§ II. On the Procuring of Abortion

Abortion is the premature ejection of a fetus from the womb of the mother.

¹ On the title above. In order that questions on this argument may be aptly instituted and solved, the principles indeed of the older Theologians must be retained; but their application must also depend on the theories which the more accurate study of medical art has brought in over the passage of time.

And 1. indeed as regards the causes of abortion, with those things passed over which the older authors disputed concerning medicines killing the offspring in the womb, for medical science now admits no medicines of this sort, those causes can be recalled to these heads. 1. Cutting or rather rupture of the uterus, or of the membrane by which the fetus is enclosed, by the aid of an instrument; by which it happens that, the humor in which the fetus swims being withdrawn, it cannot long live there, but is necessarily ejected, although it can come forth into the light even alive. - 2. Force brought from without through blows or compressions, which would strike the infant born and deprive it of life. - 3. Violent shakings, which can have a cause both extrinsic and also intrinsic, for example convulsions. - 4. Finally, relaxation of the fibers, by which it happens that the fetus, pressed by its own weight, is born prematurely; which relaxation or acceleration of birth can have either natural causes or be obtained by art, for example by baths, medicated drinks, etc.

2. But it will be very useful to distinguish both causes which directly and positively injure the fetus, of which sort, for example, would be a violent blow, or even a wound inflicted by the aid of an instrument on the fetus itself still hidden in the womb, and causes which merely bring it about that preservation of the life of the offspring ceases; of this sort is acceleration of birth before the seventh month of gestation, whether this happens through mere relaxation or through cutting of the membrane containing the fetus.

3. Already from his own age St. Alphonsus wrote (lib. 6, n. 124): "Since today the opinion flourishes, received not without applause by experts, that the fetus from the beginning of conception, or at least after some days, is informed by a soul," etc.; which "some days" in the edition of the year 1748 he says are three or four. Moreover this opinion, insofar as it admits no inanimate fetus, since it is now more commonly received, especially after more accurate observations instituted by physiologists, and is defended as more consonant not only with philosophical, but also with theological principles, it follows that there is scarcely any cause why a special question be made concerning the hypothesis of an inanimate fetus.

4. Since surgical art has now found an instrument by which the membranes enveloping the fetus are cut in such a way that water injected by the aid of a little siphon can certainly touch the fetus immediately, and therefore since according to those things which St. Alphonsus (lib. 6, n. 107), after Benedict XIV, discusses, we can be altogether certain of the validity of baptism thus conferred on infants enclosed in the womb, consequently the difficulties and questions raised by the older Doctors concerning the dangers which the mother would be bound to undergo so that the eternal salvation of the offspring may be provided for almost cease.

5. Since there can be no doubt as regards those causes by which there is a direct tendency positively to injure and kill the fetus, since a direct intention of killing, concerning the indirect see above, n. 396, can never be lawful from any cause; therefore the principal hinge of the controversy will reside in this: whether and when it is lawful to accelerate birth, and indeed through that time of gestation in which the offspring, however alive it may come forth into the light, must nevertheless soon succumb to death.

6. But this acceleration of birth, as doctors are accustomed to speak both concerning abortion and generally concerning the killing of the neighbor, can be considered as excited or promoted either directly or indirectly. It will be called indirectly excited when, for curing the disease of the mother, those remedies must be applied from which, besides the intention, that relaxation of the fibers follows on account of which premature birth follows. But directly, when means are used which per se are directed not to healing the mother's disease, but merely to unloading her of the fetus by accelerated birth. This indeed could happen from a twofold cause, namely either only on account of preserving the temporal life of the mother, or on account of procuring the spiritual salvation of the offspring through baptism, or also on account of each of these ends at the same time.

Besides, even when the remedy per se does not tend to curing the disease of the mother, but only to obtaining birth more maturely, nevertheless the abortion in another sense can be held as directly or indirectly sought, namely when one considers not the material reason of accelerating birth, but the will or intention of the one operating. For what the Doctors commonly have with St. Thomas, that the death of an unjust aggressor in just defense follows only indirectly, for the reason that the direct intention of the killer is borne only toward his own defense, but the other effect, namely the death of the aggressor, is besides the intention and by accident; this very thing can have place in the acceleration of birth, namely when the will tends directly not to the temporal damage of the offspring, which follows by accident and besides the intention, but to another end.

7. Finally, for the easier solution of the proposed question, it will be very useful to advert to that which we suggested above: that the controversy about acceleration of birth, whether this happens through relaxation of the fibers or through cutting of the membranes containing the fetus, does not regard whether it is lawful to deprive the offspring of life, but rather how far the mother is bound to guard and preserve life for the offspring. In this matter, account must indeed be taken not only of the general obligation which charity requires from all regarding the protection of others' life, nor only of the special obligation of parents toward children, but also of the singular office which binds the mother, since nature has especially committed this care to her. Nevertheless it remains to be inquired how far this obligation extends itself, just as it can be inquired how far the obligation of a mother can be urged not to let the infant whom she carries in her arms fall from her hands into waves or into some abyss, which indeed comes back to the same thing as if it were asked whether and what sort of just cause there can be on account of which the mother may lawfully cease from guarding the life of the offspring.

