What is the church's teaching on ectopic pregnancy?

[itsjustdave1988]

mbrothersrn:

I would like to know what the churches teaching is on ectopic pregnancy? Since the embryo can’t develop completely in the Fallopean tube is it permissable to remove that tube to save the mother’s life?

Catholics United for Faith provides an article which covers this quite well. See here… Ectopic for Discussion: A Catholic Approach to Tubal Pregnancies

 

[Corki]

Lorarose:

I
The tube was normal before the embryo implanted - the tube is normal after the embryo is removed.
It is a normal tube.
It is temporarily declared diseased because of the presence of the embryo - which still makes the embryo the direct target of the procedure.

And is there a way to treat it without mutilating the tube and rendering the woman infertile?

I think the problem is that you don’t fully understand the “medicine” behind ectopic pregnancies or the treatments. First, the tube is not diseased because of the presence of the embryo. The presence of the embryo triggers another disease, usually a rupture or infection of the fallopian tube. This is the condidtion that causes the symptoms that usually bring a woman in for treatment. The tube is removed. It is not “normal” afterward - it is gone entirely. The reason that some women go on to have normal pregnancies afterward is that the embryo can no longer travel through the “abnormal” tube (it is gone). He/she has to go through the other tube which is in better shape.

There is a treatment that removes just the embryo and leaves the tube . This is direct abortion and not licit.

 

[itsjustdave1988]

Lorarose:

Maybe I missed it, but I have not seen Rome tackle this issue head on.

The Church affirms the principle of double effect within *Humanae Vitae, *which the US Catholic Bishops have applied more specifically to ectopic pregnancies:

Paul VI:

the Church does not consider at all illicit the use of those therapeutic means necessary to cure bodily diseases, even if a foreseeable impediment to procreation should result there from—provided such impediment is not directly intended for any motive whatsoever. (Humanae Vitae, 15)

 

[WorBlux]

Perhaps we need to first define abortion.

Abort: to stop or cease a course of action before it is completed.

In this case the course of action is the nine months of pregnancy

I propose for the porpose of this thread that abortion shall be defined as any termination of any pregnancy by any method or reason before live birth is given.

Now to narrow the definition to abortion that is morally wrong. Abortion is a sin when the mother takes deliberate and willfull action to terminate a pregnancy in order to deny the embryo the chance to develop and be born into this world or employes another to do the same.

There is also a last consideration of the mothers health. It is morally acceptable to abort when the health of the mother is in danger. The reason being is that the life of the mother is certain, while that to the embryo is uncertain.

The church deals in actualities, not in potentalities. If the mother dies, the embryo will certainly die with her.

Now in the case of the ectopic pregnancy, the embyro has no chance to survive, and the mother’s health is in danger. The answer here is clear… abortion in this case is morally acceptable. by any means… chemical, surgical, or the natural course.

It’s funny the emotional attatchments to the word “abortion” many on this site have. It’s a word,and yes it can describe an immoral act, but this is not always the case

English lesson aside, now for a Science lesson. When the fertilized egg (name removed by moderator)lanted into tissue, it groes into the tissue that is implants on, and from this growth, the placenta forms. Once the blastula grows into the tissue around it any attempt to move it will destroy the tissue that connects the embryo to it’s lifeline i.e. the mothere. Tranplantaion after implantaion is not an option

 

[Lorarose]

I think this site has very basic information that coincides with what I have learned from my ob/gyn and friends of mine who have experienced this condition.

ehealthmd.com/library/ectopicpreg/EP_causes.html

So…in response to this statement…

The tube is removed. It is not “normal” afterward - it is gone entirely

I have to say…the tube is not always damaged beyond repair. Often it is…often it is not.
So it is not true that that tube -medically speaking- HAS to be removed because it is too damaged.
What I am reading here is that the tube is removed because it is the only acceptable treatment according to the Church.
That dissolving the embryo is unacceptable - and removing the embryo alone is unacceptable. This is considered to be abortion.

What I am reading is that - even if the tube is not damaged beyond repair - it is not considered to be abortion to remove the section of tube containing the embryo -even though the process kills the embryo, and even though it is not always medically necessary to destroy the tube.
Is this correct?

I’m sorry everyone - I really am - I’m not trying to upset all of you, but I still see this as splitting hairs and redefining one procedure to make it not sound like an abortion, when it is.

In fact, I have been working towards a certificate in bioethics and this is the first time I have seen this issue challenged.

I’m sorry Daniel - I guess I just have a knack for irritating people.

