Ectopic Pregnancy, Abortion, and Contraception

[Boston]

Hi All,

I have a doozy here!

My reading tells me that indirect abortion (as in excision of an oviduct, vs direct abortive methods like injected chemicals) is permitted. I understand the principles that differentiate indirect from direct abortions and I’m not looking for an explanation or debate on the difference. My question is this:

In the case of a mother with only one functioning ovary, if removing part of the oviduct could result in sterility, doesn’t that count as surgical contraception, also a mortal sin (as is abortion)?

 

[underacloud]

In the case of a mother with only one functioning ovary, if removing part of the oviduct could result in sterility, doesn’t that count as surgical contraception, also a mortal sin (as is abortion)?

No, since the sterility is not intended, but is another unintended effect allowable by the greater good of treating a serious medical condition.

Hysterectomies and other procedures than bring about sterility are allowable to treat serious medical conditions. Medications that inhibit a woman’s natural cycle are likewise alllowable when a serious medical condition is treated by such medication.

It is only sinful when the contraceptive effect is intended (as an end or as a means).

 

[Boston]

No, since the sterility is not intended, but is another unintended effect allowable by the greater good of treating a serious medical condition.

Hysterectomies and other procedures than bring about sterility are allowable to treat serious medical conditions. Medications that inhibit a woman’s natural cycle are likewise alllowable when a serious medical condition is treated by such medication.

It is only sinful when the contraceptive effect is intended (as an end or as a means).

If the mother knows that the sterility is a consequence of the action before choosing to commit the act, isn’t she therefore accepting sterilization as it’s part of a “package deal” with saving her life?

 

[underacloud]

If the mother knows that the sterility is a consequence of the action before choosing to commit the act, isn’t she therefore accepting sterilization as it’s part of a “package deal” with saving her life?

She accepts but does not intend it.

It’s perfectly acceptable. No sin at all.

 

[MilesVitae]

If the mother knows that the sterility is a consequence of the action before choosing to commit the act, isn’t she therefore accepting sterilization as it’s part of a “package deal” with saving her life?

The real distinction between something being foreseen and it being intended is a vital component in understanding the morality of issues like these. I think it’s something which needs to be made clear in discussion of these issues, because the difference is not always obvious to everyone.

 

[RPRPsych]

Hi All,

I have a doozy here!

My reading tells me that indirect abortion (as in excision of an oviduct, vs direct abortive methods like injected chemicals) is permitted. I understand the principles that differentiate indirect from direct abortions and I’m not looking for an explanation or debate on the difference. My question is this:

In the case of a mother with only one functioning ovary, if removing part of the oviduct could result in sterility, doesn’t that count as surgical contraception, also a mortal sin (as is abortion)?

In this case, the aim of the surgery is not to perform a sterilization, but to save the mother’s life.

The sterility is an unwanted and unwilled consequence of the procedure.

Therefore, this isn’t a mortal sin. If the mother is informed of this (as she should, that’s what informed consent is all about!) that doesn’t make it a sin either, as it is the surgeon who wills the procedure, to save her life. The mother hasn’t “asked for” a sterilization. (The mother could, of course, opt to defer the decision until a rupture is imminent - or a miracle occurs - but this is certainly not mandatory, and could even be seen as presumption.)

 

[George_Stegmeir]

I can speak with some authority on the subject in that my wife had to have a hysterectomy during her fertile years due to severe fibroid tumors. Had she not had the operation, she would have died. There was absolutely no intent of sterilization on either of our parts.
FWIW, we had three boys, and would have had more had she not become ill.

 

[Kelfa28]

I can speak with some authority on the subject in that my wife had to have a hysterectomy during her fertile years due to severe fibroid tumors. Had she not had the operation, she would have died. There was absolutely no intent of sterilization on either of our parts.
FWIW, we had three boys, and would have had more had she not become ill.

My mom is in this category as well.

She had severe complications that came about when my sister was born. This, unfortunately, resulted in a complete hysterectomy. My mom was totally aware of this and consented because she was told it would save her life.

My parents were lucky to have both of us…but I know they wanted more.

