Seven (not so) Quick Takes Friday (v. 51): Tavita Halappanavar, Abortion, and the Principle of Double Effect

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A picture of every person in Ireland who is pro-abortion.

Pray for Savita Halappanavar and the handful of other women who die each day because of botched treatment under the rubric of not getting an abortion. These losses of life are terrible tragedies, and should rightly be mourned as such. Pray also for the consulting Ob/Gyn involved, who has had a history of making the wrong call in these cases. Similarly, pray for the handful of women who die because of so-called "back alley abortions," including "back-alley abortions" of the form in which a woman is counselled by her pro-choice friends to go get an abortion (chemical or otherwise) without any kind of medical supervision. Next pray for those who have died from complications involving the supposedly safe and legal type of abortions. Pray also for the occasionally reported children who are born in the clinics of the abortionist, but then are either killed or left to die, and this with the blessing of some people. Last but not least, pray for the hundred thousand or so people who die every day in abortions, the unborn victims of abortion.

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Many people's desired outcome for this fiasco.

With that said, there sure is a lot of dudgeon to be had here, a lot of "this is all the Church's fault!" It's not, as a number of other bloggers have labored to make clear (bishops, I expect, will be a little slower to respond). It's also not thanks to Irish Law. The nearest thing which can be said is that the Church could be a bit clearer as to what does and does not count as "ok" under the principle of double effect. Protip: administering antibiotics is clearly not the same thing as causing an aboriton, and this was not done until days after Mrs. Halappanavar was admitted. That seems to be malpractice, and was clearly not motivated by any kind of misunderstanding of the Catholic Church's teaching on abortion (emphasis mine):

It's been pointed out to me that according to the reports, Savita was admitted to hospital with a miscarriage underway, her cervix being open from Sunday, but that antibiotics were only brought into play on Tuesday night, a full two days later; it's as though she spent two days there with an open wound. Again, I'm no doctor and would appreciate if someone could clarify this, but given that this was a case of death from infection,  it seems to me to have been utterly egregious medical negligence from the start, and nothing whatsoever to do with the law, medical guidelines, or religious principles.

Not a reasonable response.

Given that the Church quite clearly teaches that (for example) chemotherapy to save a cancer patient which results in the death of the unborn infant is not an abortion and does fall under the principle of double effect, I would think that antibiotics quite clearly also fall under this principle. Actually, it does not seem to me that abortion has anything whatsoever to do with saving Mrs. Halappanavar's life.

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The next four takes are more-or-less my speculations. We don't have all of the facts, and I should re-emphasize that I am not a theologian, canon lawyer, or medical professional. The question has been raised a few times about whether this really does fall under the principle of double effect. For example, it has been asked how this is different from, say, the semi-recent case in Phoenix in which Sr Margaret McBride was excommunicated for performing an abortion. The answer can be found in the linked article (which was linked in the original question, posed by Mr Kaoro Nagisa):

Where both mother and child will surely perish—as in the case of an ectopic pregnancy threatening to burst a fallopian tube, or a uterine cancer or hemorrhage necessitating the whole removal of the uterus—the death of the child is a secondary (and unintentional) result of the life-saving treatment. This “indirect” abortion is made distinct from a “direct” (and therefore illicit) abortion, by intention.

 There is, in other words, a difference between, say, removing a fallopian tube in an ectopic pregnancy, which results in the death of the child, and tearing the still living child limb-from limb in the womb (as in an abortion) and then delivering the pieces. The difference is about as great as unplugging the life support from a dying man and allowing him to die, and bursting into his hospice room and drawing and quartering him.

