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Doc_Keele
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I’m looking for official Church documents about the ethical treatment of ectopic pregnancy - can anyone point me to them?
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Rence
Guest
I found this article that might help you. At least, I hope it helps.
uffl.org/vol12/bowring12.pdf
Here is an excerpt to answer your question. :
**In extrauterine pregnancy the affected part of the mother (e.g., cervix, ovary, or
fallopian tube) may be removed, even though fetal death is foreseen, provided that
(a) the affected part is presumed already to be so damaged and dangerously affected
as to warrant its removal, and that (b) the operation is not just a separation of the
embryo or fetus from its site within the part (which would be a direct abortion from
a uterine appendage) and that (c) the operation cannot be postponed without notably
increasing the danger to the mother.41
About this statement, Dr. May concludes, “This directive clearly authorizes as morally
licit the use of partial salpingectomy or total salpingectomy in order to safeguard the
mother’s life when there is grave danger of hemorrhaging from the fallopian-tube
pregnancy. But it also clearly excludes use of a salpingostomy. At the time this directive
was written, the management of tubal pregnancies by methotrexate was not known.”42
The more recent 1994 U.S. Bishops’ directive states more simply as follows: “In the
case of extrauterine pregnancy, no intervention is morally licit which constitutes a direct
abortion.”43 On the other hand, the document continues, “Operations, treatments and
medications that have as their direct purpose the cure of a proportionately serious
pathological condition of a pregnant woman (i.e., a salpingectomy) are permitted when
they cannot be safely postponed until the unborn child is viable, even if they will result in
the death of the unborn child” (47, italics added). In a section on emergency
contraception, the new directive also states, “It is not permissible, however, to initiate or
to recommend treatments that have as their purpose or direct effect the removal,
destruction, or interference with the implantation of a fertilized ovum” (36).
Reference:
41 National Conference of Catholic Bishops, Ethical and Religious Directives for Catholic Health Care Facilities (Washington, D.C., NCCB, 1971), 16.
42 William E. May. Catholic Bioethics and the Gift of Human Life (Huntington: OSV, 2000), 183. 43 National Conference of Catholic Bishops. Ethical band Religious Directives for Health Care Services (Washington, D.C.: NCCB, 1994), 28.**
uffl.org/vol12/bowring12.pdf
Here is an excerpt to answer your question. :
**In extrauterine pregnancy the affected part of the mother (e.g., cervix, ovary, or
fallopian tube) may be removed, even though fetal death is foreseen, provided that
(a) the affected part is presumed already to be so damaged and dangerously affected
as to warrant its removal, and that (b) the operation is not just a separation of the
embryo or fetus from its site within the part (which would be a direct abortion from
a uterine appendage) and that (c) the operation cannot be postponed without notably
increasing the danger to the mother.41
About this statement, Dr. May concludes, “This directive clearly authorizes as morally
licit the use of partial salpingectomy or total salpingectomy in order to safeguard the
mother’s life when there is grave danger of hemorrhaging from the fallopian-tube
pregnancy. But it also clearly excludes use of a salpingostomy. At the time this directive
was written, the management of tubal pregnancies by methotrexate was not known.”42
The more recent 1994 U.S. Bishops’ directive states more simply as follows: “In the
case of extrauterine pregnancy, no intervention is morally licit which constitutes a direct
abortion.”43 On the other hand, the document continues, “Operations, treatments and
medications that have as their direct purpose the cure of a proportionately serious
pathological condition of a pregnant woman (i.e., a salpingectomy) are permitted when
they cannot be safely postponed until the unborn child is viable, even if they will result in
the death of the unborn child” (47, italics added). In a section on emergency
contraception, the new directive also states, “It is not permissible, however, to initiate or
to recommend treatments that have as their purpose or direct effect the removal,
destruction, or interference with the implantation of a fertilized ovum” (36).
Reference:
41 National Conference of Catholic Bishops, Ethical and Religious Directives for Catholic Health Care Facilities (Washington, D.C., NCCB, 1971), 16.
42 William E. May. Catholic Bioethics and the Gift of Human Life (Huntington: OSV, 2000), 183. 43 National Conference of Catholic Bishops. Ethical band Religious Directives for Health Care Services (Washington, D.C.: NCCB, 1994), 28.**
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Bookcat
Guest
i will send you to one of the very very best sources.
ncbcenter.org/NetCommunity/Page.aspx?pid=940
you can call them too for more info.
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Doc_Keele
Guest
I’m really needing official Vatican documents, rather than individual’s opinions or even Bishops’ Councils.
