Selective reduction to save mother?

[meft22]

Hello,
I’ve recently gone back to school for nursing. In a chapter about ethics, a scenario was presented in which a mother was pregnant with triplets (in first trimester), and had a heart condition, such that the pregnancy with multiples was already straining her heart, and would be a risk to her life. The cardiologist recommended selective reduction. I’m skeptical that any of this scenario is a “certainty”, i.e. that the mother would definitely die, but I’m curious IF this were true, what would be the moral decision in this case?

I understand that selective reduction to “improve the odds” of the other babies is not morally licit, but I’m wondering what would be the morally acceptable answer in this scenario? How would this be handled? Are there cases where the pregnancy is truly a risk to the mother’s life, and what is the morally acceptable way to address it? Surely not let all 4 perish? But how to get around this? It’s not like an ectopic pregnancy, where the tube could be surgically be removed. Do a hysterectomy? That seems worse, as all 3 babies would die, whereas they might make it otherwise?

Thank you for any insight.

 

[Della]

It would not be morally acceptable to “reduce” the pregnancy by one child. Wouldn’t total bed rest be the better prescription so all 4 lives might be given the chance at life?

 

[manualman]

Torturous decision, to be sure. But let’s look at what the scenario is REALLY pushing here. Deep down, they are trying to push you towards seeing unborn children as LESS than human. Disagree? Try this:

A terrorist kidnaps you and your three children. He hands you a dagger and promises to let the rest of you go if you kill ONE of your children. If you refuse, he’ll kill you all. What do you do?

By the cold medical calculus, you should pick the weakest one and stab her to death, right? Could you do it? Not me.

 

[donna369]

its a confusing issue to me. i thought before that we preserve the mother at all cost. but i’ve only heard of this in the case of a single birth. i’ve heard more recently that we are supposed to save the child even at the cost of the mother. what do we do if it really is a case of one must die to save the other?

 

[1ke]

selective reduction

Baby killing by any other name is still baby killing. “Selective reduction” = abortion = always evil, never permissible.

IF this were true, what would be the moral decision in this case?

Then the doctor has 4 patients.

I understand that selective reduction to “improve the odds” of the other babies is not morally licit, but I’m wondering what would be the morally acceptable answer in this scenario?

Monitor carefully, place on bed rest, do everything to bring the babies to the point where they can be delivered.

Are there cases where the pregnancy is truly a risk to the mother’s life, and what is the morally acceptable way to address it?

If there is such a thing, abortion can never be the answer.

Surely not let all 4 perish?

Surely not kill one or more of them.

The doctor has 4 patients. They are all his responsibility to bring through the crisis to the best of his ability.

But how to get around this? It’s not like an ectopic pregnancy, where the tube could be surgically be removed. Do a hysterectomy? That seems worse, as all 3 babies would die, whereas they might make it otherwise?

Thank you for any insight.

A hysterectomy is not medically indicated, that would be murder.

 

[1ke]

its a confusing issue to me. i thought before that we preserve the mother at all cost. but i’ve only heard of this in the case of a single birth. i’ve heard more recently that we are supposed to save the child even at the cost of the mother. what do we do if it really is a case of one must die to save the other?

Both/all are patients. You do your best to save them all.

 

[Lapey]

its a confusing issue to me. i thought before that we preserve the mother at all cost. but I’ve only heard of this in the case of a single birth. I’ve heard more recently that we are supposed to save the child even at the cost of the mother. what do we do if it really is a case of one must die to save the other?

It is not confusing if we stay inside of Church teachings. Direct abortion, which this would be, is intrinsically evil. That is it, case closed. There are no options to terminate pregnancy, even to save the mother’s life.

Now, on the other hand, if you care more about what society or secular law dictates, then it is lawful and withing the rights of those involved to take this action; however, there is no way to do this without committing grave sin.

 

[Stillsosola]

Nope as far as I know the baby cannot be sacrificed to save the mother

 

[Corki]

Hello,
I’ve recently gone back to school for nursing. In a chapter about ethics, a scenario was presented in which a mother was pregnant with triplets (in first trimester), and had a heart condition, such that the pregnancy with multiples was already straining her heart, and would be a risk to her life. The cardiologist recommended selective reduction. I’m skeptical that any of this scenario is a “certainty”, i.e. that the mother would definitely die, but I’m curious IF this were true, what would be the moral decision in this case?

I understand that selective reduction to “improve the odds” of the other babies is not morally licit, but I’m wondering what would be the morally acceptable answer in this scenario? How would this be handled? Are there cases where the pregnancy is truly a risk to the mother’s life, and what is the morally acceptable way to address it? Surely not let all 4 perish? But how to get around this? It’s not like an ectopic pregnancy, where the tube could be surgically be removed. Do a hysterectomy? That seems worse, as all 3 babies would die, whereas they might make it otherwise?

