Ectopic Pregnancy

[javelin]

Sorry for any confusion , real or feigned…

AAA = Ask an Apologist

Peace,
javelin

 

[javelin]

john doran:

but this begs the question: why is the death of the child morally evil in these cases?

are you suggesting that simply performing an action which causes a death is immoral? if so, why? what makes killing in self-defense, say, morally rectifiable, but not killing for money or revenge?

I think the short answer is that the child is an innocent, whereas with self-defense you have an unjust, intentional agressor, and the killing response must be the only real option.

But even with self-defense, the taking of another life as an action is morally evil. The culpability is reduced greatly, if not completely, but the action is still evil in nature. If this was not the case, would martyrdom be so special, or would it just be stupid? (I don’t think martyrs are stupid!)

Peace,
javelin

 

[Benedictus]

javelin:

I think the short answer is that the child is an innocent, whereas with self-defense you have an unjust, intentional agressor, and the killing response must be the only real option.

What if the agressor is an mentally ill man with a gun? Can I not act in self-defense, even if the person shooting at me is mentally ill and doesn’t really know what he’s doing?

 

[yochumjy]

vern humphrey:

So does cutting out the fallopian tube with the child inside. …When you cut out the fallopian tube with the child in it, that IS direct action on the child. How much more direct can you get?

We are having a definition problem. Direct action upon and results are not equivalent. Going into surgery, opening the tube and sucking the child out is direct action upon the child and immoral. Going in to surgery, cutting out the tube, is direct action on the tube. The result of both surgeries is death of the child. But direct vs indirect action is used.
vern humphrey:

We’ve already learned it has a high mortality rate for the mother, and a zero chance of success for the child – one possible success in the distant past notwithstanding.

Sorry, I missed that. Where did we learn that? Where are the statistics that say there is a high mortality rate for the mother?
vern humphrey:

I agree we should strive to find a way to correctly implant the child, but we aren’t there yet.

And that will happen how, as you suggest just to abort the child for all cases? At least when you cut the tube out, you can extract the child from the tube (not worrying about the tube, just the child) and try to implant.
vern humphrey:

No. I say, “Go with the method that offers the least risk.” That includes risk to life, risk to fertility and risk to future pregnacies.

Not all things are morally equal. Just because you define it so doesn’t make it right. Question, what is the church’s view on abortion? That is the view we should start with, right? Not yours, not mine, the church’s.
vern humphrey:

I think you just caught yourself in your own trap.

“Removing the tube” is really “removing the baby.”

Empty win. Never said that removing the tube didn’t remove the baby. We are talking about morals, not simply physical results
vern humphrey:

You offered YOUR definition, one carefully calculated to allow you to pretend a surgical abortion is somehow not an abortion.

There is the technical term abortion, which I believe includes miscarriage, that is senseless to use. I am attempting to define a moral abortion vs immoral. One that is consistant with church teaching. Feel free to apply church teaching also.
vern humphrey:

You shouldn’t make these leaps.

I didn’t say there was no cause to ectopic pregnancies. There are MANY causes of ectopic pregnancies.

But a prior ectopic pregnancy is not one of them.

I look directly at your link and see that there are NO causes, only risks. I looked at my link and see that previous tubal is a cause:

healthsquare.com/mc/fgmc0202.htm

But as javalin says, the future isn’t the best reason. The present is what will kill the mother. Removing the tube is removing the part of the mother’s system that will kill her. Removing the child is abortion.
vern humphrey:

You need to understand the difference between causation and correlation. A previous ectopic pregnancy cannot “cause” a later ectopic pregnancy. There is a slight correlation but no causation.

Actually, you can’t say that it can’t be a cause, you can assume it, but you can’t definitively say that. Unless of course you are a medical doctor specializing in ectopic pregnancy who knows all. I can’t prove it myself, but I did show a link above that lists it under causes. You have a link that lists everything under Risk factors, which is not the same as proof that what you say is true.

 

[yochumjy]

vern humphrey:

When you seek to justify a surgical abortion with sterilization, you created that importance.

I seek to justify that the removing of the tube which will unfortunately abort the child is moral and in that context sterilization does not have the moral importance that directly attacking the child with drugs or vacuum does. The 10 commandments say to not kill, not to make sure everyone is as fertile as possible.
vern humphrey:

Why is it so important to you to claim that it isn’t abortion?

