Yesterday North Dakota became the first state in the Union to pass a personhood ammendment that covers humans in their embryonic stages of development. Read it here at HuffPo. For all the work involved in getting to this day, the easy part is over, and the real fight lies ahead.
The lesislation, SCR4009, states:
“The inalienable right to life of every human being at any stage of development must be recognized and protected.”
While this amendment is beautiful in its absolutist elegance, it presents the Pro-life Movement with a constellation of challenges in selling this proposed amendment to the North Dakota voters who must now vote to ratify it. That won’t be an easy sell when the voters move past the noble principle and consider the specific applications in the lives and reproductive health of North Dakota’s women.
The first objection that will need to be overcome is what is to be done in the case of ectopic pregnancy, which occurs at a rate of 19.7 per 1,000 in North America. This is no small question, as even pro-lifers are split on the approach to this potentially fatal condition. All would agree that it is out of tyhe question to sit back and let nature take its course. Read here for a good article about ectopic pregnancy.
While many case spontaneously resolve, with the embryo being resorbed by the mother’s body, many do not. In the case of tubal pregnancies there are two basic approaches, only one of which is morally acceptable to Catholics. The first, and morally unacceptable method, is to treat the mother with drugs such as methotrexate, which target the baby for death. Proponents of this method prefer it, as it preserves the Fallopian tube for future pregnancy.
The direct targeting of the baby is morally unacceptable to Roman Catholics, leaving salpingotomy (removing the tube with the baby inside), as the only morally acceptable solution. This approach satisfies the moral principle of Double-Effect, which according to the David Solomon article just linked states:
four conditions [need to] be met if the action in question is to be morally permissible: first, that the action contemplated be in itself either morally good or morally indifferent; second, that the bad result not be directly intended; third, that the good result not be a direct causal result of the bad result; and fourth, that the good result be “proportionate to” the bad result.
A question that arises is whether Catholic pro-lifers are willing to endorse methotrexate over salpingotomy in the case of ectopic pregnancy. If not, count on the other side arguing that we are trying to force our morality on the public through this amendment. When asked, how will we respond?
Will fidelity to our moral compass fracture the absolutist tone of the amendment’s language? If so, what other concessions will be sought and made? How rapidly will personhood be eviscerated?
These questions require answers now, today, as North Dakota voters are forming their impressions as we speak.
More potential objections and exceptions in Part II.
Coming Home 
Isn’t the result of “salpingotomy (removing the tube with the baby inside)” the same as that of methotrexate: the developing baby dies? It seems to me that in both methods the goal is saving the life of the mother; were her life not at risk neither course would be necessary. So I’m not really grasping how one course of treatment is preferable over the other inasmuch as both have the same purpose: saving the life of the mother at the regrettable expense of the life of the developing baby.
It seems to be that being able to retain a fallopian tube and thus a greater potential for future conceptions would be more ideal than removing the tube, but maybe I’m unclear on all the variables (I’m assuming that the fetus developing in the fallopian tube can not possibly develop fully and be born alive).
Dr. Nadal, do you really think these foolish,misguided and dangerous laws in North Dakota will do anything to stop abortion there or anywhere in America? If you do, you are unbelievably foolish . They won’t ! Women will STILL have illegal abortions, and there will be no way to stop them. Get in touch with reality for a change,please !
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Robert, you are correct! I’m glad someone else sees how dangerous these laws are to the profits of Planned Parenthood and other abortionists!
Dude, really.
Dr. Nadal, with his prolific work for the pro-life cause, is enormously in touch with reality. You? Not so much.
RT,
The difference here is one of intent and who/what is the target of therapeutic intervention. One may never do evil that good may result, so in targeting the baby directly with methotrexate we demolish that principle. The baby is not the enemy here. The problem is the defective tube.
Morally, one may remove the tube with the unintended consequence being the death of the baby.
Yes, the end result is the same in one respect, that there is a dead baby. However, there are several end results that differ between the two approaches. First, the parents have either taken the approach that the baby must be targeted, as opposed to targeting a badly damaged and potentially death-inducing organ that happens to contain the baby. That mentality matters. Also, a tubal pregnancy is often the result of a severely defective tube as a result of pelvic inflammatory disease, etc. Leaving it in place after methotrexate raises the probability of recurring tubal prgnancies.
Second, the medical establishment either practices traditional Hippocratic medicine, and honors the ancient oath to not give a pregnant woman abortifacient drugs, or it goes down a road from which it is difficult to return (Why not Plan B for rape victims, or women suffering the violence of poverty?). Life and Health become subjective definitions. Having established the principle that it is acceptable to directly target babies leads to absolute chaos on BOTH ends of the life spectrum.
