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Seatuck
Guest
You cannot use it to treat an ectopic because it directly attacks the unborn child and it’s placenta. Think about what you have written. A child is not a cancer. Methotrexate is most commonly used to attack cancer.
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Doc_Keele
Guest
Actually methotrexate is most commonly used in the UK to treat rheumatoid arthritis.
A child isn’t a cancer. Clearly not. But are there significant similarities? How does trophoblast invade? What about choriocarcinoma?
Salpingectomy also attacks the child. It is morally equivalent.
A child isn’t a cancer. Clearly not. But are there significant similarities? How does trophoblast invade? What about choriocarcinoma?
Salpingectomy also attacks the child. It is morally equivalent.
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Seatuck
Guest
Ok methotrexate is very often used to attack cancer or other rapidly growing cells.Actually methotrexate is most commonly used in the UK to treat rheumatoid arthritis.
A child isn’t a cancer. Clearly not. But are there significant similarities? How does trophoblast invade? What about choriocarcinoma?
Salpingectomy also attacks the child. It is morally equivalent.
Methotrexate treatment of ectopic pregnancIt is not morally equivalent to salpingectomy. With salpingectomy there is usually a bleed in progress. The surgeon acts to remove the diseased tube.Unfortunately this causes the inintended , indirect killing of the child. With the methotrexate treatment they go in and directly attack the fetus with a medication. There is a difference. With the methotrexate they do not wait to see what is happening and if there will be a natural death of the fetus. It’s use must be early before the situation is a crisis.
Father Tad-
Some say that cutting out a section of the tube with a baby inside is no different than using methotrexate because, in either case, the baby ends up dying. Yet the difference in how the baby dies is, in fact, critical. There is always a difference between killing someone directly and allowing someone to die of indirect causes. We may never directly take the life of an innocent human being, though we may sometimes tolerate the indirect and unintended loss of life that comes with trying to properly address a life-threatening medical situation.
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Doc_Keele
Guest
Quoting Father Tad is an appeal to authority.
Methotrexate will not be used when there is bleeding normally, because surgery is the safest option. Salpingectomy is not always necessary, salpingostomy is often possible.
This distinction between “direct attack” and “indirect attack” is spurious. The tube does not necessarily need to be resected, the cause of the problem is the expanding pregnancy in the wrong place. The problem is sorted out by removing the conceptus, and to claim that the death of the developing child is not intended is to lie to oneself. It is not desired, but it is intended.
Consistency would require either the expectant management of all ectopic pregnancies or any methods that removes the pregnancy (since with salpingectomy the Church doesn’t mandate transplantation to the uterus).
Methotrexate will not be used when there is bleeding normally, because surgery is the safest option. Salpingectomy is not always necessary, salpingostomy is often possible.
This distinction between “direct attack” and “indirect attack” is spurious. The tube does not necessarily need to be resected, the cause of the problem is the expanding pregnancy in the wrong place. The problem is sorted out by removing the conceptus, and to claim that the death of the developing child is not intended is to lie to oneself. It is not desired, but it is intended.
Consistency would require either the expectant management of all ectopic pregnancies or any methods that removes the pregnancy (since with salpingectomy the Church doesn’t mandate transplantation to the uterus).
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Fran65
Guest
Consistency may not apply because ectopic pregnancies are different in location (i.e. where the embryo is implanted within or even outside the tube), stage and presentation.
Removing the tube before it ruptures has the side effect of ending the pregnancy, but with the intention of preventing a woman bleeding to death. Adminstering the drug is with the intention of ending the pregnancy. The two things are different as explained earlier.
The intention is key. the surgeon does not intend to terminate the pregnancy as with the drug. She intends to prevent death through haemmorhage and shock by removing the tube. If she could save the pregnancy she would. With the drug there is not that intention.
It is similar to giving someone with severe pain a dose of morphine big enough to control the pain that has the side effect of respiratory arrest. Or giving someone a dose of morphine with the intention of killing them.
Removing the tube before it ruptures has the side effect of ending the pregnancy, but with the intention of preventing a woman bleeding to death. Adminstering the drug is with the intention of ending the pregnancy. The two things are different as explained earlier.
The intention is key. the surgeon does not intend to terminate the pregnancy as with the drug. She intends to prevent death through haemmorhage and shock by removing the tube. If she could save the pregnancy she would. With the drug there is not that intention.
