Monday, March 16, 2009

Another amateur attempt at moral reasoning

I held off commenting on this highly-charged moral issue until the dust settled a bit. As most people know, last week in Brazil, a nine year-old girl turned up pregnant with twins. Her pregnancy was the result of her step-father repeatedly raping her. It is difficult to imagine a case that would provoke more emotion. Add to this the public announcement that Archbishop José Cardoso Sobrinho, of Recife and Olinda, excommunicated the girl's mother and the doctors who performed an abortion to save the life of the pregnant 9 year-old.

Archbishop Rino Fisichella
The dust settled for me over the weekend when the voice of reason and conscience was raised in the Vatican by Archbishop Rino Fisichella, in an article he wrote for yesterday's edition of the Vatican's newspaper, L'Osservatore Romano. As with most high-ranking prelates in the Vatican, Archbishop Fisichella is not just any old someone. He is the head of the Pontifical Academy for Life. Expressing the same concern as did the girl's doctor, namely that the life of pregnant 9 year-old was endangered, not just by giving birth, but by carrying the twins to a point at which they could survive on their own, His Excellency wrote that the excommunications were unwarranted because her mother and doctors did it in order to save the life of the 9 year-old.

Predictably, far from settling the dust, this pronouncement has stirred things up once again, especially among those who, while staunchly pro-life, are unfamiliar with the Church's moral teaching. I surmise that the moral principle under which the abortion was performed was the principle of double-effect, which sets forth the criteria for acting in a way that has both good and bad consequences (i.e., a "double effect"). It states that an action having an unintended, harmful effect (e.g., an early death) is defensible on four conditions as follows:

 the nature of the act is itself good (e.g., its nature is to relieve someone of pain or distress);
 the intention is for the good effect and not the bad;
 the good effect outweighs the bad effect in a situation sufficiently grave to merit the risk of yielding the bad effect (e.g., risking a patient's death to stop intolerable pain); and
 the good effect (relieving pain) does not go through the bad effect

Here is where my amateur attempt comes in: If I understand the reasoning in this case correctly (I readily admit that I may not), the four conditions were met in something like the following way:

 The abortions were performed to save the life of 9 year-old mother, as it is certainly mortally dangerous for a girl of that age either to give birth naturally or carry the children in her until such a time as they can be born and live
 the intention is to save the life of the 9 year-old mother, who is the victim of a horrible crime, not to take the lives of the twins, whose survival was doubtful at best
 the good effect in this case certainly outweighs the bad effect, as it is, again, likely that none of the three would survive, at least by doing this the life of the 9 year-old girl is saved
 in this case, while the good effect goes through, as it were, the bad effect, it is mitigated by the fact the lives of all three were seriously imperiled anyway

This is a moral judgment far superior to what appears to be an unfortunate reaction on the part of the local ordinary. It is a judgment that is in perfect harmony with authentic Christian morality. Archbishop Fisichella's judgment is not one determined by a false sense of mercy, by sentiment, nor is it caving in to public opinion. With words directed to the little girl in the center of this storm, Archbishop Fisichella wrote: "There are others who merit excommunication and our pardon, not those who have allowed you to live and have helped you to regain hope and trust." Amen.

Thanks to Deacon Greg Kandra, writing over at The Deacon's Bench, for bringing this much needed clarification to my attention. This post began with comments I made in the discussion that resulted from Deacon Greg's post.

No matter what happened afterwards, this is just a heart-breaking event. Oh, the things we do to each other. I was moved by what yesterday's Gospel said of those who "began to believe in his name": "Jesus would not trust himself to them because he knew them all, and did not need anyone to testify about human nature. He himself understood it well" (Jn 2:23).

4 comments:

  1. I tread very cautiously with opinions in this field. I also don't see what would be wrong with your argument, at least if what is being done is not directly "killing", but removing the babies from the mother.