I seek morality and unity with the Church. I seek the best way in God’s eyes (as best defined through the Church).
vern humphrey:

Why do you believe the surgical removal of a child from the mother’s body, knowing the child will die is not abortion?

I’ve already stated that, you have not answered the question. You seem content to just ask the question back to me. Why?
vern humphrey:

yochumjy:

You are now placing the faithful in the position of being able to pick and choose when abortion is okay. /quote]

No, you did that when you pretended that surgical abortions are okay if you have your fingers crossed.

Let’s skip the future ectopic reasoning for now, even though I believe it is a factor for the future health of the mother. The tube will burst, the mother and child will die. Remove the tube, the tube will not burst. The bursting of the tube is what we prevent by removing it. By only removing the child, you put the child in the position of the killing agent, and the child is not the aggressor.
vern humphrey:

The same ones that lead you to claim a surgical abotion is not an abortion.

See above, moral vs immoral abortion if you MUST use the technical definition of abortion. Miscarriage - moral abortion, removing uterine cancer along with child due to immenant death - moral abortion, removing tube that will burst -moral abortion. Taking drugs that kill the child -immoral abortion surgically removing child alone, focusing only on the child as the problem -immoral abortion. I contend that these definitions are all supported by the church.

 

[yochumjy]

Benedictus:

What if the agressor is an mentally ill man with a gun? Can I not act in self-defense, even if the person shooting at me is mentally ill and doesn’t really know what he’s doing?

Whether or not the menatlly ill person completely understands what they are doing is not relevant if they are the aggressor. You can always act in self-defense against an aggressive act. This, of course, has nothing to do with ectopic pregnancy, as there is no aggressive act being done against the mother. The child growing is not an aggressive act, it is natural and normal. The fact that the tube will burst is how the mother will die.

 

[yochumjy]

vern humphrey:

We keep forgetting one thing – the bloody lump of tissue in the surgeon’s hand. That bloody lump contains a tiny corpse.

When you say that act – intruding into the woman’s body and removing the baby – with or without the fallopian tube is morally neutral, how do we square it with that bloody tissue and tiny corpse?

Therefore action B1 (surgically remove the tube) cannot be morally neutral. We can PRETEND that it is somehow different and morally neutral – but only if we keep our eyes averted and ignore the drip of blood on the floor.

You seem to latch on to the “bloody lump” thing. This is a nice emotional/sensational view. If the tube is removed with the child in in, the only blood is the mother’s, not the child. I will continue to side with javelin that the baby should then be placed in the uterus at that point. That additional action is the most moral thing we can do. Even if the chance is slim to none, it is the best we have.

 

[yochumjy]

vern humphrey:

I suggest when a doctor intrudes into a woman’s body, removes the baby, and turns around with a lump of bloody tissue in his hand – a lump containing the tiny corpse – that’s direct abortion.

Now, we are agreed that we have a moral obligation to save the mother. And we are also agreed that at the current state of medical technology the child will die.

And, if we wait until we are sure the child is dead before acting the mother will also be near death, and the risk will be so high as to be unsupportable.

The morality of that act must therefore be judged by something other than the means of killing the child.

You suggestion ignores what you are cutting out and only focuses on the result. Cutting out a child will result in your sensational “bloody lump” result. Cutting the tube will result in a baby in the tube which can now be transferred to the uterus intact, no bloody lump, no abortion. An abortion might result with a high percentage due to the innability of the child to reconnect correctly in the uterus, but that again is an indirect abortion. One that we obviously had a hand in, but did our best to not allow.

BTW, the only thing your drugs do is create a bloody lump.

You are wrong that morality must be judged by something other than the means of killing the child.

 

[john_doran]

javelin:

I think the short answer is that the child is an innocent, whereas with self-defense you have an unjust, intentional agressor, and the killing response must be the only real option.

