EXCEPTION: TO SAVE THE LIFE OF THE MOTHER
by Rev. E. M. Robinson, O.P.; copyright 1991
"Never and in no case has the Church taught that the life of the
child must be preferred to that of the mother. It is erroneous
to put the question with this alternative: either the life of
the child or that of the mother. No, neither the life of the
mother nor that of the child can be subjected to direct
suppression. In the one case as in the other, there can be but
one obligation: to make every effort to save the lives of both,
of the mother and the child." (Pope Pius XII, Allocution to the
Association of Large Families, AAS (1951), XLIII, p. 855.)
RESTRICTIONS AGAINST abortion, both moral and legal, are written in such a
way that sometimes a faulty reason is offered, or at least presumed, for
the exception which entitles this article. In some instances the child is
looked upon as an unjust aggressor. In other cases the child's right to
life is considered to be inferior to the mother's right to life. A
further problem arises in the assumption that there are medically
warranted situations in which the mother's life can be saved only by a
direct attack upon the child-to kill the child "in order to save the
mother's life."
The only ethically justified understanding of this much-celebrated
exception shows that it is not an exception at all! The classical example
of an ectopic pregnancy or the example of the cancerous uterus, which
allow the surgeon, ethically, to remove the woman's damaged reproductive
organs in order to save her life, should not be used as examples of
abortion, even though a baby's life is terminated in the progress.
It is true that early medical terminology speaks of natural miscarriage as
abortion, but it does not refer to the above examples by the name of
abortion. In the case of the uterus, the usual name hysterectomy would be
used, and the pregnancy would be noted in the pathology report. Both
medically and legally, for the purposes of discussion, abortion is a
direct and fatal attack upon the life of an unborn offspring of human
parentage.
It becomes necessary now to see why a medical procedure, such as the
excision of a cancerous, pregnant uterus, is sometimes ethically
permissible and should not be called an abortion.
What is involved here are two individuals, the mother and her child,
having equal, inalienable rights to continue living. If it can be
established that the mother's life demands the removal of the diseased
uterus, she has a right to this necessary means of preserving her own
life. The surgical removal is not a direct attack upon the child, either
by intention or by the nature of the procedure. Therefore, it should not
be called an abortion.
The ethical principle governing this, and similar cases, is a
long-standing one called the principle of double-effect. It is explained
in this way: an action which terminates in two effects, one good and one
evil, may be undertaken if the action, by its nature, is not evil, and if
the good end is primarily intended and the first to be executed, and if
the good effect is at least equal to the evil effect, and if the action is
necessary and is the least harmful means for attaining the good effect.
The excision of the diseased uterus is immediately necessary and is the
minimum that is required to save the life of the mother. The good and evil
effects are equal in magnitude, since both mother and child, as human
beings, have identical rights to life. In such instances there is said to
be a conflict of rights, but not a denial of the rights of either party.
One faulty assumption which is sometimes intended by the so-called
exception to the prohibition of abortion claims that the child is an
unjust aggressor and to kill the child would be a matter of justifiable
self- defense. There is no sense in which the child can be called unjust,
since this is a moral concept and requires evil intention on the part of
the actor. As for being an aggressor, the child is not responsible for
being in the uterus and is not, either by his or her presence or activity,
injuring the mother. In the previous case, for example, it is not because
of the pregnancy that the uterus is being removed.
In the present state of obstetrics there is no justification for a direct
attack on the child's life as a means of saving the mother's. It is true
that pregnancy may aggravate certain conditions of maternal ill-health and
even be the cause of other physiological upsets in the mother. Yet,
through adequate management by the obstetrician, especially in suitable
health care facilities, the pregnancy need not be an unsurmountable
obstacle to the mother's continued living and eventual survival. But, even
if this were not so, the child may never be killed on the pretext of
saving the mother's life. The human dignity of each individual does not
permit that one human being may be sacrificed even to save the life of
another.
In another faulty assumption, the child's right to life is said to be
inferior to that of his or her mother's. From the viewpoint of
existentialism, which seems to be the basis of this assumption, the
greatest good is experience. The mother, experienced from many years of
living, is "worth" more than the inexperienced child. But, even here, it
is not the value of human rights which is being compared, but something
extraneous to the right to life. Certainly, experience gained by living is
something to be treasured, but it cannot be equated in value with the
right to continue living!
The enactment of laws prohibiting abortion should be carefully formulated
whenever the law provides the clause: "except in order to save the life of
the mother." If abortion were understood in the sense stated above, there
would be no need to use the exception clause. Moral and medical prudence
would be sufficient, as it has been in past centuries, to guide the doctor
in the performance of his duties. The pro-life people who do not accept
the use of that clause could be heartened in their moral stance when the
clause is used, if it clearly states that it includes only the so-called
"indirect abortion," meaning, of course, cases similar to those considered
above, which are conformable with the ethical principle of double-effect.
These persons are correct in fearing that the clause, as stated in the
title of this article, could be used to justify a direct attack upon the
life of the child as a supposedly valid means of saving the mother's life.
In this day of presumed "options," additional care must be taken to insure
the complete and accurate legal recognition of each individual human
being's right to life. In phrasing the prohibition against abortion, it
would be wise to define abortion as the direct and willful killing of an
unborn offspring of human parentage from the time of fertilization. To
this should be added that the prohibition does not include necessary
surgical procedure on the mother's body whose primary and direct purpose
is to prevent her death.
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