Quick proofreading note: D&E and D&C should be briefly explained. Currently (11:30 AM CDT), the abbreviations are presented without clarification of what they stand for, though context suggests they're abortion procedures of some kind.
Dilation and evacuation, dilation and curettage, in both cases dilation means the opening up of the cervix for access to the womb, in order to remove the womb contents, by evacuation, which is suction with a machine like a hoover, usually for smaller contents, or curettage, using a curet to divide the contents up to make it possible to remove. I'm not being vague or euphemistic, obviously if the womb contents are a living child this is abortion, but womb contents could be an unborn child who has already died naturally, or could be incompletely delivered placenta and so on
Thank you for this article. I hate the play on words used in liberal politics, as well as everywhere else. An abortion (defined as the willful and intention killing of an unborn human life) is *NEVER* necessary to save the life of the mother. Medical care given to the mother that results in the unintentional death of the child is *not* an abortion and no one advocates for getting rid of that.
I agree that both D&E and D&C should be defined, and I propose one additional caveat. In the event of a miscarriage, and the child is dead within the womb, then D&E or D&C may be carried out in order to remove the dead child from the mother’s womb.
I don’t know whether there are less gruesome alternatives for the removal of dead child, but there are situations where D&E and D&C could be performed and not be abortions.
Yes. Unfortunately much harm and misunderstanding (willful or not…) has been caused by the inclusion of both miscarriage and induced abortion under the medical coding umbrella term of “abortion.” It seems self-evident to separate cases between ones with a living child (embryo or fetus) whose life is being ended by the procedure and ones with a deceased child whose mother needs to be cared for. And yet it is politically expedient for pro-abortion activists to conflate and confuse the two, aided by the confusing language and the fact that similar or identical procedures or medications are sometimes used for both induced abortion and miscarriage management. Truly diabolical.
It is also worth noting that some miscarriages are resolved naturally/without the use of a D&C procedure or any medication (I myself had this happen- truly the best case scenario in a bad situation). But many women feel uneasy about needing to use medical or surgical means to manage the aftermath of a miscarriage, as those medications (e.g. misoprostol/cytotec) or procedures (D&C for an early m/c, D&E for a later m/c if i am not mistaken) are also used in induced abortion. But when you have had a miscarriage, your child is already deceased- using these medical or surgical management routes is not wrong or shameful. It is important to understand these distinctions.
Very interesting to read of the internal disagreement within Catholic ethicists. The moral of this story seems to be that some Catholic institutions need clearer policies. I'd be interested in a Pillar story discussing whether this applies to the various post-Dobbs pro-life legislation in various states. Is there fire with all of the pregnancy "horror stories" being shared by the MSM? All smoke and mirrors? Somewhere in between?
Secular Pro Life has been doing a good job debunking a lot of the horror stories. You can find them on YouTube or tiktok, and they also have a Twitter/X account and a blog at their website where they have reference links to cite the sources they use in their tiktok videos. Since Dobbs they've been trying to build common ground by raising awareness about post viability elective abortion. Their spokeswoman had the experience of going undercover at 28 weeks pregnant to see how far in the process she would get before the clinic asked whether there was a medical reason for wanting an abortion so late. Spoiler alert: they never did.
One thing I’ll admit to not fully understanding with regards to removal of the diseased organ double effect is how it comes in to play with things like abdominal ectopic pregnancies; can’t very well remove the liver to save the life of the mother (despite certain Florida surgeons…). That would seem to put more favor to concept of previable delivery since it would account for those edge cases.
With a liver, you’d just remove that portion of the liver and leave the rest alone (lots of talk lately with a relative preparing for surgery to remove part of a cancerous liver). And in ectopics, I don’t believe it’s possible for the ectopic embryo to reach viability in any case but I am glad to be corrected, and will be when Mrs. Doctor wakes up I’m sure.
An excellent article. "Yes," to greater clarity on the subject of induced labor, but also the meaning of viability.
