Ectopic pregnancy, methotrexate and pharmacists

[gingersensei]

I read in the policy that there is a check for a heartbeat before the drug is administered. But there is a fertility doctor that uses it and I dont know if he does the same or not.

 

[Pattylt]

For those that understand how this drug works, I have a question.

After using the drug (and with time to heal) is the Fallopian tube saved so that the tube is functional in a future pregnancy or is the Fallopian tube damaged permanently?

 

[TheLittleLady]

That is the entire excuse for using the drug, so that there is not damage to the tube as there is with the moral, surgical procedure.

 

[ColorMomma]

I had an ectopic pregnancy and there is currently no way to save the baby. Either the baby keeps growing, the tube ruptures and is removed, or both the mother and baby die.

When it happened to me, I wished desperately that there was a way to save the baby, but there was no chance.

 

[ColorMomma]

My problem with this is that the surgery reduces the chance of the mother getting pregnant again with only one functioning fallopian tube. It was hard for me to get pregnant again after my surgery.

 

[Sophie111]

As one trained in moral theology I see two or three mitigating factors which means you are only indirectly and somewhat remotely cooperating in evil. This reasonably constitutes a form of material cooperation that is acceptable to the Church provided you do not agree with the evil that some others may or may not do with the drug.

The litmus test for me in these cases is this question. Would it still happen if you resigned from your role?
Clearly it would, therefore you are not an essential cog in this.
Second, you cannot be sure it is always being used for unacceptable purposes.
Third, even if it were you are still quite remote from those decisions.

God bless.

 

[KathleenT]

I was offered the drug to attempt to clear the tube after my baby had already died. We opted for the surgery due to the fact my doc believe the tube was too damaged to save. She was amazed the tube hadn’t ruptured. It wasn’t until years later I understood how close I came to dying. God is the only reason I lived. All I cared about at the time was the baby.

If I had taken the drug and the pharmacist had insisted on knowing all the gory details I probably would have lost my mind.

There is no way to save an ectopic pregnancy and ectopic pregnancies are one of the leading causes of maternal death. With a ruptured tube a woman can bleed out very quickly.

I think there is enough danger to the mother you should feel confident in relying on your priest. An elective abortion there is usually not a threat to the mothe that’s not the case with an ectopic.

Honestly, I would also worry about the occasion of sin for the husbands by slowing the process of treatment for their wives.

 

[Gorgias]

The litmus test for me in these cases is this question. Would it still happen if you resigned from your role?
Clearly it would, therefore you are not an essential cog in this.
Second, you cannot be sure it is always being used for unacceptable purposes.
Third, even if it were you are still quite remote from those decisions.

That’s an odd analysis for someone “trained in moral theology”. Let’s look at your thoughts a bit more closely:

Would it still happen if you resigned from your role?
Clearly it would, therefore you are not an essential cog in this.

IMHO, that’s close, but not quite, the question to ask. The question isn’t whether there’s a potential replacement who could be hired. (By that reasoning, we could ask the abortion doctor, “if you resigned, would Planned Parenthood still perform abortions? Well, then, you’re not the agent of the action.” )

The question really has to do with the role being performed. The question, then, becomes, “if you don’t verify the dosage and send it to the physician, will the procedure still be performed?” The answer to that question seems to be “no”, especially since no one else at the hospital has the requisite expertise; and therefore, the OP’s role is significant. (Contrast this to the role of the parking attendant at the hospital: if we ask him “if you don’t park the doctor’s car, will the procedure still take place?” – now that answer is “yes”!)

So, on this consideration, the answer seems to be “yes, the OP is an essential cog.”

Let’s look at the second consideration you raise:

you cannot be sure it is always being used for unacceptable purposes.

Only the OP can answer this question, but it would seem that, if he’s verifying the dosage, then he’s aware of the particular procedure. If it were being used for other purposes (for instance, as a treatment for cancer), then he would have to be aware of this purpose, in order to verify the dosage.

So, again, your assertion seems to fail here.

Let’s look at your third claim:

Third, even if it were you are still quite remote from those decisions.

That’s not how the term “remote” is being used in this context. Here, ‘remote’ and ‘proximate’ are relevant to mediate material cooperation. However, in this case, the OP seems to be providing immediate material cooperation. Therefore, the consideration of the ‘remoteness’ of his act doesn’t come into play. Rather, you seem to be conflating the secular meaning of ‘remote’ with the particular meaning of the term in the context of Catholic moral theology.

