appendix — Gury-Ballerini, Compendium of Moral Theology (8th ed., 1884)
Appendix. On the Caesarean Operation
In order to baptize an infant not yet born.
The operation or Caesarean section consists in this: that the uterus of the pregnant mother is opened, so that the fetus may be extracted. A twofold chief question occurs, namely whether or when it can be done, or must be done.
- Questions. - QUESTION 1. Whether or when it can be done?
Resp. The following rules seem to have to be established:
Rule I. When the mother is dead, it is certain that the Caesarean operation can be done, and indeed immediately when her death is established. Yet the Prefect or Superior of the place must be admonished, and witnesses approved by him must be used both for recognizing the death, and for greater certainty of the matter, and especially lest the author of the operation be traduced as guilty of homicide. But the reason why it can be done is evident: for if anything stood in the way, it would be the danger of the mother; but from the hypothesis her death is certainly established; and from another side the life spiritual, indeed perhaps also temporal, of the infant can be saved. - See Gangiamila in the work whose title is Sacred Embryology.
Rule II. While the mother is living, the Caesarean operation can never licitly be done whenever there is danger, either proximate or probable, of the death of the mother to follow from it, although, if it is not done, the mother and the offspring will certainly perish. The reason is that this would be the same as directly killing the mother, which is never permitted. - Thus St. Thomas, 3 part, q. 68, art. 11, ad 3, where he says: A man ought not to kill the mother in order to baptize the child. - St. Ligorius, n. 106. - Hence the operation cannot be done when a very skilled surgeon is lacking, nor when the mother is so debilitated by disease that the operation, otherwise not dangerous, is going to induce proximate danger of death from the circumstances, etc.
- Rule III. While the mother is living, the Caesarean operation can licitly be done, with these circumstances posited, namely: 1. if she cannot give birth naturally, or is going to die before she gives birth, with the greatest danger of the infant's death before he can be baptized; 2. if, from the judgment of a skilled surgeon, proximate danger of the mother's death is absent. But such danger can be absent if the mother is robust, as is clear from innumerable examples and from the more common opinion of physicians and surgeons, whose art, especially in our times, has become much more advanced and perfect. - See Sacred Embryology, lib. 3, c. 9. - Elbel, n. 60, etc. - The reason is clear; for there is no danger, or at least it is very slight and remote, and therefore if perhaps death follows, it will seem to follow only per accidens.
- QUESTION 2. Whether or when it must be done?
Resp. 1. When the mother is dead, it is certainly to be done under grave obligation, even with the parents or relatives unwilling or resisting, if it can be done; because from the law of charity the eternal salvation of the infant must be procured with every care and labor. - Thus St. Thomas, ibid., where he adds: If, however, the mother has died while the offspring is living in the womb, she must be opened, that the child may be baptized. - Thus also the Roman Ritual establishes. This especially holds if the time of delivery is imminent, because, since the fetus is more robust, a greater hope of baptizing him shines forth.
The operation is not for that reason to be omitted if it is known that the mother has been pregnant for a short time; because it is clear from many examples that the animation of the fetus occurs a little after conception. - See Sacred Embryology, lib. 1, c. 7.
Moreover diligent care must be used that the region of the uterus of the deceased woman be kept warm until the operation has been done; otherwise the infant would more easily withdraw from life before he could be baptized.
- Resp. 2. The operation is to be done even while the mother is living, if from the judgment of experts the infant cannot otherwise be baptized. But the mother is bound per se, and speaking speculatively under grave obligation, to suffer it, if it can be done without proximate danger of death. The reason is that anyone is bound to suffer a temporal inconvenience for preserving the spiritual and eternal life of the infant. This follows from the general law of charity. - Thus commonly with Elbel, n. 60. - St. Ligorius, ibid. - Sacred Embryology, lib. 3, c. 4.
I said: per se and speaking speculatively; for in practice the Confessor must take care not to urge the mother under grave obligation on account of the too great danger that, by denying consent, she die in the state of mortal sin; and thus, while he wishes to save the spiritual life of the infant, the mother herself be damned. Therefore it will be enough to exhort her to consent to the incision.
Besides, since it is clear that the fetus very often survives the deceased mother, great hope shines forth of baptizing him when she has died, and therefore a lesser obligation of incision presses.
The mother is not bound to undergo the operation if, with the operation omitted, she alone is judged to be going to perish; because no one is bound to preserve life by extraordinary and so arduous means. - But if there were only a slight hope of preserving the offspring, the mother indeed could undergo the operation, but would not be bound to do so, because charity does not press so much amid so great uncertainty of the outcome. - Thus commonly with St. Ligorius, ibid.
Besides, from the new art of physicians, the infant can be baptized in the mother's womb with moral certainty by the aid of some instrument, as was said above, without there being need to recur to the Caesarean operation 1.
1 Compare the things said above (vol. I, note to n. 401), where abortion is treated, and the things which you have on the same argument in the note to n. 239 of this volume.
End of the Treatise on Baptism.