Wow. I had no idea that some Catholics would go so far as to prevent simple procedures to remove ectopic pregnancies. These are conditions in which the zygote implants in the wrong place — the fallopian tube, rather than the uterus. The embryo can grow for a while, but not long, before it reaches a size that ruptures the fallopian tube and causes the mother to bleed to death. The solution is easy: either surgically remove the doomed embryo before it can become deadly, or use a drug, methotrexate, that kills dividing cells to destroy it.
But no, that’s an abortion and some Catholic hospitals prohibit even procedures that would end an utterly futile pregnancy.
Yes, some Catholic ethicists argue that the catholic “Directives” preclude physicians at Catholic hospitals from managing ectopic pregnancies in a way that involves direct action on the embryo. So a woman can have her whole tube removed (an unnecessary procedure that could reduce her future fertility), but she can not have the pregnancy plucked out (as is done with the standard therapy, a salpingostomy, where a small incision is made in the tube and the pregnancy removed) and she most certainly could not have the methotrexate.
How common is this practice? Well, it is pretty sad that someone had to study it. According to a study from 2011 by Foster e. al., (Womens Health Issues, 2011) some Catholic hospitals refuse to offer methotrexate (three in this study of 16 hospitals). The lack of methotrexate resulted in changes in therapy, transferring patients to other facilities, and even administering it surreptitiously. All of these expose women to unnecessary risks, expense and are, quite frankly, wrong.
These patients who are turned away go, we hope, to less ideologically abusive hospitals, where they get treated. Imagine a country with nothing but Catholic hospitals, though: they’d be sending these women away to die.
I have no understanding at all of the logic that justifies a Catholic hospital refusing to remove a deadly embryo, but does allow them to chop out the whole organ bearing the deadly embryo, at a cost of reduced fertility. It seems somehow un-Catholic…but on the other hand, the fact that it requires twisted theological logic that ignores basic human needs makes it profoundly Catholic.
Unless they intend to re-implant the embryo into someone else’s womb, this is just morally splitting hairs. You’re still operating with the full expectation that your action will kill the embryo.
Orwell: One cannot really be a Catholic and a grownup.
I think this is awesome. We need more hospitals like this. Let’s have the Jehovah’s Witnesses start hospitals that refuse to perform blood transfusions. Let’s have Christian Scientists start hospitals that refuse to do anything but pray. Let’s have the Church of the Flying Spaghetti Monster start a church that heals people with pasta and pirate-speak. Why the hell not.
Surely the free nmarket will fix this!
Pirate speak has gotten me through many a myocardial infarction.
That is an oxymoron.
Like giant microbes.
Or Intelligent creationist.
There is no such thing as a Catholic ethicist. There is such a thing as ex-Catholic ethicists though.
The ethical thing is to run screaming out of the religion. In the last few years, 22 million Catholics have left, 1/3 of their US membership.
It makes perfect sense if you consider moral purity based on arcane rules to be more important than the actual effects of your action.
FWIW, the Catholic opposition to abortion is recent. Up to 1869 they didn’t much care up to the time of quickening.
Religions evolve and quite rapidly. And not necessarily in a benign direction. Quite often they get worse.
@1: Look up Doctrine of Double Effect. It says that you can perform an action intended to bring about a good end (in this case, saving the life of a woman) which has an unavoidable bad side-effect (killing the fetus) as long as the latter wasn’t intended.
Because in Catholic morality, intentions *are* magic.
Trading off good vs. bad consequences of an action will always be problematic, but the DDE approach is just fucked up — it basically encourages you to pretend you aren’t doing what you’re really doing, and mandates (as in the case of ectopic pregnancy) sub-optimal ways of accomplishing the good end.
(Note: that’s assuming for the sake of discussion that we consider the destruction of an early-stage embryo as an evil, which I don’t. Because I’m not in thrall to Cathologic).