Robert,
Have you ever pressured a woman to abort one of your children? Have you ever had anything to do with abortion? Did some woman abort one of your children without your knowledge or consent? I ask because your vitriol betrays an interest in the topic that goes way beyond the academic, or some pathetically whipped guy groveling at the feet of his feminist mistresses, trying to prove his enlightenment.
You’re right, women may well procure illegal abortions. But then we’ll have the ability to lock the backalley butchers away.
BTW, drop the sarcasm here and watch your tone or I’ll ban you.
Thanks, Yank. You’re beautiful!
Equal protection under the law must include the removal of any threat that will almost certainly lead to the death of the patient. In this one, tragic case, the removal of the tube is the only reasonable course of action. Women have already died from the killer drugs themselves, such as Holly Patterson in California – and others.
We know that abortion never saves a woman’s life or cures any disease, as the International Consortium on Maternal health has already concluded. But in this one case, they did indeed discuss this one exception when they said that the life of the mother should always be treated as of equal importance to her child. The third alternative – doing nothing – leaves both mother and child dead..
As always, defending a proposed new law based entirely on the teachings of one particular religion is a mistake – although perfectly valid on a blog that makes no attempt to say that it is not passionate about the superiority of Canon Law over state and national laws.
Sean,
This blog does not plug the superiority of Canon Law, but of the Catholic moral tradition. No other religion or system of jurisprudence on the planet is as liberal in its embrace of the human dignity of every person on the planet as is the Catholic Church. Therein lies the superiority.
Robert,
Slavery and rape still continue, all over the world. So does child sex trafficking, something Planned Parenthood was rather enthusiastic about helping some people out with on videotape in 6 different locations. Your appeal to circumstance has no merit. Your side is still the ones who end up with all these dead corpses to get rid of. Pretend they are not there if you wish. None of us must engage in your purposeful denial of reality. The bottom line is that you support beheadings – in the year 2013. We do not.
Ankrom v. State of Alabama will provide a better, more direct, and hopefully more timely challenge to Roe v. Wade in the SCOTUS.
Dr. Nadal, this conversation is important but seems way, way premature. Abortions cannot actually be banned without a change in the U.S. Supreme Court or a federal constitutional amendment. The courts would not let the North Dakota measure go into effect. Perhaps you plan to discuss this in Part 2.
Dr. Nadal,
“The inalienable right to life of every human being at any stage of development must be recognized and protected.”
EVERY human being. That includes the mother too.
If a mother’s life is at risk from pregnancy, then the decision of what to do is between her and her doctor. Honestly, if your non-Catholic physician friend told you that he aborted a woman’s ectopic pregnancy with a shot of methotrexate, would you make a big deal over it? Would you report him to the law?
Please, please don’t get into the salpingectomy/salpingostomy debate. All that will do is give abortion advocates ammunition: “See, they really don’t have women’s best interests at heart. They would FORCE her to undergo SURGERY when a simple drug would take care of the problem.”
The salpingectomy debate is for hardcore Catholics, and hardcore Catholics alone.
I imagine there will still be a few doctors in North Dakota who would perform an elective abortion for cash. But most doctors in ND would follow the law. If there is a dispute as to how the law should be applied, it will be resolved between the North Dakota medical association, the North Dakota doctors, the North Dakota media, and the North Dakota courts. We don’t need to go in there and tell them “Thou shalt treat every ectopic pregnancy with a salpingectomy; thou shalt never use methotrexate because that is immoral.”
Btw, Dr. Nadal, here is a local news source from North Dakota. Please read it before commenting on this issue further.
http://mobile.jamestownsun.com/page/article/id/182421/
Hi Melissa,
Rather than providing the other side with ammunition, I am simply reflecting back the same arguments I’ve already heard from them. I know plenty of pro-lifers who are taking victory laps when in reality we’ve only won the first round in a 15-round heavyweight fight.
Dr. Nadal,
I would very much like to get your opinion of my research on ectopic pregnancies. I seem to have uncovered evidence that such pregnancies can be allowed to continue to 28 weeks of development and then surgically delivered with a successful outcome for both the mother and the child. I have made my research available online at: http://www.personhoodinitiative.com/ectopic-personhood.html
Perhaps you are right, Dr. Nadal, but I would be more inclined to trust local papers to have a better sense of the public opinion on the ground, rather than to go by the opinions of rags that have a definite agenda. We are the aggressors on this bill. Naysayers are the ones who have to defend why they don’t believe that all human beings have an inalienable right to life. That is a hard position to defend.
