Ectopic Pregnancy

[BayCityRickL]

As an ambulance EMT, I saw one case of ruptured ectopic pregnancy. By the time we got there, the rupture had already occurred and the patient’s blood pressure was 60 over 0 due to hemorrhage. In this case, fetal death can be assumed and the object is to save the life of the mother.

This is obviously a case where we just snatch and run, to get the patient to the hospital to have the surgery to stop the bleeding. The hospital staff was mobilized as we travelled the icy streets in town, you know, we felt like we were in slow motion. They took her right to surgery.

For someone to say that a case was reported where an ectopic pregnancy was brought to term is interesting. but, it was reported simply for the rarity that it was.

Everything happens. Some women don’t even know they’re pregnant and suddenly they’re dying. We have unique blessings through our modern health care system, but extrapolate to the entire world and then tell me what the rules are.

I could be dead wrong, but I think, worldwide, women simply die a brief, horrific death by blood loss. Does that make everybody feel good about their sanitary and heroic rules?

 

[bogeyjlg]

DaveBj:

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

Utero or not, he is correct in saying that the intentional or direct killing of an innocent human life is evil reguardless.

 

[BayCityRickL]

bogeyjlg:

Utero or not, he is correct in saying that the intentional or direct killing of an innocent human life is evil reguardless.

Please refer to my previous post. We all know what abortion on demand is. I surely accept that that is the intentional killing of a human being.

An ectopic pregnancy is an accident waiting to happen and the fetus is going to die anyway. Protecting the life of the mother in this case is in no way morally equivalent to abortion on demand.

I wish you would imagine your wife (sister, mother, etc.) screaming in pain and bleeding to death and then tell me you’d just look at her and say “Too bad.”

I’ve watched enough episodes of Law and Order and they call such a thing “depraved indifference.” You’re not dealing with the fact that that fetus is not viable.

 

[Ham1]

BayCityRickL:

Please refer to my previous post. We all know what abortion on demand is. I surely accept that that is the intentional killing of a human being.

An ectopic pregnancy is an accident waiting to happen and the fetus is going to die anyway. Protecting the life of the mother in this case is in no way morally equivalent to abortion on demand.

I wish you would imagine your wife (sister, mother, etc.) screaming in pain and bleeding to death and then tell me you’d just look at her and say “Too bad.”

I’ve watched enough episodes of Law and Order and they call such a thing “depraved indifference.” You’re not dealing with the fact that that fetus is not viable.

You’re falling prey to the errors of “proportionalism.” See Veritatis Splendor. Although the proportionality of good and bad effects from an act are a part of the evaluation of a moral act, they are not the whole evaluation - it is only one of 4 points of the principle of double effect. When we fall into “proportionalism” we fall into a system that can justify contraception, abortion, euthanasia, infanticide, homosexuality…anything.

 

[javelin]

bogeyjlg:

Utero or not, he is correct in saying that the intentional or direct killing of an innocent human life is evil reguardless.

Yes, but no one has dealt yet with my previous question of whether or not an ectopic pregnancy is even considered a living human being.

When does it die (as it most surely will)?

Regardless, I thought the Church taught that it is morally licit to choose the “lesser of two evils” when there is no other alternative. In this case, we have the death of the child, which is unavoidable, and the death of the mother if we do nothing. Taking one life (that may be already in spiritual death) is a far lesser evil than taking that same life, plus the life of a person we know is alive, and may also be a mother and (hopefully) a wife.

This doesn’t change the fact that the action is still evil (taking the child’s life), but it does eliminate our culpability for it.

It seems a no-brainer to me.

The only case where I would think the God may hold us accountable would be if the mother or father was grateful that the pregnancy was ectopic because she/he didn’t want the child to begin with.

Peace,
javelin

 

[javelin]

One other thing that helps me through this…

I like to believe that our child gave his/her life to save my wife and the mother of my children. There is not greater love than that, and I firmly believe that child is now with God, praying for our souls that he/she may one day meet us in Heaven.

Peace,
javelin

 

[TAS2000]

The church DOES NOT support choosing the lesser of two evils. It NEVER supports evil at all, and niehter should we. The church does allow for choosing a path of good that indirectly causes an undesired effect, but not an evil. The child is alive and real from the moment of conception, until it dies. Ectopic or not, it is a living being. Directly going in and removing the child or killing it, even to save the life of the mother is evil. And yes, I had an ectopic pregnancy that did almost kill me, so I know what I am speaking of. Taking one life in favor of another is never right or any less evil than direct murder. It is not up to us to decide who is worth more than another. Then we end up with cases like Terry Shiavo. In the case of ectopic pregnancies, it is only morally licit to remove the child as part of another medical procedure done to save the mother’s life, but to directly kill the child alone is evil. It is to be hoped that doctors will spend more time and energy learning how to safely transplany the child back into the uterus, rather than find faster ways to kill them. After all, they seem to have no problems doing IVF and using surrogate mothers when the cause suits them.

