Ectopic pregnancy

Anyone have any resources on ectopic pregnancy? Particularly what interventions are available and any work done on ethics.

3 Likes

Family Medicine Obstetrics has a section on ectopics. The ebook is not too bad price-wise. Its very to-the-point but discusses the common “interventions” - surgical, medical, expectant - and when they are appropriate/recommended.

It doesn’t discuss the ethical component. Generally the medical community considers ectopic pregnancies non-viable (despite demonstrations that some are viable) and therefore ethically uncomplicated. The idea that there could even be an ethical aspect to ectopic pregnancies was not even acknowledged when I was in school.

2 Likes

The Catholic Church has a fairly well developed ethical position on this issue, which may be worth reviewing. See the section on ectopic pregnancies in this pdf, for instance: http://www.cathmed.org/assets/files/EntireBinder4-030617-SecuritySettingsOnForWeb.pdf

2 Likes

I don’t have any personal experience or medical knowledge, but I remember C Everett Koop indirectly spoke of them once. Found this while I was looking for it:

2 Likes

Susan,

I appreciate The Personhood Initiative’s attempt to save babies’ lives, but I have some big concerns about this piece. The article states that “These pregnancies are generally assumed to be fatal unless an abortion is performed, and the explanation is given that it is better to save the mother by killing the unborn child than to do nothing and allow both of them to die.” I’m sure some pro-abortion groups make that claim, but I haven’t seen a similar reference from any medical sources. The resource I linked above indicates that in cases where serious symptoms are not observed at the time the ectopic pregnancy is diagnosed 88% will resolve on their own (through miscarriage without massive hemorrhage).

The article also uses some very poor statistical reasoning to make it seem like ectopic pregnancies are far more likely to result in live births than is reasonable, and they give a lot of credence to a couple of anecdotal claims of transplantation.

A couple more resources for anyone looking for a deep dive:

A review of the medical treatment and ethics from pro-life OBs

A pair of pieces in The Federalist, the first echoing some of the claims in The Personhood Initiative’s piece, and the second a retraction and apology.


I do agree with the article that the low value placed on the lives of the preborn has led to a lack of research into potentially transplanting embryos. But, in my opinion, many of us who are staunchly anti-abortion find it hard to acknowledge that there are difficult moral and ethical tradeoffs in some situations.

1 Like

Thank you. As I said as I posted it, I don’t have any medical knowledge and just found the article in a search. The Koop quote was what I was looking for. Perhaps he wasn’t considering an ectopic pregnancy to be an abortion when he said that?

Koop may not consider it “a pregnancy.” I once asked a very conservative physician (not an OB) about ectopic pregnancies and he didn’t consider it a moral quandary at all. He considered an embryo implanted outside of the uterus to be equivalent to a fertilized egg that fails to implant. It is a sad thing that this young life never had a chance but there is no reason to compound that by threatening the mother’s health.

To me it seems that the Catholic position has merit. The intention of the actions taken is important. If part of the fallopian tube is at risk of rupturing and a portion must be removed, that is different than aborting as soon as the pregnancy is identified.

Here is some animal research work being done to develop “a surgical technique to transfer an implanted embryo/fetus in an ectopic pregnancy, in an animal model”

That lab has a few published articles: https://sammutlab.com/ectopic-pregnancy-transfer-procedure-study/

The American Association of Pro-Life Obstetricians and Gynecologists has some write ups: https://aaplog.org/what-is-aaplogs-position-on-treatment-of-ectopic-pregnancy/

I would be curious to know if there is any non-catholic discussions of the principle of double effect.

2 Likes

The principle of double effect is Aquinian, so any discussion is probably going to have a Catholic flavor. I have looked around a little and there is a real dearth of ethical discussion on this issue that isn’t Catholic.

I don’t know if the author of this piece is Catholic, but she is definitely using the double effect frame when doing ethical reasoning:

One section stuck out:

“In Sub-Saharan Africa, the culture is so sensitive to the sanctity of life that medical professionals gasp in mournful awe at the sight of the ectopic child. After the surgery is complete they will allow the mother to hold the ectopic child, allowing her to truly mourn the loss of the life. The care and mindfulness with which these people invest into having a small funeral service proves that salpingostomy can be done rightly (Sullivan, 2013).”

3 Likes

Wonderful, thanks for sharing. I look forward to reading the rest of the article.

General Protestant thinking on abortion seems to stop somewhere between “rape and incest” and “morning-after pill.” I don’t know if it’s because the RCC is more monolithic, more given to a philosophical bent or some other reason, but Roman Catholic thinking is a thousand light years beyond Protestant thinking on these topics. The same goes for birth control, fertility treatments and affiliated topics. (Which is not to say that’s it’s all correct, well-grounded, etc., just that it’s deeply thought-out.)

6 Likes