Sunday, December 3, 2006

The Treatment of Ectopic Pregnancies (2/3/07)

This is taken from an email to "Kresta in the Afternoon":

"Citing the Catholic medical principle of 'double effect,' Catholic health care has allowed the removal of a fallopian tube to save a mother’s life, in the case of an ectopic pregnancy. Of course, this unintentionally results in the death of the preborn child. In the July/August 1998 issue of Health Progress (i.e., the official journal of the Catholic Health Association of the United States), Father Kevin O’Rourke seemed to indicate that a Salpingostomy (i.e., removal of the child from the fallopian tube) and use of the chemical Methotrexate might also be acceptable <>. However, it appears that Catholic thinking is moving decidedly away from the position of Father O’Rourke, recognizing salpingostomies and this use of Methotrexate as direct abortions. Yet, some Catholic hospitals apparently continue to employ Salpingostomies and Methotrexate.

"Writing in the February 1999 Linacre Quarterly (i.e., the official journal of the Catholic Medical Association), Dr. John E. Foran bemoans 'toleration of salpinotomy(ostomy) and pharmacologic (methotrexate) treatment of ectopic pregnancy in Catholic health facilities….since the immediate effect of methotrexate and saplingotomy(ostomy) is the death of the fetus, the principle of double effect is not applicable because the act is evil. In The Management of Ectopic Pregnancies: A Moral Analysis, William E. May points out that ‘it is morally imperative today to make every effort possible to discover and transplant into the uterus those unborn babies who have, unfortunately, implanted in the fallopian tube or other ectopic site’…. no matter how good the intention, salpingotomy/ostomy and the use of methotrexate or similar pharmacologic agents result in the death of the infant as a direct effect of the action and culminates in the good effect. The death is the means chosen to the end. To willfully choose to terminate innocent human life, no matter how good the intent, is anywhere and everywhere morally wrong' .

"In the July 1999 Homiletic & Pastoral Review, Msgr. William Smith explains that 'All Catholic authors agree that salpingectomy is a licit application of the principle of double effect. That is, full salpingectomy—the entire fallopian tube (together with the ectopic pregnancy) is surgically removed; or, partial salpingectomy—only the damaged segment of the tube enveloping the ectopic pregnancy is removed, and then the severed ends of the tube are brought together and sutured….[By contrast] salpingostomy and this administration of MTX are direct abortions ….Since the procedures are not necessary to protect the mother’s life (salpingectomy can preserve that) but allegedly to preserve future fertility, I would judge that the final condition of double effect, proportion, is also not verified here and thus is not a legitimate application of double effect and is a direct abortion' <>.

"As per # 48 of the 2001 Ethical and Religious Directives for Catholic Health Care Services, Fourth Edition, 'In case of extrauterine pregnancy, no intervention is morally licit which constitutes a direct abortion' <>.

"As per the March 2006 issue of Ethics and Medics (the official journal of the National Catholic Bioethics Center), Dr. Eugene Diamond writes: 'The consensus among Catholic theologians and practicing obstetricians is that the use of methotrexate in ectopic pregnancy is a direct abortion of a developing embryo or fetus….[However] The proscription against the use of methotrexate and against surgical procedures such as salpingostomy (the opening of the fallopian tube) with evacuation of the tubal contents (in favor of the use of salpingectomy, the removal of the fallopian tube, instead), do not apply if the ectopic pregnancy has terminated with fetal demise'" <>.

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