Ectopic Pregnancy

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I have a question about the church’s views on an ectopic pregnancy. I posted this below in response to another person, but I thought I would try it here in a new thread.

When you have an ectopic pregnancy, I know they say that having surgery to save the mom’s life is fine, and the unfortunate fact that the baby can’t survive the surgery is not a sin. But now they can give you a shot of methotrexate which will end the pregnancy and save the mother from having surgery. The shot saves the mother from surgery and it saves the tubes from being cut, increasing the mother’s chances of having another healthy pregnancy and not limiting her fertility as the surgery can do. If you find out early enough that your pregancy is ectopic, you can get the shots, but if the baby is over 3mm (I believe), the shots don’t work and you have to have surgery.

If your pregancy is ectopic, meaning the baby is in the tubes, there is no way the baby will survive. There is not enough room in the tubes for the baby to grow. If the baby does grow, the tubes will rupture and emergency surgery is needed to save the mother’s life.

So, what does the church teach about this situation?
 
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RuffinIt:
I have a question about the church’s views on an ectopic pregnancy. I posted this below in response to another person, but I thought I would try it here in a new thread.

When you have an ectopic pregnancy, I know they say that having surgery to save the mom’s life is fine, and the unfortunate fact that the baby can’t survive the surgery is not a sin. But now they can give you a shot of methotrexate which will end the pregnancy and save the mother from having surgery. The shot saves the mother from surgery and it saves the tubes from being cut, increasing the mother’s chances of having another healthy pregnancy and not limiting her fertility as the surgery can do. If you find out early enough that your pregancy is ectopic, you can get the shots, but if the baby is over 3mm (I believe), the shots don’t work and you have to have surgery.

If your pregancy is ectopic, meaning the baby is in the tubes, there is no way the baby will survive. There is not enough room in the tubes for the baby to grow. If the baby does grow, the tubes will rupture and emergency surgery is needed to save the mother’s life.

So, what does the church teach about this situation?
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No situation in which the child’s life is directly and intentionally ended is morally permissible. Ever. The Church cannot change the rules just become some scientist invents some whoopdeedoo new drug. Intentionally ending the life of a child in utero is a mortal sin.
 
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RuffinIt:
If your pregancy is ectopic, meaning the baby is in the tubes, there is no way the baby will survive.
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Actually, not all ectopic pregnancies are tubal; the baby may implant in other places as well. Tubal ectopic pregnancies are more common, but they are not the only kind.

Many will argue that the only permissible treatment is to remove the fallopian tube, but I remain unconvinced. Even if only the embryo is removed, the intent is still not to kill the child. If the ectopic pregnancy occurs outside the fallopian tube, removing the tube would have no effect.

Methotrexate is not approved for use as a way of ending pregnancies, even ectopic pregnancies, in the United States. It was used (and maybe still is used) as a cancer drug because it works by inhibiting the growth of rapidly dividing cells. My feeling is that it is probably not morally licit to use it to treat an ectopic pregnancy, but I am a bit unsure.
 
As a mother who lost a child to a ruptured ectopic pregnancy, almost losing my own life, I can tell you that every year on the day we lost our child, I mourn. I have to take that day off work, the pain and loss comes back in waves on that day – every year – for 12 years now. If on that day, I’d been told that I could take a shot that would dissolve my baby and save my tube and make it easier on me, I’d venture to say that I could not live with the guilt! We lost a baby, and I carry the scars in my body and on my heart. It was sad, but we did not kill our child. I pray for any woman who sees this shot as an option!
 
I’m anxiously praying and waiting for the day that our technology advances to the point where doctors can safely move an ectopic baby into the womb and have him/her attach to the lining. I hope we can see this in our lifetime.
 
I may be wrong, but I seem to recall reading somewhere on this forum that it was acceptable to end an ectopic pregnancy. It had something to so with the fact that the egg was not implanted in the right place. I believe it was in the Ask an Apologist forum. You might post this question there and see what the response is.
 
Hypothetical question: A women gets pregnant, and the fertilized egg implants somewhere in her body. If the egg is left in place, it is a medical certainty that both mother and child will die. Under consideration is surgery option #1 to remove the egg from the woman’s body, without affecting the woman in any other way, e.g. removing any other part of her body. Also under consideration is surgery option #2 to remove the egg and the surrounding body parts of the woman, leaving her infertile. The woman would love to keep the baby, and would consider implantation in a surrogate mother were that a moral option. However, because it is not, it is certain that the egg will die outside the mother in the event of either surgical option.

