Ectopic pregnancy and direct abortion.

[Mary_Gail_36]

The fallopian tube in this instance is not necessarily “diseased”. It’s just that the fetus became implanted in the wrong place.

I understand the moral principle involved and that morality cannot be relative. But in real life, this is sort of a “Sophie’s Choice” type of question where one is faced with an impossible moral choice.

Take for instance a woman who may already have a damaged or missing fallopian tube, and now has an ectopic pregnancy in the remaining tube. Surgery will, for all intents and purposes, render her sterile. Whether she has surgery or takes the abortifacient, the result will be the same: a dead baby. But in the latter case, at least there is a chance for a new baby.

It’s a bit like this: the moral “truth” is like a mathematical formula where 2+2 = 4. That’s an unchangeable, inviolable, rule. But let’s say you’re designing an industrial process, where you are adding two measures of one ingredient, and 2 measures of another, to create a result that will yield 4 measures of a product.

But the yield of the chemical reaction is only 80% due to inefficiencies in the process, thermal losses, leakage, etc.

The mathematical formula, 2+2=4 remains the foundational argument. But imperfections in the process mean that 2+2 will only equal 3.2, instead of 4.

And isn’t that a bit how humanity works? God teaches us a perfect moral law. But in our fallen world, we are presented with sometimes horrendous choices that we need to make and whichever choice we elect, the result will be imperfect: 2+2 = 3.2, that is to say, neither of our choices will be perfectly moral.

So, how much should we condemn someone who is faced with this form of Sophie’s Choice, and who elects the drug? Does not one have to look at the reasons for choosing the drug? They could be: preventing sterility; risk of surgery, or simply fear of surgery. Especially in the case of the woman with only one good fallopian tube facing sterility, the decision may be so heavily coloured by emotion, that the rational, moral choice is impossible to arrive at. It would seem to me then, that being so heavily clouded by emotion, the choice, while constituting an issue of grave matter, would be not based on full consent of the will and the sin would thus be venial rather than mortal.

We can kill another human in self-defense. Even if the attacker is “innocent” (say a mentally handicapped person attempting to grievously assault someone). Why is it any different in this case? Am I missing something here?

I had posted the side effects of methotrexate. One of which is possible infertility.

 

[OraLabora]

I had posted the side effects of methotrexate. One of which is possible infertility.

Possible infertility. Removing the good last fallopian tube is certain infertility.

I would think that this would weigh heavily in any decision especially by a woman with an ectopic pregnancy who has already lost a fallopian tube.

Unfortunately this is the result of a fallen world, where clear-cut moral decisions are clouded by human imperfection.

 

[mchale]

But the intent is not to kill the child, its to allow the mother to live. The drug from what I understand disolves the cells that attach it to the tube, thus allowing it to detach and die of a natural miscarriage. This would be no differant then removing life sustaining therapies such as breathing from a brain dead person who cannot breath on there own.

Its not just a question of intent, but a question of means.

In one case, you are saving the mother by removing the fallopian tube. The removal of a fallopian tube for the treatment of a medical condition is at worst morally neutral, and could be justly argued to be a moral good. The death of the child is an unintended side effect of the means taken (And indeed, in the future, one could imagine technology being developed that might be able to save the child!).

In the second case, the means of saving the mother is the destruction of the child directly.

I would point out that there is a distinct difference between removing a brain dead person from a respirator and removing a child’s means of support. A brain dead person is for all intents and purposes already dead. All that is removed is a mechanical method of keeping air pumping into the person’s lungs. In the case of using the drugs to end an ectopic pregnancy, the natural means of life are removed from the child.

Ultimately, this comes down to the following question. Is the death of the child an unintended consequence of the means used to save the mother or are they the means themselves. Unjust means cannot be justified by their end. Just means with unintended (though in this case inevitable) consequences can be.

–
Bill

 

[puzzleannie]

Discussion on EWTN Q&A Judie Brown’s site is relevant to this topic
note the expert’s opinion that removal of one fallopian tube does not impair fertility.

and yes, administration of a deadly drug to the fetus is the direct intent to kill the fetus, is murder, and is abortion, and is gravely immoral, and incurs automatic excommunication to any Catholic who willingly undergoes it, causes it or abets it

ewtn.com/vexperts/showresult.asp?RecNum=594197&Forums=0&Experts=0&Days=1&Author=&Keyword=&pgnu=1&groupnum=0&record_bookmark=9&ORDER_BY_TXT=ORDER+BY+ReplyDate+DESC&start_at=

 

[CDelphine]

The fallopian tube in this instance is not necessarily “diseased”. It’s just that the fetus became implanted in the wrong place.