But even with self-defense, the taking of another life as an action is morally evil. The culpability is reduced greatly, if not completely, but the action is still evil in nature. If

ok. so what makes an action wrong? if intention and outcomes contribute to the (im)morality of an act, what is it that each has in common with the other that allows them both to count toward the same moral measurement?

in other words, what makes causing a death morally evil? and if causing a death is morally evil, why isn’t, say, a lion immoral when it causes the death of a human? or a car? or a bolt of lightning? or the ocean?

and what is it that makes a murderous intention morally evil? for example, if someone tries to kill someone and fails, they have done something immoral despite the fact that no one was actually hurt. what is it that makes that intention wrong?

and, finally, if what makes outcomes immoral isn’t the same thing that makes intentions immoral, then you’re saying two totally different things when you say each is immoral…

how is that supposed to work?

javelin:

this was not the case, would martyrdom be so special, or would it just be stupid? (I don’t think martyrs are stupid!)

martyrdom’s special because people give up the thing that we typically have the greatest fear and aversion to losing: our lives.

i don’t understand what that has to do with the subject at hand.

 

[john_doran]

yochumjy:

Going into surgery, opening the tube and sucking the child out is direct action upon the child and immoral.

but why?

for one thing, how do you even get the “direct / indirect” distinction off the ground? for example, is stabbing someone with an implement direct or indirect action? is pulling a trigger which drops a hammer which ignites gundowder which propels a bullet across open space and into someone’s chest direct or indirect action? and what about preventing someone from getting something they need to survive, like air or water? direct or indirect? and what about sneaking someone peanuts when you know they’re fatally allergic to them? what about just not alerting that person to the presence of peanuts in food you see they’re about to consume? and so on…

perhaps even more basically, isn’t what’s wrong with “direct action”, as you term it, the fact that the result is some kind of harm to the subject?

i don’t get it.

 

[javelin]

yochumjy:

Whether or not the menatlly ill person completely understands what they are doing is not relevant if they are the aggressor. You can always act in self-defense against an aggressive act.

I think that it is always OK to act in self-defense, but in every case you must use as little force or violence as necessary.

yochumjy:

This, of course, has nothing to do with ectopic pregnancy, as there is no aggressive act being done against the mother. The child growing is not an aggressive act, it is natural and normal. The fact that the tube will burst is how the mother will die.

I think that this may be disputed. I’m not sure that a woman would necessarily bleed out and die if one of her fallopian tubes ruptured. I believe that women can have cysts on their ovaries and tubes that rupture, causing severe pain, but not excessive bleeding or death. Normally, it doesn’t even require surgery.

Rather, it is the very presence of the child and supporting placenta that causes this scenario to be dangerous, as the child requires much blood and nutrients. The pregnancy is surrounded by exponentially increased vascularization, and it is that focus of new blood vessels that causes the extensive bleeding if there is a rupture of the system.

Point being, that without the child’s presence even a rupture of the tube would not be imminently fatal. So, to amend your quote above, “the fact that the tube will burst with a growing child inside is how the mother will die.”

That said, most of your arguments make sense .

Peace,
javelin

 

[yochumjy]

javelin,

Thank you for this, this is really good. I think you have surely forced me to add that for the best possible solution trying to implant in the uterus is the best possible moral solution. Although I will now struggle with the cancerous uterous dillemma, thanks.

javelin:

Main intent: Save the life of the mother (morally good)
possible actions aimed at that intent:

A) administer methotrexate:
A.1) action of MTX: stop the development of cells, in this case, the developing child, which kills it (morally evil)
A.2) intent of administering the drug must then be to stop the developing cells, killing the child (morally evil) AND spare the mother the need for surgery (morally good)
A.3) Additional effects: none known

Not quite: rxlist.com/cgi/generic/mtx_ad.htm

SIDE EFFECTS WITH METHOTREXATE.

The most frequently reported adverse reactions include ulcerative stomatitis, leukopenia, nausea, and abdominal distress. Other frequently reported adverse effects are malaise, undue fatigue, chills and fever, dizziness and decreased resistance to infection.

Other adverse reactions that have been reported with methotrexate are listed below by organ system. In the oncology setting, concomitant treatment and the underlying disease make specific attribution of a reaction to methotrexate difficult.