    Nonetheless, it is not only the local ordinary's opinion that it was wrong: such questions were raised long ago. I quote from the Catholic Encyclopedia of 1907, which refers to the answers given by the Holy Office in Rome:
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    The teachings of the Catholic Church admit of no doubt on the subject. Such moral questions, when they are submitted, are decided by the Tribunal of the Holy Office. Now this authority decreed, 28 May, 1884, and again, 18 August, 1889, that "it cannot be safely taught in Catholic schools that it is lawful to perform . . . any surgical operation which is directly destructive of the life of the fetus or the mother." Abortion was condemned by name, 24 July, 1895, in answer to the question whether when the mother is in immediate danger of death and there is no other means of saving her life, a physician can with a safe conscience cause abortion not by destroying the child in the womb (which was explicitly condemned in the former decree), but by giving it a chance to be born alive, though not being yet viable, it would soon expire. The answer was that he cannot. After these and other similar decisions had been given, some moralists thought they saw reasons to doubt whether an exception might not be allowed in the case of ectopic gestations. Therefore the question was submitted: "Is it ever allowed to extract from the body of the mother ectopic embryos still immature, before the sixth month after conception is completed?" The answer given, 20 March, 1902, was: "No; according to the decree of 4 May, 1898; according to which, as far as possible, earnest and opportune provision is to be made to safeguard the life of the child and of the mother. As to the time, let the questioner remember that no acceleration of birth is licit unless it be done at a time, and in ways in which, according to the usual course of things, the life of the mother and the child be provided for". Ethics, then, and the Church agree in teaching that no action is lawful which directly destroys fetal life. It is also clear that extracting the living fetus before it is viable, is destroying its life as directly as it would be killing a grown man directly to plunge him into a medium in which he cannot live, and hold him there till he expires.
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    I disagree with the last argument in that encyclopedia, as I think it is covered under the principle of double effect, and is not directly killing, if one's intention is not to kill. Nonetheless that was the argument made.

    Also the United States Conference of Catholic Bishops Ethical and Religious Directives for Catholic Health Care Services says that "Abortion (that is, the directly intended termination of pregnancy before viability or the directly intended destruction of a viable fetus) is never permitted." (n. 45) They also say "For a proportionate reason, labor may be induced after the fetus is viable," which seems to suggest that in their opinion labor may not be induced before the fetus is viable, even in order to save the mother's life.

    It does seem to me that the principle of double effect would allow for at least inducing labor to save the mother's life, even if the baby will be sure to die almost immediately afterwards. But the old interpretation from Rome and the present answer from the bishops doesn't seem to allow for this.

    The bishops aren't infallible in this point of interpretation, but I myself at least am hesitant to definitely contradict them.

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  2. Thanks for your thoughtful comment, Joseph. I certainly agree that treading cautiously here is important. However, I would not see the 1907Catholic Encyclopedia as any kind of an authority on this matter. The inescapable fact is that human judgment can never be taken out of the equation when dealing with difficult issues. Far from being a bad thing, it is a good thing. Life issues, because we are dealing with human life, are easily the most vexing issues we face.

    The application of the principle of double effect is always a judgment call. It is not a principle that can be applied lightly to just any moral problem. It is certainly not something one would apply to one's own actions and, even in medical ethics, it is a judgment to be arrived at in a collaborative manner.

    Nonetheless, I am confident in the judgment of Archbishop Fisichella, whose article on this sensitive matter would not have been published in L'Osservatore Romano without at least approval from the Holy See's Secretariat of State, which, since the curial reforms of Paul VI, has supplanted the former Holy Office, now known as the Congregation for the Doctrine of the Faith, when it comes to such matters.

    Also, the citation from the U.S. Bishops does not seem to be dealing with a case in which the life of the mother is really and truly imperiled by giving birth. As I mentioned, in this sad case, not only the life of the mother, but the life of the twins, were endangered, not only by giving birth, but even by carrying the twins to the point of viability. In other words, the sure saving of the mother's life resulted in a better outcome.

    As I understand it, the only objection the U.S. Bishops have to medical clauses in legislation restricting abortions, clauses that permit it in cases where the mother's life is genuinely jeopardized by giving birth, is that these clauses tend to be written in a way that almost any reason qualifies as medical necessity, not just the reason of sparing of the mother's life.

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  3. Fisichella did a bad work.

    He was not well informed about what was really going here in Brazil.
    He was right when he talked of the need of protecting the girl and her family,but he was completely bad informed about the rest.
    Our pro abortists politics,doctors and activists will keep his letter to justify their future "social abortions".
    The message sent:the church is a mess,with poor communications,abortions are endorsed in this cases.
    Dom jose was trying to save the 3 children.Last week a girl with 11 gave birth here,helped by the local church,she is well.She was rapped too.
    The doctors who performed the abortion,were from a staff of abortists,with political connections and interests.
    Only they say she was immediatly in danger.

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  4. Deacon,today,at rorate caeli,there is the answer from the diocese of recife,in english,about the rino's letter.

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