Ectopic Pregnancy Question


#1

I was listening to relevant radio today and I was fascinated by the discussion about ectopic pregnancy. According the natural law principle of double effect you cannot do something if the primary means and end are immoral. For instance if you are pregnant and a doctor tells you that there is a 20% chance that you will die from cardiac complications, you cannot abort the unborn child so as to decrease this chance of death. The act of killing the child would be necessary for the benefit. This is a direct effect and not allowed. If a woman has a cancerus uterus she could have her uterus removed to treat the cancer with the unintended consequence of the death of the baby. This would be moral by the principle of double effect.

In ectopic pregnancy one can remove the so called “diseased” portion of the fallopian tube that contains the unborn child. The death of the child is the unintended consequence of removing the so called “diseased” portion of the tube.

It would be immoral to give methotrexate to kill the baby first and then remove it.

What about if the surgeon was able to open the fallopian tube and remove the unborn child (which could not survive out of the mother). No portion of the tube would be removed. In this case, would this be immoral? If this was possible (and I am not sure if it is) then removing the so called “diseased” part of the tube might be medically unnecessary. The only reason to remove that portion of the tube would be to “claim” an unintended consequence.

Can anyone who understands natural law theory comment on this?

Also what is the churches teaching on molar pregnancies? Can methotrexate be used in this situation?


#2

[quote=SHEMP]What about if the surgeon was able to open the fallopian tube and remove the unborn child (which could not survive out of the mother). No portion of the tube would be removed. In this case, would this be immoral? If this was possible (and I am not sure if it is) then removing the so called “diseased” part of the tube might be medically unnecessary. The only reason to remove that portion of the tube would be to “claim” an unintended consequence.

Can anyone who understands natural law theory comment on this?

Also what is the churches teaching on molar pregnancies? Can methotrexate be used in this situation?
[/quote]

Excellent question! I too would like some clarification, but Ican assure you that the baby CAN be removed without harming the fallopian tube. My wife had an eptopic pregnancy, and this was how the pregnancey was terminated (baby was removed by the laser). This saved my wife’s fertility and allowed us to have a baby subsequent to this eptopic. I was told at the time that there was no way to save the baby; either the baby dies and you remove one of the fallopian tubes (cutting chances of future pregnancies), or you remove the baby without harming the fallopian, in theory enhancing future prospects of pregnancies, or do nothing and my wife and the baby both die.

As in all matters, I would defer to the magesterium as to whether it was a moral choice. At the time, I was not as concerned about these things as I am today.


#3

In the case of this, there are no real choices. The baby has zero chance of survival. The tube WILL, not maybe but will erupt and the mother could die, not usually but she could and the situation is an emergency when the tube erupts, she will hemorrhage.

90% of the time no one even knows there is a eptopic pregnancy until the tube erupts. The question should be what is the more moral choice, if the person does find out before the tube erupts to surgically remove the fertilized egg or to wait for the tube to erupt.

The case is different because we are not talking about a baby who can survive and so the mother will risk her life to save the child, we are talking about a baby won’t survive and can not survive, should the mother still risk her life just so she does not remove the baby before the tube erupts? Another thing is the rupture of a tube, depending on how bad it is can render the woman infertile. So what is really the moral thing to do?


#4

I have seen catholics argue that the ONLY morally acceptable manner to resolve this is to remove the bulging section of the tube - as opposed to removing the baby alone (which officially constitutes an abortion)
They claim the tubal surgery is for the purpose of treating the damaged tube - versus the primary function of killing a baby.

I disagree with this argument.
The tube is healthy. It is bulging because of the growing fetus.
So - I see no difference here. If you are removing the tube - because it is bulging from a growing fetus - how is this different from simply removing only the fetus?


#5

I totally do not understand calling the removal of a baby from a fallopian tube that can not survive an abortion. This is not what abortion is. Abortion is when you take a perfectly healthy pregnancy or a high risk pregnancy and you terminate it.

This is no ones fault that this happened. The baby is not going to survive so is it moral to risk the mother when the baby isn’t going to survive? There is no other question other than do you remove it or wait until it erupts?


#6

Well…technically it is an abortion.

I’m just wondering if this might be a case where the Church needs to address a moral issue that does not fall into traditional categories.

For ex: Christians are forbidden to kill…but they can if necessary for self defense.

War is wrong…yet we have a “just war” doctrine.

So…here we have a medical condition where there is no hope for the embryo to survive (barring any new advances in medicine)

There is a high chance the mother may bleed to death when the tube WILL definitely burst.

Plus…this condition is not all that rare.
For the sake of catholic couples - I believe it would be a good idea if our church leaders addressed this issue with more clarity.


#7

I think I heard that in one case, the baby was removed from the fallopian tube and then the doctors tried to re-implant the baby in the uterus? I may not be remembering this correctly or if it was successful. Has anyone heard of this? If that could happen, it seems like the moral choice, giving both mom and baby the chance to live.


