Patients with ectopic pregnancies

[Rau]

In principle, the surgical removal of just the embryo need not have the intention or the effect of killing the embryo. We are able today, in rare cases, to save babies with only 22 weeks of gestation - something that was unthinkable 100 years ago. It is not out of the question that 100 years from now there may be a way to provide for the full development of an embryo removed from an ectopic pregnancy, either by providing an artificial womb, or by transplanting the embryo into the uterus of the same woman. Certainly in that case the surgical removal of the embryo would not constitute abortion, even if some or most of the embryos died in the process. The key point is that the death of the embryo is not deliberate or intended. The death of the embryo is not necessary to treatment of the mother. It is clearly an unintended side effect of the removal.

Methotrexate, on the other hand, is a completely different situation. The means by which the tube is cleared is by killing the embryo. If the dosage of methotrexate is not high enough, and the embryo does not die, then the operation is a failure and the woman remains untreated. So in that case the intention is clearly to kill the embryo, because without the death of the embryo, the treatment does not work. This is unlike the surgical removal of just the embryo because the death of the embryo, while probably inevitable, is not essential to the treatment. It is possible to imagine a successful treatment without the death of the embryo, even if such a treatment is currently out of reach of present technology.

But what about today, when no such technology exists? Does the absence of that technology change the intention of the removal? I don’t think so. Unless the doctor wantonly carves up the embryo and takes it out in pieces, the operation can appear the same as if the advanced technology existed. And when such an operation is compared with the (licit) removal of the section of tube, the operations appear very similar, except that in one case the embryo is surrounded by a section of tube and in the other case he isn’t. But that tube is not keeping him alive. What is the difference between the two procedures with regard to the intention of the doctor?

Ectopic pregnancies need to be treated well before 22 weeks. Any attempt at removing the embryo would have a zero % chance of saving the child. It would not be credible to assert the objective of the procedure was to save the child.

 

[LeafByNiggle]

Ectopic pregnancies need to be treated well before 22 weeks. Any attempt at removing the embryo would have a zero % chance of saving the child. It would not be credible to assert the objective of the procedure was to save the child.

I said multiple times that this technology is not currently available. I get it. But the chance of saving the child is not relevant to the question of “is it abortion”. The removal of the section of tube also has zero chance of saving the child, but that is not deemed to be abortion. So the chance of saving the child is not relevant. The intention of the doctor performing the operation is what is relevant. And I don’t see why the doctor needs to have the intention to kill the child when he does a removal of the embryo.

 

[Rau]

I said multiple times that this technology is not currently available. I get it. But the chance of saving the child is not relevant to the question of “is it abortion”. The removal of the section of tube also has zero chance of saving the child, but that is not deemed to be abortion. So the chance of saving the child is not relevant. The intention of the doctor performing the operation is what is relevant. And I don’t see why the doctor needs to have the intention to kill the child when he does a removal of the embryo.

We can only know what the doctor claims to be his intention. If the chance of saving the child is Zero, we can infer with great confidence his true intention.

The intention in removing the tube is not in doubt or debate.

 

[Et_Cetera]

The Church says that removing the fallopian tube in the case of an ectopic pregnancy is a legitimate medical procedure due to an abnormality of the tube: the emplanted embryo. It’s the principle of double effect: something bad results from a good thing, in this case the bad, unintended effect is the death of the embryo, the good is the removal of the diseased fallopian tube.

The Church also says that a treatment for ectopic pregnancy that only targets the embryo either surgically (removal from the tube) or chemically (dissolving the embryo with methotrexate) is abortion and forbidden. No double effect here, the intended action is the killing of the embryo.

This is pure semantics and makes no sense. The fetus will die either way. How on earth does it make sense to get caught up in what method takes place? Anyone with common sense would do whatever is best for the mother. And for anyone who wants to start an argument with this post, just repeat to yourself, “The fetus will die either way…”

OP: I think your question has been answered in this thread, but in case there is still controversy, I think the correct answer is for your to do your job.

 

[Rau]

This is pure semantics and makes no sense. The fetus will die either way. How on earth does it make sense to get caught up in what method takes place? Anyone with common sense would do whatever is best for the mother. And for anyone who wants to start an argument with this post, just repeat to yourself, “The fetus will die either way…”

OP: I think your question has been answered in this thread, but in case there is still controversy, I think the correct answer is for your to do your job.

The child will die either way. But only some ways add the additional evil of murder.