What moral teachings of the entire college of American Bishops speaking with one voice have ever been superseded by Rome? I have never heard of that occurring.

You’ve heard of Always Our Children?

Can you find any theologian (at this point I would take anyone, even a non-Catholic source) that concurs with your opinion? I gave you 263 bishops and the National Catholic Bioethics Center’s staff who concur with mine.

I didn’t realize this was a game of one-upmanship.
These are my own questions formed in my own little brain.
I have come across other catholics who have wondered the same things I am wondering for the same reasons.
I cannot remember if any of them are theologians.

The Bishops did not say that disease of the tube had to be proven.They said presumed to be damaged, different standard totally.

Why are they presumed to be damaged when it is possible they are not? That is where I begin to suspect we are only playing word games here.

I have never seen or heard of a totally normal ectopically pregnant tube removal reported in a pathology report. Visually at surgery, the surgeon can see with the naked eye the dysfunctional tube. There is always dysfunction in the tube reported grossly and microscopically. But then again, these are American pathologists, not Roman, so the final word is still not in yet.

As the link I provided stated…the damage varies. Sometimes it is minimal enough that the tube can be repaired.
Your condescending attitude is duly noted…thanks.

If they fail in this critical function and risk the life of the mother, they are presumed to be already to be so damaged and dangerously affected as to warrant their removal

Presumed by whom I wonder?
There are women who are treated for damaged tubes without having them removed. Blockages are removed without removing the tube.
It is not true that removing tubes is the only solution to treating them.

The removal of a presumed to be damaged tube with an embryo in it is a moral act with an foreseen, unintended and sadly unfortunate result under existing Catholic teaching. It is considered to be a moral application of the principal of the double effect.

You are losing me at “presumed to be damaged tube”
For all the reasons I’ve already stated.

I think the case of ectopic pregnancy is a one of kind case.
In both procedures the embryo must be removed, and in both procedures the embryo is directly killed from the procedure.

I can see how - if the tube is indeed damaged beyond repair - one could argue the primary intent of the tubal extraction is to remove the damaged tube - but that is not the case with every situation.
In some cases the tube is not damaged beyond repair.
In those cases I can think the only reason to totally remove the section of tube - is to remove the embryo, thereby killing it.

 

[Lorarose]

I am giving up forums for lent…I’ll check in again on Sunday.
Happy Ash Wednesday everyone!

 

[Daniel_Kane]

Always Our Children was a work of a committee of the USCCB and was never approved by the body of bishops. You are not saying that Always Our Children was supercede by Rome are you? Because the fact is, it was not.

Your opinion does not irritate me in the least. It interests me. I was merely stating that your opinion is at odds with not the majority, but all of the Catholic ethicists. Your opinion though interesting, lacks factual back up except to say sometimes fallopian tubes heal and I concur.
The fact that many of your friends have similar questions is reflective of the era and the inadequacy of the Church in effectively communicating her message on bioethics and Christian morality to adults, even adults who are interested.

This is not in the least a game of one upmanship to me but rather a simple observation that possibility your vision may not be as complete as all of the American bishops and others who have dedicated their lives to the study of this issue in great detail.

The morality of an act is not based on opinions but truths.
It is either licit to remove a ectopic tube or illicit. The Catholic Church says it is licit to remove the tube along with the embryo within it. Consistent teaching.

By suggesting to the contrary, it appears that you think that individuals who remove the tubes or allow tubes to be removed procure an abortion. If this is the case, then the removal of a fallopian tube with an ectopic pregnancy is a grave sin, an act of premeditated intentional murder against an embryonic person. I and the Church disagree with this contention.

Presumed by whom you ask? That would be the parties involved. They are faced with what seems to be two ethical options and all of the information. In the final analisis, they could do nothing and risk a 40 to 60% morbidity and mortality or remove the tube or a portion of it and have a very high chance of survival. Either decision is a moral one as a matter of Catholic teaching. One may not directly attack the embryo as that is a direct abortion.

**I still see this as splitting hairs and redefining one procedure to make it not sound like an abortion, when it is. *You are merging definition of direct abortion and indirect abortion not always wrong. Indirect abortions, that is abortions that are neither willed or intended but rather a foreseen consequence of a rational and moral act are not sinful, they are unfortunate and the principal of the double effect applies. Evangelium Vitae speaks many times on abortion, almost always with the modifier direct. Direct abortion *is abortion as a means of terminating fetal life.

I think the case of ectopic pregnancy is a one of kind case.