So, on all three accounts, it seems that your analysis doesn’t work well.

 

[Sophie111]

I am confident the 3 principles I have brought to the OPs issue are the cardinal ones.

Clearly the application of them is his competence not yours or mine. It is silly, I opine, to assert the hospitals treatment of ectopics will halt completely if he gives 1 month notice.
JIT protocols tend to operate these days, squeaky wheels will be oiled and money found when a professional staff crisis occurs.

 

[Gorgias]

I am confident the 3 principles I have brought to the OPs issue are the cardinal ones.

If only confidence were competence…

Clearly the application of them is his competence not yours or mine

No. That’s patently absurd. What’s within the sphere of the OP’s ‘competence’ is his professional action. In addition, what’s within the sphere of his responsibility is the way he applies Catholic moral teaching to his situation. Whether or not he makes a valid decision is something he’ll have to live with (and, if we believe the teaching of Christ, something upon which he’ll be divinely judged).

. It is silly, I opine, to assert the hospitals treatment of ectopics will halt completely if he gives 1 month notice.

I agree. That’s why your first point – unless you expressed it differently than you had intended – is irrelevant. (On the other hand, if he – as the sole pharmacist on staff – refuses to perform his role and verify the dose, then the procedure will not be performed. That’s the principle that you’re looking to address, here… and the answer comes out differently than you asserted.)

 

[Sophie111]

As I was writing to the OP not yourself I am happy to leave my comments as they stand. Am happy to take further should the OP have any questions.

 

[D.Erasmus.R]

Removal of a ruptured tube is moral even if the child is still alive.

 

[TheLittleLady]

Correct. It is the sure, moral, option in the situation.

 

[Crusaderbear]

My SIL had one…the embryo cannot last in the tube, and it was a threat to her life. The second tube remains, so there is still the possibility of future pregnancies. Their priest agreed it was a sound move…this was in the early 80’s.

 

[Gorgias]

Their priest agreed it was a sound move…this was in the early 80’s.

Two thoughts:

First, as long as the act isn’t the direct abortion of the child, then it is a morally acceptable act.

Second, there’s a dimension in play here that folks tend to not recognize: whereas moral principles don’t change, medical procedures and therapies do advance over time! Therefore, what might not have had a morally acceptable alternative at one point in time might later actually do have an approach that’s morally licit. Since the lay public (i.e., 99% of us) aren’t up to speed on the latest advances in medical science, it’s not always the best approach to say “oh, there’s nothing that can be done here”.

(That might not apply in this particular case, mind you, but it’s a good reminder in general, when talking about concrete applications of the principles of Catholic moral theology…).

 

[Canvas]

First, as long as the act isn’t the direct abortion of the child, then it is a morally acceptable act.

Saying that cutting the tube out is not direct but using MXT is an abortion is just semantics. Both acts are meant to terminate the ectopic pregnancy. It is unlike other abortions because it is medically necessary, there is no other way around it. The baby is doomed regardless. The only hope is to save the mother.

Many doctors and hospitals would not perform surgery and cut the tube out when there is a less invasive, safer method to save the mother just so they could hide behind the moral fig leaf of saying that cutting the tube out is not direct but other methods are. Cutting the tube out is killing the baby. Full stop. There is no way to make this anything but a tragedy.

 

[Sophie111]

Public forum, Sophie.

Indeed, welcome to listen.

 

[Gorgias]

Indeed, welcome to listen.

And comment. As you have.

 

[Gorgias]

Saying that cutting the tube out is not direct but using MXT is an abortion is just semantics. Both acts are meant to terminate the ectopic pregnancy.

No. The former saves the life of the mother by the act of cutting out the fallopian tube. The latter kills the baby… and also has the side effect of preserving the fallopian tube. The distinction here is between act and side effect, by way of intent.

I appreciate that it’s a subtle distinction. I recognize that, in an age in which consequentialism is perceived as acceptable, that this appears to be ‘just semantics’. However, that’s not what Catholic moral theology teaches.

just so they could hide behind the moral fig leaf

My… you seem to have a better grip on others’ intent than they do, eh?

There is no way to make this anything but a tragedy.

Non sequitur.

 

[Sophie111]

Saying that cutting the tube out is not direct but using MXT is an abortion is just semantics

For me the semantics is pretending that directly cutting the tube out but somehow forgetting there is a live foetus inside and therefore we are not also directly cutting out the foetus ….

Personally I believe the acceptability of doing so has never been adequately explained by the usual definition of the PODE.