That the concept of viability is integrated into the ERDs is problematic for me, because it depends largely on the technology available. Premature children who didn't have a chance a century ago can now be saved and mature outside the womb, all due to technological advancements made. Theoretically, if someone were to develop an artificial womb for use in emergency situations (though I fear that many would want to create a Brave New World with such a technology), then viability would slip even further back as a standard. Thus, I find it an inadequate standard through which to make life and death decisions.
There's still legitimate debate on the issue, so I'll just say that I lean towards induced labor in cases where the dangers to the mother cannot be mitigated through medical treatment, regardless of viability. If the mother dies or becomes so sick that miscarriage occurs, the child will die also. I see a stark difference between "terminating pregnancy" by separating mother and child and the same achieved by directly attacking the physical integrity of said child. The former could theoretically be mitigated through more advanced technology, making the child's survival possible, whereas the latter makes the survival of the child impossible.
To me, this manner of thinking is a case of the more general distinction between "killing" and "letting die," which are very different acts depending on the circumstances surrounding them. But I admit that what I've said above could be criticized because one is actively bringing about the circumstances where "letting die" is taking place.
All I can say is, when we're dealing with a tragic situation in which a life will likely be lost no matter what we do, we have a choice between circumstances in which more death or less death will take place. I do believe that moral grey areas will always exist and that hospitals have to be allowed to make tough decisions in exceptional cases with the best possible prudence, involving family, doctors, ethicists, and anyone else who needs to be involved-- above all, a priest who needs to be there to baptize the child who genuinely cannot be saved.
Incorporating "viability" into a general analysis of killing vs letting die is hardly problematic. We use exactly the same concept for end-of-life care all the time, even though we usually don't use the language of viability. Where the unborn are becoming viable at earlier times during pregnancy, the elderly are remaining viable until later times during ailment and old age. Ultimately, viability is just a probabilistic assessment of the likelihood of a given patient's survival under the present conditions. There is inevitably a big difference in the moral gravity of decisions between cases where it is assessed that survival is almost certain, that death is almost certain, and that life or death appears to be a toss-up. Indeed, it would be negligent to fail to assess viability in such decision making.
The incorporation of viability becomes problematic when it being used to evaluate the moral worthiness of the patient themselves. In this mindset, the action is always killing. The question is, who is it okay to kill? One way of answering this question is by viability: it is wrong to kill those who are viable; it is okay to kill those who are not viable. In this thinking, viability is functionally an on-off switch for human rights.
In the former case, the change in viability over time is not a moral problem. It may be a happy or sad accident that a given patient lives in a time and place where medical technology makes the probability of survival better or worse under given conditions. But that individual's moral worthiness is entirely unchanged by those circumstances. This is the Catholic way. In the latter case, the change in viability determines whether or not that individual has even the basic right to life. The individual's moral worthiness is entirely dependent upon their circumstances--an no Catholic can hold to such a principle.
Hopefully this helps disambiguate the different ways viability is used in these analyses!
Just a clarification: A salpingectomy is removal of the whole fallopian tube and is considered the most ethical treatment available for ectopic pregnancies. A salpingostomy involves only partial removal of fallopian tissue - that area where the embryo has implanted - versus complete removal of the organ. Therefore, it's considered problematic by many moral theologians because it targets only the embryo vs. the whole organ. Sadly, I had to learn these terms when I suffered an ectopic pregnancy several years ago. I had to fight for the salpingectomy vs. the salpingostomy. Moreover, having been in that position and knowing there were major moral issues involved, it was still unbelievably difficult to navigate. Women with ectopic pregnancies are in terrible physical pain, not to mention severe emotional and spiritual distress, and once doctors have identified the problem they move *very* quickly to treat it (not without reason), while reminding you that your condition is life threatening.
