Scratching my head over the issue with methotrexate use in ectopic pregnancy

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Benjinho said:
My problem with this point for indirectness is that it argues for a difference by re-defining the fetus. It defines the fetus as a pathology in the Fallopian tube to justify his/her removal with the tube, whereas the fetus is correctly defined as human life when methotrexate is used. The fetus is a human life in either case.
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It does not redefine the
unborn child. It calls the fallopian tube pathological, not the embryo.

However, your comment indicates something important: It is debatable to what extent this distinction (pathological fallopian tube/ non-pathological embryo) is a genuine or disingenuous distinction.

“Child” is an entity. It is predicated of the embryo.

“Pregnancy” is a condition. It is predicated of the mother

Suppose we say the pregnancy has become pathological.

(The term “pregnancy”, unlike “child”, includes for example, the placenta.)
 
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Ana_v said:
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Benjinho:
My problem with this point for indirectness is that it argues for a difference by re-defining the fetus. It defines the fetus as a pathology in the Fallopian tube to justify his/her removal with the tube, whereas the fetus is correctly defined as human life when methotrexate is used. The fetus is a human life in either case.
Click to expand...
It does not redefine the
unborn child. It calls the fallopian tube pathological, not the embryo.

However, your comment indicates something important: It is debatable extent distinction (pathological fallopian tube/ non-pathological embryo) is a genuine or disingenuous distinction.

“Child” is an entity. It is predicated of the embryo.

“Pregnancy” is a condition. It is predicated of the mother

Suppose we say the pregnancy has become pathological.

(The term “pregnancy”, unlike “child”, includes for example, the placenta.)
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It does redefine the child because the child is the pathology of the pathological tube. How do we know this? Because you wouldn’t be calling the tube pathological and in need of removal unless the otherwise normal child was implanted in it, plain and simple.
 
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Benjinho said:
It does redefine the child because the child is the pathology of the pathological tube. How do we know this? Because you wouldn’t be calling the tube pathological and in need of removal unless the otherwise normal child was implanted in it, plain and simple.
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I understand what you’re saying, but I disagree that they are redefining “child” (in and of itself).

The compromise between what you are saying, and what they are saying,
is that the embryo (which in-itself is non pathological) has caused a pathogogical condition in the fallopian tube.
 
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Ana_v said:
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Benjinho:
It does redefine the child because the child is the pathology of the pathological tube. How do we know this? Because you wouldn’t be calling the tube pathological and in need of removal unless the otherwise normal child was implanted in it, plain and simple.
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I understand what you’re saying, but I disagree that they are redefining “child” (in and of itself).

The compromise between what you are saying, and what they are saying,
is that the embryo (which in-itself is non pathological) has caused a pathogogical condition in the fallopian tube.
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Yes. Although just a pathology of baby by him or herself is not a reason to kill him or her, though I’m sure you agree with that.
 
Benjinho said:
Yes. Although just a pathology of baby by him or herself is not a reason to kill him or her, though I’m sure you agree with that.
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This is precisely where the bioethical question lies:

How do you target a pathological pregnancy in order to “treat” or “terminate” it without targeting the child, if the child and the pregnancy are intrinsically intertwined?

I am morally certain the child should not be intentionally killed. I am unsure about the way “direct” and “indirect” killing are being applied to the termination of pregnancy in the methotrexate debate.

Consider this, for the sake of comparison:

Do Catholic bioethicists regard the removal of the fallopian tube in the case of ectopic pregnancy to be an attempt at sterilization / reduced fertility?

If the answer is “no, because compromised fertility is an unintended effect” then I say in response:

Ah, so in that case, even though the mechanics of the procedure quite clearly targets the fertility of the woman, it is nevertheless regarded as “indirect” because of the intention.

So, it only returns me to the question of, why is it immoral to remove the embryo (“scoop it out”) in order to save the mother and her fallopian tube, provided you do not intend the embryo to die? It just happens that, given its stage of development, removal is concomitant with loss of life.
 
