Abortion and the Principle of Double Effect

[meltzerboy]

I believe I understand (finally) this principle and its application to abortion only in instances in which the abortion is an indirect, non-intentional consequence of treating a life-threatening condition of the mother by means of surgery or medication. But my question is with regard to a situation in which the treatment is known in advance to almost surely result in the death of the unborn baby. Would such a high probability, compared to a lower probability, of death be considered in deciding the morality of the treatment or procedure?

[manualman]

I'm an amatuer too, so let's see if we can work this out. IIRC, there are 4 questions that must be satisfied for double effect to apply.

1. Is the end a moral good? (i.e. we'd sure like to save at least ONE of the lives at risk in the case of ectopic pregnancy)
2. Is the direct action morally good or at least innately morally neutral? (i.e. you can't take a pill to poison an unborn child, but you can surgically removed a diseased section of fallopian tube in an ectopic pregnancy)
3. Is the morally bad side effect unintended and unavoidable? If there are other options, double effect doesn't apply.
4. Is the proportionate impact of the morally good end larger than the proportionately bad impact of the indirect side effect? (i.e. check if the 'do nothing' option does less harm in the end.)

IIRC, you have to satisfy all four, not just one or even 3 of 4. All of them.

So to answer your question, if the mother (hypothetically) had a condition that required surgery or medication in order to save her life and that action had a high likelyhood of causing the death of the child and the near certain outcome of doing nothing would be the death of both of them, D.E. may apply. But only if the surgery or medication had a morally good direct effect (not just end). If the direct purpose is to kill the child in order to (for example) shut down the hormone imbalance about to kill the mother, it fails the test. This stuff gets pretty hairy, but the alternative of going with the gut is worse.

[meltzerboy]

Originally Posted by manualman

I'm an amatuer too, so let's see if we can work this out. IIRC, there are 4 questions that must be satisfied for double effect to apply.

1. Is the end a moral good? (i.e. we'd sure like to save at least ONE of the lives at risk in the case of ectopic pregnancy)
2. Is the direct action morally good or at least innately morally neutral? (i.e. you can't take a pill to poison an unborn child, but you can surgically removed a diseased section of fallopian tube in an ectopic pregnancy)
3. Is the morally bad side effect unintended and unavoidable? If there are other options, double effect doesn't apply.
4. Is the proportionate impact of the morally good end larger than the proportionately bad impact of the indirect side effect? (i.e. check if the 'do nothing' option does less harm in the end.)

IIRC, you have to satisfy all four, not just one or even 3 of 4. All of them.

So to answer your question, if the mother (hypothetically) had a condition that required surgery or medication in order to save her life and that action had a high likelyhood of causing the death of the child and the near certain outcome of doing nothing would be the death of both of them, D.E. may apply. But only if the surgery or medication had a morally good direct effect (not just end). If the direct purpose is to kill the child in order to (for example) shut down the hormone imbalance about to kill the mother, it fails the test. This stuff gets pretty hairy, but the alternative of going with the gut is worse.

It's probably so hard to go through this rational process when one has to make an urgent decision. In Judaism, there is also a rational process involved, but it is a somewhat different one.

[SonCatcher]

Originally Posted by meltzerboy

I believe I understand (finally) this principle and its application to abortion only in instances in which the abortion is an indirect, non-intentional consequence of treating a life-threatening condition of the mother by means of surgery or medication. But my question is with regard to a situation in which the treatment is known in advance to almost surely result in the death of the unborn baby. Would such a high probability, compared to a lower probability, of death be considered in deciding the morality of the treatment or procedure?

Do you mean choosing between 2 or more different procedures with varying levels of success?

[meltzerboy]

Originally Posted by SonCatcher

Do you mean choosing between 2 or more different procedures with varying levels of success?

That would be one possibility. Another would be choosing whether or not to do the procedure.

[SonCatcher]

Originally Posted by meltzerboy

That would be one possibility. Another would be choosing whether or not to do the procedure.

Choosing to refuse a procedure solely because of the harm it would do to the child is allowed. Although, since we do have a moral obligation to protect our own lives through moral or neutral means, it is prudent to consider the action in cases where the child absolutely cannot survive.

If multiple procedures are possible with similar levels of success (at preserving the life of the mother) then the one that gives the best chance to the child should be preferred.

If, for example, someone developed a technique of transferring an ectopic pregnancy into the uterus that greatly reduced the chance of complication to the mother but only had a 20% chance of success at allowing the child to survive, the parents would need to seriously consider it.

