Ectopic Pregnancy

[Rence]

You are correct. I used the wrong terminology: I should have said that MTX is said to constitute a direct attack on the fetus, not a direct abortion (slightly different concepts). My memory is that treatments which constitute direct attacks cannot be covered by the principle of double effect.

I think your confusion comes from the diagnosis that calls for methotrexate usage in a pregnant woman. For example, if a woman is pregnant, and has cancer, the usage of methotrexate to treat the cancer is licit and falls under double effect. The reason she is taking the methotrexate is directed at the cancer. The fact that an embryo will be affected is a side effect of the treatment acted on her. The intent is to treat the cancer. She can wait if she chooses, but she is not required by the Church to decline medical treatment for her cancer. But, If a woman is pregnant and doesn’t have any other diagnosis befitting methotrexate usage, and takes methotrexate, it’s because she wants to flush the embryo out, which is a direct abortion and is not licit according to Church rules.

Methotrexate is also used for rheumatoid arthritis, and often is prescribed to prevent permanent disability. So it could be licit for a pregnant woman to take it if she has rheumatoid arthritis in which delay of treatment might be detrimental to her health. It really depends on how bad it is, if she can wait, how the disease is progressing, etc.

 

[Bookcat]

“Double effect” does not, to my knowledge cover measures which constitute a direct abortion.

(not that I am getting back in the thread per se…:…)

And such would not BE a direct abortion …one is not seeking to abort the child or directly aborting the child…if such happened it would be an unintended side effect.

Direct abortion is when one --well goes and does an abortion. Either for the abortion itself or for some other reason…(it would then be the means and thus very wrong).

See the principle DE.

(again all the aspects of the PDE would need to be looked at in the case)

 

[Rence]

So the Bioethics Center responded to my call. The ethicist told me that in the situation involving an ectopic pregnancy and the liver, it is possible to take off the portion of the liver where the embryo is attached. He said that generally, the liver can regenerate.

However, he also said in extreme and unusual cases such as these, MTX could be used…which kind of put me off.

So if the liver can regenerate, can similar operations done to the intestines, spleen, kidneys or whatever potential organ an embryo can somehow attach itself to be easily repaired if it had to come to it?

Yes, because the affected part of the potential organ to which the embryo is attached is probably removed, not just the embryo. Interesting that he said MTX could be used but not unbelieveable…(so then why can’t it be used in tubal pregancies? what is the difference? Maybe that’s why the Vatican hasn’t specifically addressed this issue). remember that there is another diagnosis besides pregnancy going on here. The intent isn’t to have an abortion. The intent is to rectify something that went wrong in the first place.

 

[Corki]

I have seen the argument for using methotrexate to detach the placenta (with effects on the embryo accepted as unintended side-effects). Either way, I have never seen an official Church directive, only ethicists’ arguments.

The problem is that using methotrexate is that it kills the embryo as the primary action and the detachment of the placenta is the intended secondary effect. According to the article I found, the primary action is to stop the cells of the embryo from dividing anymore. Once the embryo is not drawing on the placenta for nurishment, the placenta detaches (usually).

webmd.com/baby/methotrexate-for-ectopic-pregnancy

While the death of the embryo can be tolerated as an unintended secondary effect, it can’t be sought as the intended primary effect.

 

[Bookcat]

Yes, because the affected part of the potential organ to which the embryo is attached is probably removed, not just the embryo. Interesting that he said MTX could be used but not unbelieveable…(so then why can’t it be used in tubal pregancies? what is the difference? Maybe that’s why the Vatican hasn’t specifically addressed this issue). remember that there is another diagnosis besides pregnancy going on here. The intent isn’t to have an abortion. The intent is to rectify something that went wrong in the first place.

One would have to discuss with him what he meant etc exactly (the NCBC is a very good source --but one can find differing opinions…and without his presence in the discussion we can not know exactly all he might say) . I know there has been some debate on MTX-- questions of how it works etc perhaps. .I go with the links I noted above.

 

[Bookcat]

So the Bioethics Center responded to my call. The ethicist told me that in the situation involving an ectopic pregnancy and the liver, it is possible to take off the portion of the liver where the embryo is attached. He said that generally, the liver can regenerate.

However, he also said in extreme and unusual cases such as these, MTX could be used…which kind of put me off.

One would have to discuss with him what he meant etc exactly (one can find differing opinions…and without his presence in the discussion we can not know exactly all he might say) . I know there has been some debate on MTX in the past-- questions of how it works etc perhaps. I go with the links I noted above.

forums.catholic-questions.org/showpost.php?p=9024455&postcount=25

 

[seekerz]

The problem is that using methotrexate is that it kills the embryo as the primary action and the detachment of the placenta is the intended secondary effect. According to the article I found, the primary action is to stop the cells of the embryo from dividing anymore. Once the embryo is not drawing on the placenta for nurishment, the placenta detaches (usually).

webmd.com/baby/methotrexate-for-ectopic-pregnancy

While the death of the embryo can be tolerated as an unintended secondary effect, it can’t be sought as the intended primary effect.

Here is a somewhat different explanation of why MTX use is generally not considered permissible: ncbcenter.org/page.aspx?pid=940. It’s the same drug, working in the same way - why can’t we settle on a single argument?

 

[Bookcat]

It is one thing to abort a child.

(Aborting a child “in order” to treat a serious disease is also an abortion and can not be done.)

It is another to treat a serious disease foreseeing an unintended side effect of the death of the child.

See the Principle of Double effect. (and all the aspects of the PDE would have to be met)

(I am not saying that such treatment would be the one to choose…by the way…one would have to know the case to know all the options).