Thank you for any insight.

Why is this scenario in a nursing textbook? Nurses do not perform “selective reductions”.

It sounds like an attempt to desensitize vulnerable students using a far-fetched hypothetical example.

 

[RoseMary131]

MEFT, blessings upon you as you study nursing. May God continue to direct you towards what is good and holy even among classes which may suggest otherwise. May God lead you in your studies of nursing and in helping patients.

Look at the name change from surgical abortion to selective reduction. The medical field changes definition and words - to make a “more accepted statement.”

One has the sound of killing innocent babies within the womb of her dear mother. The other could sound like reducing in number any thing. Baby is left dead without regard to the “name” of the procedure. Mother hurts for a lifetime for the child she allowed killed by the abortionist.

When Mother looks at her surviving babies, she remembers the child she selected to die. When sister and brother hear they were allowed to live while littlest sister was killed for them - they suffer.

Nurses for Life might be a good organization to join. They may be able to help guide you every time you come across something that is distrurbing in your classes.
nursesforlife.org/

Understanding the effects of abortion on the life of Mother is very important.

Below are links to consider when hearing “selective reduction” or other class teachings on abortion.

Project Rachel :Hope after Abortion hopeafterabortion.com/

Post Abortion Walk postabortionwalk.blogspot.com/

Rachel’s Vineyard rachelsvineyard.org/

Silent No More silentnomoreawareness.org/

October Baby youtube.com/watch?v=I_9l7lEe-AA

Healing - October Baby pattimaguirearmstrong.com/2012/04/healing-through-october-baby.html

Surrendering the Secret surrenderingthesecret.com/

National Helpline for Abortion Recovery nationalhelpline.org/

 

[meft22]

I appreciate all the helpful replies. One poster asked why this was in a textbook. It had to do with how to support someone as a nurse, even if we don’t agree with what procedure they are having done. It was on a chapter on “ethics.” In the scenario, the Catholic nurse decided it was okay to hold the mother’s hand, even though she disagreed with the procedure. Personally, I don’t think I could even do that. I wouldn’t want to be in the room. I feel like just being in the room would make me complicit. Not sure if that’s church teaching, but that’s how I feel about it at the moment. All the material I have read so far is from such an anti-life perspective, it makes me wonder how it’s possible to even be a nurse (or doctor, or tech) when the establishment is not pro-life at all.

I do appreciate the analogy of the terrorist. I would hope I would do the right thing if I were in such a scenario, and this does help a lot.

However, one point I could use clarification on… how is a hysterectomy different from removing a tube in an ectopic pregnancy? The tube is removed to prevent rupture, correct? Because the rupture would kill the mother? The death of the baby is double effect. Would this not be the same thing? Is the only difference that the uterus isn’t actually “damaged.” Just trying to get a handle on this argument, should it come up again. I do hope to work in L&D, so, unfortunately, it very well could.

 

[Lapey]

However, one point I could use clarification on… how is a hysterectomy different from removing a tube in an ectopic pregnancy? The tube is removed to prevent rupture, correct? Because the rupture would kill the mother? The death of the baby is double effect. Would this not be the same thing? Is the only difference that the uterus isn’t actually “damaged.” Just trying to get a handle on this argument, should it come up again. I do hope to work in L&D, so, unfortunately, it very well could.

This is exactly correct. The tube is in a state of “disease”. Without removing the diseased part it will kill the mother. The uterus is working exactly how it is supposed to work, just with triplets in the scenario you mention. The only problem to the mother is the three growing fetuses. So a perfectly normal uterus would be removed to eliminate the problem, the babies. This is direct abortion by an indirect method and is against Church teaching.

 

[meft22]

Thank you, that helps. And I will check out the links, esp. nurses for life.

 

[RoseMary131]

You might find encouragement from St. Gianna Beretta Molla, mother and physician.

This page is on the medical circumstances of St. Gianna’s last pregnancy.
saintgianna.org/medicalcircum.htm

saintgianna.org/giaemmanual.htm
On Good Friday, April 20, 1962, Gianna went to the Monza Maternity Hospital to deliver her fourth child. A few days before the child was due, although trusting as always in Providence, she was ready to give her life in order to save that of her child: “If you must decide between me and the child, do not hesitate: choose the child–I insist on it. Save the baby.” On the morning of 21 April 1962 Gianna Emanuela was born.

St. Gianna Beretta Molla ~ Pray for us.

 

[1ke]

I appreciate all the helpful replies. One poster asked why this was in a textbook. It had to do with how to support someone as a nurse, even if we don’t agree with what procedure they are having done. It was on a chapter on “ethics.”

i suggest you contact the National Catholic Bioethics Center for a Catholic answer. I also suggest that if you are going into the health care field you know your rights in your state and join an organization that can help you such as the Catholic Medical Association and the National Association for Pro Life Nurses.