Not really, what about a cancer patient that is pregnant and needs chemo or radiation and a 3 or 6 month delay would be fatal for the mother (and by extension the child). In this unfortunate situation it is licit to take the therapy even if it results in the death of the child. To delay the therapy (which of course is an option) would be heroic. Catholics are not morally bound to be heroic, only moral. Another is cancer of the female reproductive organs that is coincident with a pregnancy. Those organs can licitly be removed even if removing them causes the fetal death.

What is one of a kind about ectopic pregnancy is that under our existing technology, it is impossible to save an ectopic embryo. In other cases one can choose to forgo their life for another (heroic but not required). Here the sad option is one dead for sure, two dead maybe. Ectopic pregnancy is responsible for 1 in 10 maternal deaths. Tubal ectopic pregnancies do not result in live births.

 

[svoboda]

mbrothersrn:

I would like to know what the churches teaching is on ectopic pregnancy? Since the embryo can’t develop completely in the Fallopean tube is it permissable to remove that tube to save the mother’s life?

Yes.

 

[LittleDeb]

I can see where Lorarose is coming from because one of her points is the most difficult I have in defending the Church’s teaching on this.

It is easier for me to say, "do nothing and risk death, " than to show how removing a tube that one person might call healthy is a good thing. Please don’t get me wrong, I agree with the Church’s teaching. Its just hard to get others willing to agree to remove what they view as a healthy tube so as to not euthanize a terminal baby. Many people see absolutely no difference between the direct and the indirect act.

My explanation has been that the tube has a faulty section in the first place. That is why the embryo stopped, so it needs to be removed. But that sounds a little weak, even to me.

It would be interesting to know how many successful pregnancies have happened through one of these “healed” tubes that previously had an ectopic pregnancy. To know for sure it would have to be in the rare case of a woman who also had the other ovary and tube removed completely.

Tough sell to a lot of people. Direct and indirect is the hardest to explain. I guess if someone is pro euthanasia nothing will make sense.

 

[Daniel_Kane]

Three things cause this in abstract:

1 - Unhealthy tube.
2 - Unhealthy embryo.
3 - Both an unhealthy tube and unhealthy embryo.

“Unhealthiness” may be situational, temporary or permanent but it is in the present sense.

In any case, the embryo can not stay where it is. So, if you have an unhealthy embryo in a healthy tube, the tube though injured may heal and in fact does in some cases. Unfortunately, one can not differentiate between one cause and another most of the time (apart from the obvious like IUDs, infection, etc.

It is the intention that counts in this act most. One does not intend to kill the embryo. It is foreseeable but not intended. One intends to remove what is presumed to be a pathologic organ that regrettably contains an embryo that can not live there and at this point, can not live anywhere else. There is no heroic virtue shown is not doing this because the other party has no chance to live at all. Sometimes letting nature take its course this resolves itself about have the time it does not and in that case causes significant injury and death.

Either way the embryo dies. Either indirectly as a result on an operation on a diseased organ or indirectly as a result of a lack of technology or inaction.

 

[AlanFromWichita]

Lorarose:

I am giving up forums for lent…I’ll check in again on Sunday.
Happy Ash Wednesday everyone!

Dear Lorarose,

I wish I’d seen this thread sooner because I very much appreciate both your ability to think logically and to express yourself clearly.

To me, you have been a bit generous, if anything, is suggesting that removing a baby and removing a tube containing a baby is morally equivalent. They aren’t. One does more damage than the other. One damages the mother’s fertility and the other one doesn’t. They both result in a dead baby, and it doesn’t matter a hill of beans whether the baby dies at our hands because we took it away from its home or because we destroyed its home with it inside.

It’s an insane argument, really. It’s like a house with a doomed child inside, and if we don’t accelerate the death then the house and possibly the whole neighborhood could be destroyed or damaged in addition to the death.

However, it is not legal to remove the child from the house because we can’t get the judge to sign an order. It is, however, OK to bulldoze down the whole house with the child inside because the judge doesn’t have to sign the order for a house demolition (and apparently it isn’t standard procedure for such demolitions to be prohibit solely on the fact that it has occupants) – such is considered “morally licit” even though no other babies in that house will ever survive again – as they might have if the doomed child were simply removed.

Yes, I will go beyond saying the procedures are morally equivalent. By my sense of what’s right – which is obviously corrupt if others here are correct – when faced with two ways of saving a life, one is morally bound to use the least destructive option available.

Alan

 

[AlanFromWichita]

Daniel Kane:

Three things cause this in abstract:

1 - Unhealthy tube.
2 - Unhealthy embryo.
3 - Both an unhealthy tube and unhealthy embryo.

