From the Catholic Encyclopedia entry on Abortion:
The teachings of the Catholic Church admit of no doubt on the subject. Such moral questions, when they are submitted, are decided by the Tribunal of the Holy Office. Now this authority decreed, 28 May, 1884, and again, 18 August, 1889, that “it cannot be safely taught in Catholic schools that it is lawful to perform . . . any surgical operation which is directly destructive of the life of the fetus or the mother.” Abortion was condemned by name, 24 July, 1895, in answer to the question whether when the mother is in immediate danger of death and there is no other means of saving her life, a physician can with a safe conscience cause abortion not by destroying the child in the womb (which was explicitly condemned in the former decree), but by giving it a chance to be born alive, though not being yet viable, it would soon expire. The answer was that he cannot. After these and other similar decisions had been given, some moralists thought they saw reasons to doubt whether an exception might not be allowed in the case of ectopic gestations. Therefore the question was submitted: “Is it ever allowed to extract from the body of the mother ectopic embryos still immature, before the sixth month after conception is completed?” The answer given, 20 March, 1902, was: “No; according to the decree of 4 May, 1898; according to which, as far as possible, earnest and opportune provision is to be made to safeguard the life of the child and of the mother. As to the time, let the questioner remember that no acceleration of birth is licit unless it be done at a time, and in ways in which, according to the usual course of things, the life of the mother and the child be provided for”. Ethics, then, and the Church agree in teaching that no action is lawful which directly destroys fetal life. It is also clear that extracting the living fetus before it is viable, is destroying its life as directly as it would be killing a grown man directly to plunge him into a medium in which he cannot live, and hold him there till he expires.
So, as of 1902, the answer seemed clear. No, even removing the fetus without harm is not permissible.
What most people are citing is actually a theory that came from one moralist who, himself, described it as a “thin distinction”. Since then, the distinction has gotten thinner still.
A number of things have changed over the years. For example, we now detect many ectopic pregnancies much earlier, and we have plasma and antibiotics. So, while a tubal rupture can still present a significant health risk, the most probably outcome is not maternal death.
Also, the distinction between a salpingectomy (tubal removal) and salpingostomy (removal of the fetus from the tube) used to be more moot. The pregnancy itself was not usually detected until there was bleeding or other severe outward signs. However, now that we have early detection, and managed health care, justifying a salpingectomy over, say, MTX (a chemical abortificant) is difficult.
The outcome is identical, a medical abortion (no one disputes it is an abortion, the question is rather it is ‘direct’, per Church teaching), but one requires surgery and causes partial sterility, the other is less intrussive and normally has no effect on sterility.
This has led to some interesting changes in the theological arguments. Some groups, like CHA, simply contends that all three treatments could be construed as falling under “double effect”. However, given that the original distinction was ‘thin’, many theologians disagree.
In the Ask An Apologist answer linked above, you’ll find a link to a group concerned with Catholic Bioethics. For the most part, the arguments and papers you will find there no longer try to apply the double effect argument. For example, the last paper I read there on ectopic pregnancy started with the contention that certain ectopic pregnancies weren’t pregnancies at all, but ‘interrupted miscarriages’. The fetus was already ‘dead or dying’, so the use of MTX (chemical abortificant) was legitimate. The relationship to our teaching on euthanasia was not addressed.
It should be noted that the Church has declined to comment on the legitimacy of any of these applications of theology and specific medical procedures.
Personally, I think that the Church is being prudent. Our belief is that life is treasured from fertilization to natural death. Both the zygote and the mother are loved infininately by God, so, as the Church has stated, both must be treated equally. But, the absolute ban on abortions to save the life of the mother is relatively new. Really dating only from 1884 and 1889. In of itself, it is an incredibly hard teaching for many to accept, let alone live.
So, with an ectopic pregnancy, where the fetus is so clearly doomed, I think that the Church is being intentionally tolerant. Particularly since ectopic pregnancies are on the rise (well over 100,000 a year in the US alone).
I could, of course, be wrong. I do not have any way of knowing the thinking of the Magesterium. But I do know that the only clear statements we have from the Church all lean towards our ban on abortion being absolute. So anyone asserting with certainty that our teaching is clearly ‘salpingectomy yes, everything else no’ is incorrect. That is the opinion of some theologians, but the belief is hardly universal. And, as mentioned, the Church has not specifically weighed in.
Peace
doesn’t get the difference.