Need a theologian's help to understand this

The issue of the morality of treating a woman with an ectopic pregnancy came up on another thread and we’ve had some discussion about it but I remain terribly confused.

Please read the discussion here (posts 57 and onward)

How can any one method of treatment be better or worse than the other when all result in death of the unborn, when it is known beforehand (regardless of method used) that that is what is going to happen and when that end is unavoidable regardless of whether treatment is given or not given? Is it wrong to just accept the death as inevitable and use the means of treatment which will best serve the mother?

Is the advice given on previously mentioned thread really the Church’s official position or just someone’s interpretation of it?

This is the kind of thing which people of faith need to know and understand before they get into an emergency room and many of us, including myself, just don’t.

The official line is that the principle of double effect comes into play: surgery to correct an ectopic pregnancy is not intended to abort, but to save the mother’s life. The resultant abortion is reduced to an unhappy coincidence. It is essentially a ‘side effect’ as you mentioned.

Many people have great difficulty understanding the difference between knowing that the act you will do will have certain results, which you do not intened, and knowing that an act you will do will have certain results, and intending those results.

That is the case in an operation, for example, which is needed to save the mother’s life (she has a fast growing cancer in the uterous); she is pregnant and the operation will result in the death of the child.

It is not intended that the child die; that is not the reason for the operation but is an unavoidable consequence.

If she had the operation with the intent to kill the child, that would be seriously morally wrong.

If she had the operation with the intent to save her life (entirely permissible) and the child died as the unintended consequences of the operation, the operation is still permissible (assuming, of course, there were no other viable alternatives that would have a result of saving the child. She is not required morally to not have the operation (that is, to die instead) so that the child may be born. However, we have a new saint declared by John Paul 2 who did that; chose to not have the operation and died as a result.

Perhaps a poor analogy: she is driving down the highway and a deer bolts out from the right; in order to miss the deer she pulls sharply to the left hitting an oncoming vehicle and the child dies; her pulling to the left did not have the intent to kill the child; but to an outside observer, it certainly was a foreseeable event.

Thank you very much for these answers.

I do not qualify as a theologian, attached are references for your answers

#47] Operations, treatments, and medications that have as their direct purpose the cure of a proportionately serious pathological condition of a pregnant woman are permitted when they cannot be safely postponed until the unborn child is viable, even if they will result in the death of the unborn child.

An extended discussion :
[excerpt]}“There is no treatment available that can guarantee the life of both. The Church has moral principles that can be applied in ruling out some options, but she has not officially instructed the faithful as to which treatments are morally licit and which are illicit. Most reputable moral theologians, as discussed below, accept full or partial salpingectomy (removal of the fallopian tube), as a morally acceptable medical intervention in the case of a tubal pregnancy.”

Texas Roofer, that article is the most complete that I have read so far on the topic. It considers different scenarios and gives room for the couple to make a truly informed decision, applying medical and moral guidelines to their particular situation. Thank you so much.

I’m glad you finally found something which satisfied you. I only hope you didn’t stop reading after paragraph 47 of the Ethical and Religious Directives for Catholic Health Care Services. Paragraph 48, immediately following, was even more explicit and pertinent to your original question. It states:

[sign]In case of extrauterine pregnancy, no intervention is morally licit which constitutes a direct abortion. [/sign]

The USCCB has not given a different response than the one you were provided with (on another thread) by the Priests For Life or the American Life League. Both are in line with the Magisterium. “Donum Vitae” otherwise known as “Gift of Life”

Thus they will make it possible to understand ever more clearly the reasons for and the validity of this teaching. By defending man against the excesses of his own power, the Church of God reminds him of the reasons for his true nobility; only in this way can the possibility of living and loving with that dignity and liberty which derive from respect for the truth be ensured for the men and women of tomorrow. The precise indications which are offered in the present instruction, therefore, are not meant to halt the effort of reflection but rather to give it a renewed impulse in unrenounceable fidelity to the teaching of the Church.
In the light of the truth about the gift of human life and in the light of the moral principles which flow from that truth, everyone is invited to act in the area of responsibility proper to each and, like the good Samaritan, to recognize as a neighbor even the littlest among the children of men (cf. Lk. 10:29-37). Here Christ’s words find a new and particular echo: “What you do to one of the least of my brethren, you do unto me” (Mt. 25:40).

I don’t like the tone of your post but will try not to take it personally.

It’s not about satisfying myself. If something doesn’t make sense to someone there’s no reason not to question it. Theologians themselves have labored over these issues. Do you know that there was a point in time when according to the history of this matter that I’ve been able to find, theologians tended to believe that any measure taken before the tube had actually ruptured, was immoral? Now the directives are different, is my understanding. If they had so much trouble figuring it out, why shouldn’t I?

I wonder if you really understand the fine line of difference between a direct and an indirect abortion in this case? It’s not like the baby is removed with the tube and then dies in an incubator somewhere: it’s way too small for that; it dies after the tube is cut and because the tube is cut. Is it any wonder why those who understand what an ectopic really is have difficulty understanding the difference between direct and indirect abortion in this case?

If you like I can complicate the matter even further: for an ectopic pregnancy in the cervix, the choices are even less clear because surgery then can be higly risky and may even mean loss of the entire uterus (women have only one cervix and it can’t just be cut off the way a tube can). Are the moral choices the same then? What if the doctor faces malpractice problems for removing a woman’s uterus when there was an alternative? Whose beliefs take precedence: the woman’s or the doctor’s? (Remember this may be an emergency with no the time to shop around for doctors).

If a woman’s doctor isn’t Catholic and he doesn’t approach the procedure with the correct intent, is the procedure (even the allowed one) considered moral or immoral (maybe as far as he’s concerned whatever he does is done to end the baby’s life).

Pardon me for making this an issue, but I believe it is - a very important one to all concerned.

Thanks for the clarification.

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