Chalk one up for willful ignorance. The only hospital in my area is Crapolic and every one within 100 miles is too. If you check the box that says you do not wish to be visited by clergy they send a nun. The one that visited me was nice enough I guess, until she saw I was watching Hell’s Angel on Youtube that is. I can’t help it if I needed a Hitchens fix as soon as she walked through the door, it was instinctive.
Wait a minute Eamon, does that mean if we send Slayer to play for the Pope at a private audience, and one of Kerry’s solos stops his heart from teh awsum, then we didn’t commit a sin in the eyes of the church.
These people are fucking insane.
I doubt that the ‘good end’ in this case is saving the woman’s life. It’s making that Catholic hospital more money with all the unnecessary procedures. Removing troublesome body parts and people to which they’re attached has not been an issue with the RCC when large sums of money are to be had.
catholic ideology is so warped that it makes quaternion julia fractals look straight
In the infamous “train experiment”, the Catholic church seems to have decided that if two trains are racing along two tracks each with a person on it, it is immoral to stop one of the trains. Even taking the rather outrageous claim that a zygote or an embryo is a person, there is no supportable moral position to be had in preventing the abortion of an ectopic pregnancy. Again, this emphasizes how much this is not about saving “babies” but about controlling and punishing women.
Unless they intend to re-implant the embryo into someone else’s womb, this is just morally splitting hairs.
But consider how many embryangels can dance on that split hair.
More Papal Bull.
They are the guardians of the ultimate truth. They are the distributors of absolute love. They share in the divine knowledge, wisdom and goodness.
You cannot really demand that they would let go of all these holy and sacred principles just because they might hurt some humans?
That is the true sign of divine love: love the principle, ignore all the rest.
I personally had an ectopic pregnancy, and thank the FSM there were plenty of non-catholic hospitals to choose from. Nobody even suggested that that bleeding to death would be less sinful than removing a doomed embryo. They just took care of what I needed, and now I’m still here, as is the daughter that I subsequently went on to have. I have a friend who was in the same situation, except that she’s catholic. She had to get the permission of her priest before the doctors could do the surgery to save her life! I don’t understand how she didn’t just dump the whole corrupt institution right there and then.
(However, just to be accurate, my doctor’s information to me was that having an ectopic pregnancy removed almost always results in the tube scarring shut, even in the best of circumstances. So it would not have really made a difference to my fertility whether they removed it or left it. But how dare some self-important parasite presume to tell doctors how surgical procedures should be done!)
Eamon Knight @ 9
Yeah, I know, right? Even the super orthodox Jews have all sorts of clever legalistic ways of violation their weird rules when it suits them – why can’t the super Catholic Catholics do so as well? (As for regular members of the Catholic laity, well, I’ve never met a one that did not use birth control, for example. They don’t let such crap rules interfere with their lives.)
Jeez, doc, just tie a string to your Bible or crucifix and your arm when you write the order for methotrexate or whatever. Be creative, then dogmatize the solution.
Catholic doctrine holds that it is better to murder a woman than to remove a cluster of cells that might possibly be male.
Referring back to (9) and the “Double Effect Doctrine.” Beyond it being at face value stupid, what’s really screwed up about the Doctrine is that if one takes it seriously (for shits and giggles) and sees how it plays out, the logic of it ends up supporting arguments for abortion. Aquinas (who first fully articulated the Double Effect Doctrine) carefully laid it out partly in terms of self defense. So, if the primary end/intention is saving one’s own life, not killing another, and if that secondary (double) effect (the death of the other) is foreseen but not intended and is not disproportional to the primary end, then it’s considered a licit act. So there’s automatically a weighing process, both of the agent’s intention and the proportionality of the two effects–which makes abortion not an intrinsically evil act, by the RCC’s own articulation of the Doctrine, except that we know they’ve gone ahead and done the weighing for us and (of course!) the woman loses and abortion always gets labeled as an inherent evil. Taking the Doctrine seriously should–at the VERY least–mean that a no-exceptions position like the RCC’s (no abortion in rape, incest, or to save the life of the mother) is untenable by their own moral theology.