The fetus became implanted in the wrong place – now the fallopian tubes is a bodily system which is deviating from its normal structure and function. That’s a disease.

To the OP: I’m sorry for your friend, and for your frustration about poor catechesis and all the other circumstances. In my prayers.

 

[nicole22]

Methotrexate has side effects as well…

drugs.com/sfx/methotrexate-side-effects.html

Isn’t it sad that infertility isn’t considered a “severe” side effect?

 

[chain]

One difference is dignity. The allowable surgical method delivers the baby whole, but fatally (by today’s medical practices) premature. In a handful of years perhaps we will have the ability to keep the baby alive by either a surrogate or artificial womb.

If the surgery (attempting to be less invasive) chopped up the baby to save (more of) the tube, I suspect it would be viewed similarly as chemically dissolving it is ((I keep thinking of acid).

 

[ALLGIRLS]

It would almost seem that the “pro-life” approach would be medication, not surgery, given that if this happens more than once, with surgery sterility will result.

I don’t quite get it: medication, the baby dies. Surgery, the baby dies. Do nothing, the baby and mother die. Either way it isn’t a viable pregnancy. At least the medication option doesn’t harm a woman’s reproductive chances. We have a friend who had two ectopic pregnancies, with surgery in both cases, and she of course was rendered sterile and was never able to have children.

I think the Church may need to re-think this one. At least that’s how it appears to me on the surface. If there are good reasons not to, I’d like to hear them.

Because w/ the medication, the child (and yes, it is a child, not just “cells of pregnancy”. Can these euphamisms get any more ridiculous and demeaning?) is being directly killed. When the section of tube is removed, the child dies as a secondary consequence, not directly. It’s the difference between having an abortion versus delivering a baby early, who then dies as a result of being born too early. It’s not the ends , it’s the means. You can’t directly kill a child, no matter his stage of developement or location.

In Christ,

Ellen

 

[ALLGIRLS]

As an aside, as I read through this thread, it occured to me that the topic of how to treat and ectopic pregnancy is a glaring example of how messed up and hypocritical our society is. Metho-whateveritscalled is considered “the gold standard” in treatment b/c removing a section of tube can render a woman sterile. The thought of sterility in this case is bemoaned and horrifying. Yet, have 2 or 3 kids and society tells you you should purposely render yourself sterile. Fertility then is horrifying and bemoaned.

Does anyone else see this? Or am I just particulary fed up w/ the world today?

In Christ,

Ellen

 

[LilyM]

We can kill another human in self-defense. Even if the attacker is “innocent” (say a mentally handicapped person attempting to grievously assault someone). Why is it any different in this case? Am I missing something here?

You are missing the fact that even in obvious cases of self defence direct killing is an absolute last resort. Even, say, a serious wound that is highly likely to be fatal (possibly indirect killing) must be used in preference to direct killing, if we know that the indirect method would stop the attacker. To go further would be to use excessive force - since you are obliged to only use the level of force necessary to prevent the attack.

In this case you’re acting as if the direct killing is a morally equivalent option to indirect killing. It isn’t, even from a self-defence point of view.

 

[Jermosh]

The whole point is that it’s NOT a natural miscarriage by any definition. It’s an entirely UNnatural one.

You’re not ALLOWING the embryo to detach, as if it would somehow naturally do so anyway.You are FORCIBLY and unnaturally making detachment happen at a time when it isn’t supposed to. Every bit as much forcibly and unnaturally as if you got a set of surgical forceps in there and yanked the poor embryo out of that tube.

And thus this ‘procedure’ is not morally different from any other artificially-induced abortion - for example from the taking of the pill RU486.

And it’s nothing like removing tubes from a brain-dead person. For starters the embryo is NOT brain dead, or ailing in any other way for that matter, but very much entirely alive and perfectly healthy.

It’s morally the equivalent of denying legitimate and necessary medical treatment to a PERFECTLY conscious and otherwise generally healthy person - say refusing someone an oxygen mask when they cannot breathe unaided. Or a feeding tube if the only thing wrong with them is that they cannot swallow unaided and thus cannot eat properly.