 

[javelin]

TAS2000:

The church DOES NOT support choosing the lesser of two evils. It NEVER supports evil at all, and niehter should we. The church does allow for choosing a path of good that indirectly causes an undesired effect, but not an evil.

But in your example, following your logic, choosing to remove the fallopian tube is the equivalent of choosing a “path of good” that indirectly causes an evil.

In any case, I believe you are incorrect on the lesser of two evils statement.

As I said earlier, the outcome is still evil, but the culpability is still negated by the circumstance. The Chruch does support choosing the lesser of evils; it certainly doesn’t support choosing the greater of the evils!

How does the Church view self-defense? In this case, the child is directly killing the mother.

Remember, it is the culpability that is mitigated, if not eliminated, even though the intrinsic nature of the act will always be evil.

Peace,
javelin

 

[DailyBread]

To clear up the confusion of development of the embryo, the child will have normal development early on with development of placental tissue, amniotic sac, and decidual changes. Ultimately, these usually end with hemorrage into the abdominal cavity, some do also end with the death of the child due to poor attachment. Morally speaking, acceptable ways to deal with this are to either do nothing or a salpingectomy which is removal of that portion of the tube which unfortunately leads to the undesired affect of the death of the child. MXT (the drug you are referring to) is morally illicit because it acts like a chemotherapy (prevents DNA synthesis therefore harming rapidly dividing cells) and is designed to attack the trophoblast tissuse which is part of the embryo which connects it to its mother. Hope this helps !

 

[DailyBread]

"How does the Church view self-defense? In this case, the child is directly killing the mother."
**This is not the case. In the case of self defense, one is morally permitted to defends oneself from an unjust aggressor who willfully is threatening the life of another, not whose mere existence threatens your life. If it weren’t the case, then if I was stuck on a desert island with you javelin and you had the plague, it would be morally acceptable for me to kill you in self defense because your continued existence and acting as a resivoir for the plague threatens my life. I hope you see the logic of my arguement.

**

 

[snoopy]

javelin:

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

I agree. There is 100% certainty that the child will die anyway, and so will the mother if left untreated. The tube is not diseased, so removing it would be a sin, just like sterilization would be. The only moral thing to do, now that we have the technology, is to remove the fertilized egg that is possibly dead by now anyway and save the tube so the mother can bring more of God’s children into the world. This unfortunate circumstance can never yield a child anyway, so to destroy a healthy tube for a dead child just doesn’t make sense. I’m sure God would rather have more of his children brought into the world and not destroy a healthy tube.

 

[TAS2000]

Well, I’m glad you can be sure of what God would prefer, but I can only go by what the church teaches. You also seem to know a whole lot more than the doctors, since you say the child is probably dead anyway. It is never moral to remove a living fetus directly. That is murder. Even if the child would not survive anyway, that is for God to decide, not man. The “only moral thing to do” would be to try to save both. Doctors seem to be unwilling to try implanting the fetus back into the uterous. They prefer to remove or kill it. It is “easier”, not more moral. The tube is othewise healthy in the same respect that the child is otherwise healthy, just in the wrong spot. We need to stop spending time arguing for the easy way out (abortion, euthanasia, etc) and work on finding ways to do the right thing.

 

[javelin]

No offense, but I don’t think the Church has definitively stated anything regarding the situation of an ectopic pregnancy. What has happened is that people have extrapolated from well-defined Church teaching what would be appropriate action to take. What we’re considering here is how Church teaching on the various things that are in play when a pregnancy is ectopic converge, and what the best course of action would be that follows that teaching, and is true to God’s Truth inherent in Church moral law.

So, I think is it worthwhile to explore what is at play here, and I think there are enough valid questions raised that it can be discussed.

For instance, I still don’t see how removing the fallopian tube (that just “happens” to have the child in it) is any different than removing the child directly. The reason the tube is being removed, after all, is because the child is there. There is no doubt that removing the tube will kill the child. Somehow I don’t think that God is fooled as to what you’re really doing when you take out the tube and say “Oops! Oh, I guess there was a baby in there”.