Alimentary System: gingivitis, pharyngitis, stomatitis, anorexia, nausea, vomiting, diarrhea, hematemesis, melena, gastrointestinal ulceration and bleeding, enteritis, pancreatitis.

but relatively minor compared to death of the mother. How these compare with sparing the mother surgery is unknown. I don’t have any feel for just how bad surgery is in this case, it might not be that big a mortality with today’s medicine.

javelin:

B) Remove the fallopian tube surrounding the developing child
B.1) Action: surgically remove the tube (morally neutral?)
B.2) intent: surgical removal of the tube that will burst (morally neutral)
B.3) Additional Effects: child that is developing in the tube will essentially starve and die, and we know this (morally evil)

Good point on B.3, I should have thought that part through more, but this still begs the question of uterine cancer and pregnancy and how that works.

javelin:

C) Attempt to move the child to the uterus intact
C.1) Remove the child (morally neutral?)
C.1.1) Action (current): Surgically remove the child intact and as much of the surrounding support system (placenta, etc.) as possible. (morally neutral)
C.1.2) intent: surgical removal of the child from the place where it is developing that offers it no chance of survival (morally neutral) AND sparing the mother, if possible, the loss of her tube (morally good).
C.2) Attempt to implant the child in the uterus
C.2.1) Action: surgically place the child in the uterus (morally neutral)
C.2.2) Intent: Allow the child to live and grow (morally good)
C.2.3) Additional Effects: Child will die, as there is no known way to successfully place the child in the womb so that it can continue to develop. (morally evil?)

I think that C.2.3 is not morally evil. How could it be. When you go in for surgery and something goes wrong and you die it is not necessarily morally evil, unless there was other mitigating factors (ie surgeon drinking) The intent is to save the child, and doing everything possible to do that. If you use every possible thing at your disposal and the child still dies, this is not morally evil. Otherwise, if a child is playing and a tree branch falls on them and the doctor is unable to save them, it would be morally evil.

javelin:

OK, I thought this may have been a good idea at first, but it is still really hard to say if certain sub-actions are good, neutral, or evil.

You made the case beautifully. Thanks.

javelin:

Still, I think the case for MTX is poor, in that it is hard to separate the intent of a procedure from its most immediate effect, which in the case of MTX is the death of the child. At least the express effect of removing the tube is one step removed from the death of the child.

There is no real case for the drug, the intent of the drug is to turn the child into a bloody lump (to borrow Vern’s colorful language). This is direct abortion, unlike removal of the tube, which is indirect abortion. Placing the child in the uterous gives God the oportunity for a miricle, I’ll place my bets with God.

 

[vern_humphrey]

javelin:

Which bring us way back to a question I posed long ago – how far removed from an act must the consequences be before we can be held culpable for them?

I think this is the wrong question – we cannot escape culpability merely by distancing ourselves from the act. If that were the case, a person who hires a murder would be less culpable than the triggerman.

Since we cannot distance ourselves from the act (or to put it another way, since distancing ourselves doesn’t affect the morality of the act) we must come at it another way.

I say go back to basics. What are we trying to do? We are trying to SAVE a life. Unfortunately, in the circumstances, the baby will die – no matter what we do. But we can save the mother.

Given those considerations, the morality of the act is NOT contigent on how “distant” we are from the killing of the baby, nor in the mechanism by which the baby is killed, nor in any clever legalese pretense. The morality of the act is in the intent to save the mother’s life.

The methodology is therefore validated by the intent, plus medical considerations. IF the only way to save the mother is to remove the fallopian tube, the surgeon who does so incurrs no guilt. Similarly, it the best practice (taking the individual situation into account) is simply to remove the baby (with drugs or surgery) no guilt attaches.

 

[yochumjy]

javelin:

I think that this may be disputed. I’m not sure that a woman would necessarily bleed out and die if one of her fallopian tubes ruptured. I believe that women can have cysts on their ovaries and tubes that rupture, causing severe pain, but not excessive bleeding or death. Normally, it doesn’t even require surgery.

Rather, it is the very presence of the child and supporting placenta that causes this scenario to be dangerous, as the child requires much blood and nutrients. The pregnancy is surrounded by exponentially increased vascularization, and it is that focus of new blood vessels that causes the extensive bleeding if there is a rupture of the system.

Point being, that without the child’s presence even a rupture of the tube would not be imminently fatal. So, to amend your quote above, “the fact that the tube will burst with a growing child inside is how the mother will die.”

That said, most of your arguments make sense .

