The moral management of ectopic pregnancies
By Fr. Joseph C. Howard, Jr., M. Div.
Director of the American Bioethics Advisory Commission
The presence of an ectopic pregnancy may result from a tubal disorder
or cause the fallopian tube to be pathological. In all cases, all actions must be
analyzed according to intention, means, and end. If any of these
three are immoral, the act itself is immoral.
Using the Thomistic Principle of Totality
(removal of a pathological part to preserve the life of the person) and the
Doctrine of Double Effect, the only moral action in an ectopic pregnancy
where a woman's life is directly threatened is the removal of the tube
containing the human embryo.
The death of the human embryo is unintended
although foreseen. Put another way, if there were a way to save both lives,
which, of course, are of equal value, one would be obliged morally to do so.
At this time, this is not possible.
It is acknowledged that it has become
commonplace even in Catholic hospitals to open the tube and "suction out the
human embryo" or administer methotrexate either via mouth or laparoscopy.
Both of these procedures directly attack an innocent human life and are
intrinsically immoral and never can be justified. In fact, they violate the Fifth
Commandment, which under all circumstances prohibits a direct attack on
innocent human life. There are absolutely no exceptions to the 5th
Commandment as described.
While removing the tube containing the human
embryo results in the death of a human being as does suctioning out the human
embryo or administration of methotrexate, one cannot ethically conclude that
all the actions have the same intended end result.
The reason for this is that the
"means" used to accomplish the "end" are not the same.
Refusal to make this
distinction results in a Machiavellian approach employing any "means" to the
"end" including the direct assault on the human being intended to result in his
death. While it is acknowledged that removal of the tube containing the
human embryo may result in sterility, it is not morally justified to directly
attack human life by suctioning out the human embryo or administering
methotrexate even though fertility is preserved.
One should note that removal
of the fallopian tube containing the human embryo does not result in impaired
fertility, if the remaining fallopian tube is intact.