#8

[quote=ThyKingdomCome]I think I heard that in one case, the baby was removed from the fallopian tube and then the doctors tried to re-implant the baby in the uterus? I may not be remembering this correctly or if it was successful. Has anyone heard of this? If that could happen, it seems like the moral choice, giving both mom and baby the chance to live.
[/quote]

I don’t think that is currently possible.

Just so people understand the principle of double effect, I will list the criteria. The principle is that you MUST satisfy ALL four conditions.

  1. The act must be good or indifferent in itself.
  2. The good the agent intends must not be obtained by means of evil.
  3. The evil effect must not be intended for itself but only permitted.
  4. There must be a proportionately grave reason for permitting the evil effect to occur.

Removing only the unborn child does not satisfy criteria #1.


#9

This is a very difficult situation and more clarity would doubtless be helpful, as Lorarose says.
You could argue: that the unborn child must be removed from the tube to avoid the mother’s death. The child’s death is not intended, but with our present technical abilities is unavoidable (that may change).
Removing the fallopian tube just to avoid the accusation of abortion seems hypocritical.


#10

Removing only the unborn child does not satisfy criteria #1.

But does leaving it when the end result is positively a rupture that can cause death maybe and infertility maybe? Is it moral to risk one’s life for a no win cause? What would be the benefit of not removing it other than a miracle occurring? I could see waiting on a miracle, other than that, I can’t see any moral reason to not seek medical help.


#11

The only way to satisfy all 4 criteria is to do nothing and pray for a miracle.
This puts catholic women in an impossible position as ultimately many other young catholic children will be left motherless because of this.
I have a very hard time believing the Church would intentionally request it’s women to risk death like this.
The Church needs to examine this and bring clarity to the situation.


#12

The Church allows the right of self-defence, provided that every attempt is made to save the child, whose death we mourn.

The removal of a fallopian tube is a salpingectomy.
The child is doomed, as far too young to survive, given present technology.

EVEN if the child were still alive, and beyond help, this is not an abortion.

The pro-choice factions have deliberately created this confusion of terminology so they can FALSELY claim that abortion is sometimes necessary to save a mother’s life.

Hysterectomy and salpingectomy are life saving,
abortion never is.

See Apologetics thread: Is Abortion OK?


#13

So was there any conclusion?

What is the moral way to handle an ectopic pregnancy?

Thanks in advance for answering.


#14

Wow, I had never thought of that situation. Thats a great question. Here is what Father Frank Pavone (Priests for Life Praises for Priests for Life ) has to say in his Q&A section:

"Question 6: I am an oncology nurse and was asked to give methotrexate for an ectopic pregnancy on another floor since only oncology nurses can give chemotherapeutic drugs. I believe the pregnancy was tubal. Needless to say I refused because I was unsure of the morality of it. I do not know the entire patient situation since the patient was on another floor. Could you please explain the morality of this act according to the church’s teaching. I do not think the mother’s life was in danger at this particular time. Thanks and God bless you. P.S. I work at a catholic hospital

Answer: There is more than one medical way of handling an ectopic pregnancy. The relevant moral question is whether the method or action is in fact a killing of the child. If so, that is a direct abortion, which is **never permissible ** for any reason. “Direct means that the destruction of the child is willed as the end or the means to another end. Sometimes ectopic pregnancies are handled this way, killing the child but leaving the tube intact. Such an action is morally wrong.
However, if what is done is that the damaged portion of the tube is removed because of the threat it poses to the mother, that is not a direct abortion, even if the child dies. What is done is the same thing that would be done if the tube were damaged from some other cause. The mother is not saved by the death of the child but by the removal of the tube. Because the death of the child in this case is a side effect which is not intended, and because the saving of the mother’s life is not brought about by the death of the child, such a removal of the damaged portion of the tube is morally permissible. The ethical rule that applies here is called the Principle of the Double Effect.”


#15

[quote=SHEMP]I was listening to relevant radio today and I was fascinated by the discussion about ectopic pregnancy. According the natural law principle of double effect you cannot do something if the primary means and end are immoral. For instance if you are pregnant and a doctor tells you that there is a 20% chance that you will die from cardiac complications, you cannot abort the unborn child so as to decrease this chance of death. The act of killing the child would be necessary for the benefit. This is a direct effect and not allowed.
Yep. Sounds correct so far.

If a woman has a cancerus uterus she could have her uterus removed to treat the cancer with the unintended consequence of the death of the baby. This would be moral by the principle of double effect.
:ehh: Not so I think. A direct result of removing the uterus, would the removal of the baby it holds. Therefore is would NOT be moral. Same rule as your first example.

In ectopic pregnancy one can remove the so called “diseased” portion of the fallopian tube that contains the unborn child. The death of the child is the unintended consequence of removing the so called “diseased” portion of the tube.

First, it is not always neccessary to remove part of the tube - it depends on how early it is detected. It also assumes the baby is still alive - most of the time that is not the case.