With regard to double effect, it is easy to think of it in context not involving pregnancy. Heart surgeon opens up your chest with spreaders and scalpels and all,, and you don't make it, it's still clear that the intention was to save you not to kill you. In pregnancy there are two patients, but the child is dependent on the mother. It is not that the mother has more, or less rights, simply that her survival is necessary to the child's survival as well . Early delivery for her survival may be necessary. First however you would delay delivery as long as you reasonably can, to give the child more time, also doing what you can to prepare the child in utero for delivery. Viability is not a definable thing, only probabilistically determinable. In earlier times a baby would die if their mother died before they were weaned, unless a wet nurse could help. Early delivery nowadays, dependent on available technology, could be as early as twenty weeks, and that is possibly going down in the future, womb like incubators anyone? But it remains impossible to say for sure, just as your heart surgeon would not give absolute guarantees. And there can be margins of error too, your dating of the age of the child could be off, and so on. It is sad to be delivering any baby who has a low chance of survival, but even their little chance should be respected and supported.
This article could almost be taught as a class in bioethics. I went to the link to read the article but as a non medical person was overwhelmed with the content about half way through it and could not go any further in one sitting. What I did read was pretty common sensical and it sickens me to see the Leftists make a swipe at Roe v Wade with their main accomplice, the MSM.
"The action in this case is ejecting infected placental tissue from the mother’s body, because the infected tissue poses a risk to the mother, Cerroni explained. This action itself is a morally acceptable act, and is directed at treating the pathological tissue in the mother’s body. The child’s death is an undesired side effect."
I'm not understanding this argument because the placenta is part of the child's tissue not the mother's.
There are various approaches to defining "whose" organ the placenta is, but on a biological level, the placenta is comprised of tissue from both the mother and child.
Quick proofreading note: D&E and D&C should be briefly explained. Currently (11:30 AM CDT), the abbreviations are presented without clarification of what they stand for, though context suggests they're abortion procedures of some kind.
Seconded, especially since both of those procedures (by the same names) can be performed in non-abortion situations.
Dilation and evacuation, dilation and curettage, in both cases dilation means the opening up of the cervix for access to the womb, in order to remove the womb contents, by evacuation, which is suction with a machine like a hoover, usually for smaller contents, or curettage, using a curet to divide the contents up to make it possible to remove. I'm not being vague or euphemistic, obviously if the womb contents are a living child this is abortion, but womb contents could be an unborn child who has already died naturally, or could be incompletely delivered placenta and so on
NCBC is very well respected so it's really interesting to read about the debates surrounding early induction of labor. Thank you for this article.
Thank you for this article. I hate the play on words used in liberal politics, as well as everywhere else. An abortion (defined as the willful and intention killing of an unborn human life) is *NEVER* necessary to save the life of the mother. Medical care given to the mother that results in the unintentional death of the child is *not* an abortion and no one advocates for getting rid of that.
I agree that both D&E and D&C should be defined, and I propose one additional caveat. In the event of a miscarriage, and the child is dead within the womb, then D&E or D&C may be carried out in order to remove the dead child from the mother’s womb.
I don’t know whether there are less gruesome alternatives for the removal of dead child, but there are situations where D&E and D&C could be performed and not be abortions.
Yes. Unfortunately much harm and misunderstanding (willful or not…) has been caused by the inclusion of both miscarriage and induced abortion under the medical coding umbrella term of “abortion.” It seems self-evident to separate cases between ones with a living child (embryo or fetus) whose life is being ended by the procedure and ones with a deceased child whose mother needs to be cared for. And yet it is politically expedient for pro-abortion activists to conflate and confuse the two, aided by the confusing language and the fact that similar or identical procedures or medications are sometimes used for both induced abortion and miscarriage management. Truly diabolical.