It is similar to giving someone with severe pain a dose of morphine big enough to control the pain that has the side effect of respiratory arrest. Or giving someone a dose of morphine with the intention of killing them.
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Doc_Keele
Guest
Oh I understand the doctrine of double effect, I just don’t think that the situation here is comparable to the morphine example. With the morphine, the intention is important, but not the oblique intention. With the ectopic pregnancy, it seems the oblique intention is important. Why the difference?
Salpingectomy, salpingostomy and methotrexate all kill the conceptus. If there’s no empirical difference, what is the point in qiubbling over supposed moral differences?
The person with an ectopic pregnancy most likely doesn’t desire the death of the child, but desires to live. Unfortunately the Vatican has rejected proportionalism.
Salpingectomy, salpingostomy and methotrexate all kill the conceptus. If there’s no empirical difference, what is the point in qiubbling over supposed moral differences?
The person with an ectopic pregnancy most likely doesn’t desire the death of the child, but desires to live. Unfortunately the Vatican has rejected proportionalism.
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seekerz
Guest
Intent here is debatable: the pregnancy’s location is the life-threatening problem not the tube (even if it is diseased, a diseased tube by itself would scarcely kill the mother). Since relocation is not a possibility at present, the only alternative is removal - either by surgery or drugs.The intention is key. the surgeon does not intend to terminate the pregnancy as with the drug. She intends to prevent death through haemmorhage and shock by removing the tube. If she could save the pregnancy she would. With the drug there is not that intention.
In any case it is medically very risky (and as far as I know not morally required by the Church) to wait for the tube to rupture i.e. become ‘diseased’, so many tubes that are removed are not even bleeding before removal. The treatment for a diseased tube may or may not be removal but either way that alone would hardly be considered an emergency.
If the baby is lying in there, respiring and feeding via the placenta and I cut off the blood supply to that placenta (by cutting the tube), how is that really different from giving a drug that destroys the placenta? Either way the food and oxygen supply to the baby is cut off by the doctor’s action. The difference between direct and indirect action here is…?
Even with a perfectly normal tube (not yet damaged), there is just no way a pregnancy can develop to term in that limited space, so to say one is treating a diseased tube and not a pregnancy is to not be the actual surgeon I think…
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Doc_Keele
Guest
Yes the premise that the tube is the problem is wrong, so even if the argument is valid it cannot be sound.
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Holly3278
Guest
What exactly is Methotrexate? If I am understanding the issue correctly, I think there is only one moral way to deal with an ectopic pregnancy and that is to remove the entire fallopian tube. That way a direct abortion does not occur.
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Rence
Guest
It’s an antimetabolite, it’s an antifolate. It hinders cell reproduction so that the fetus stops growing and dies. So it directly causes an abortion.What exactly is Methotrexate? If I am understanding the issue correctly, I think there is only one moral way to deal with an ectopic pregnancy and that is to remove the entire fallopian tube. That way a direct abortion does not occur.
Methotrexate is also used to treat some cancers, rheumatoid arthritis and crohn’s disease.
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Pug
Guest
If we imagine more technology, say an “iron womb”, then there may be a difference between a technique that appears to move the baby and one that appears to kill the baby. Merely moving the baby would be a prelude to placing it in the iron womb, where it could live. Could MTX ever be used to detach a baby as a prelude to moving it? Or would MTX always kill the baby outright?Oh I understand the doctrine of double effect, I just don’t think that the situation here is comparable to the morphine example. With the morphine, the intention is important, but not the oblique intention. With the ectopic pregnancy, it seems the oblique intention is important. Why the difference?
Salpingectomy, salpingostomy and methotrexate all kill the conceptus. If there’s no empirical difference, what is the point in qiubbling over supposed moral differences?
The person with an ectopic pregnancy most likely doesn’t desire the death of the child, but desires to live. Unfortunately the Vatican has rejected proportionalism.
By oblique intention, do you mean the “means”? If so, it has to do with certain things can never be done as an end itself, or as a means to some other end. However, certain bad effects can be tolerated as a side effect, if the side effect is neither the ends, nor the means, and meets the golden rule, fairness, etc.