One cannot justify the denial of these sorts of treatments to someone who otherwise is in fact in perfect health, brain functioning properly and all.

Sorry I have to disagree, you are splitting hairs and inducing a major risk on the mother.

Your situation is not correctly inline with this issue, it is not a perfectly healthy person. Its a person who is doomed to die, have not attached properly, and put another viable person in harms way including death.

I have researched this issue, and have yet to see anything official on it. The only thing I could find is moral theologians who are using this “splitting hair” argument, which is an opinion. The thing that bothers me the most is some of these theologians are attempting to place this situation in the same bucket as Abortion on Demand, I think that is wrong on many accounts. We are talking about a life or death situation, the Church morally allows homicide when a life or death situation is put into place. The act of death was already put in place by nature, not Man.

 

[vz71]

The intent of the procedure is to not kill the baby, and killing another human is not always a moral evil. This is not a direct abortion on demand. I would like an official statement on this if you could.

The surgical removal of a woman’s fallopian tube during pregnancy is permissible only under the principle of double effect. St Thomas Aquinas defined the principle of double effect as follows (source: saintmarys.edu/~incandel/doubleeffect.html):

OK, I need some clarification here.

At this time, it is possible to detect an ectopic pregnancy long before it can cause damage.
So how can surgery to remove a completely healthy and undamaged fallopian tube be licit?

 

[Zatzat]

An ectopic pregnancy is a non-viable pregnancy.

In some cases, although appearing as an ectopic pregnancy, can actually be a condition called gestational trophoblastic neoplasia. Which, if left unchecked, will spread benign or malignant cancer cells throughout the women’s body in a very short period of time and end up killing her.

‘Gestational trophoblastic disease is a tumor originating from the trophoblast, which surrounds the blastocyst and develops into the chorion and amnion (see Conception and Prenatal Development). This disease can occur during or after an intrauterine or ectopic pregnancy’

merck.com/mmpe/sec18/ch254/ch254f.html

 

[Mamanurse]

Being a woman who has just had an ectopic pregnancy, I find it hard to read some of these statements. I had my left tube removed just over a month ago, we had been wanting another child for nearly 3 yrs, and this was the first time we had concieved since our first. I was devastated to find out that the baby wasn’t inutero. The Ob’s that I go to would prefer not to even do the Methotrexate due to the fact that no matter what you will be left with a damaged tube which increases future ectopic pregnancies. Not to mention the possibility that cells could remain even after the meds which would result in surgery anyway. If I had another ectopic pregnancy in the my right tube, I would have to opt for the tube removal. Yes, I understand it would render me sterile, but that would not be my intention nor desire…but I also try to follow the commandments, which instruct me not to kill. I understand that while removing my tube, my baby died as a secondary outcome…but I would have had them move the baby into my uterus if that was medically possible. One thing that makes me angry is why people think that just because they want, they deserve to have!! I feel that children are a blessing, so if my next baby were to implant in my only tube, then I would be saddened to have to accept the outcome…but I would never intentionally kill of my child just so I may have a shot at a future healthy one. If this situation were to arise, I would try to find God’s Hand in all of it and would likely adopt.

 

[Julianna]

Being a woman who has just had an ectopic pregnancy, I find it hard to read some of these statements. I had my left tube removed just over a month ago, we had been wanting another child for nearly 3 yrs, and this was the first time we had concieved since our first. I was devastated to find out that the baby wasn’t inutero. The Ob’s that I go to would prefer not to even do the Methotrexate due to the fact that no matter what you will be left with a damaged tube which increases future ectopic pregnancies. Not to mention the possibility that cells could remain even after the meds which would result in surgery anyway. If I had another ectopic pregnancy in the my right tube, I would have to opt for the tube removal. Yes, I understand it would render me sterile, but that would not be my intention nor desire…but I also try to follow the commandments, which instruct me not to kill. I understand that while removing my tube, my baby died as a secondary outcome…but I would have had them move the baby into my uterus if that was medically possible. One thing that makes me angry is why people think that just because they want, they deserve to have!! I feel that children are a blessing, so if my next baby were to implant in my only tube, then I would be saddened to have to accept the outcome…but I would never intentionally kill of my child just so I may have a shot at a future healthy one. If this situation were to arise, I would try to find God’s Hand in all of it and would likely adopt.