Question 1: Is surgery option #1 moral?
Question 2: Is surgery option #2 moral?
Possible answers for each question:
  • Yes, it is moral.
  • No, it is not moral.
  • It may or may not be moral depending on some addition piece of information not given in the description of this hypothetical.
My impression is that the Church teaches: For question 1, the answer is No. For question 2, the answer is Maybe, where ectopic pregnancies are the only cases that are moral. Is this true?
 
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Benedictus:
Methotrexate is not approved for use as a way of ending pregnancies, even ectopic pregnancies, in the United States. It was used (and maybe still is used) as a cancer drug because it works by inhibiting the growth of rapidly dividing cells. My feeling is that it is probably not morally licit to use it to treat an ectopic pregnancy, but I am a bit unsure.
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It is used for ending types of ectopic pregnancies in the USA and for other uses as well such as autoimmune conditions like rheumatoid arthritis. It may still be used as an antimitotic in cancer therapy. I have never seen an answer from the Church as to its licitness for treating ectopic pregnancies.
 
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Catholic2003:
Question 1: Is surgery option #1 moral?
Question 2: Is surgery option #2 moral?
Possible answers for each question:
  • Yes, it is moral.
  • No, it is not moral.
  • It may or may not be moral depending on some addition piece of information not given in the description of this hypothetical.
My impression is that the Church teaches: For question 1, the answer is No. For question 2, the answer is Maybe, where ectopic pregnancies are the only cases that are moral. Is this true?
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I believe the answer is yes in both cases. The intent is not to kill the baby, but save the mother. The baby will die either way, and the baby is not being directly killed in either case. Morally, I see no difference between 1 and 2.
 
No situation in which the child’s life is directly and intentionally ended is morally permissible. Ever. The Church cannot change the rules just become some scientist invents some whoopdeedoo new drug. Intentionally ending the life of a child in utero is a mortal sin.
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This requires clarification. IF the intent is simply to kill the child, then mortal sin. If the child is certainly doomed (as is the case in an ectopic pregnancy)* and to continue endangers the life of the mother*, then termination is acceptable. Proportionality.

as for
Question 1: Is surgery option #1 moral?
Question 2: Is surgery option #2 moral?
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If I parse your question correctly, #1 is moral, # 2 = “depends”. It is a multi-part question. The bit of removing organs relating to fertility depend on the intent. Are we removing diseased organs? Then yes, that part is moral. Is it to sterilize the woman by removing healthy organs? Then no, it is not moral.

As for the implantation in surrogate mother option, my reading on current church teaching is that this too is immoral; children are to result from intercourse between one man and one woman. In introducing the surrogate, the math becomes screwed up. There is more involved than simple arithmetic, I know, yet for the purposes of interpreting Church teaching it will serve in this case.
 
Note that question #1 includes the case of a D&C on a pregnant woman whose internal organs cannot handle carrying a pregnancy to term, e.g., diabetic with other complications. This is why I thought the answer for question #1 was No.

For #2, my intent of including the woman’s other body parts was so that it wasn’t the egg by itself being removed directly, but only as an incidental part of a larger surgical removal.
 
I posted on this in another thread with a link to a very informative document about this very subject. The churches position is clear, it is the interpretation of that position that causes problems for some people. Scott is absolutely right. Wrong is wrong, no matter how much “easier” it might be another way. Any procedure, surgical, medicinal, etc that directly kills the child is worng, even though niether the child or mother would survive without it. Thus, the drug, and surgery to remove only the child are both wrong. In the case of the tubal pregnancy it would not be allowed to simply cut the tube, remove the child, and sew the tube back up. In that case, the child is directly killed. It is acceptable to remove the section of the tube the child is in, then killing the child is an unfortunate effect. To many this seems a fine distinction. If the egg is someplace other than the tube, the same principal applies. Thus the drug would always be wrong, unless you were taking it to treat cancer and the unwanted effect was killing the child. There have also been cases where the child was transfered to the womb, but they were apparently not very successful, and most children died anyway. Personnaly, I think I’d take that chance if it were offered, but most doctors won’t even attempt it. It is to be hoped that doctors will spend more time trying to find successful solutions to that problem, rather than better ways to kill children.
For the record, I had an ectopic pregnancy, burst tube, and came within an hour of bleeding to death internally. I did not know all these morals then, and I am glad that I inadvertantly did the right thing anyway, even if it means I no longer have all the factory original parts.
 
This may or may not be true, but I was told by a doctor when my wife went through an ectopic pregnancy (that required surgery) that an egg that implants in a fallopian tube does not even replicate and develop normally – that it very early on more closely resembles the growth of a tumor, with no characteristics of an individual life, than that of a living, unique embryo.