 

[Dmitri451]

This is the perfect application of the Principle of Double Effect. The Principle of Double Effect addresses the question of whether or not it is permissible to take a certain course of action if it can reasonably be foreseen to have two effects, one of which is good and the other of which is evil.

In the question at hand, the two effects could be articulated as:

1. The good effect is that the woman’s health is restored.
2. The evil effect is that the woman will be infertile.

For it to be moral to pursue this course, there are four conditions which must be **simultaneously **met:

1. The act, in itself, must be either morally good or morally neutral. I think it’s clear that there is nothing intrinsically wrong with removing a diseased part of a woman’s body to save her life. So this condition is clearly met.
2. The good effect must not be contingent on the evil effect occurring. That is to say, the good and evil effects must be independent, or, if they are not independent, then the evil effect must be a result of the good effect, not the other way around. In this case, the restoration of the woman’s health does not depend on her becoming sterile. They are independent. So this condition is met.
3. Only the good effect can be intended. This is what we’re talking about… the woman does not want to become sterile, but is simply accepting that as a consequence of the therapy required to restore her health. So this condition, too, is met.
4. There must be a reasonable balance between the good and evil effects. In other words, it can’t be a small good and a huge evil. A woman’s life is clearly worth more than her fertility. So this condition is met.

If you think about it, this is the logic we use when we agree to any surgery. The good effect is the restoration of health, and the evil effect is possible death or injury. In fact, in some surgeries, such as amputation, severe injury to the body is an intrinsic part of the surgery. When amputating a diseased leg the loss of the leg is not intended, but simply tolerated.

 

[Gorgias]

1. The good effect must not be contingent on the evil effect occurring. That is to say, the good and evil effects must be independent, or, if they are not independent, then the evil effect must be a result of the good effect, not the other way around.

Another way of putting this is that the evil effect must not be the means by which the good effect occurs.

 

[edwest2]

Here’s a good article, and the last two paragraphs sum things up pretty well.

ncbcenter.org/page.aspx?pid=940

Peace,
Ed

 

[Listener]

The problem I have with this kind of hair splitting is that we have a woman who is going to die if something is not done. If the medical professionals want to give the woman a pill to fix the problem, she is not exactly in a position to shop around for a doctor who is willing to remove her her tube.

Couldn’t you just say that the tube is becoming dangerously swollen, and you are taking a pill to reduce the swelling? If the baby died in the process, wouldn’t that be an unintended result of reducing the dangerous swelling in your tube?

Doesn’t it say in the Catholic Catechism that it is morally permissible to kill in self-defense? The baby would be in the process of killing the mother.

I don’t think the pill they take for this is even an abortion pill. I think that it is rather a medication that reduces tumors in cancer patients.

I will never understand this type of reasoning as long as I live.

 

[underacloud]

Couldn’t you just say that the tube is becoming dangerously swollen, and you are taking a pill to reduce the swelling? If the baby died in the process, wouldn’t that be an unintended result of reducing the dangerous swelling in your tube?

This is covered in the article linked to above. The mechanism of the drugs…ie the “means”…are a direct attack on the embryo and so are not permissable.

Doesn’t it say in the Catholic Catechism that it is morally permissible to kill in self-defense? The baby would be in the process of killing the mother.

The baby is not an unjust aggressor. The baby is not an assailant. The baby is entirely innocent. There is no self defense argument in this case.

I will never understand this type of reasoning as long as I live.

It’s very complicated and hard to grapple with. Moral theologians continue to work through these issues and there is certainly not outright agreement regarding some of the treatments available. The principles are clear - it’s basically governed by double effect - but the specifics can sometimes be hard to assess. But even in the worst case scenarios, which can happen, we must trust in God and the moral principle He has given us to follow. When reason alone does not provide a sufficient answer, faith does.

 

[Dmitri451]

The problem I have with this kind of hair splitting …

It is not hair splitting. It is an an application of clear moral principles to a difficult moral problem, the likes of which are quite common, especially in the medical world, and especially toward the end of life. These issues are as real and as important as it gets, and it’s important to have a good handle on how to approach them in real situations because one day you may be in the position of having to make a choice like this. I’ve been in such a difficult situation, and having had this understanding not only helped me make a moral choice, but also gave me the peace of knowing I chose correctly even though things didn’t work out the way we had hoped.