[Of course, I stick with “her bodily autonomy, her choice” and leave it at that.]
Not really the topic here, but how can anyone think that things like ectopic pregnancy are designed? Unless the designer is incompetent and/or evil, that is.
Oooh, well clearly they have to remove her fertility because the fact the fetus was implanted wrong means god doesn’t want her to have children. Also, it means she’s a witch.
Or maybe the catholic church thinks all women are witches, and the only way to exorcise them is for them to have children and abortions keep them as witches?? I don’t know I’m just spitballin’ here.
Yes, that was my thought too. Eamon’s description @9 would apply just as easily to drugs or the regular surgery. IANA doctor but it seems to me that in all three cases, you are removing the embryo from its source of food and oxygen and putting it in an environment where you know it will quickly die. Taking a bit of the tube out with it just delays things by maybe a minute or two – but really does nothing different from taking a regular embryo off the uterine wall.
The real joke when super Catholic politicians are put to the test, they ignore their own religion a well. Or did I imagine the whole Santorum late term abortion thing?
Someone up-thread mentioned having the woman bleed out as a less sinful resolution to an ectopic pregnancy, per Catholic doctrine.
That’s the option PZ did NOT recommend. He is sooo intolerant of religious ideals.
The Catholic approach gets bonus points for being both anti-woman and anti-science.
The Cat-hole-yick church really needs to die in a most spectacular and horrible fashion, it is the breeding ground for the most amazingly disgusting behaviour:
http://www.abc.net.au/news/2012-11-05/st-johns-councillor-speaks-out-over-initiation-ceremonies/4354466
Some years ago a nine year old girl in Brazil was raped by her stepfather and impregnated with twins. Because there was no way she would survive the pregnancy, let alone the birth, she was given an abortion. The local Catholic bishop excommunicated everyone involved with two exceptions. The girl was given a pass because she was too young to make an informed decision about the abortion. The rapist was also given a pass because the Catholic Church approves of child rape.
@25: Since someone mentioned the Trolley Problem upthread: Consider that most people are willing to throw the track switch and kill one person to save five, but few are willing to push the fat man on the track to stop the trolley, even though the final body count (and lack of consent by the sacrificial victim) is the same. The answer seems to be that the former situation affords a greater psychological distance between the act and the consequence than the second does — you’re only indirectly causing a remote death, rather than directly causing a proximate one. I see the DDE as a canonization of the same psychology that gives rise to the inconsistent responses people tend to give to different trolley scenarios.
Since I believe that moral intuitions arise primarily from emotion, I’m prepared to accept that they will be situation-dependent in ways that yield these apparently inconsistent outcomes. What the DDE does is attempt to impose consistency in a way that, in cases like this, quickly reduces to absurdity. Why tubectomy should be seen as providing a moral prophylaxis against the charge of embryo-cide — “I only meant to remove the tube! It’s not my faaaaault there was a pre-born human in there!! — I just don’t get. It reminds me something some guy (who was that again?) said about straining at gnats and swallowing camels….
Rodney, the long time regulars are aware of that horror story. It has been a touchstone for many of us about how awful that organization is.
@Eric: spot on. There’s a specific part of the Doctrine that gets at temporality/causality. In the example at hand: the licit choice is remove the tube or a portion thereof, which saves the “mother” and…then…the “baby” dies. To use medication to terminate/dissolve the ectopic pregnancy kills the “baby”…and…then…the “mother” is saved, therefore badwrongexcommunication. So it’s both about direct intention and some fucked up notion of causation.
The damage that is being done to women because of this backwards religion is truly frightening. Where I live almost all of the hospitals are Catholic. The hospital nearest me and where my GP has admitting privileges is Catholic. The hospital where my wife’s OB/GYN has admitting privileges is Catholic. This is truly scary. My wife had an ectopic pregnancy when she was younger. Had she been sent to a Catholic hospital, perhaps she would have died, or we would never have been able to have our children. This seriously pisses me off. Fuck the Catholic church. They should be required to meet the standard of care of the medical profession or sell off the hospitals and stick to the preaching business.