It is also worth noting that some miscarriages are resolved naturally/without the use of a D&C procedure or any medication (I myself had this happen- truly the best case scenario in a bad situation). But many women feel uneasy about needing to use medical or surgical means to manage the aftermath of a miscarriage, as those medications (e.g. misoprostol/cytotec) or procedures (D&C for an early m/c, D&E for a later m/c if i am not mistaken) are also used in induced abortion. But when you have had a miscarriage, your child is already deceased- using these medical or surgical management routes is not wrong or shameful. It is important to understand these distinctions.
Very interesting to read of the internal disagreement within Catholic ethicists. The moral of this story seems to be that some Catholic institutions need clearer policies. I'd be interested in a Pillar story discussing whether this applies to the various post-Dobbs pro-life legislation in various states. Is there fire with all of the pregnancy "horror stories" being shared by the MSM? All smoke and mirrors? Somewhere in between?
Secular Pro Life has been doing a good job debunking a lot of the horror stories. You can find them on YouTube or tiktok, and they also have a Twitter/X account and a blog at their website where they have reference links to cite the sources they use in their tiktok videos. Since Dobbs they've been trying to build common ground by raising awareness about post viability elective abortion. Their spokeswoman had the experience of going undercover at 28 weeks pregnant to see how far in the process she would get before the clinic asked whether there was a medical reason for wanting an abortion so late. Spoiler alert: they never did.
One thing I’ll admit to not fully understanding with regards to removal of the diseased organ double effect is how it comes in to play with things like abdominal ectopic pregnancies; can’t very well remove the liver to save the life of the mother (despite certain Florida surgeons…). That would seem to put more favor to concept of previable delivery since it would account for those edge cases.
With a liver, you’d just remove that portion of the liver and leave the rest alone (lots of talk lately with a relative preparing for surgery to remove part of a cancerous liver). And in ectopics, I don’t believe it’s possible for the ectopic embryo to reach viability in any case but I am glad to be corrected, and will be when Mrs. Doctor wakes up I’m sure.
One case of an abdominal delivered by not quite c-section at 29 weeks, but only one I’m aware of https://www.nejm.org/doi/full/10.1056/NEJMicm2120220
An excellent article. "Yes," to greater clarity on the subject of induced labor, but also the meaning of viability.
That the concept of viability is integrated into the ERDs is problematic for me, because it depends largely on the technology available. Premature children who didn't have a chance a century ago can now be saved and mature outside the womb, all due to technological advancements made. Theoretically, if someone were to develop an artificial womb for use in emergency situations (though I fear that many would want to create a Brave New World with such a technology), then viability would slip even further back as a standard. Thus, I find it an inadequate standard through which to make life and death decisions.
There's still legitimate debate on the issue, so I'll just say that I lean towards induced labor in cases where the dangers to the mother cannot be mitigated through medical treatment, regardless of viability. If the mother dies or becomes so sick that miscarriage occurs, the child will die also. I see a stark difference between "terminating pregnancy" by separating mother and child and the same achieved by directly attacking the physical integrity of said child. The former could theoretically be mitigated through more advanced technology, making the child's survival possible, whereas the latter makes the survival of the child impossible.
To me, this manner of thinking is a case of the more general distinction between "killing" and "letting die," which are very different acts depending on the circumstances surrounding them. But I admit that what I've said above could be criticized because one is actively bringing about the circumstances where "letting die" is taking place.
All I can say is, when we're dealing with a tragic situation in which a life will likely be lost no matter what we do, we have a choice between circumstances in which more death or less death will take place. I do believe that moral grey areas will always exist and that hospitals have to be allowed to make tough decisions in exceptional cases with the best possible prudence, involving family, doctors, ethicists, and anyone else who needs to be involved-- above all, a priest who needs to be there to baptize the child who genuinely cannot be saved.
Incorporating "viability" into a general analysis of killing vs letting die is hardly problematic. We use exactly the same concept for end-of-life care all the time, even though we usually don't use the language of viability. Where the unborn are becoming viable at earlier times during pregnancy, the elderly are remaining viable until later times during ailment and old age. Ultimately, viability is just a probabilistic assessment of the likelihood of a given patient's survival under the present conditions. There is inevitably a big difference in the moral gravity of decisions between cases where it is assessed that survival is almost certain, that death is almost certain, and that life or death appears to be a toss-up. Indeed, it would be negligent to fail to assess viability in such decision making.
