Ectopic Pregnancy

Key Texts

  1. Ashley, Benedict and Kevin O’Rourke. Ethics of Health Care: An Introductory Textbook. Washington, D.C.: Georgetown University Press, 2002.
  2. Rhonheimer, Martin. Vital Conflicts in Medical Ethics: A Virtue Approach to Craniotomy and Tubal Pregnancies, ed. William F. Murphy Jr. Washington, DC: Catholic University of America Press, 2009.
  3. May, William E. “The Management of Ectopic Pregnancies: A Moral Analysis,” 121–141 in The Fetal Tissue Issue: Medical and Ethical Aspects, ed. Peter J. Cataldo and Albert S. Moraczewski. Braintree, MA: Pope John Center, 1994.

Key Abstracts

Against Salpingostomy as a Treatment for Ectopic Pregnancy (Hager, ethical analysis, 2016)

Ectopic pregnancy, when not resolved naturally, can be fatal to the mother if left untreated. A number of medical solutions exist, though none that save the life of the embryo. This article assesses the ethical value of one of these solutions, the salpingostomy, by examining the moral object of the salpingostomy and whether the procedure constitutes a direct abortion. The author responds with William E. May and Maria DeGoede to salpingostomy proponents Albert Moraczewski, Christopher Kaczor, John Tuohey, and others. Because of the lack of moral certitude that the trophoblast is neither a vital organ of the fetus nor a member of the fetus’s body, the author concludes that the salpingostomy may not be considered a licit procedure in the treatment of ectopic pregnancy, and challenges readers to admit that medical science lacks a direct, active solution to ectopic pregnancy.

The Metaphysical Status of the Placenta (Gremmels et al, ethical analysis, 2014)

The metaphysical status of the placenta has bearing on several ongoing discussions within Catholic moral theology. Numerous bioethicists and theologians have touched on this topic briefly, but to date no robust metaphysical argument appears in the literature. The authors aim to provide such an analysis. First, they provide an overview of the existing literature on the topic. Second, they briefly review the anatomy and physiology of the placenta. Third, they provide metaphysical and biological reasons why the placenta cannot be a part of the fetus, a part of the mother, simultaneously a part of both, the border at which mother and fetus meet, or a separate individual substance. Finally, they provide reasons that support their claim that the placenta is a quasi-substance that exists in symbiosis with mother and child.

An Argument Against the Use of Methotrexate in Ectopic Pregnancies (DeGoede, ethical analysis, 2014)

Catholic ethicists faithful to the magisterium of the Church are currently divided on the permissibility of using methotrexate to treat ectopic pregnancies. This paper examines the defenses of Rev. Albert Moraczewski, OP, and Christopher Kaczor, who argue that its use is morally permissible, in an attempt to demonstrate that methotrexate constitutes a direct abortion by virtue of its object. Specifically, the paper challenges the claims that metho-
trexate is aimed at inhibiting pathological tissues, that the trophoblast is not an organ of the embryo, and that direct removal of a nonviable fetus is not a direct abortion.

Bodily Invasions: When Side Effects are Morally Conclusive (Watt, ethical analysis, 2011)

What kind of interventions on the body of an innocent human being may be licitly intended? This question arises in relation to maternal–fetal conflicts such as ectopic pregnancy and obstructed labor, and to other cases such as organ harvesting and separation of conjoined twins. Many assume that harm must be intended for absolute moral prohibitions to apply; however, it is not always the case that foreseen harm is merely a factor to weigh against benefits we intend. On the contrary, foreseen harm (and absence of benefit) for someone we affect can be morally conclusive when linked to an immediate intention to affect the person’s body or invade the space it fills.

The Ethics of Ectopic Pregnancy: a Critical Reconsideration of Salpingostomy and Methotrexate (Kaczor, ethical analysis, 2009)

Ethicists have continued to debate about two means of treating ectopic pregnancy, namely, the removal of the embryo from the tube (salpingostomy) and the use of methotrexate. This article examines the major arguments in favor of considering salpingostomy intentional killing. The article goes on to evaluate the major arguments in favor of the conclusion that methotrexate is intentional killing or intentional mutilation. The tentative conclusion reached is that both salpingostomy and the use of methotrexate should be considered morally permissible.