 

[Millie123]

OP: I think your question has been answered in this thread, but in case there is still controversy, I think the correct answer is for your to do your job.

No, no one has cleared up anything for me, a few people have offered me advice (The best advice has been to contact NCBC, I’m still waiting for their response), other member have offered me pearls of knowledge to think about…All that is now taking place is a debate on how to treat ectopic pregnancy. Which isn’t helpful at all

The church has already defined the licit and illicit ways to treat an ectopic pregnancy…

1)first way to treat ectopic pregnancy…give the mother Methotrexate, a drug that attacks and kills the embryo, it is illicit because it directly attacks the baby…it is abortion.

1. The second way to treat an ectopic pregnancy is to surgically cut out the baby itself from the fallopian tube, then sew up the tube…this is also illicit because again this is directly attacking and killing the baby…it is abortion.
2. The third, and only licit way that the church has defined to treat an ectopic pregnancy, is to tie off 2 sides of the fallopian tube and remove the tube itself, with the baby inside. The reason why this behavior is morally licit is because the only action is being taken on the diseased tube itself, no attack is being performed on the child…it is not abortion.

If you need more to read about…You can read Father Tadeus from the National Catholic Bioethics Center wrote an article on it.
catholiceducation.org/articles/medical_ethics/me0140.htm

I don’t need any advice on the licit and illicit ways to treat ectopic pregnancies. I already know the answer to that question…
1)Treating with Methotrexate = Abortion…which is bad
2)Treating by surgically removing baby himselff from tube = Abortion…which is bad
3)Treating by surgically removing the entire fallopian tube with baby inside, is the only licit way, that the church has defined to treat an ectopic pregnancy…It is not abortion.

I don’t need more discussion on the licit and illicit ways to treat ectopic pregnancies…that is not what my question is about

The root of my question is not about how to treat it… but rather on automatic (latae sententiae) excommunication.

Canon 1398 provides that, “a person who procures a successful abortion incurs an automatic (latae sententiae) excommunication.” This means that at the very moment that the abortion is successfully accomplished, the woman and all formal conspirators are excommunicated. …Conspirators who incur the excommunication can be defined as those who make access to the abortion possible. This certainly includes doctors and nurses who actually do it, husbands, family and others whose counsel and encouragement made it morally possible for the woman, and those whose direct practical support made it possible (financially, driving to the clinic etc.).ewtn.com/expert/answers/abortio2.htm

Being how I am transferring and transporting a patient into a Doctor’s care who may decide to perform an abortion on a woman’s ectopic pregnancy…is that cooperating with the abortion? As is stated above…“Conspirators who incur the excommunication can be defined as those who make access to the abortion possible. This certainly includes doctors and nurses who actually do it, husbands, family and others whose counsel and encouragement made it morally possible for the woman, and those whose direct practical support made it possible”

Would the action of myself transferring and transporting a patient into the care of a physician who will perform an abortion on her ectopic pregnancy make me a conspirator in her abortion? Will that be an action of “direct practical support”…and hence will I obtain an “automatic (latae sententiae) excommunication”

I thank everyone who has contributed to my post so far…but I think I will just wait until the ethicists return my e-mail.

 

[Rau]

No, no one has cleared up anything for me…

Millie - I believe your query was answered, however I suspect you are needing to be “convinced” that you do no wrong by an “authority”, and perhaps that is not possible in this forum.

But, as I said in Post 16, you are not providing “formal” cooperation, therefore you are doing no wrong. You are providing “material” cooperation - which is not wrong. You can read further about those ideas here:
ncregister.com/site/article/formal_vs_material/

It seems “obvious” to me you do no wrong. The above article may help you to see that.

 

[Millie123]

Millie - I believe your query was answered, however I suspect you are needing to be “convinced” that you do no wrong by an “authority”, and perhaps that is not possible in this forum.

But, as I said in Post 16, you are not providing “formal” cooperation, therefore you are doing no wrong. You are providing “material” cooperation - which is not wrong. You can read further about those ideas here:
ncregister.com/site/article/formal_vs_material/

It seems “obvious” to me you do no wrong. The above article may help you to see that.

Rau, Yes that article is actually quite helpful…thank you.

 

[Rau]

…“Conspirators who incur the excommunication can be defined as those who make access to the abortion possible. This certainly includes doctors and nurses who actually do it, husbands, family and others whose counsel and **encouragement **made it morally possible for the woman, and those whose **direct practical support **made it possible”

The above refers to “formal cooperation”. All these people seek to enable an abortion. That is wrong.