It would be immoral to give methotrexate to kill the baby first and then remove it.

What about if the surgeon was able to open the fallopian tube and remove the unborn child (which could not survive out of the mother). No portion of the tube would be removed. In this case, would this be immoral? If this was possible (and I am not sure if it is) then removing the so called “diseased” part of the tube might be medically unnecessary. The only reason to remove that portion of the tube would be to “claim” an unintended consequence.

It is very rare for the baby to be living at that point. Usually the tube needs surgery because it isn’t until things have progressed to that point that there is a diagnoses. If the baby was alive, I imagine it would be a horror of a choice for the Catholic mother.

Can anyone who understands natural law theory comment on this?

Also what is the churches teaching on molar pregnancies? Can methotrexate be used in this situation?
I’m not a dr. , but I believe a molar pregnancy is not an actual fetus. A molar pregnancy is when an empty ovum (like an egg without yolk) develops cancerous cell growth. It is not “growing” into a baby and will never have a heartbeat. It is actually a very rare form of cancer. I don’t believe it’s even really a pregnancy - it’s actually a cancerous growth on the uterus lining that mimics pregnancy.


hmmm, interesting…

[/quote]


#16

[quote=lorarose]For ex: Christians are forbidden to kill…but they can if necessary for self defense.
[/quote]

In this circumstance, would the baby not be a direct threat to the life and health of the mother warranting the mother to act in self defense? It seems like a terrible analogy, but I can see a likening to being backed into a corner with a guy holding a gun to your head (or reproductive system). The presence of the baby in the fallopian tube backs a mom into a corner and presents no possible way out. In this circumstance, the taking of another’s life is justified because it is not murder, but protection. A miracle is the lifting of natural law and is not to be relied on. Sure, the gun can misfire. Sure, the tube might not rupture so bad. But given the position of the mother at the time and the knowledge she has, is she not allowed to act in self defense?


#17

[quote=Lorarose]I have seen catholics argue that the ONLY morally acceptable manner to resolve this is to remove the bulging section of the tube - as opposed to removing the baby alone (which officially constitutes an abortion)
They claim the tubal surgery is for the purpose of treating the damaged tube - versus the primary function of killing a baby.

I disagree with this argument.
The tube is healthy. It is bulging because of the growing fetus.
So - I see no difference here. If you are removing the tube - because it is bulging from a growing fetus - how is this different from simply removing only the fetus?
[/quote]

How do you know the tube is healthy? If the child ended up in the tube, could something have happened in the tube to cause that?

The answer by the church is you are NEVER allowed to do a direct abortion, period. Statistics show that people who have had tubals before are more prone to them. In some studies, the cause of a tubal includes previous tubals. There is a reacurrance rate. One conclusion of this is that the tube is not (always) healthy. One can defend the removal of the tube as more legitamate than aborting the baby.

ectopic link

ectopic link #2


#18

I think the director of Priests for Life (Father Pavone)said it nicely:
"The relevant moral question is whether the method or action is in fact a killing of the child. If so, that is a direct abortion, which is never permissible for any reason. “Direct means that the destruction of the child is willed as the end or the means to another end. Sometimes ectopic pregnancies are handled this way, killing the child but leaving the tube intact. Such an action is morally wrong.”

Killing an innocent child is never right.

Here’s info on Father Pavone and his reputability:
priestsforlife.org/intro/ffbio.html


#19

[quote=Forest-Pine]In this circumstance, would the baby not be a direct threat to the life and health of the mother warranting the mother to act in self defense? It seems like a terrible analogy, but I can see a likening to being backed into a corner with a guy holding a gun to your head (or reproductive system). The presence of the baby in the fallopian tube backs a mom into a corner and presents no possible way out. In this circumstance, the taking of another’s life is justified because it is not murder, but protection. A miracle is the lifting of natural law and is not to be relied on. Sure, the gun can misfire. Sure, the tube might not rupture so bad. But given the position of the mother at the time and the knowledge she has, is she not allowed to act in self defense?
[/quote]

The baby is not an instigator. The baby is an innocent. The babies growth by itself is not a threat, since all of us here grew in our mother’s womb. The problem is where the baby ended up implanting. The tube is an incorrect implantation point, and the rupture of the tube will cause the mother’s death. That analogy doesn’t work well.


#20

Something doesn’t pass the sniff test here. I quite respect Fr. Pavone, but this is almost blatant semantics. The TUBE isn’t the problem, the pregnancy is. The tube isn’t diseased, it has a doomed baby stuck inside. I don’t see how removal of the tube section isn’t a direct abortion.

What about this: If the ectopic pregnancy is detected when the baby is still quite small, which it would have to be when still in a fallopian tube, why not open the tube, remove the baby and place it into the uterous? Would this involve additional medical risk to the mom? Even if it was considered to medically have no chance, the INTENT would be to try to relocate the baby to a place where it could grow to term.

Even if it had no chance now, perhaps starting to behave this way would lead to developments that would make it possible in the future?


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