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fix
Guest
But, they are not similar circumstances. The innocent child is not the proximate cause of the mother’s illness. The pathology associate with the pregnancy is the cause. Why must the child be punished?Well you’re asserting that innocence precludes one being an unjust aggressor. This is not the case. If someone had a psychotic reaction through no fault of their own, and attacked you, they would be an unjust aggressor. They would not be morally or criminally responsible, but you would still be entitled to defend yourself.
The patient with a psychotic episode trying to harm another is the proximate cause, even though they may be morally inculpable.
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o_mlly
Guest
If the “innocent child is not the proximate cause of the mother’s illness”, then it seems reasonable that mother’s intention is not to end the child’s life. The child dies in the same circumstance innocent civilians die in a just war. Unintended “collateral damage” is the euphemism.But, they are not similar circumstances. The innocent child is not the proximate cause of the mother’s illness. The pathology associate with the pregnancy is the cause. Why must the child be punished?
The patient with a psychotic episode trying to harm another is the proximate cause, even though they may be morally inculpable.
The act is morally neutral - administering a drug. If the proximate cause of the threat to the mother’s life is the pathogen (not the on-going life of the child), and the mother intends to save her life, and if the drug attacks the pathogen, then the saving of the mother’s life (good effect) does not proceed directly from the child’s death (bad effect). The two lives are proportionate and the act is morally licit.
The contentions - the drug’s actual interaction with the mother/child and the prognosis of the probability of the child coming to term - are important in determining the morality of the drug’s use and is a highly technical determination. Since it is the mother’s act, the important judgement is hers - not her advisors - and, absent her own expertise, is a matter of her own prudence in as much as God must give her the grace to decide.
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seekerz
Guest
The pathology is what is punishing the child because it necessitates a treatment incompatible with the child’s life and because even declining treatment will not save the child’s life.But, they are not similar circumstances. The innocent child is not the proximate cause of the mother’s illness. The pathology associate with the pregnancy is the cause. Why must the child be punished?
The patient with a psychotic episode trying to harm another is the proximate cause, even though they may be morally inculpable.
I don’t see how treating ectopics is so different from treating a woman with life-threatening bleeding from an inevitable abortion (baby still alive but cannot be saved).
As far as I know, a D&C is completely licit in this case (I’ve seen it explained as removal of the bleeding uterus lining, with death of baby as an unavoidable side effect) and it is not required that the uterus be removed!
The reasoning behind requiring the removal of the whole tube, I can’t quite see when I consider the matter from this angle (why not removal of the bleeding segment of tube, with death of baby as unavoidable side effect?)…
BTW, if anyone has ever seen a D&C done, they will agree that there is nothing “indirect” about the action on the fetus. Gauging the “intent” of a patient or doctor is quite another story altogether. Ultimately, “intent” has to left to the individual conscience, I think.
It would help to have a Catholic doc who treats such patients weigh in on this type of discussion.
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Doc_Keele
Guest
Oblique intention is an effect that is almost certain and foreseen by the actor.If we imagine more technology, say an “iron womb”, then there may be a difference between a technique that appears to move the baby and one that appears to kill the baby. Merely moving the baby would be a prelude to placing it in the iron womb, where it could live. Could MTX ever be used to detach a baby as a prelude to moving it? Or would MTX always kill the baby outright?
By oblique intention, do you mean the “means”? If so, it has to do with certain things can never be done as an end itself, or as a means to some other end. However, certain bad effects can be tolerated as a side effect, if the side effect is neither the ends, nor the means, and meets the golden rule, fairness, etc.
The Church’s deontological approach is just one of many, and is based on a circular argument. It’s counter-intuitive to distinguish between removing the embryo wrapped
in salpinx and removing the embryo, don’t you think?
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Doc_Keele
Guest
The child is not the cause of the illness? How do you reckon that?But, they are not similar circumstances. The innocent child is not the proximate cause of the mother’s illness. The pathology associate with the pregnancy is the cause. Why must the child be punished?
The patient with a psychotic episode trying to harm another is the proximate cause, even though they may be morally inculpable.
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Pug
Guest
When you are removing the container of the child for no reason other than to be able to say that you didn’t terminally separate the child from the only source of food, it seems hard to tell the difference. It seems like saying, “Oh, I didn’t pull the plug. I just turned off the electric main. See for yourself, the plug is still in the wall.”Oblique intention is an effect that is almost certain and foreseen by the actor.