I hope this will provide a little impetus to try moving embryos who implant ectopically. So little work has been done on this, but it’s clearly possible because of cases where a tube with an ectopically implanted baby has ruptured and the baby has implanted elsewhere. If the baby could be cut out of the tube and moved into the uterus–or if the tube could be cut open (so it wouldn’t rupture) and moved so that the placenta could grow into the uterine blood supply–that would be so much better than this mentality of “We have to kill the baby, now let’s figure out how to kill the baby such that it’s least like killing the baby.” I am convinced there is so little work done on this because the easy recourse to a “solution” of abortion, and no one seems motivated to find a solution that saves the baby…. Of course, the pro-“choice”rs would not want it to be an option because it ruins the whole “life of the mother” meme for the most part… It’s not “choice” if the choice is “which way do you want to kill your baby?”
There have been hundreds of verified reports of children being born from ectopic pregnancies, and I would very much like to hear Dr. Nadal’s opinion of my research in this area. My work can be found online at: http://www.personhoodinitiative.com/ectopic-personhood.html
Melissa,
On what basis and with what logic do you refer to a drug that has already killed people and severely injured others as “a simple drug?”
Sean,
Oh, I know that methotrexate isn’t a simple drug. However, if I were a non-Catholic woman with an ectopic pregnancy, I’m not sure that I would be willing to undergo surgery if a drug would fix the problem. Surgery has risks too, and people are also severely injured and killed while under the knife.
Here’s my question for you: if a physician aborts an ectopic pregnancy with a shot of methotrexate, should either the physician or the woman face some kind of sanctions? Should there be a law saying that, in the case of an ectopic pregnancy, the only treatment that should be legally available is salpingectomy/salpingostomy?
The question is ridiculous, isn’t it? Of course there shouldn’t be that kind of law. Those kinds of decisions are best made in private between a woman and her doctor.
Because, ultimately, abortion is a decision between a woman, her family, and her doctor. I’m just thrilled that, in North Dakota at least, the unborn baby will be considered as a person who has a vested interest in the decision.
“personhoodinitiative”, thanks for sharing that great resource.
Personhoodinitiative,
You have good data and weak data along with some conclusions I find questionable. I’m with family now, but will respond by Tuesday. God Bless.
I was thinking the same thing as Glorify His Son: why can’t the embryo be moved?
Lena,
Dr. C. J. Wallace successfully transplanted an ectopic embryo from the fallopian tube into the womb in 1915. He wrote that:
“when we do find an early case, where the tube is still in a healthy condition, not too badly distended, and all things favorable, I think we should make a supreme attempt to save the life of the growing child by opening the tube carefully and dissecting out the pregnancy intact and transplanting it into the uterus where nature intended it should go. It can be very quickly done. It does not endanger the life of the mother and may be her only chance to bear a child.”
Dr, Wallace then recounted his success and performing this procedure and concluded that:
“I have not the least doubt that many such transplanted ectopic pregnancies will be reported in the near future.”
Unfortunately, at that time in medical history, it was very difficult to diagnose ectopic pregnancies at a stage early enough for such a transplant to be possible. Dr. Wallace came upon his case entirely by accident. The mother didn’t even know that she was pregnant, and Dr. Wallace was operating on her to remove “a fibroid in the posterior wall of the uterus” when he discovered the tubal pregnancy. He decided to transplant the small child into the womb which he had already opened in order to remove the fibroid. The mother made a full recovery, and the child was born “fully developed and without a scar” on May 2, 1916. At that time, it was very difficult for doctors to diagnose ectopic pregnancies at such an early stage, and Dr. Wallace’s method seems to have been abandoned because of that impracticality. With today’s technology, however, I see no reason why his method should not be pursued.
You can read Dr. Wallace’s report online at this link:
http://books.google.com/books?id=5aUCAAAAYAAJ&pg=PA578
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Good post. I must, however, respectfully disagree with your conclusion on the ethics of terminating ectopic pregnancies with methotrexate. I think there are cases where it’s morally acceptable to directly and intentionally kill an innocent human being. As Philippa Foot once wrote, “The Catholic doctrine on abortion must here conflict with that of most reasonable men”. Consider the following two scenarios:
1. A cave explorer becomes trapped when an innocent fat man is lodged in the mouth of the cave. The floodwaters are rising, and the only way to get out alive is to blow him up with a stick of dynamite. If the dynamite is not used, both will drown.
