PCS342 – Medically Necessary Abortion?

Abortion when the Life of the Mother is at Risk

The claim is often made that abortion can be medically necessary to save the life of a pregnant woman who is experiencing certain life-threatening medical conditions. But many scientists, physicians, and bioethicists dispute this claim.

For example, leading medical experts speaking at the 2012 International Symposium on Excellence in Maternal Healthcare held in Dublin, Ireland concluded that “direct abortion is not medically necessary to save the life of a mother.” The Symposium’s conclusions were issued in the Dublin Declaration on Maternal Healthcare:

As experienced practitioners and researchers in Obstetrics and Gynaecology, we affirm that direct abortion is not medically necessary to save the life of a woman. We uphold that there is a fundamental difference between abortion, and necessary medical treatments that are carried out to save the life of the mother, even if such treatment results in the loss of life of her unborn child. We confirm that the prohibition of abortion does not affect, in any way, the availability of optimal care to pregnant women.

To better understand the issue, we interviewed Edward Furton, MA., Ph.D., the Director of Publications and an ethicist with the National Catholic Bioethics Center on December 21, 2011:

Q. “Ectopic pregnancy” occurs when an embryo implants outside the uterus, usually in the fallopian tube. As the baby develops, his growth will likely rupture the fallopian tube, causing the death of the mother and child. How do we resolve this dilemma?

Dr. Furton: You can remove a length of the fallopian tube section with the embryo in it, because there is a pathological condition in the tube itself that is imminently threatening the life of the mother. The death of the child is indirect. You are acting directly on the pathologically compromised tube. But you cannot slit the tube and press the embryo out, because this is a direct action of killing the child, and constitutes murder.

Q. What’s the difference?

Dr. Furton: The difference is that, in the first case, the loss of human life is indirect. In the second case, the embryo is directly scooped out, and so that is a direct attack on the embryo. If the loss of life is direct, it is not permissible. If the act is indirect, and it is judged to be necessary to save the life of the mother, and there are no alternatives, it is permissible.

Q. Can you clarify “direct” and “indirect” a bit more?

Dr. Furton: The difference between direct and indirect is a very hot topic right now. Look for how the words “direct” and “indirect” are being used. Some top ethicists and theologians are confusing direct and indirect in debates today, and are trying to argue that something direct is “indirect.” For example, the case of the Phoenix woman who had pulmonary hypertension and so a dilation and curettage was done to remove the fetus. This was a direct attack on the fetus because the child was not the pathology. If they had done something else to treat the actual condition, such as medication, and the medication (hypothetically) simultaneously attacked the fetus and killed the child, this would be permissible because it would be indirect. The drug is being used to counter the pathological condition that is threatening imminent death.

In the Phoenix case, there was nothing wrong with the child, placenta, and uterus. It was a blood pressure problem. In not performing the abortion, the woman may have died, and both would have been lost. But there are ways to treat these conditions where at least the mother can survive, or even both, without killing the child.

Another example is a craniotomy – which is not really done anymore. This is where the child’s head will not pass through the birth canal, and a C-section cannot be done for whatever reason, so the doctors strike the skull of the infant, crush it, and deliver the remains. Some people justify this as an indirect action. This baffles me because you directly strike the skull of the infant, and crush it.

In another example, chorioamnionitis is an inflammation of the fetal membranes (amnion and chorion) due to a bacterial infection. In this case, if the life of the mother is in imminent danger, the uterus and its contents can be removed early even though the child will not survive, because the object of the action is to remove the infection.

Q. Is there a “rule of thumb” that we can always apply here?

Dr. Furton: Life of the mother dilemma cannot be answered with one generic statement. You have to look at each case. There is a possibility that there will be no way to save mother and child. If the solution is to directly kill an innocent human being to save another, you cannot do that. But as long as the baby is not directly attacked, it’s permissible.


For further discussion, go to: http://www.ncbcenter.org/document.doc?id=830

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