Honestly, this seems like a razor-thin edge to base a moral proposition on.

Again I will say that I believe there is room in Catholic moral theology to support the position that one’s culpability for the death of the child is mitigated or removed altogether in the case of treating an ectopic pregnancy. What it is, in reality, is an accidental death. The parent didn’t ask for the child to implant in the tube, and doesn’t want the child to die, but nevertheless, it will. It is no one’s fault. No one will be accountable for it. I think that someone might be culpable for a sin of omission if the mother is just left to die without assistance that is definitely available.

That said, I agree completely with the previous posters who said what is really needed is for doctors to learn the technology that will allow the child to be transferred to the womb. That would change everything, and all for the better. How I wish my child could be safely with me now.

Peace,
javelin

 

[javelin]

"How does the Church view self-defense? In this case, the child is directly killing the mother."
**This is not the case. In the case of self defense, one is morally permitted to defends oneself from an unjust aggressor who willfully is threatening the life of another, not whose mere existence threatens your life. If it weren’t the case, then if I was stuck on a desert island with you javelin and you had the plague, it would be morally acceptable for me to kill you in self defense because your continued existence and acting as a resivoir for the plague threatens my life. I hope you see the logic of my arguement.
**

Somewhat, but the analogy does fall short in one critical way. In the case of the ectopic pregnancy, the child is* killing* (present tense) the mother, as in the mother is already in a state of medical malfunction that will result in her death, and that state is directly caused by the developing child. The child does not just threaten the mother’s life; it is already attacking it. The child is like a suicide bomber, just getting ready to push “the button”. That the child is is such a state as to not know what it is doing is the tragedy in all this.

The options are simple: remove the abnormal and fatal pregnancy and save the mother; spare the child initially and both mother and child die. Either outcome is tragic, and both involve the loss of life. Yet the choice is obvious – the pregnancy must end. Whether the tube is removed, or just the child, the same result comes from the same underlying motive: removal of the ectopic pregnancy.

It is so obvious, in fact, that it is almost humorous how some moralists attempt to justify it. If it really was the case that the child’s life always takes precedence over the mother’s, then why is there any option other than allowing the fatal pregnancy to run its course and kill them both? Why is it somehow OK to remove the child via the fallopian tube? I would argue that the difference is man-made, and that God sees right through it to the true intention of the act.

The other thing to consider is that many parents probably don’t even get the choice. I know I didn’t. My wife went in for exploratory surgery for severe abdominal pain and came out with the ectopic pregnancy removed, and neither of us were consulted. The doctor tried to save the fallopian tube, which was what doctors generally try to do. The “easy” thing would have been to just tie it up.

This got longer than I intended.

Peace everyone,
javelin

 

[snoopy]

I agree totally with you javelin. If you remove a healthy tube and put the mother through the anguish of surgery not to mention that half of her reproductive options are gone, what good have you done. There is no chance for the baby anyway. THE CHILD CANNOT LIVE. It will just make it that much harder for her to conceive and bear children that God wanted her to have. It just doesn’t make any sense to get the same result by playing games and putting the mother through hell when there is a new technology that can’t possibly be immoral, because the child will die no matter what. You are not killing the child. There is no chance for the baby to live. BTW, I am totally prolife and always have been.

 

[joshua1]

BayCityRickL:

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.

Ectopic does not mean in the tube. If you look up the word “ectopic”. It iliterally means “misplaced”. Ectopic can be anywhere. My wife’s doctor told us where an embryo actually implanted in the abdominal cavity or peritonium. In any case the baby will not survive. the way it was explained by our pastor, is that the intention was not to end the pregnancy. The ending of the pregnancy was the result or secondary effect of the surgery. But we better be careful with that explanation because you can say that any situation where the life of the mother is in danger, then termination is OK. I am speaking from a personal experience as my wife has had both a molar pregnacy and a tubal pregnancy.

 

[vern_humphrey]

I don’t want to ruffle feathers here, but let me offer something.

My Mother-in-law died of pancreatic cancer – a very painful death. The doctor put her on a morphine drip, and the dose necessary to control her pain was so strong that to be technically correct, we would have to say it hastened her death. What does the Church say about this?

2279 Even if death is thought imminent, the ordinary care owed to a sick person cannot be legitimately interrupted. The use of painkillers to alleviate the sufferings of the dying, even at the risk of shortening their days, can be morally in conformity with human dignity if death is not willed as either an end or a means, but only foreseen and tolerated as inevitable Palliative care is a special form of disinterested charity. As such it should be encouraged.