Do the doctors at these Catholic hospitals inform patients that there are other options if they go elsewhere?
At least we’re fortunate enough not to live in Ron Paul’s world, where the poor can only get care from Catholic hospitals because we rely on religious groups to handle charity care.
Forcing people to take the treatment on the sly, that’s an especially nice twist to this mania from the Catholic Church. I take methotrexate myself, for rheumatoid arthritis, and I can tell you that even at the low doses I take it’s a very dangerous drug. This is not something someone should ever take unsupervised. Yet that’s what these poor women are forced to do when someone at the Catholic hospital is at least attempting to help them despite their own administration. But hey, that’s just putting the woman in danger, so there’s no problem with their religious sensibilities or morality on that point.
It’s time to end the whole concept of the “reasons of conscience” exception for refusal of treatment. If you’re going to be a healthcare professional, you should put your conscience in second place to the needs and health of your patient, period. Any doctor, nurse, pharmacist, etc. who does not should lose their license to practice permanently.
@31: And don’t forget the infamous Phoenix case, somewhat more recently. Woman — mother of several children already — dying of a serious complication of current pregnancy. The nun in charge of the hospital did the right thing and authorized whatever it was they needed to do (which included aborting the pregnancy) to save her life. Bastard local bishop excommunicated everyone involved (OK, not a bad thing in my book — as far as I’m concerned they should all give the Church the middle finger while absconding with chalices full of holy crackers and wine, add some cheese and have a coming out party — but it demonstrates that the Church is anything but “pro-life”).
OK, this is personal now. My own mother would have died 48 years before she actually did had these cretins got their way.
The thing is that Catholic owned and operated hospitals aren’t owned by the Vatican. The theology/doctrine may be top-down but the business reality isn’t. So what individual Catholic hospitals enact as their standard of ob/gyn medical care differs, as does (and as ya’ll noted above, this is what’s truly scary from a patient’s perspective) what individual Catholic hospitals are willing to *allow* as standard practice while turning a blind eye. (Which makes it crucial that folks stuck with Catholic hospitals as options call and find out in advance, if for no other reason than to force some local light on the issue. This is important for end-of-life issues, too, btw!) Many Catholic hospitals and hospital systems are owned and operated by orders of women religious (nuns or sisters); folks who followed the contraceptive mandate and Obamacare fights might’ve noticed that the Catholic Health Association (and its outspoken Sister President) was frequently on the opposite side of the RCC hierarchy.
The Phoenix case was a perfect example of the difference between how medicine was actually being practiced (abortion to save the life of the mother in a case where all the doctors, the hospital ethics board, and the Sister big cheese reviewed the case and agreed it was a no-brainer call to perform an abortion) and what happens when some fool hears about it and anonymously tips off the local Bishop, who is a raging Conservative who then jumped in to make political hay.
His ONLY power in the case was to threaten to remove his diocese’s permission for the hospital to continue to call itself a Catholic hospital and to refuse to allow priests from the diocese to perform Mass at the hospital. He couldn’t close it down, fire anyone, etc. He used the threat of disallowing the label “Catholic” to try to get the Sister’s Order to remove her from her administrative position. Also, the excommunication thing isn’t something he did (other than yammer on about it): the RCC rule is that the excommunication is automatic. It technically happened at the moment of the abortion. The tree makes the sound even if no pompous man in a silly hat is there to hear and pontificate about it.
And let me go out on a limb here. If a corporate insurance policy covers ectopic pregnancies and the CEO is catholic, its within his rights to remove this procedure from coverage for all women, catholic or non.
Or baby jesus cries or something.
Often, no they don’t. Some don’t care to, and some are subject to gag orders (usually informal… i.e. if they’re giving advice that helps women get abortions, they could be censured or fired.)
Articles to back this up:
http://www.msnbc.msn.com/id/19190916/ns/health-womens_health/
http://www.dailykos.com/story/2012/04/22/1085161/-Anti-Capitalist-Meet-Up-Pelt-the-President-with-the-Pill
*note: that MSNBC article I keep linking is several years old and undated. As best I can tell it’s from 2006.