However, one point I could use clarification on… how is a hysterectomy different from removing a tube in an ectopic pregnancy? The tube is removed to prevent rupture, correct? Because the rupture would kill the mother? The death of the baby is double effect. Would this not be the same thing? Is the only difference that the uterus isn’t actually “damaged.”

No it is not the same thing. If the uterus were actually damaged and the medical problem itself, then yes it could be removed-- i.e. for example cancer of the uterus, uterine rupture, etc. But that is not the case here. Removing the healthy uterus is simply another means of aborting the children for a totally unrelated issue-- heart condition.

 

[RoseMary131]

It was on a chapter on “ethics.” In the scenario, the Catholic nurse decided it was okay to hold the mother’s hand, even though she disagreed with the procedure. Personally, I don’t think I could even do that. I wouldn’t want to be in the room. I feel like just being in the room would make me complicit.

Its good that you can see the teachings of “ethics” in this text book does not really teach the true teachings of the Catholic Church.

It shows a lot - in that the text book is trying to show Catholic nurses, or other Pro-Life People, how to “believe”. When in reality, the text book is teaching a falsehood.

Followers of Christ and Pro-Life People do not want to participate in any way with the culture of death, with abortion, with selective reduction of killing babies in the womb.

Using the “Catholic nurse” to “show compassion” to the patient while undergoing the evils of abortion is “pulling on the heart strings of Christians” to walk them past their own conscience. Shame on the authors of this textbook for “manipulating” nursing students.

As Catholics, we want to share the Truth about Life - sharing the truth about abortion. For women who have aborted their babies, we offer help in forms of Post Abortion Healing. We do not participate in the abortion - not even by being made the “compassionate hand-holder” during the abortion or abortion prep.

(Evil hides in many places - including textbooks.)

 

[weller2]

Torturous decision, to be sure. But let’s look at what the scenario is REALLY pushing here. Deep down, they are trying to push you towards seeing unborn children as LESS than human. Disagree? Try this:

A terrorist kidnaps you and your three children. He hands you a dagger and promises to let the rest of you go if you kill ONE of your children. If you refuse, he’ll kill you all. What do you do?

By the cold medical calculus, you should pick the weakest one and stab her to death, right? Could you do it? Not me.

This is a faulty analogy, because you have no guarantee that the terrorist will obey his promise. Indeed, you are going to subconciously assume that he will not (you don’t trust him, why would you?).

 

[Corki]

This is a faulty analogy, because you have no guarantee that the terrorist will obey his promise. Indeed, you are going to subconciously assume that he will not (you don’t trust him, why would you?).

Neither do you have any guarantee that death or even harm will come to the woman or any of her unborn children. “risk” to her life is no more certain than threat from a terrorist.

 

[weller2]

This is exactly correct. The tube is in a state of “disease”.

I disagree. The tube is healthy, it just happens to have an embryo attached in a wrong place.

The idea that it’s a problem with the tube has always struck me as an obvious lawyering.

Surely not let all 4 perish?

Well, that’s the problem with Catholic morality. If saving other 3 would require you to directly kill one, then you have to let all 4 die. You have 4 dead, but you have clear conscience.

Also, remember that abortion is an excommunicable offense. Interestingly, murder is not. So paradoxically, you would be better off just killing the woman (and her children).

Unless you can somehow lawyer out of the problem by (ab)using double effect principle. Say that there is a drug which is somehow useful in treating of the mother’s condition. The drug has a known side effect of inducing miscarriage. You administer the drug for the primary purpose of treating the mother’s condition and you accept the “unavoidable and unfortunate” secondary consequence of spontaneous abortion. Said abortion will also happen to reduce stress on woman’s cardiovascular system – which is what you were after in the first place. But that was never your goal – at least that’s what you’ll tell the ethical commitee afterwards.

So, to sum up, you have 3 options:

1. Do nothing. 4 dead, but you have commited no sin in the eyes of the Catholic Church.
2. Abuse the double effect. You may succeed in saving some lifes and possibly even escape being in state of sin.
3. Perform an abortion. 3 lives saved, you are in state of sin and excommunicated. And, if it’s a Catholic hospital, you may end up being fired.

So, take your pick… and in the mean time, prey that you are never put in this situation.

 

[MJJean]

This is a faulty analogy, because you have no guarantee that the terrorist will obey his promise. Indeed, you are going to subconciously assume that he will not (you don’t trust him, why would you?).

Nope, I don’t think it is a faulty analogy. Sure, you don’t know if the terrorist will keep his word and let the mother and remaining children live. In a “selective reduction” there is the chance all fetuses will be lost. There is also the chance the mothers heart will fail anyways or that some other medical condition will rear it’s head and cause the death of mother and/or babies.

Just like you have no guarantee the terrorist will let mother and children live, you have no guarantee that medical intervention will allow the mother and children to live.