Hmmm, you are correct, I was wrong. I haven’t been able to find a site that describes the long term effect after the rupture of the tube though. Well, I did find a single sentance that said mothers rarely die from the rupture alone:
nlm.nih.gov/medlineplus/ency/article/000895.htm
Although without medical intervention, I assume the mother would/could die more than rarely, as they seem to require blood transfusions.

FWIW I did find this:
rcav.org/olf/Library/articles/deathfetus-01-05-14.htm

Which supports the removal of the tube and defines the moral points.

 

[javelin]

john doran:

ok. so what makes an action wrong? if intention and outcomes contribute to the (im)morality of an act, what is it that each has in common with the other that allows them both to count toward the same moral measurement?

in other words, what makes causing a death morally evil? and if causing a death is morally evil, why isn’t, say, a lion immoral when it causes the death of a human? or a car? or a bolt of lightning? or the ocean?

and what is it that makes a murderous intention morally evil? for example, if someone tries to kill someone and fails, they have done something immoral despite the fact that no one was actually hurt. what is it that makes that intention wrong?

and, finally, if what makes outcomes immoral isn’t the same thing that makes intentions immoral, then you’re saying two totally different things when you say each is immoral…

how is that supposed to work?

These are all very good questions, and I’m not sure I have the capacity or time to answer them completely, but let me at least try.

First, we must understand that God is Perfect. Completely. Anything imperfect opposes God, and is at some level an affront to him, because God is Perfection.

Second, I think the Bible makes it pretty clear that we will be judged by our actions (Matt 25:32 – the sheep to the right, goats to the left…).

Third, our intentions (in the broadest sense, whether we intend to do good or evil) matter, but bad intent is NOT required to make something bad (read Luke 12:42-49).

Thus, actions in and of themselves, if they go against the will of God, can be immoral whether or not the person doing them even knows they are immoral, and we WILL be judged on them.

Intent to do good, then, cannot make an evil action suddenly good. It only means that the person has done good *and *bad.

The Bible also says that lusting for an evil is as bad (or almost as bad) as actually doing the evil (Matt 5:27-28). And if merely thinking of doing something wrong is wrong, then intending to do something wrong must be immoral, too. Add that to Luke 12 again and you see why the servant who deliberately disobeyed his master’s will recieved the serverest beating and was put out “with the unfaithful.”

It seems to me that the Bible puts a distinction between the absolute morality of an action and the morality of the intent, or what is in the heart, of the person committing that act. It is entirely possible for one to be good while the other is bad. That being the case, we always must weigh them against one another when they come in conflict, and choose the action that carries the most moral goodness and the least moral evil.

Obviously, this can take a lot of thought and prayer to determine, which is why we have the obligation to form our consciences correctly so we can weigh good and evil appropriately and act rightly as often as we can.

Well, I’m about spent on this now. I know the answer is inadequate, but it may give you something more to think about.
john doran:

martyrdom’s special because people give up the thing that we typically have the greatest fear and aversion to losing: our lives.

i don’t understand what that has to do with the subject at hand.

I’m sorry I even brought it up, really. The initial thought was something like “if it is always OK for a person to defend themselves against an aggressor, then why would anyone choose not to defend themselves and instead be martyred?”

But it’s off-topic and convoluted, so let’s drop it.

Peace,
javelin

 

[yochumjy]

john doran:

but why?

for one thing, how do you even get the “direct / indirect” distinction off the ground? for example, is stabbing someone with an implement direct or indirect action? is pulling a trigger which drops a hammer which ignites gundowder which propels a bullet across open space and into someone’s chest direct or indirect action? and what about preventing someone from getting something they need to survive, like air or water? direct or indirect? and what about sneaking someone peanuts when you know they’re fatally allergic to them? what about just not alerting that person to the presence of peanuts in food you see they’re about to consume? and so on…

perhaps even more basically, isn’t what’s wrong with “direct action”, as you term it, the fact that the result is some kind of harm to the subject?

i don’t get it.

Going into any situation where you are focused on hurting/killing is what is immoral. All the situations you talk about are a person going in with the sole intent to kill. That is direct action. You intend by your action that death should be the result. The indirect action I am talking about is when you are focused on saving the mother’s life. The tube will burst and the area will not support child birth, the mother will die and the child will die. The action of removing the tube is to remove the section of the mother’s system that will cause death. The child is in the tube and must be removed with the tube. The desired effect is to remove part of the mothers system that will cause the death of the mother.