2. Conjoined twins are born, and only one has a working heart and lungs (which both rely on). If they are not separated, both will die within six months. But the only way to do this is to sever the weaker twin’s artery, killing her.
I don’t expect Catholics to condone directly taking life in either of these cases (especially the second one, which the bishops did object to when it took place in Manchester). However, they do show that a non-Catholic can support abortion when the mother’s life is threatened without also accepting it for other reasons (rape, poverty, etc). After all, removing this feature would drastically change the conclusions (we would not fatally separate the twins if the alternative meant both could live, and blowing up the fat man would be wrong if the cave explorer could survive a different way).
Blow up a fat man with a stick of dynamite? Speaking as a fat man, I would hope that you would keep trying to un-wedge any stuck fat man from the cave walls instead. If you did in fact resort to explosives, I hope the look on the fat man’s face when you stuck the dynamite in his mouth and lit the fuse would haunt you for the rest of your life.
Navi,
pt just said it all!!
As for your take on Catholic moral norms, you have much to learn.
Gerard, I’m sure I do. I would however like to know what (if anything) I’ve misrepresented in my last post. I believe the teaching relevant to the problem of ectopic pregnancies is that it’s an intrinsic evil (a serious moral wrong under all circumstances) to intentionally kill an innocent human being. I tried to address this above.
Pt, I did not mean to offend. I wasn’t trying to suggest that weight makes a person liable to be killed, in case that’s how I came across. Though as a side note, you may wish to avoid the literature on the trolley problem. You could argue that my analogy is unrealistic because in real life there is a change of successfully dislodging the man without killing him. But it can be slightly tweaked so that the cave explorer is too injured to attempt it (thus his only options are.using the dynamite or drowning).
From a psychological perspective, I doubt anyone (aside from psychopaths) would be undisturbed by the thought of blowing someone to pieces or cutting apart a baby (or at least I hope this is the case)! However, it doesn’t necessarily follow that such actions are morally criticizable or impermissible in these cases. After all, an abortion proponent could just as easily use a similar appeal to emotion to argue for abortion in the case of rape because we don’t want to increase the victim’s suffering by making her give birth to her attacker’s child. Yet, this argument is fallacious because it implicitly denies the humanity of the unborn (after all, we otherwise wouldn’t let hardship justify homicide). So I’m not convinced that the two examples I offered in my last post, or the ectopic pregnancy, would constitute unjust killing.
Did my last comment not go through?
Gerard, I’m sure I do have more to learn. I would however like to know what (if anything) I misrepresented in my last comment. It seems that the teaching relevant to the problem of ectopic pregnancy is that directly and intentionally killing an innocent human being is an intrinsic evil (so it’s a serious moral wrong under all circumstances). I tried to address this above.
Pt, I didn’t mean to be offensive. I was not trying to suggest that weight makes someone liable to be killed, in case that’s how I came across. Though just a word of advice, you may wish to stay away from the literature on the trolley problem. You could say that my analogy is unrealistic because in real life you could try to dislodge the man a different way, but we can tweak it so that the cave explorer is injured (so his only options are using the dynamite or drowning).
From a psychological perspective, I don’t think anyone (apart from psychopaths) would be undisturbed at the thought of blowing someone to pieces or cutting up a baby (or at least I certainly hope this is the case)! This doesn’t, however, automatically mean that such actions are morally criticizable or impermissible in these cases. After all, an abortion proponent could use a similar appeal to emotion. For instance, they could ask how anyone could possibly want to force a rape victim to suffer more by carrying and giving birth to her attacker’s child, which would leave her with a constant reminder of the assault. This is a fallacious argument because it implicitly assumes that the unborn isn’t human (as otherwise we wouldn’t let hardship justify homicide). So I’m not convinced that my conclusions are wrong in either of the above scenarios, or in the case of ectopic pregnancy.
Dr. Nadal,
It has been a full week since I asked for your opinion of my research and five days since your personal deadline for responding. I understand that the material requires a great deal of study and verification, but I wonder if you might be able to provide us with an update of your progress.
Navi, you need to learn your lessons through careful reading and thinking. Dr. Nadal cannot tutor you at this time. He is needed on more urgent business, for example, the pizza I ordered from him yesterday. Dr. Nadal, where is it? Having trouble with the dough? (Note to self…. must stay fat… so won’t fit in cave opening…)