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

[F_Marturana]

Well no. The ectopic could be the symptom of a diseased Fallopian tube. Not the cause.

 

[Benjinho]

No. An ectopic pregnancy is not a symptom. The disease is the ectopic pregnancy, not the Fallopian tube itself, which may or may not have been itself diseased prior to the ectopic.

 

[TheLittleLady]

I’ve known exactly one person who had their ectopic pregnancy diagnosed before the tube ruptured. That is because they were trying for pregnancy, had a medical condition and were monitoring the early pregnancy with blood draws every couple of days.

For most people, there is severe pain that diagnoses the ectopic. That is because the tube is rupturing. The tupe IS the pathology at that point.

 

[Benjinho]

In that case, there is secondary pathology that would justify its removal separately from the embryo’s presence. I’m talking about the case where there isn’t such pathology though.

 

[Shakuhachi]

Ok, I agree because then to be consistent even an individuals in PVS or any other condition that renders them incapable of the the faculties and functions of human cognition are still persons. The defining characteristic is individuality (as evidenced by DNA) not “personality” or higher mental functions.

 

[Shakuhachi]

Trying to differentiate a “direct vs indirect” is completely meaningless.

Not meaningless, it refers to intention.

 

[edward_george1]

Full disclosure: I have an advanced degree in Bioethics, so this is kind of my field.

In cases of ectopic pregnancy, if the embryo is still alive, then it would seem that the only licit treatment is a salpingectomy, that is, the removal of the Fallopian tube. This is morally licit via the principle of double effect: the unintended, yet foreseen, consequence of removing a pathological Fallopian tube is the death of the embryo. In cases of a woman with a gravid uterus during pregnancy, this is also the reasoning employed.

HOWEVER, in the majority of cases of ectopic pregnancy, something like 93% (which, if you’ve ever taken a statistics class, you know what a staggering percentage that really is), the embryo has already died by the time the ectopic pregnancy is detected. Cell growth continues in the trophoblast, which is the forerunner to the placenta, and this is what causes the ectopic pregnancy to continue to burrow into the Fallopian tube. If this is what has occurred, an abortion is impossible, as what you have is no longer a living human being, and you are acting to rather remove this rapidly growing tissue. In this case, methotrexate is perfectly morally licit.

Dr. Christopher Kaczor has an excellent paper on it, which may be read here.

-Fr ACEGC

 

[Shakuhachi]

HOWEVER, in the majority of cases of ectopic pregnancy, something like 93% (which, if you’ve ever taken a statistics class, you know what a staggering percentage that really is), the embryo has already died by the time the ectopic pregnancy is detected

Can that be determined in time to provide the less invasive methotrexate?

 

[Benjinho]

Full disclosure: I have an advanced degree in Bioethics, so this is kind of my field.

In cases of ectopic pregnancy, if the embryo is still alive, then it would seem that the only licit treatment is a salpingectomy, that is, the removal of the Fallopian tube. This is morally licit via the principle of double effect: the unintended, yet foreseen, consequence of removing a pathological Fallopian tube is the death of the embryo. In cases of a woman with a gravid uterus during pregnancy, this is also the reasoning employed.

HOWEVER, in the majority of cases of ectopic pregnancy, something like 93% (which, if you’ve ever taken a statistics class, you know what a staggering percentage that really is), the embryo has already died by the time the ectopic pregnancy is detected. Cell growth continues in the trophoblast, which is the forerunner to the placenta, and this is what causes the ectopic pregnancy to continue to burrow into the Fallopian tube. If this is what has occurred, an abortion is impossible, as what you have is no longer a living human being, and you are acting to rather remove this rapidly growing tissue. In this case, methotrexate is perfectly morally licit.

Dr. Christopher Kaczor has an excellent paper on it, which may be read here.

-Fr ACEGC

Thank you for your response. In this scenario, if an ectopic pregnancy were detected and it could not be determined whether the baby was still alive, would it be licit to use methotrexate assuming that the baby is most likely already dead?

 

[Elf01]

Thank you for your response. In this scenario, if an ectopic pregnancy were detected and it could not be determined whether the baby was still alive, would it be licit to use methotrexate assuming that the baby is most likely already dead?

My thought would be only if you were sure the baby is dead.

 

[0Scarlett_nidiyilii]

While in the fallopian tube I wonder if we can even call it a fetus

The answer is no, it’s not a fetus.
Fetus is a medical term.
But it’s still a human being.

 

[TheLittleLady]

If this is what has occurred, an abortion is impossible, as what you have is no longer a living human being, and you are acting to rather remove this rapidly growing tissue. In this case, methotrexate is perfectly morally licit.

Answered in Father’s post.

 

[EnglishTeacher]

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.

I don’t see why this would be considered immoral, either. My thought, though, is perhaps it is not physically possible to do so with the technology we currently have.

 

[Mtatum1958]

Dr. Christopher Kaczor has an excellent paper on it, which may be read

Thank you for the excellent summary and link to the paper.

 

[Benjinho]

Full disclosure: I have an advanced degree in Bioethics, so this is kind of my field.

In cases of ectopic pregnancy, if the embryo is still alive, then it would seem that the only licit treatment is a salpingectomy, that is, the removal of the Fallopian tube. This is morally licit via the principle of double effect: the unintended, yet foreseen, consequence of removing a pathological Fallopian tube is the death of the embryo. In cases of a woman with a gravid uterus during pregnancy, this is also the reasoning employed.

HOWEVER, in the majority of cases of ectopic pregnancy, something like 93% (which, if you’ve ever taken a statistics class, you know what a staggering percentage that really is), the embryo has already died by the time the ectopic pregnancy is detected. Cell growth continues in the trophoblast, which is the forerunner to the placenta, and this is what causes the ectopic pregnancy to continue to burrow into the Fallopian tube. If this is what has occurred, an abortion is impossible, as what you have is no longer a living human being, and you are acting to rather remove this rapidly growing tissue. In this case, methotrexate is perfectly morally licit.

Dr. Christopher Kaczor has an excellent paper on it, which may be read here.

-Fr ACEGC

Father,

I understand that you have an advanced degree in Bioethics, but the point you made in the first paragraph isn’t different from other articles I’ve read.

Why is the Fallopian tube considered pathological?

 

[edward_george1]

Because the Fallopian tube isn’t where an embryo is supposed to implant. The uterus is. When an embryo implants in the Fallopian tube, it inevitably dies, even if the trophoblast continues to grow around it, thus causing it to burrow into the tube, leading to a rupture.

 

[twoangels]

I agree with you. These arguments are from some moral theologians, but the Church has no official position on it. I think it’s an attempt to say that abortion is never medically necessary. But even when it comes to law, the removal of the Fallopean tube will be labeled as an abortion on the medical record.

I think the real question is which method is more humane? Which respects the bodily integrity of the individual? I’d still lean on probably the fallopean tube removal, but not by much. Moreover, I think this is a painful topic. I have a friend who went through this and even though she heard the argument, she still had a lot of “I had an abortion. Oh my gosh. I had an abortion.” I think it’s a sensitive subject and most women will go with their doctor’s advise. Shaming women isn’t going to help matters.

 

[Benjinho]

Then, there doesn’t need to be any disease secondary to the implantation of the embryo (inflammation, bleeding, etc.) in the Fallopian tube to consider the tube diseased? That is, just the implantation of the embryo into the tube is enough to consider the Fallopian tube pathological?