Ectopic pregnancies aren’t rare.
The risk is estimated at 1 for 40 pregnancies so the lifetime risk of an American women is ca. 5%. (average 2 children per woman).
Some of those will spontaneously resolve.
That is still a lot of pain, suffering, anxiety, and possible death for the RCC to inflict on the majority of the population.
If MD’s followed the guidelines of the RCC, there would be a whole lot of women running around with 1 fallopian tube and a surgical incision scar, probably in the millions.
the only way I can look at this kind of religious behavior with the least bit of sympathy is to considerate it extremely fear based.
They are in thrall and terror of their psychopathic god and the dreaded afterlife they believe in. They will do anything and everything they can to avoid eternal punishment in the hell they imagine awaits them. They go so far as to create in the hear and know all of the trauma such a place could entail. They act in their gods place to judge and punish all the “sins” they can imagine while they turn life into a self hating pointless waste land of guilt and shame and submission.
uncle frogy
@Ed, you betcha it’s personal (and yes, I’m going to stop monopolizing the thread, but the whole thing PISSES ME OFF to no end). My mom had 10 pregnancies and 5 live births. One was a straight-up miscarriage (God apparently intended for her to fall down the stairs at 7 months–what I call The Almighty Rube Goldberg Abortion) and four were “D & Cs” or what good Catholics back then called abortions that their priests told them were OK to have (especially if the woman’s health/life was in danger). So in four cases, the “official” position would say one thing but the reality was three different priests (and this is pre-Vatican II so these guys were pretty conservative) took the position that it was a matter of personal conscience in which my parents needed to weigh the various goods, among them the end of not leaving motherless children who’d already been born.
These Catholic unethicists are way out in La La land. (I’m being polite here, actually they are crazy and/or evil).
1. The ectopic embryo has no chance of being born.
2. That tissue attached to the embryo is called…a woman. Chances are good she has a husband at home and other children at home as well.
If she dies, the kids are minus one mother. It’s survivable for them but it isn’t easy. They have needs and feelings too.
If you run the moral calculus, the answer is obvious. Which is why no reputable and competent health care professional pays any attention to the Catholic church.
Catholic doctors have ways around the rules. They’re more dangerous and less effective than an open abortion, but they don’t result in anyone losing their job or being excommunicated. An acquaintance of mine who will be identified no further lest she become individually identifiable, describes having been told by her doctor to walk up and down stairs for several hours until she had a miscarriage at 6 months. She wasn’t going to survive the pregnancy and would have left her (at the time) three children without a mother if he hadn’t induced the miscarriage, but it was done without her explicit consent and she went through a lot of unnecessary stress when the same result could have been obtained through a simple D and E or induction, but the Catholic church wouldn’t allow that.
Okay, I went looking further into Dr. Jen Gunter’s blog and…
OH SHIIIIII—-
http://drjengunter.wordpress.com/2012/10/14/the-affordable-care-act-facilitates-state-level-abortion-restrictions/
Religion: promoting evil since 2500 BC.
How utterly perverse. It’s like saying if I shoot a man in the head that is murder, but if I demolish his house while he is in it, that is okay!
Catholic Church is fine with murder for hire as long as you nake it look like an accident
“I have no understanding at all of the logic that justifies a Catholic hospital refusing to remove a deadly embryo, but does allow them to chop out the whole organ bearing the deadly embryo, at a cost of reduced fertility.”
The logic is in the Catholic “Doctrine of Double Effect” in their moral philosophy. I’ve written about this absurdity here:
http://exconvert.blogspot.com/2012/08/on-doctrine-of-double-effect.html
Essentially it’s a way to mentally divorce the known outcome of an action from the action itself by referencing intention.
