wouldn’t touch this idea.

And it’s not a hyperbole. It’s a reality to thousands of catholic women. I find it very revealing that you can’t type out the unavoidable conclusion of your position: If a woman who has an EP doesn’t put her life in grave danger by refusing MTX treatment, then she is automatically excommunicated. Because, in your opinion, using MTX to treat an ectopic pregnancy (a condition where the embryo dies no matter what) is the moral eqiuvalent of an elective abortion. If this was the logical conclusion of my position I wouldn’t want to type it out either.

“To say any less or change positions on the matter is to crumble the fabric of our belief in the Chrch as God’s infallable representative on earth. So the church is not cruel, unfeeling, driving people away etc., unless those people refuse to accept obvious TRUTH.”:

The above quote by TAS2000 is the most revealing of all. It confirms what I have long suspected. Many people defend this idea, not because they are concerned for life, nor because they are so moved by its truth, but because they believe that to even question it is to put their faith in God in jeopardy. I don’t know how we catholics can build our faith on such a foundation. As if our faith would “crumble” if Rome came out tommorow and declared MTX to be acceptable for EP treatment even when Rome herself has not taken a definitive position. I now understand why some catholics vigorously defend what seems to be indefensible to every other christian church or community in the world. Because they attribute this opinion to the church’s infallibilty, their very faith in God is on the line. How very far we have come from the Faith of the Fathers.

 

[Joan_M]

But the trophoplast is useless an any event. In the tube the trophoplast will not provide enough nutrition to bring a baby a to term. It abosulutely will not. The embryo cannot be moved either. There is nothing that can be done to save the embryo. To not see that is to not tell the tree from the leaves.

So, what you are saying is that if a human being is going to die because of the circumstances of his life it is licit to kill him? This is truly immoral!

There is an overemphasis on the letter of the law and no thought as to the spirit of the law. The spirit of the law against abortion being that embryos are people too and they must be treated like people. In the case of tubal ectopic pregnancy nothing can be done to save the child.

Again, you are saying that because nothing can be done to save the child you are recommending murder. Why can’t you see that this is totally immoral?

You demand that the mother must die too if she can’t aford surgery. The ironic thing is that you claim this is the pro-life position. It boggles my mind. **Apparantly your mind is easily boggled! Is there no hospital where the mother can have surgery at low or no cost? Anyway, it is God who tells us " Thou shalt not murder". What mother would abort her child like that? **