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While in the fallopian tube I wonder if we can even call it a fetus. It is a fertilized egg or Zygote, also called a blastocyst. Certainly not a baby or child or even human person yet. That is not to say that we do not respect its right to thrive. But we can still acknowledge it as pathology if implanted int eh wrong place. And it seems to me that the intent is always to relieve the pathology even if directly removing the blastocyst. But yes, the Catholic position demand salpingectomy, removal of that portion of the Fallopian tube rather than methotrexate or salpingostomy.
 
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Ana_v said:
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Benjinho:
Yes. Although just a pathology of baby by him or herself is not a reason to kill him or her, though I’m sure you agree with that.
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This is precisely where the bioethical question lies:

How do you target a pathological pregnancy in order to “treat” or “terminate” it without targeting the child, if the child and the pregnancy are intrinsically intertwined?

I am morally certain the child should not be intentionally killed. I am unsure about the way “direct” and “indirect” killing are being applied to the termination of pregnancy in the methotrexate debate.

Consider this, for the sake of comparison:

Do Catholic bioethicists regard the removal of the fallopian tube in the case of ectopic pregnancy to be an attempt at sterilization / reduced fertility?

If the answer is “no, because compromised fertility is an unintended effect” then I say in response:

Ah, so in that case, even though the mechanics of the procedure quite clearly targets the fertility of the woman, it is nevertheless regarded as “indirect” because of the intention.

So, it only returns me to the question of, why is it immoral to remove the embryo (“scoop it out”) in order to save the mother and her fallopian tube, provided you do not intend the embryo to die? It just happens that, given its stage of development, removal is concomitant with loss of life.
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Given that there is nothing available that can sustain or save the embryo after removal, I see no difference between this and a direct attack on the embryo’s body. Maybe if there’s something actively wrong with the Fallopian tube, like hemorrhaging, but definitely not without that condition.
 
Benjinho said:
Given that there is nothing available that can sustain or save the embryo after removal, I see no difference between this and a direct attack on the embryo’s body.
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Three questions:
  1. Why does it matter whether or not there exists a way of preserving the embryo outside the womb? Why does this decide whether or not removal is licit? We remove people from life-support regardless of whether there are any other alternatives to keeping the person alive (something other than a ventilator).
  2. Is the act of embryo-removal (in and of itself) an act of killing in cases where presence is endangering the mother?
  3. Does the term “direct abortion” refer to an act which is embryocidal by intention AND mechanism?
Or

Does the term “direct abortion” refer to an act which is embryocidal merely by intention (e.g. suffocating the mother with a pillow so that both die)?

OR

Does it refer to an act which is embryocidal merely by mechanism?

It’s entirely conceivable to me to imagine removing an embryo, foreseeing its death, but wishing that it could live, and having the willingness to preserve it if there was a way. But the fact that there isn’t a way is outside of your control.
 
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Ana_v said:
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Benjinho:
Given that there is nothing available that can sustain or save the embryo after removal, I see no difference between this and a direct attack on the embryo’s body.
Click to expand...
Three questions:
  1. Why does it matter whether or not there exists a way of preserving the embryo outside the womb? Why does this decide whether or not removal is licit? We remove people from life-support regardless of whether there are any other alternatives to keeping the person alive (something other than a ventilator).
  2. Is the act of embryo-removal (in and of itself) an act of killing in cases where presence is endangering the mother?
  3. Does the term “direct abortion” refer to an act which is embryocidal by intention AND mechanism?
Or

Does the term “direct abortion” refer to an act which is embryocidal merely by intention (e.g. suffocating the mother with a pillow so that both die)?

OR

Does it refer to an act which is embryocidal merely by mechanism?

It’s entirely conceivable to me to imagine removing an embryo, foreseeing its death, but wishing that it could live, and having the willingness to preserve it if there was a way. But the fact that there isn’t a way is outside of your control.
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  1. Because knowledge that the embryo will definitely die when cutting off his/her life support means the intention is to kill him/her. The “actual intention” in methotrexate is also saving the mother, but is also killing the embryo.
  2. Yep, no different than methotrexate because his/her presence is threatening the mother in both cases.
  3. Frankly, I think “direct and indirect” in this case are meaningless terms made by pedantic bioethicists.
Intention is inseparable from mechanism. There are also plenty of moms who take methotrexate but would rather have their wrongly placed baby live.
 