Then there is the woman who was sainted precisely because she carried a dangerous pregnancy to term, dying shortly after childbirth and leaving her children without their mother.
http://exconvert.blogspot.com/2012/08/disturbing-saints-2-gianna-molla.html
It’s all very backwards and ultimately anti-life, IMHO.
And this is exactly why, as a peri-menopausal woman referred to a Catholic ob/gyn who is an expert in HRT, I made very very sure to discuss whether she supported abortion access for her patients and prescribed contraception and Plan B. Even though I forgot to do it during the clothed talking-over-her-desk part of the visit, I asked wearing the silly gown after the clinical exam. A bit of a lack of dignity, I suppose, but the answer was yes, she’s performed abortions, prescribes contraception, and while other members of her group do the surgical abortions now because her area of practice has changed, she would do abortions if required. Of course, she’s one of those practical, ethical Catholics who does actual useful volunteer work with international aid groups, just the sort of liberal Catholic I was in the late 70s and early 80s. I don’t know precisely why she’s still Catholic, but I was a whole lot more comfortable with her clinical ethics after that conversation. (Also, she does not practice at a Catholic hospital – I grew up hearing my poorly educated, Protestant mother insisting that one should never ever receive any reproductive health care at a Catholic hospital because it was a good way to die if there was any problem involving a choice of priorities between mother and fetus.)
So sometimes there are sane Catholic medical professionals, but they sure have to work hard to fly under the radar…
I can vouch – in case anyone doubts it – that this is true, as it happened to me. I was an employee of a Catholic hospital. Not only won’t they treat an ectopic pregnancy (unless no heartbeat is seen on ultrasound which also means you have to be pregnant enough for one to be detectable), the healthcare insurance I had from them forbade treatment (I.e an “abortion” ) of ectopic pregnancy so I couldn’t even go to a non-catholic hospital for treatment. I was lucky and no heartbeat was seen on my second ultrasound so I got methotrexate and survived without tubal rupture. After all, it’s MUCH more important to not allow abortions and have to care for tubal ruptures and all the subsequent surgical costs than treat early.
6 states limit coverage to life endangerment.
2 states limit coverage to life endangerment and “substantial and irreversible impairment of a major bodily function.”
1 state limits coverage to life endangerment, “substantial and irreversible impairment of a major bodily function,” rape or incest.
7 states limit coverage to life endangerment, rape and incest.
1 state limits coverage to life endangerment, rape and incest, fetal impairment and “substantial and irreversible impairment of a major bodily function.”
1 state limits coverage to life endangerment, rape, incest and cases of “grave long-lasting physical health damage.”
2 states prohibit all abortion coverage in the exchange (Tennessee and Louisiana)
this is why I keep saying it no longer matters whether Roe is overturned or not, if SCOTUS maintains ANY of the above state actions are constitutionally valid.
No sign from SCOTUS that they will rule against any of these things.
Somehow, I ended up in rural and oh so catholic Italy. I have a young daughter and this kind of thing always makes me shudder.
Must-find-the-way-out.
Removing the entire fallopian tube would kill the embryo anyway! Jesus hopping Christ on a pogo stick, these people are fucking stupid it’s scary.
That’s unfair. Intention is a significant factor in making moral decisions in all ethical systems I’m aware of.
I guess dogma trumps medicine. Perhaps the answer to this nuttiness might be for doctors to refuse to work at Catholic hospitals.
Looks like the RCC is competing with Islam. Islam beliefs tells us that children are born Fitra or born Muslim and so the RCC currently want to own humanity by making each Zygote a Catholic. it would be an insurance for its subsistence for the next millenium.
At least some good news: The “Catholic vote” (which wasn’t ever anything resembling a bloc, no matter how much the hierarchy tried to mold it into one with threats and scolding) break-downs from the polling show the majority supported Obama and did so largely on social justice teachings (on economic issues, poverty, that whole caring about the least of your bros part) as out-weighing the anti-abortion and phony religious freedom tied to contraceptive coverage crap. For atheists who are progressives, there’s at least some reassurance that carefully chosen strategic partnerships on certain social justice issues can be useful.