Being how I am transferring and transporting a patient into a Doctor’s care who may decide to perform an abortion on a woman’s ectopic pregnancy…is that cooperating with the abortion?

I assume you do not know whether the patient’s intention is to secure an abortion, or another procedure, you have not encouraged an abortion, nor do you know what the doctor may recommend, nor what response the patient may have to the options to be discussed with the doctor. From your description, it appears you have no knowledge of any intent to seek or perform an abortion. IMHO, as I understand the facts, you do no wrong.

 

[Prodigal_Son]

The root of my question is not about how to treat it… but rather on automatic (latae sententiae) excommunication.

Canon 1398 provides that, “a person who procures a successful abortion incurs an automatic (latae sententiae) excommunication.” This means that at the very moment that the abortion is successfully accomplished, the woman and all formal conspirators are excommunicated. …Conspirators who incur the excommunication can be defined as those who make access to the abortion possible. This certainly includes doctors and nurses who actually do it, husbands, family and others whose counsel and encouragement made it morally possible for the woman, and those whose direct practical support made it possible (financially, driving to the clinic etc.).ewtn.com/expert/answers/abortio2.htm

Being how I am transferring and transporting a patient into a Doctor’s care who may decide to perform an abortion on a woman’s ectopic pregnancy…is that cooperating with the abortion? As is stated above…“Conspirators who incur the excommunication can be defined as those who make access to the abortion possible. This certainly includes doctors and nurses who actually do it, husbands, family and others whose counsel and encouragement made it morally possible for the woman, and those whose direct practical support made it possible”

Would the action of myself transferring and transporting a patient into the care of a physician who will perform an abortion on her ectopic pregnancy make me a conspirator in her abortion? Will that be an action of “direct practical support”…and hence will I obtain an “automatic (latae sententiae) excommunication”

I thank everyone who has contributed to my post so far…but I think I will just wait until the ethicists return my e-mail.

You are far, far away from formal cooperation with evil. You do not even know whether an evil action will take place, since you don’t know the decision the doctor will make.

Moreover, the moral accountability of abortionists in the case of ectopic pregnancy is clearly much less than the moral accountability of abortionists in other cases – just as the moral accountability of a person who euthanizes another person who is about to die anyway is much less than the moral accountability of a cold-blooded murderer.

 

[Prodigal_Son]

We can only know what the doctor claims to be his intention. If the chance of saving the child is Zero, we can infer with great confidence his true intention.

Huh? Do you think that OB’s that abort babies in an ectopic situation are doing this out of a desire to end a life?

Again, their intention doesn’t matter. The action itself has a nature. We don’t need to denigrate the intentions of well-intentioned OBs, in order to defend Catholic teaching.

 

[Rau]

Huh? Do you think that OB’s that abort babies in an ectopic situation are doing this out of a desire to end a life?

Again, their intention doesn’t matter. The action itself has a nature. We don’t need to denigrate the intentions of well-intentioned OBs, in order to defend Catholic teaching.

Desire - no. Intent - yes. These are intelligent, knowledgeable and caring people who know what they are doing it. There is no denigration whatsoever in recognizing this.

 

[LeafByNiggle]

We can only know what the doctor claims to be his intention. If the chance of saving the child is Zero, we can infer with great confidence his true intention.

The intention in removing the tube is not in doubt or debate.

How am I to reconcile the two statements you just made? In your first statement you implied that if the chance of saving the child is Zero, the true intention of the doctor is to kill the child. But in your second statement you acknowledge that removing the tube with the baby inside is licit, even though the chance of saving the child is also Zero.

 

[Rau]

How am I to reconcile the two statements you just made? In your first statement you implied that if the chance of saving the child is Zero, the true intention of the doctor is to kill the child. But in your second statement you acknowledge that removing the tube with the baby inside is licit, even though the chance of saving the child is also Zero.

Removing the tube does not intend harm to the child. It is a side effect.

Setting out to remove the child when it is known that there is no such process that has a non zero success rate is identical to intending to kill the child. The child is being attacked.

 

[Prodigal_Son]

Desire - no. Intent - yes. These are intelligent, knowledgeable and caring people who know what they are doing it. There is no denigration whatsoever in recognizing this.

One can possess a desire to X without possessing an intent to X. One cannot possess an intent to X without possessing a desire to X.