[underacloud]

Originally Posted by meltzerboy

I believe I understand (finally) this principle and its application to abortion only in instances in which the abortion is an indirect, non-intentional consequence of treating a life-threatening condition of the mother by means of surgery or medication. But my question is with regard to a situation in which the treatment is known in advance to almost surely result in the death of the unborn baby. Would such a high probability, compared to a lower probability, of death be considered in deciding the morality of the treatment or procedure?

The removal of a fallopian tube in the case of an ectopic pregnancy is a direct and clear example of this. The chances of the baby dying are high (100%), but the procedure is allowed.

Other cases may be a matter of judgement. In the case of cancer, it is licit to treat cancer even though there may be clear danger to the baby. But some mothers deny treatment and indirectly sacrifice their own lives for the sake of their child. Such a sacrifice is not prescribed, but will no doubt be looked on favourably by our great God.

[SonCatcher]

Originally Posted by underacloud

Other cases may be a matter of judgement. In the case of cancer, it is licit to treat cancer even though there may be clear danger to the baby. But some mothers deny treatment and indirectly sacrifice their own lives for the sake of their child. Such a sacrifice is not prescribed, but will no doubt be looked on favourably by our great God.

* See St. Gianna Molla

[underacloud]

Originally Posted by SonCatcher

* See St. Gianna Molla

Yes, thank you! I was trying to remember her name and I couldn't.

[meltzerboy]

Originally Posted by underacloud

The removal of a fallopian tube in the case of an ectopic pregnancy is a direct and clear example of this. The chances of the baby dying are high (100%), but the procedure is allowed.

Other cases may be a matter of judgement. In the case of cancer, it is licit to treat cancer even though there may be clear danger to the baby. But some mothers deny treatment and indirectly sacrifice their own lives for the sake of their child. Such a sacrifice is not prescribed, but will no doubt be looked on favourably by our great God.

The first example you give of removing the fallopian tube is one of those I am talking about. Is the ONLY moral argument for allowing this procedure, that the death of the child is not intentional even though it is almost certain? Or is saving one life, that of the mother, rather than losing both lives, the main part of the rationale? Otherwise, wouldn't there be a kind of dishonesty in "pretending" one is not sacrificing the child to save the mother? What I don't quite understand is why this is allowed according to Catholic teaching.

[underacloud]

Originally Posted by meltzerboy

The first example you give of removing the fallopian tube is one of those I am talking about. Is the ONLY moral argument for allowing this procedure, that the death of the child is not intentional even though it is almost certain? Or is saving one life, that of the mother, rather than losing both lives, the main part of the rationale? Otherwise, wouldn't there be a kind of dishonesty in "pretending" one is not sacrificing the child to save the mother? What I don't quite understand is why this is allowed according to Catholic teaching.

You need to consider the principles of double effect, as manualman provided. In fact, manualman's post provides the case of ectopic pregnancy as direct examples to three of the four principles.

The moral end - saving the mothers life - is good.
The direct action - removal of the fallopian tube - is morally neutral.
The bad effect is unintended and unaviodable.
The moral good outweighs the bad effect (which would happen anyway).

The key difference, and why this is licit for Catholics, is that the means is not immoral. We cannot abort the child, even though the outcome is the same (in fact, better as it preserves the fallopian tube), as abortion is itself immoral. But we can take the morally neutral path of removing the diseased tube.

We don't pretend that one is not sacrificing the child for the mother...yet the child will die regardless, which is why saving the mother (the moral good) sufficiently outweighs the bad (which happens either way).

[meltzerboy]

Originally Posted by underacloud

You need to consider the principles of double effect, as manualman provided. In fact, manualman's post provides the case of ectopic pregnancy as direct examples to three of the four principles.

The moral end - saving the mothers life - is good.
The direct action - removal of the fallopian tube - is morally neutral.
The bad effect is unintended and unaviodable.
The moral good outweighs the bad effect (which would happen anyway).

The key difference, and why this is licit for Catholics, is that the means is not immoral. We cannot abort the child, even though the outcome is the same (in fact, better as it preserves the fallopian tube), as abortion is itself immoral. But we can take the morally neutral path of removing the diseased tube.

We don't pretend that one is not sacrificing the child for the mother...yet the child will die regardless, which is why saving the mother (the moral good) sufficiently outweighs the bad (which happens either way).

Good explanation, and I thank you.