The incorporation of viability becomes problematic when it being used to evaluate the moral worthiness of the patient themselves. In this mindset, the action is always killing. The question is, who is it okay to kill? One way of answering this question is by viability: it is wrong to kill those who are viable; it is okay to kill those who are not viable. In this thinking, viability is functionally an on-off switch for human rights.
In the former case, the change in viability over time is not a moral problem. It may be a happy or sad accident that a given patient lives in a time and place where medical technology makes the probability of survival better or worse under given conditions. But that individual's moral worthiness is entirely unchanged by those circumstances. This is the Catholic way. In the latter case, the change in viability determines whether or not that individual has even the basic right to life. The individual's moral worthiness is entirely dependent upon their circumstances--an no Catholic can hold to such a principle.
Hopefully this helps disambiguate the different ways viability is used in these analyses!
What's up with the weird AI stock photo?
I initially read this as weird AL stock photo, as in Weird Al Yankovic. I was really confused haha.
Just a clarification: A salpingectomy is removal of the whole fallopian tube and is considered the most ethical treatment available for ectopic pregnancies. A salpingostomy involves only partial removal of fallopian tissue - that area where the embryo has implanted - versus complete removal of the organ. Therefore, it's considered problematic by many moral theologians because it targets only the embryo vs. the whole organ. Sadly, I had to learn these terms when I suffered an ectopic pregnancy several years ago. I had to fight for the salpingectomy vs. the salpingostomy. Moreover, having been in that position and knowing there were major moral issues involved, it was still unbelievably difficult to navigate. Women with ectopic pregnancies are in terrible physical pain, not to mention severe emotional and spiritual distress, and once doctors have identified the problem they move *very* quickly to treat it (not without reason), while reminding you that your condition is life threatening.
With regard to double effect, it is easy to think of it in context not involving pregnancy. Heart surgeon opens up your chest with spreaders and scalpels and all,, and you don't make it, it's still clear that the intention was to save you not to kill you. In pregnancy there are two patients, but the child is dependent on the mother. It is not that the mother has more, or less rights, simply that her survival is necessary to the child's survival as well . Early delivery for her survival may be necessary. First however you would delay delivery as long as you reasonably can, to give the child more time, also doing what you can to prepare the child in utero for delivery. Viability is not a definable thing, only probabilistically determinable. In earlier times a baby would die if their mother died before they were weaned, unless a wet nurse could help. Early delivery nowadays, dependent on available technology, could be as early as twenty weeks, and that is possibly going down in the future, womb like incubators anyone? But it remains impossible to say for sure, just as your heart surgeon would not give absolute guarantees. And there can be margins of error too, your dating of the age of the child could be off, and so on. It is sad to be delivering any baby who has a low chance of survival, but even their little chance should be respected and supported.
Excellent article, Michelle! Thanks so much!!!
Excellent article on this topic. Every Catholic should read it. Thank you
This article could almost be taught as a class in bioethics. I went to the link to read the article but as a non medical person was overwhelmed with the content about half way through it and could not go any further in one sitting. What I did read was pretty common sensical and it sickens me to see the Leftists make a swipe at Roe v Wade with their main accomplice, the MSM.
"The action in this case is ejecting infected placental tissue from the mother’s body, because the infected tissue poses a risk to the mother, Cerroni explained. This action itself is a morally acceptable act, and is directed at treating the pathological tissue in the mother’s body. The child’s death is an undesired side effect."
I'm not understanding this argument because the placenta is part of the child's tissue not the mother's.
Overall great article.
There are various approaches to defining "whose" organ the placenta is, but on a biological level, the placenta is comprised of tissue from both the mother and child.