Look at this link:
rcav.org/olf/Library/articles/deathfetus-01-05-14.htm

The drug that Vern is talking about is injected into the mother’s body which directly acts upon the child. So the injection is direct action on a human life. That is what I am trying to explain.

 

[yochumjy]

vern humphrey:

I think this is the wrong question – we cannot escape culpability merely by distancing ourselves from the act. If that were the case, a person who hires a murder would be less culpable than the triggerman.

Since we cannot distance ourselves from the act (or to put it another way, since distancing ourselves doesn’t affect the morality of the act) we must come at it another way.

I say go back to basics. What are we trying to do? We are trying to SAVE a life. Unfortunately, in the circumstances, the baby will die – no matter what we do. But we can save the mother.

Given those considerations, the morality of the act is NOT contigent on how “distant” we are from the killing of the baby, nor in the mechanism by which the baby is killed, nor in any clever legalese pretense. The morality of the act is in the intent to save the mother’s life.

The methodology is therefore validated by the intent, plus medical considerations. IF the only way to save the mother is to remove the fallopian tube, the surgeon who does so incurrs no guilt. Similarly, it the best practice (taking the individual situation into account) is simply to remove the baby (with drugs or surgery) no guilt attaches.

This reduces the arguement to “the ends justify the means”. Ignoring my arguement for the second, which I know you disagree with. How does your suggestion NOT fall under
the ends (saving a life) justifies the means (using a drug to abort the child)

 

[javelin]

yochumjy:

This reduces the arguement to “the ends justify the means”. Ignoring my arguement for the second, which I know you disagree with. How does your suggestion NOT fall under
the ends (saving a life) justifies the means (using a drug to abort the child)

I think I can answer that.

It does not fall under that because any means that will accomplish saving the life of the mother necessitates the death of the child.

If we were to mathematically add up the comparative good/bad of every action involved, the death of the child would essentially cancel out of every equation because no matter what we do, even if doing nothing is one of our options, the child will die because of our action (or inaction).

Peace,
javelin

 

[vern_humphrey]

javelin:

Second, I think the Bible makes it pretty clear that we will be judged by our actions (Matt 25:32 – the sheep to the right, goats to the left…).

I don’t find the word “actions” in that verse. I suggest we will be judged by our SINS – which may or may not be “actions.”

javelin:

Third, our intentions (in the broadest sense, whether we intend to do good or evil) matter, but bad intent is NOT required to make something bad (read Luke 12:42-49).

Note that the Pharasees which are described in these verses are the poster child for legalism as a basis of morality. They were the ones who split hairs over the commandments, and came up with things like sending out a servant with trash when they wanted to go on a journey on the Sabbath (the servant would leave pieces of trash beside the road, representing the master’s “home” so he never went more that the prescribed distance from “home.”

javelin:

Thus, actions in and of themselves, if they go against the will of God, can be immoral whether or not the person doing them even knows they are immoral, and we WILL be judged on them.

And my point is, what is a wrong action (removing the baby) is always wrong, no matter what ruses we apply to make it appear different.

javelin:

Intent to do good, then, cannot make an evil action suddenly good. It only means that the person has done good *and *bad.

And therefore such situations should be approached with caution, not with blinders on.

javelin:

It seems to me that the Bible puts a distinction between the absolute morality of an action and the morality of the intent, or what is in the heart, of the person committing that act. It is entirely possible for one to be good while the other is bad. That being the case, we always must weigh them against one another when they come in conflict, and choose the action that carries the most moral goodness and the least moral evil.

No argument there. My only argument is when we pretend what we are doing is NOT bad because we’re doing it with our fingers crossed.

javelin:

I’m sorry I even brought it up, really. The initial thought was something like “if it is always OK for a person to defend themselves against an aggressor, then why would anyone choose not to defend themselves and instead be martyred?”

Because we are not automatons and have free will. Martyrdom unto death is a dangerous moral choice – it can border on suicide.

 

[javelin]

BTW, I’m still waiting on a reply from an apologist. I’ll post here when(if) it comes down the pipe…

javelin