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The point has been brought up that some theologians disagree as to whether or not there is a difference between these two actions. Of course, some theologians simply disagree that abortion is immoral--and thus are clearly wrong--so that "some theologians" disagree does not count for much. But the argument has been made that inducing labor for a pre-viable baby is the same as abortion. It seems strange to me that removing an ectopic fallopian tube is not an abortion, and chemotherapy is not an abortion, and even removing part of the uterus is not abortion (all assuming, of course, that no viable alternatives exist), but inducing pre-viable labor to save the mother's life is an abortion. I think that there may be more to this, however, than just to say "inducing labor=abortion, but none of those other things are"--stopping there might be a case of "lazy thinking," or sincere but mistaken interpretation of the bishops' teaching. I have seen one good counterargument--made by Mr John Smeaton (a pro-life Catholic)--though I think he is wrong here (it would be a bit ambitious to refute him in these quick takes, however). Also, to be fair, one of the few fair and reasonable criticisms I've heard during all of this is that the bishops need to do a better job of communicating the moral principles involved if this is an honest misinterpretation of Catholic moral theology.

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Pope Pius XII

So how do I respond to the argument that inducing labor when the baby is pre-viable is the same thing as abortion? First of all, I do not know whether inducing labor here is so important as getting proper treatment (e.g. antibiotics) in saving this woman's life. Supposing that it is, I turn to Dr William Oddie, who cites Pope Pius XII:

"the saving of the life of the future mother … should urgently require a surgical act or other therapeutic treatment which would have as an accessory consequence, in no way desired nor intended, but inevitable, the death of the fetus, such an act could no longer be called a direct attempt on an innocent life. Under these conditions the operation can be lawful, like other similar medical interventions — granted always that a good of high worth is concerned, such as life, and that it is not possible to postpone the operation until after the birth of the child, nor to have recourse to other efficacious remedies."

Doctor Oddie goes on to note that in this case, that both the lives of Mrs Halappanavar and her baby "were lost because normal medical practice in Ireland was not followed after a grossly misplaced application to her case, by those treating her, of a heretical misreading of Catholic moral law." Such is the high cost of heresy, I suppose, or even of simply misinterpreting correct moral theology.

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It is worth noting that in discussing this issue in general, the guiding philosophy should not be, "under what circumstances do I get to procure an abortion?" Or, alternatively, "how can I get away with an abortion, which includes inducing premature labor (whether the baby is viable or not)." It does not seem to me that inducing labor would have saved Savita Halappanavar's life. It does seem to me that she needed--and did not get--medical treatment (antibiotics, etc) for septicema. It also seems to me that if anything, it was the placenta and the amniotic fluid which were infected, and thus which needed to be evacuated. If in doing this, the result is that her baby also died--or, perhaps, died more quickly, since it seems that the baby was already dying--then this would surely be under the rubrics of the principle of double effect, just as removing an ectopic pregnancy or a malignant tumor in the womb (thereby resulting in the unfortunate death of the unborn child) would also fall under the principle of double effect, and thus would not constitute participation in the sin of abortion.

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About 1% of the people give cover to the other 99% of the abortions.

Given the media's frenzy of fact-checking during the presidential debates (mostly against Romney, sometimes not even factually), it sure seems to be suspiciously quiet on fact-checking what the Church or Irish law actually say here. Perhaps it is because this is such a useful cudgel for bludgeoning the institutional, magisterial Church, and also for doing the same to pro-lifers. It is also quite useful as ammo for those who have for so long been saying to Catholics, "violate your consciences: it's the law," which is the most common rebuttal to Catholics concerning the Obama administration's tyrannical HHS mandate. Also not mentioned in the mainstream media is that Ireland has one of the lowest mortality rates for pregnant women in the world. It will also be interesting to hear from, say, Dr Edward Peters (the canon lawyer), Mr Jimmy Akins (apologist extraordinaire), or any of our bishops on this issue; they can certainly clarify this better than I can. I was originally going to be writing something about abortion and rape at the Nicene Guys, but that post has been more-or-less cancelled. I may have more to say later, though.


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Seven Quick Takes Friday is hosted by Mrs Jennifer Fulwiler at her Conversion Diary blog.