“Unhealthiness” may be situational, temporary or permanent but it is in the present sense.

In any case, the embryo can not stay where it is. So, if you have an unhealthy embryo in a healthy tube, the tube though injured may heal and in fact does in some cases. Unfortunately, one can not differentiate between one cause and another most of the time (apart from the obvious like IUDs, infection, etc.

It is the intention that counts in this act most. One does not intend to kill the embryo. It is foreseeable but not intended. One intends to remove what is presumed to be a pathologic organ that regrettably contains an embryo that can not live there and at this point, can not live anywhere else. There is no heroic virtue shown is not doing this because the other party has no chance to live at all. Sometimes letting nature take its course this resolves itself about have the time it does not and in that case causes significant injury and death.

Either way the embryo dies. Either indirectly as a result on an operation on a diseased organ or indirectly as a result of a lack of technology or inaction.

Apparently you throw some ideas to enough intellectuals they can concoct all sorts of intellectual mumbo-jumbo that result in conclusions that are self-contradictory even by the standards of the intellectuals themselves.

This is one of the most confused topics I have ever heard of. Has the Church officially bought into any of these opinions by all these moral ethicists? It would seem they are more interested in flapping their gums and sounding pure than in advising behavior that actually upholds a pro-life position.

Alan

edit>> P.S. I just searched and did not find the word “ectopic” in the catechism.

 

[ncjohn]

AlanFromWichita:

Yes, I will go beyond saying the procedures are morally equivalent. By my sense of what’s right – which is obviously corrupt if others here are correct – when faced with two ways of saving a life, one is morally bound to use the least destructive option available.

Alan

This is one of those teachings that I really struggle with also. While I understand that the Church doesn’t want to ever suggest that abortion could be acceptable (creating a “chink in the armor”), this is a special case that involves unique circumstances.

In the end the result is the same–dead baby–regardless of tube removal or chemical means. The tube removal not only creates a fertility issues, but the surgery itself involves MORE risk to the mother’s life. If the argument is to remove the tube with the indirect result being the death of the baby, I can easily make the argument that using the chemicals is to clear the tube and that the death of the baby is an unintended result. Same intention, same ethics, same dead baby, but less harm to mother.

As a comparison, one requirement in Just War theory is that collateral damage must be minimized. Yet here we are justifiying INCREASING collateral damage just so we can say it wasn’t the direct reason and then wasn’t “really” an abortion.

With all due respect, in my humble opinion, this is ivory tower hair-splitting at the greatest level. If the results are ultimatly the same in this case, the goal should be to minimize the collateral damage. While I will submit to the Church’s teaching–making the assumption that it really is the teaching in this specific case–I truly feel that this special case really needs further examination.

Peace,

 

[Brendan]

ncjohn:

In the end the result is the same–dead baby–regardless of tube removal or chemical means. The tube removal not only creates a fertility issues, but the surgery itself involves MORE risk to the mother’s life.

.

With all due respect, in my humble opinion, this is ivory tower hair-splitting at the greatest level. If the results are ultimatly the same in this case, the goal should be to minimize the collateral damage. While I will submit to the Church’s teaching–making the assumption that it really is the teaching in this specific case–I truly feel that this special case really needs further examination.

Peace,

ncjohn, one of the key aspects of Catholic Moral Theology is that the specific ends do not justify the means.

What you are describing is ‘goal’ orientated morality, regardless of the means. That is specifically contrary to Church teaching.

For a object to be moral three key things need to be examined, the Intent, Method and End.

It is NEVER, EVER morally allowable to directly target an innocent life. There are no circumstances what so ever that would make such an action moral.

Such is the case with the use of chemicals to ‘dissolve’ the baby, they are a deliberate targeting of an innocent person.

Let’s say you read of a bomber pilot. His mission is to destroy a bridge. Enemy troops are approaching and need the bridge to compelete their attack.

So the bomber approaches the bridge, and through the bomber sight he not only sees the bridge, but notices that there is a child playing on the bridge.

Now a case may be made under the Principle of Double Effect for the pilot to complete his mission and target the bridge, even though the child might die.

But a case could never be made for the pilot to do a straffing run on the child first before blowing up the bridge.

In either case the effect is the same, destroyed bridge, and a dead child.

But one can be licit, the other never can be.

It might appear to be ‘ivory tower hair splitting’, but it’s not. All theology (as well as most other areas of study) has very specific terms. Moral theology is no exception.

The target of a moral action is what one intents to do. And, in using chemicals, one is specifically intending to dissovle another person. That is a bad thing.