My sis in law has been through the same. My thoughts and prayers are with you as this is a very difficult situation. You hope for the best and pray the worst does not happen. I do not believe than any human being with a heart would state that your intentions were to kill a child and to purposely render yourself sterile. This is surely not the case in any situation like and ectopic pregnancy. Those who say otherwise are pompous and arrogant in their theories…and when “Church MEN” have an ectopic pregnancy…I will consider their thoughts…until then…

 

[elts1956]

I would have to ask for something officially stating there is a difference. They both have the end effect minus surgery. A sugery that can put the person in harms way, and possible make them infertile.

Jermosh, I thinky you have posted on similar threads about similar situation. To end an ectopic pregnancy, the most moral thing to do is have the diseased portion of the"tube" surgically removed. Thus the child would not die through direct abortion. There is a difference. The difference is in “intent”.

 

[elts1956]

I would have to ask for something officially stating there is a difference. They both have the end effect minus surgery. A sugery that can put the person in harms way, and possible make them infertile.

If she didn’t know, then she can’t be held accountable. She probably had no clue. Resolving an early ectopic pregnancy with chemicals rather than surgery is one of the gold standards of treatment more and more. This is because it is less risky than surgery and it also preserves the fallopian tube so that it can be used again later for future pregnancies. Unless you’re in a Catholic hospital, this is usually offered first, if the ectopic pregnancy is caught early enough. Taking a pill to resolve a life-threatening situation, if possible, is always medically more advantageous than surgery. Surgery itself presents it’s own risks. So it’s not a big wonder why drugs are offered first.

The Catholic Church only allows removal of the fallopian tube in the case of ectopic pregnancy. But many don’t see the difference between removing a tube and giving the medication because they both have the same exact outcome with regards to the fetus. But in the one case the fallopian tube is saved, and in the other case it is removed, in addition to the risk to the woman with surgery. But that’s a teaching of the Church.

The entire fallopian tube is not removed, but only the diseased portion… Until I hear a direct answer from the Catholic ethics committee, I assert, the chemical procedure is a direct abortion. The surgical procedure is not. I will check it out. The ethics committee is on line.

The end does not justify the means.

 

[elts1956]

It would almost seem that the “pro-life” approach would be medication, not surgery, given that if this happens more than once, with surgery sterility will result.

I don’t quite get it: medication, the baby dies. Surgery, the baby dies. Do nothing, the baby and mother die. Either way it isn’t a viable pregnancy. At least the medication option doesn’t harm a woman’s reproductive chances. We have a friend who had two ectopic pregnancies, with surgery in both cases, and she of course was rendered sterile and was never able to have children.

I think the Church may need to re-think this one. At least that’s how it appears to me on the surface. If there are good reasons not to, I’d like to hear them.

Why don’t you just write to the Pope? This was addressed on another thread with the same misconcieved “personal” opinions.

 

[elts1956]

It would almost seem that the “pro-life” approach would be medication, not surgery, given that if this happens more than once, with surgery sterility will result.

I don’t quite get it: medication, the baby dies. Surgery, the baby dies. Do nothing, the baby and mother die. Either way it isn’t a viable pregnancy. At least the medication option doesn’t harm a woman’s reproductive chances. We have a friend who had two ectopic pregnancies, with surgery in both cases, and she of course was rendered sterile and was never able to have children.

I think the Church may need to re-think this one. At least that’s how it appears to me on the surface. If there are good reasons not to, I’d like to hear them.

But the intent is not to kill the child, its to allow the mother to live. The drug from what I understand disolves the cells that attach it to the tube, thus allowing it to detach and die of a natural miscarriage. This would be no differant then removing life sustaining therapies such as breathing from a brain dead person who cannot breath on there own.

Those “cells” are a human being at a very early stage of development. Next stage, zygote, foetus, embryo, baby, toddler, pre schooler, 6 year old, 7 year old etc. It’s a baby and immoral to directly kill it.

The life of the mother does not over ride that of the child no matter what you “think”.

 

[elts1956]

Furthermore:
The surgery does not necessarily make a person infertile. Whether or not such actions would result in a lessening of the possibility further pregnancies is not an absolute known. But also saving the entire fallopian tube through chemical destruction of the child does not mean this would solve the problem of further pregnancies. The tube, once diseased, however that is, does not cure itself. If there is a “bump” let us say, in the tube, that causes the ectopic pregnancy, this will not magically disappear.