Ethical Considerations for an Ectopic Pregnancy & Understanding Treatment Options from a Catholic Perspective

Catholic health care guidelines do not debate whether to treat ectopic pregnancies, which are never viable and are always life-threatening to the mother. However, there is a theological debate about the means to treat them.

In the tragic case of an ectopic pregnancy, emergency care is needed to save the life of the mother from a ruptured ovary or fallopian tube. While it is not possible to save the life of the baby in an ectopic pregnancy, as Catholics, not all treatment options to save the mother’s life are equal. There are moral and ethical considerations that must inform treatment options to save the mother’s life and allow the life of the baby to be treated with dignity and respect.

  1. Principle of Double Effect

  2. What treatments are ethical for me as a Catholic?

  3. How is treating an ectopic pregnancy different from an abortion?

The Principal of Double Effect

When treating an ectopic pregnancy, the desired outcome is for both the mother’s life and the baby’s life to be preserved.  This intention is important even though it is not possible for the baby to survive an ectopic pregnancy. The inability for the baby to survive does not take away our obligation to do everything possible to preserve his or her life. 

Since the medical treatment to save the life of the mother will result in the death of the child, careful considerations must be made under the Catholic understanding of the principle of double effect. 

In the principle of double effect, moral actions need to be evaluated as follows: 

1.The action must be either morally good or neutral.

2. The bad effect must not be the means by which the good effect is achieved.

3. The intention must be the achieving of only the good effect; the bad effect can in no way be intended and must be avoided if possible.

4. The good effect must be at least equivalent in proportion to the bad effect.

Treating an ectopic pregnancy has a good effect (saving the life of the mother) and a bad effect (the baby will die).

How is Treating an Ectopic Pregnancy Different From Abortion?

Saving the life of a mother suffering from an ectopic pregnancy is not abortion. An abortion has the intended and desired effect of ending the baby’s life.  In ectopic pregnancy, the death of the baby is a tragic and unintended consequence of saving the life of the mother. 

In making treatment plans for an ectopic pregnancy, Catholic parents and Catholic medical providers must keep in mind the principles of Catholic ethics and the desire to do everything possible to protect and preserve the dignity of the lives of both mother and baby. 

Catholic social doctrine provides two distinct definitions of abortion. 

  • The more familiar term, direct abortion, is a willful attack on unborn human life, no matter what the motive.

  • An indirect abortion is the permitted evacuation of a fetus or embryo which cannot survive outside the womb. In an indirect abortion, the death of the child is not the intended or desired result, but the side effect of some legitimate procedure, like the one required to save a mother’s life in the case of an ectopic pregnancy. 

What Treatments Are Ethical for Me as a Catholic?

An ectopic pregnancy occurs when the fertilized ovum implants in the fallopian tube or in some other location. A mother facing a tubal pregnancy risks imminent rupture of the fallopian tube, and thus, there exists a danger to the lives of both the mother and the child.

Removing all or part of the fallopian tube is considered moral & ethical in accordance with the principle of double effect because:

  1. Removing a part of the body that is about to rupture and cause the death of the individual is a morally good action.

  2. The death of the child is not the direct intention of the procedure. It is the removal of the fallopian tube that saves the life of the mother, not causes the death of the child.

  3. The death of the child is not willed and would be avoided if at all possible—if, for example, re-implantation in the womb were reasonably possible.

  4. The life of the mother is, of course, equal to the life of the child.

There are currently 4 methods of treating ectopic pregnancy, 2 of which are perfectly licit, one of which is illicit, and one of which is under debate by Catholic physicians and theologians.

  • The mother and baby are monitored closely. Roughly 50% of ectopic pregnancies will involve the baby dying naturally. The mother and physician can then decide any method of safely removing the baby from the mother’s body after the child has died.

  • This procedure is licit and involves the partial or complete removal of the fallopian tube, which also contains an embryo. The death of the embryo is foreseen but not intended. In a statement published in 2011, the U.S. Conference of Catholic Bishops determined that, in the case of ectopic pregnancies, “it is morally licit to remove the threat of the mother’s life . . . by removing part or all of the fallopian tube where the child implanted, even though it is foreseeable that the child will die as an indirect and unintended effect of such surgery.”

  • Most Catholic physicians and theologians consider this procedure illicit because it involves opening the fallopian tube and directly removing the embryo. It is considered by most to be a direct abortion.

  • The drug methotrexate is injected into the mother which kills the cells supporting the embryo and eventually the embryo itself. This is the least invasive procedure and preserves the mother’s fertility to the greatest extent, but many, if not most, consider it to be a direct abortion, although the issue has not been resolved.

As a final note, the National Catholic Bioethics Center's Catholic Health Care Ethics states: "Resolution of this debate will depend on further specification of the exact nature of these medical procedures and further refinement of the arguments about the moral object of each act. Generally, if there are two competing but contrary bodies of theological opinion about a moral issue, each held by experts whose work is in accordance with the magisterium of the Church, and if there is no specific magisterial teaching on the issue that would resolve the matter, then the decision makers may licitly act on either opinion until such time that the magisterium has resolved the question." (1)

Medical disclaimer: This website does not provide medical advice. All information contained in this website is for informational purposes only. No material on this website is intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified medical provider with any questions you may have about any medical condition or concerns. Never disregard medical advice or delay treatment because of something you read on this website. 

Resources:

(1) Edward J. Furton, et al., eds., Catholic Health Care Ethics: A Manual for Practitioners, Philadelphia, PA: The National Catholic Bioethics Center, 2009, p. 123.

https://www.chausa.org/publications/health-care-ethics-usa/article/winter-2011/catholic-hospitals-and-ectopic-pregnancies

https://epublications.marquette.edu/cgi/viewcontent.cgi?referer=&httpsredir=1&article=2211&context=lnq

https://www.usccb.org/committees/pro-life-activities/life-matters-abortion-rlp-2011