If this is true, at what point would it be considered the removal of a tumor (just a mass of dividing cells) vs. removal or termination of a life? At what point does the child’s soul, possessed at conception, leave the “body” of cells that are corrupted by the tubal implantation? When does the child really die? Is it only when all the cells in it’s “body” physically die? Could it be sooner? How can we possibly know?

From what I’ve learned from speaking with a priest who specialized and taught morality and ethics in medicine, medications are morally licit if taken to treat a physical illness. If something in your body is not working correctly, it is licit to take medication (or have surgery) for the purpose of correcting that problem. If the medication (or surgery) has an unintended side effect that is morally wrong, and if there exists no reasonable alternative to treating the illness that does not relieve the unintended side-effect, it is licit to proceed with the treatment for the illness.

In the case of an ectopic pregnancy, I would think that using methotrexate would be licit, since the effect of killing the child is unintentional, and there is no medical alternative that would allow the child to live. I don’t see how that is any different than removing a fallopian tube.

What do you think?

Peace,
javelin
 
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javelin:
This may or may not be true, but I was told by a doctor when my wife went through an ectopic pregnancy (that required surgery) that an egg that implants in a fallopian tube does not even replicate and develop normally – that it very early on more closely resembles the growth of a tumor, with no characteristics of an individual life, than that of a living, unique embryo.

If this is true, at what point would it be considered the removal of a tumor (just a mass of dividing cells) vs. removal or termination of a life? At what point does the child’s soul, possessed at conception, leave the “body” of cells that are corrupted by the tubal implantation? When does the child really die? Is it only when all the cells in it’s “body” physically die? Could it be sooner? How can we possibly know?

From what I’ve learned from speaking with a priest who specialized and taught morality and ethics in medicine, medications are morally licit if taken to treat a physical illness. If something in your body is not working correctly, it is licit to take medication (or have surgery) for the purpose of correcting that problem. If the medication (or surgery) has an unintended side effect that is morally wrong, and if there exists no reasonable alternative to treating the illness that does not relieve the unintended side-effect, it is licit to proceed with the treatment for the illness.

In the case of an ectopic pregnancy, I would think that using methotrexate would be licit, since the effect of killing the child is unintentional, and there is no medical alternative that would allow the child to live. I don’t see how that is any different than removing a fallopian tube.

What do you think?

Peace,
javelin
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Great points. What about so-called molar pregnancies where there may be an “empty” egg fertilized? How many chromosomes does it take to make a human?
 
Another thing I don’t think makes sense regarding the “removing the tube is OK” perspective.

I thought that the Church taught that removing or otherwise intentionally damaging otherwise healthy body parts was mortally sinful, and equates with self-mutilation. In the case of an ectopic pregnancy, the notion that the mother’s tube is somehow sick enough to require removal seems a big stretch to me. There is no way of really even knowing in most cases if it is a malfunction of the tube itself that caused the implantation to occur there. The real problem is there are a bunch of cells growing rapidly in a very small space – actually, a very small wrong place. The location is really the problem. Taking the medication is to move the pregnancy out of the incorrect place, not to directly kill the child.

Does anyone know exactly how methotrexate works? Does it directly kill the developing cells like a poison, or does it affect the place where the developing cells connect to the mother’s body?

Peace,
javelin
 
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Scott_Lafrance:
No situation in which the child’s life is directly and intentionally ended is morally permissible. Ever. The Church cannot change the rules just become some scientist invents some whoopdeedoo new drug. Intentionally ending the life of a child in utero is a mortal sin.
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But that’s the whole point–the child is not in utero; the vast majority of times in an ectopic pregnancy it is in a place where it cannot survive anyway, no matter what is done medically.

(Caveat: I am a man, not a woman, and my wife and I are long past the years where we are concerned about this.)

Incidentally, on rare occasions an ectopic pregnancy will survive. DHC’s program Medical Incredibles has run a segment about a boy, one of a set of trips, who was carried outside the womb, with the placenta attached to the mother’s bladder. All three babies were taken early by C-section, and at the time of the filming of the segment, he was running around like the normal 4-year-old that he was.

DaveBj
 
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javelin:
Does anyone know exactly how methotrexate works? Does it directly kill the developing cells like a poison, or does it affect the place where the developing cells connect to the mother’s body?
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Anyone know more about this?
 
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Scott_Lafrance:
No situation in which the child’s life is directly and intentionally ended is morally permissible. Ever. The Church cannot change the rules just become some scientist invents some whoopdeedoo new drug. Intentionally ending the life of a child in utero is a mortal sin.
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Gotcha. Ectopic pregnancy means implantation of the embryo in the Fallopian tube, not in the uterus. So, this is not an “in utero” pregnancy. But, I know what you mean.
 
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