 

[ncjohn]

Brendan:

.
What you are describing is ‘goal’ orientated morality…

…And, in using chemicals, one is specifically intending to dissovle another person. That is a bad thing.

I disagree, both as to the intention and to your accusation that I am using goal-oriented morality. I maintain that the purpose of the chemical is to ***clear the tube *** which endangers the mother’s life and the dissolving of the baby is an “unintended though foreseeable” circumstance, just as the removal of the tube is.

You can in your mind disagree if you want and I can respect that difference of opinion. You can not however change my intention–which as you note is the compelling requirement. Unless someone can definitively show me where the Church would find a difference which would cause me to question my intention–not just someone’s opinion that there is a difference–I’ll stand by my interpretation, realizing of course that neither your interpretation or mine utlitmately means anything to the Church.

Peace,

 

[AlanFromWichita]

Brendan:

.

Let’s say you read of a bomber pilot. His mission is to destroy a bridge. Enemy troops are approaching and need the bridge to compelete their attack.

Here’s the problem.

You presuppose the mission is to destroy the bridge.

The actual mission is to prevent the child on the bridge from blowing it up, killing itself and destroying the bridge.

If your mission is to destroy the bridge, then you are guilty of intentional elective mutilation surgery, which has the exact same morality as elective self-sterilization.

Now, if it is a necessary effect that the baby cannot be removed from the bridge without destroying the bridge too, then your analogy would work in favor of your moral conclusion.

You paint a powerful picture with the strafing run analogy, but I could counter with the analogy that your intent in the strafing run is not to kill the child, but to prevent it from doing damage by succeeding in its movement toward “the button” on the bridge explosives.

Alan

edit>> wait a minute. There’s another flaw with their analogy. The bridge is owned and operated by friendly troops, so the bridge itself (the woman’s fertility) is an asset of God, and we as stewards of the bridge should know that as far as the enemy is concerned, no bridge is a good bridge until it is destroyed. Unfortunately, your logic is in favor of the enemy.

 

[shannyk]

I

I also find it odd that so many catholics are not considering the sterilization of the woman as a problem.

Having a tube removed in the case of ectopic pregnancy doesn’t make a woman sterile.

I’ve had 3 children since one of my tubes was removed.

My first pregnancy was ectopic. Had a positive home pregnancy test and made a doctors appointment. He calculated that I was 6 weeks pregnant but when he felt my uterus he said it was “too small” and sent me for an ultrasound which showed the ectopic pregnancy. Hubby and I were devastated by this ( I was 19 at the time) and consulted my hubbys long time Priest friend who concurred with my Doc (Catholic doc Catholic hospital) that removing the tube was the the thing to do. The doc also pointed out that the baby was “very likely not alive at this point”. So feeling like it was the only option (which it was) I went ahead with it. The idea of it bothers me to this day, but I have been told time and time again by reliable Catholic sources that it was a moral action to take in a very difficult situation.

 

[Consecrated]

ncjohn:

I maintain that the purpose of the chemical is to ***clear the tube *** which endangers the mother’s life and the dissolving of the baby is an “unintended though foreseeable” circumstance, just as the removal of the tube is.

The thing is, that since the chemical (name escapes me) directly targets the baby, it is always the wrong choice, regardless of what anyone’s intentions are. Good/bad intentions lessen or increase personal culpability when an objectively wrong action is committed, but they don’t change the fact that the action is objectively wrong. Using the chemical to dissolve the baby is considered objectively wrong, especially since there are other ways to save the mother’s life.

Does this make sense?

 

[ncjohn]

Consecrated:

The thing is, that since the chemical (name escapes me) directly targets the baby, it is always the wrong choice, regardless of what anyone’s intentions are. Good/bad intentions lessen or increase personal culpability when an objectively wrong action is committed, but they don’t change the fact that the action is objectively wrong. Using the chemical to dissolve the baby is considered objectively wrong, especially since there are other ways to save the mother’s life.

Does this make sense?

Makes sense but I don’t buy into it as objectively wrong since the intent is to clear the tube, not kill the baby.

As I said previously, while I appreciate your comments, I’m not going to be influenced by personal opinions. If there is something definitive from the Church addressing this specific point (not the procedure in general), I would certainly be eager to see it so I can amend my position if necessary.

Peace,

 

[Daniel_Kane]

http://www.ewtn.com/library/PROLIFE/EXCEPT.TXT

Sheds some light and perspective but is written in technical philosophical language. In abstract, it supports the contention that removal of the tube along with the embryo is a licit act properly applying the principal of the double effect.

From EWTN.