Ana_v said:
So, it only returns me to the question of, why is it immoral to remove the embryo (“scoop it out”) in order to save the mother and her fallopian tube, provided you do not intend the embryo to die? It just happens that, given its stage of development, removal is concomitant with loss of life.
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That one is much less clear than methotrexate to me.
 
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Benjinho said:
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Ana_v:
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Benjinho:
My problem with this point for indirectness is that it argues for a difference by re-defining the fetus. It defines the fetus as a pathology in the Fallopian tube to justify his/her removal with the tube, whereas the fetus is correctly defined as human life when methotrexate is used. The fetus is a human life in either case.
Click to expand...
It does not redefine the
unborn child. It calls the fallopian tube pathological, not the embryo.

However, your comment indicates something important: It is debatable extent distinction (pathological fallopian tube/ non-pathological embryo) is a genuine or disingenuous distinction.

“Child” is an entity. It is predicated of the embryo.

“Pregnancy” is a condition. It is predicated of the mother

Suppose we say the pregnancy has become pathological.

(The term “pregnancy”, unlike “child”, includes for example, the placenta.)
Click to expand...
It does redefine the child because the child is the pathology of the pathological tube. How do we know this? Because you wouldn’t be calling the tube pathological and in need of removal unless the otherwise normal child was implanted in it, plain and simple.
Click to expand...
The child is NOT the pathology in and of itself - if there were a way (and please God we come up with one soon) to remove the child from the tube in a way that keeps the child viable and healthy, we would jump at it. Unlike, say, removing a tumour or cyst from the same tube.

We don’t call a child suffering from distress in the womb a “pathology” - even if the mother is also having medical problems alongside the child. Quite the contrary, we would say the child itself is the one suffering from the pathological condition, along with the mother. Sometimes the only remedy in such cases is to remove the child from the womb. In many cases it can be done in a way that the child survives, sometimes not. In most cases it can be done in a way that leaves the mother’s reproductive system intact, sometimes not.
 
Sometimes ectopic pregnancies are misdiagnosed, and methotrexate could harm a viable embryo.
 
Elf01 said:
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jlc2k2:
How is it different than methotrexate?
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Simply I do see methotrexate as directly attacking the child.

Removing the child to save the mother is less obvious.
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It isn’t really because killing the child is still the intention. This is like saying an induced birth abortion isn’t an attack on the child because the child “dies as a consequence of removal.”
 
Does it help to see it this way?

Sometimes women get uterine cancer while pregnant. Sometimes the legitimate treatment is to remove the uterus.

The hysterectomy is removing a diseased uterus, the unborn child unfortunately dies due to the procedure.

That’s what happens with an ectopic. The Fallopian tube is diseased, and removing it causes the unborn child to die.

There is evidence that the Fallopian tube in ectopic pregnancy might have had issues to begin with, scar tissue, adhesions etc. These defects are often undiagnosed until a problem occurs.
 
Person in this context is a created individual human being after the moment of conception. Yes, every frozen IVF is a person. My grandmother who died in the 70’s is a person.

The word “person” also applies to the Three Persons of the Trinity, but, I do not think this is that sort of theological discussion.
 
F_Marturana said:
Does it help to see it this way?

Sometimes women get uterine cancer while pregnant. Sometimes the legitimate treatment is to remove the uterus.

The hysterectomy is removing a diseased uterus, the unborn child unfortunately dies due to the procedure.

That’s what happens with an ectopic. The Fallopian tube is diseased, and removing it causes the unborn child to die.

There is evidence that the Fallopian tube in ectopic pregnancy might have had issues to begin with, scar tissue, adhesions etc. These defects are often undiagnosed until a problem occurs.
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I’ve heard this point many times and also explained why it is flawed. To see why it’s flawed, ask yourself, why is the Fallopian tube diseased? Is it because it has scar tissue in it? Is it because there is active disease that isn’t an embryo?
No. The only reason it’s being removed is because the embryo is in it. It wouldn’t be removed outside of an ectopic pregnancy. Simple.

Catholics who face cognitive dissonance when faced with this moral dilemma try to pretend they’re just removing a body part, and are in denial of the fact that it’s just another abortion. Trying to differentiate a “direct vs indirect” is completely meaningless.
 
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