They know that they are killing a person, yes. But they don’t intend to end the person’s life – after all, they don’t desire to end the person’s life. They intend to do something else entirely – save another person’s life. The ethical problem is NOT that they have a bad intention. It’s that the undesirable and unintended action of killing is the means by which they accomplish the noble end of saving a life.

As the Catholic Encyclopedia says, a condition of Double Effect is that “the good effect must be produced directly by the action, not by the bad effect.”

 

[Rau]

One can possess a desire to X without possessing an intent to X. One cannot possess an intent to X without possessing a desire to X.

They know that they are killing a person, yes. But they don’t intend to end the person’s life – after all, they don’t desire to end the person’s life. They intend to do something else entirely – save another person’s life. The ethical problem is NOT that they have a bad intention. It’s that the undesirable and unintended action of killing is the means by which they accomplish the noble end of saving a life.

As the Catholic Encyclopedia says, a condition of Double Effect is that “the good effect must be produced directly by the action, not by the bad effect.”

While I don’t disagree with you, there seems little to gain from the lingual gymnastics. The medical treatment aims to serve the mother, no doubt about that. But once the means has been decided, the near term intention switches to whatever the procedure dictates. The surgeon removing a tube clearly has no intent to kill a baby, rather to remove a tube before it ruptures. A doctor administering a drug to kill a baby will ensure the intended result of that treatment. Ultimately, the intention is to look after the mother.

I appreciate the subtle distinction you are making; I just don’t think it adds a lot in the debate about what is licit or not licit, and why.

 

[LeafByNiggle]

Removing the tube does not intend harm to the child. It is a side effect.

Setting out to remove the child when it is known that there is no such process that has a non zero success rate is identical to intending to kill the child. The child is being attacked.

I don’t see the distinction. Removing the child also does not intend to harm the child. It is a side effect. And setting out to remove the tube with the child inside when it is known that there is no such process to take care care of the child inside the tube is also identical to intending the kill the child. The child is being attacked just the same. The fact that the child is covered by a tube that has no protective value seems irrelevant.

 

[Prodigal_Son]

I don’t see the distinction. Removing the child also does not intend to harm the child. It is a side effect. And setting out to remove the tube with the child inside when it is known that there is no such process to take care care of the child inside the tube is also identical to intending the kill the child. The child is being attacked just the same. The fact that the child is covered by a tube that has no protective value seems irrelevant.

Actions only can be intentional under a certain description. (See G.E.M. Anscombe, “Intention”). The doctor does not intend that the child’s life will end, since the doctor does not desire that the child’s life will end. The doctor does intend to save the mother’s life.

One description of the action is “ending the life of a child”. Under this description, the action is unintentional. (If it is wrong, this wrongness has nothing to do with intention, only with the objective nature of the action).

Another description of the action is “saving the mother’s life”. Under this description, the action is intentional.

For all actions that one takes of one’s own free will, there is at least ONE description under which the action is intentional. But there may be many more descriptions, some of which will not be intended. When I spank my child, my intention is to help my child grow in discipline, not for my child to experience pain.

 

[LeafByNiggle]

Actions only can be intentional under a certain description. (See G.E.M. Anscombe, “Intention”). The doctor does not intend that the child’s life will end, since the doctor does not desire that the child’s life will end. The doctor does intend to save the mother’s life.

One description of the action is “ending the life of a child”. Under this description, the action is unintentional. (If it is wrong, this wrongness has nothing to do with intention, only with the objective nature of the action)…

So is the “objective nature of the action” any different between the two actions:

1. Removing the embryo.
2. Removing the embryo with a tube wrapped around him.

They seem the same to me, both in intention and in the objective nature of the action.

 

[Rau]

I don’t see the distinction. Removing the child also does not intend to harm the child. It is a side effect. And setting out to remove the tube with the child inside when it is known that there is no such process to take care care of the child inside the tube is also identical to intending the kill the child. The child is being attacked just the same. The fact that the child is covered by a tube that has no protective value seems irrelevant.

I don’t know how to make it clearer for you. I suspect you are focussing on the result for the child, rather than what is done. The moral difference lies in what is done, not the fact that the child will die either way.

The only immediate purpose in delivering an injection to a woman with ectopic pregnancy is to bring about the demise of the child. That act is immoral because it attacks the child - it aims to cause its demise.

Removing the tube targets the tube for it will soon rupture and that must be prevented to save the mother. Harm to the child is incidental and cannot be avoided.