In other words, the Church accepts this as a moral act. Let’s examine HOW the Church arrives at this conclusion. There are three principles at work:

1. The principle of intent. If the intent is NOT to kill – but death is inevatible – then this principle is met.
2. The principle of alternative outcomes. If we refused the morphine drip, she would not have got out of bed, returned home and lived in the bosom of her family for another decade – she would have died anyway, but in agony.
3. The principle of proportionality. The Church does not require the dying to go through agony merely to make a point.

Now, let’s apply this to the use of methotrexate:

1. The principle of intent. We are not killing a baby here, we are saving a mother’s life. The baby is already doomed, and as in my mother-in-law’s case, we simply accept the inevatible.
2. The principle of alternative outcomes. Will removing the fallopian tube be a BETTER ourcome? Will it leave the mother healthier and MORE able to conceive another life?
3. The principle of proportionality. What is gained by choosing surgery over methotrexate? Will any great good come from it?

It seems clear to me that in a situation as we are contemplating here methotrexate is an acceptably moral choice, and to choose surgery when less intrusive means are available would be less moral.

 

[yochumjy]

snoopy:

I agree totally with you javelin. If you remove a healthy tube and put the mother through the anguish of surgery not to mention that half of her reproductive options are gone, what good have you done. There is no chance for the baby anyway. THE CHILD CANNOT LIVE. It will just make it that much harder for her to conceive and bear children that God wanted her to have. It just doesn’t make any sense to get the same result by playing games and putting the mother through hell when there is a new technology that can’t possibly be immoral, because the child will die no matter what. You are not killing the child. There is no chance for the baby to live. BTW, I am totally prolife and always have been.

How do you know the tube is healthy? What if the section of tube actually has a problem that could reacur. I was told by a doctor, that a person with a tubal pregnancy is more prone to having another, so removing the tube is stopping another tubal pregnacy from happening.

Just because the child can not live, does not mean you can abort. All direct abortion is wrong, it is intentionally killing the child. You are killing the child, period. There is no question here. The child is living, you kill them to prevent the death of the mother. You are simply playing games with words. Killing is killing. Whether or not it is direct or indirect is the question.

 

[snoopy]

yochumjy:

Killing is killing. Whether or not it is direct or indirect is the question.

You are not killing anyone. There is no chance for the child to live–no chance. If you do nothing, the mother and child will die. I can see how this would be indirect, but never will it be direct. To say that you are killing a child is so insensitive. The mother probablyalready feels horrible and is scared out of her mind, and she did nothing to deserve it. It is an act of God or nature or whatever you want to call it, but the Mother is not committing something parallel to abortion.

 

[snoopy]

vern humphrey:

I don’t want to ruffle feathers here, but let me offer something.

My Mother-in-law died of pancreatic cancer – a very painful death. The doctor put her on a morphine drip, and the dose necessary to control her pain was so strong that to be technically correct, we would have to say it hastened her death. What does the Church say about this?

2279 Even if death is thought imminent, the ordinary care owed to a sick person cannot be legitimately interrupted. The use of painkillers to alleviate the sufferings of the dying, even at the risk of shortening their days, can be morally in conformity with human dignity if death is not willed as either an end or a means, but only foreseen and tolerated as inevitable Palliative care is a special form of disinterested charity. As such it should be encouraged.

In other words, the Church accepts this as a moral act. Let’s examine HOW the Church arrives at this conclusion. There are three principles at work:

1. The principle of intent. If the intent is NOT to kill – but death is inevatible – then this principle is met.
2. The principle of alternative outcomes. If we refused the morphine drip, she would not have got out of bed, returned home and lived in the bosom of her family for another decade – she would have died anyway, but in agony.
3. The principle of proportionality. The Church does not require the dying to go through agony merely to make a point.

Now, let’s apply this to the use of methotrexate:

1. The principle of intent. We are not killing a baby here, we are saving a mother’s life. The baby is already doomed, and as in my mother-in-law’s case, we simply accept the inevatible.
2. The principle of alternative outcomes. Will removing the fallopian tube be a BETTER ourcome? Will it leave the mother healthier and MORE able to conceive another life?
3. The principle of proportionality. What is gained by choosing surgery over methotrexate? Will any great good come from it?

It seems clear to me that in a situation as we are contemplating here methotrexate is an acceptably moral choice, and to choose surgery when less intrusive means are available would be less moral.

I admire your common sense approach and your eloquent way of saying this. I wish I could get my point across so professionally and smoothly. Anyway, thank you for saying what I want to say.