The Church’s deontological approach is just one of many, and is based on a circular argument. It’s counter-intuitive to distinguish between removing the embryo wrapped
in salpinx and removing the embryo, don’t you think?
The difference is intuitive to me if your goal is to move the child somewhere safe, somewhere other than where he is, and there is another goal, that of removing a location that is diseased. Then you can do one operation, that of moving the child while leaving the location untreated, or you can do a different operation, that of moving the child and that of treating the location. Those are two separate things, but clearly someone might like to do them at the same time, under one anesthesia. I am assuming the medical ability to move the child safely to somewhere safe (not currently a significant reality), and to do it independently of moving the location. I symbolized that assumption with the phrase “iron womb”.
With your phrase “oblique intention” you are using the word “intention” differently that I might. We agree more with your use of the word “effect”. What you call an oblique intention I call a foreseen likely side effect. I do not typically view these as “intended”.
I do not concede that the Church’s way of looking at ethics/morality (whatever that way is) is circular.
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Doc_Keele
Guest
I phrased that loosely. A deontological approach is not of itself a circular argument, since it’s not an argument.
The church’s argument that an intrinsic evil can never be used to achieve a good end is however a circular argument.
Intention certainly means different things to different people. This is one of the bones of contention, as to what is intention. The paper I am looking at about moral absolutism at the moment examines that in depth.
The church’s argument that an intrinsic evil can never be used to achieve a good end is however a circular argument.
Intention certainly means different things to different people. This is one of the bones of contention, as to what is intention. The paper I am looking at about moral absolutism at the moment examines that in depth.
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o_mlly
Guest
If you are truly interested in formal argument, will you point out either the false premise, ambiguity or logical error in Kreeft’s anti-abortion argument?I phrased that loosely. A deontological approach is not of itself a circular argument, since it’s not an argument.
The church’s argument that an intrinsic evil can never be used to achieve a good end is however a circular argument.
Intention certainly means different things to different people. This is one of the bones of contention, as to what is intention. The paper I am looking at about moral absolutism at the moment examines that in depth.
A second thing we know by formal logic alone is that either we do or do not know what a fetus is. Either there is “out there,” in objective fact, independent of our minds, a human life, or there is not; and either there is knowledge in our minds of this objective fact, or there is not.
So, there are four possibilities:
•The fetus is a person, and we know that;
•The fetus is a person, but we don’t know that;
•The fetus isn’t a person, but we don’t know that;
•The fetus isn’t a person, and we know that.
What is abortion in each of these four cases?
In Case 1, where the fetus is a person and you know that, abortion is murder. First-degree murder, in fact. You deliberately kill an innocent human being.
In Case 2, where the fetus is a person and you don’t know that, abortion is manslaughter. It’s like driving over a man-shaped overcoat in the street at night or shooting toxic chemicals into a building that you’re not sure is fully evacuated. You’re not sure there is a person there, but you’re not sure there isn’t either, and it just so happens that there is a person there, and you kill him. You cannot plead ignorance. True, you didn’t know there was a person there, but you didn’t know there wasn’t either, so your act was literally the height of irresponsibility. This is the act Roe allowed.
In Case 3, the fetus isn’t a person, but you don’t know that. So abortion is just as irresponsible as it is in the previous case. You ran over the overcoat or fumigated the building without knowing that there were no persons there. You were lucky; there weren’t. But you didn’t care; you didn’t take care; you were just as irresponsible. You cannot legally be charged with manslaughter, since no man was slaughtered, but you can and should be charged with criminal negligence.
Only in Case 4 is abortion a reasonable, permissible, and responsible choice. But note: What makes Case 4 permissible is not merely the fact that the fetus is not a person but also your knowledge that it is not, your overcoming of skepticism. So skepticism counts not for abortion but against it. Only if you are not a skeptic, only if you are a dogmatist, only if you are certain that there is no person in the fetus, no man in the coat, or no person in the building, may you abort, drive, or fumigate.
For the full agrument, “The Apple Argument” go to: catholiceducation.org/articles/abortion/ab0045.html
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Doc_Keele
Guest
It looks like a case of false alternatives to me.
It’s not necessary to argue that the conceptus is not a person to argue that abortion is permissible. The unconscious violinist thought experiment is an illustration.
It’s not necessary to argue that the conceptus is not a person to argue that abortion is permissible. The unconscious violinist thought experiment is an illustration.
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