Catholic Medical Quarterly Volume 64(4) November 2014


Pre term induction and abortion.

Anthony McCarthy

Author photoDear Sir 

Dr Michael Jarmulowicz  (August 2014) tells us that he detects a certain ‘illogicality’ in my response (May 2014) to critics of my article (February 2014) on pre-viability induction. The basis for the claim concerns my use of analogy and my understanding of his own use of analogy.

I drew an analogy between a vital conflict pregnancy situation resolved by pre-viable induction and the pushing of someone off a raft. The comparison has two purposes:   a) to show that one can knowingly cause a death without intending it and b) to show the disanalogy  between the raft scenario and the special relationship of pregnancy and rights of the unborn child.  I hope that readers attentive to the logic of the original article and its precise restatement will have seen this. 

Why, then, do I find Dr Jarmulowicz’s own analogy alarming? Quite simply because the analogy of removing someone from an ICU is relevantly similar to the standard pro-choice comparison between pregnancy and ‘technological’ life support (as in the famous ‘violinist’ analogy of Judith Jarvis Thomson). There is nothing technological about pregnancy; moreover, Dr Jarmulowicz uses this analogy in order to argue in favour of targeted ‘detachment’ of a pre-viable baby from the mother. One does not have to believe that all such removals must be intended to cause death – I do not myself believe they must always have this intention – in order to see them as absolutely morally excluded, whether death is intended or not. This should be clear when we focus on the special nature of and bonds involved in pregnancy itself and not exclusively on questions of intentional homicide.

With regard to methotrexate it is indeed true that moral theologians differ on this as on various other questions. However, those who believe using methotrexate can be justified, and especially those who accept that the trophoblast/placenta is part of the embryo, owe it to us to explain how such deliberate (and lethal) bodily invasion of the baby can be defended. This is an additional objection to the objection concerning the targeted removal of the embryo (as opposed to removing an already-damaged part of the mother with the embryo still inside).

Finally Dr Jarmulowicz takes issue with one (and only one) of the many citations I gave from relevant Church teaching. Unfortunately he misses the crucial point. Directive 47 of the USCCB Ethical and Religious Directives does indeed acknowledge that the principle of double effect is one fundamental to our ethical thinking and that harm can be ethically accepted for a pre-viable baby as the result of a morally legitimate and proportionate operation on the mother. But the argument about pre-viable inductions is that they are carried out on the baby without being in any way for the baby’s benefit:  they bring about the ‘termination’ (ending) of a pregnancy deliberately, not as a side-effect of other action. The removal itself is intended, whether or not the fatal result of that removal is intended.  (Note that Directive 45, while referring to the ‘directly intended destruction’ of the viable foetus omits this phrase in the context of pre-viability removals, speaking instead of ‘directly intended termination of pregnancy’.)

David Albert Jones, who writes in the same issue, appears unaware of the distinction I drew between the wrongful intention to end a pregnancy pre-viability and the wrongful  intention to end life.  He will be very aware from his studies in theology and Church history that the Church’s condemnation of abortion continued through times when the beginning of life was far more in dispute than it is now. Yet during such times deliberate pre-viability ‘termination of pregnancy’ was condemned by the Church, along with contraception,  as seriously wrong.  To make the wrongness of deliberately ending pregnancy solely dependent on the intention to kill a human person is extremely hard, if not impossible, to square with this tradition.

Yours sincerely

Anthony McCarthy 

Click here to see all the other articles and letters relating to this debate