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Seatuck
Guest
You may not find the definitive Vatican document if you look for ectopic directly. You want to look for anything that refers to abortion and look up the references in the Bowring document and the Cuf document. When treating ectopics we defend the dignity of the mother and the fetus. So nothing that is abortive can be done. The principal of double effect may also come into play so that while a treatment may result in the demise of the fetus it is not directly abortive.
cuf.org/Faithfacts/details_view.asp?ffID=57
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Seatuck
Guest
You could contact a group such as -
cathmed.org/
The National Catholic Bioethics Center will also respond to an email.
Some general principals by John Paul 2 in his Address to Obstetricians-
vatican.va/holy_father/john_paul_ii/speeches/2001/documents/hf_jp-ii_spe_20010618_obstetricians-gynaecologists_en.html
cathmed.org/
The National Catholic Bioethics Center will also respond to an email.
Some general principals by John Paul 2 in his Address to Obstetricians-
vatican.va/holy_father/john_paul_ii/speeches/2001/documents/hf_jp-ii_spe_20010618_obstetricians-gynaecologists_en.html
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Just_Lurking
Guest
Denzinger 1890c (see here):
[From the reply of the Holy Office to the Dean of the faculty of theology of the university of Marienburg, the 5th of March, 1902] *
1890 c To the question: “Whether it is at any time permitted to extract from the womb of the mother ectopic fetuses still immature, when the sixth month after conception has not passed?”
The reply is:
“In the negative, according to the decree of Wednesday, the 4th of May, 1898, by the force of which care must be taken seriously and fittingly, insofar as it can be done, for the life of the fetus and that of the mother; moreover, with respect to time, according to the same decree, the orator is reminded that no acceleration of the birth is licit, unless it be performed at the time and according to the methods by which in the ordinary course of events the life of the mother and that of the fetus are considered.”
[From the reply of the Holy Office to the Dean of the faculty of theology of the university of Marienburg, the 5th of March, 1902] *
1890 c To the question: “Whether it is at any time permitted to extract from the womb of the mother ectopic fetuses still immature, when the sixth month after conception has not passed?”
The reply is:
“In the negative, according to the decree of Wednesday, the 4th of May, 1898, by the force of which care must be taken seriously and fittingly, insofar as it can be done, for the life of the fetus and that of the mother; moreover, with respect to time, according to the same decree, the orator is reminded that no acceleration of the birth is licit, unless it be performed at the time and according to the methods by which in the ordinary course of events the life of the mother and that of the fetus are considered.”
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Doc_Keele
Guest
Just to clarify, I am not looking for restatements of the position but the official Vatican statements or something similar that has the philosophical arguments for the position. I need to examine the philosophical arguments.
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Holly3278
Guest
There is only one ethical treatment for an ectopic pregnancy that I am aware of and that would be to remove the fallopian tube that contains the unborn child. This would cause an indirect abortion and therefore would not be immoral because the abortion is indirect.
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Doc_Keele
Guest
That’s highly arguable.
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Cetil
Guest
I don’t think there is a Vatican ruling on ectopic pregnancy. Beginning in the 1930’s Catholic moral theologians have used the “double effect” argument. The website of Catholics United for the Faith has an extensive discussion of this.
See: cuf.org/Faithfacts/details_view.asp?ffID=57
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See: cuf.org/Faithfacts/details_view.asp?ffID=57
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Doc_Keele
Guest
The Vatican has ruled that direct abortion is not OK, indirect abortion is, but never elaborated on what is and isn’t direct abortion with respect to the treatment of ectopic pregnancy. This leaves it open to individual conscience in my book.
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Cetil
Guest
No, not really. If a matter is in doubt then the Church would say a doubtful conscience is restrained from acting. I would review the subject of conscience in the Catholic catechism if I were you. This is from Father Frank Pavone and was posted here some time ago (there have already been many threads on this subject here):
"Question 6: I am an oncology nurse and was asked to give methotrexate for an ectopic pregnancy on another floor since only oncology nurses can give chemotherapeutic drugs. I believe the pregnancy was tubal. Needless to say I refused because I was unsure of the morality of it. I do not know the entire patient situation since the patient was on another floor. Could you please explain the morality of this act according to the church’s teaching. I do not think the mother’s life was in danger at this particular time. Thanks and God bless you. P.S. I work at a catholic hospital
Answer: There is more than one medical way of handling an ectopic pregnancy. The relevant moral question is whether the method or action is in fact a killing of the child. If so, that is a direct abortion, which is never permissible for any reason. “Direct means that the destruction of the child is willed as the end or the means to another end. Sometimes ectopic pregnancies are handled this way, killing the child but leaving the tube intact. Such an action is morally wrong.
However, if what is done is that the damaged portion of the tube is removed because of the threat it poses to the mother, that is not a direct abortion, even if the child dies. What is done is the same thing that would be done if the tube were damaged from some other cause. The mother is not saved by the death of the child but by the removal of the tube. Because the death of the child in this case is a side effect which is not intended, and because the saving of the mother’s life is not brought about by the death of the child, such a removal of the damaged portion of the tube is morally permissible. The ethical rule that applies here is called the Principle of the Double Effect.”
I would recommend reading Dr. William May’s “Catholic Bioethics and the Gift of Human Life”.
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"Question 6: I am an oncology nurse and was asked to give methotrexate for an ectopic pregnancy on another floor since only oncology nurses can give chemotherapeutic drugs. I believe the pregnancy was tubal. Needless to say I refused because I was unsure of the morality of it. I do not know the entire patient situation since the patient was on another floor. Could you please explain the morality of this act according to the church’s teaching. I do not think the mother’s life was in danger at this particular time. Thanks and God bless you. P.S. I work at a catholic hospital
Answer: There is more than one medical way of handling an ectopic pregnancy. The relevant moral question is whether the method or action is in fact a killing of the child. If so, that is a direct abortion, which is never permissible for any reason. “Direct means that the destruction of the child is willed as the end or the means to another end. Sometimes ectopic pregnancies are handled this way, killing the child but leaving the tube intact. Such an action is morally wrong.
However, if what is done is that the damaged portion of the tube is removed because of the threat it poses to the mother, that is not a direct abortion, even if the child dies. What is done is the same thing that would be done if the tube were damaged from some other cause. The mother is not saved by the death of the child but by the removal of the tube. Because the death of the child in this case is a side effect which is not intended, and because the saving of the mother’s life is not brought about by the death of the child, such a removal of the damaged portion of the tube is morally permissible. The ethical rule that applies here is called the Principle of the Double Effect.”
I would recommend reading Dr. William May’s “Catholic Bioethics and the Gift of Human Life”.
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Doc_Keele
Guest
It’s arguable as to whether the principle of double effect actually permits moral absolutists to perform any treatment for ectopic pregnancy Cetil. It all hinges on what exactly you count as intention and therefore what constitutes direct abortion.
I would recommend you read “Moral Absolutism and Ectopic Pregnancy” by Kaczor C in the Journal of Medicine and Philosophy
If the Church hasn’t been able to pronounce definitively on the issue, why should individuals be constrained? In doubt, choose the preservation of life I say. The life of the mother, since the embryo is almost certainly doomed.
I would recommend you read “Moral Absolutism and Ectopic Pregnancy” by Kaczor C in the Journal of Medicine and Philosophy
If the Church hasn’t been able to pronounce definitively on the issue, why should individuals be constrained? In doubt, choose the preservation of life I say. The life of the mother, since the embryo is almost certainly doomed.
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Cetil
Guest
I can only tell you what the Church says on the matter of conscience and what conscience is which you will find in the Catechism of the Catholic Church.
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Doc_Keele
Guest
If the Church could be definite, it would be. Applying the precautionary principle doesn’t really get us anyway with this particular example, except to confirm my position if anything. If treating ectopic pregnancy isn’t definitely immoral, then the precuationary principle would say the mother’s life should be saved.
An appeal to authority is contrary to the principles of natural law.
An appeal to authority is contrary to the principles of natural law.
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Cetil
Guest
The Church does teach that a doubtful conscience is restrained from acting.
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Doc_Keele
Guest
Well that doesn’t make any sense in this particular context. Being passive in this situation because of “doubt” would be immoral. In any case, holding that one must have doubt because the Church hasn’t made a definitive pronouncement is not a conclusion I agree with.
Does the Church hold that genuine moral dilemmas (in the formal philosophical sense) can occur? I imagine it wouldn’t.
Does the Church hold that genuine moral dilemmas (in the formal philosophical sense) can occur? I imagine it wouldn’t.
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Cetil
Guest
One must first understand what conscience is as the Church teaches. I think in this context one can only say what the CUF link I posted earlier says regarding “double effect”. That is the present consensus of moral theologians on the matter as I understand it. Absence of a Vatican ruling in no way frees us to do as we please.
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