Moreover, for solving this question generally, those things bear which Cardinal de Lugo establishes as a certain principle (De Iust. et Iur., disp. 10, n. 133), where he writes: "A mother is not bound with so great danger and detriment of her own life to procure and preserve the fetus; just as she is not bound to feed and retain with danger of life a son already born, nor even, in order to nurse him, to preserve milk in the breasts when, for protecting her own life, it would be necessary for her to dry the breasts." And plainly that also pertains here which Lugo adds in the same place, diligently distinguishing the mere cessation of guarding life from damage positively inflicted on the offspring, although that hypothesis of poison infecting the offspring is not admitted now. "Yet the moderation pleases," he says, "which Vasquez afterward added to this doctrine..., saying that this is understood of bloodletting, a bath, and remedies of this sort, which do not tend to the killing of the fetus except negatively, through subtraction of the humor necessary for its sustenance, but not of remedies which would positively concur to the death of the fetus, such as would be a drink which through positive alteration would kill the fetus: for this would be to give poison positively to an innocent, so that you may free yourself from death, which is never lawful."

8. These things having been set down beforehand, the various questions will not with difficulty be solved according to the various hypotheses.

And I. Where the death of one or the other is certain, namely either of the mother or of the offspring, but the life of the other is certain, and the question is only of temporal death, because, for example, baptism could have been conferred on the offspring not yet born according to the aforesaid things; the mother is not bound to die so that she may preserve temporal life for the son. See Lugo, l.c.

But this case is altogether very rare; since, as St. Alphonsus says, lib. 3, n. 394, it is morally impossible, so that it would almost be a miracle, that when the mother perishes the offspring survives... And he adds: "Several experts of medical art whom I consulted confirmed this to me."

And this indeed is valid even if there is question of a caesarean operation; which besides, since it requires most skilled physicians and a robust mother, rarely has place, especially since this remedy is customarily required then, when other remedies have been applied in vain, and therefore when both mother and offspring have their strength prostrated by a long struggle.

II. Indeed St. Alphonsus (lib. 6, n. 106), having before his eyes that saying of St. Thomas (3, q. 68, art. 11, ad 3): "Evils are not to be done that goods may come; and therefore a man ought not to kill the mother in order to baptize the child," concludes that the mother, when danger of death is proximate or probable, is not bound to undergo that danger so that the offspring may be baptized, nor can the surgeon lead her into this danger.

III. If the mother, seized by disease, labors under grave danger of death unless the fetus is expelled by accelerating birth, but there is probable hope that by the aid of medicine it can be brought about that the fetus comes forth alive into the light, and therefore is going to obtain, if not temporal, at least eternal life; then an expulsion of this sort seems not only lawful, but prescribed. The reason is that the danger and death of the mother would profit nothing for the temporal life of the offspring, and besides would cast the offspring itself into most grave peril of eternal salvation.

Nor ought it to obstruct that perhaps the death of the offspring is accelerated a little. For first indeed, from what has been said with Lugo, the mother is not bound with such danger to preserve the life of the offspring further. And then in that case, as St. Alphonsus says (lib. 6, n. 106, at the end), "that small loss of life can be disregarded, so that the infant may attain eternal life."

IV. When, the mother being sick, the danger of abortion is equally imminent whether she takes a remedy for curing the disease or does not take it, because the very force of the disease, as sometimes happens, brings on abortion, it is lawful for the medicine to be taken; for abstinence from remedies would not profit the offspring, and therefore the mother consults for her own life without greater detriment of the offspring. But if without greater detriment of the offspring the mother can consult for her own life, not only lawfully can she she can, but because of the obligation which each one has of preserving his own life through ordinary remedies, she altogether ought to use medicines.

V. If from the force of the disease a probable danger of abortion is imminent, but at the same time danger is imminent that, if the abortion in reality follows from the disease, the offspring may die in the womb; but, on the contrary, probable hope shines forth that, through birth accelerated by medicines, the offspring may come forth alive into the light, and thus its eternal salvation can be provided for; an uncertain hope of temporal life does not seem to be preferred to the more probable hope of eternal salvation, and therefore it would be lawful to accelerate birth. This indeed must be said to be valid even if the disease brings no danger to the life of the mother, but there is question only of the better good of the offspring.

VI. When, with account taken both of the physical and moral state of the mother, namely that she does not so dread the incision that even this horror alone could gravely harm the offspring, and at the same time after considering both the state of the offspring and the skill of the physician, it can prudently be judged that through a caesarean operation the mother will not be brought into grave danger, but that the offspring can be consulted for not only in temporal but also eternal life, it must be said that the mother is bound to suffer the incision, although the eternal salvation of the offspring could be provided for otherwise. Yet it is required that the hope of the salvation of the offspring and of the mother at the same time be much more probable; for otherwise, for the uncertain hope of the temporal life of the son, since the eternal can be cared for otherwise, as we said, the mother is not bound to undergo a probable danger of her own life (St. Alphonsus, lib. 6, n. 106).

402. Principles. - I. It is never lawful directly to procure abortion, even if the fetus were supposed still inanimate. The reason is that if the fetus is animated, it is homicide properly so called; but if it is not animated, it is anticipated homicide. For a fetus even not animated is ordered to forming a man; therefore its ejection is anticipated homicide. - St. Alphonsus, n. 394. - Lacroix, n. 825. per se directed to curing the disease; 3. that there be no hope of procuring eternal life for that fetus through Baptism. But hope of this sort can be absent in a twofold case: namely where it is morally certain that the fetus is not yet animated, as in the first days of conception; or that it, when the mother dies, will die at the same time or before. - St. Alphonsus, ibid. - Lacroix, n. 826 and following. - Billuart.

III. It is lawful to give to a pregnant woman who is sick remedies suitable for curing diseases, even if sometimes abortion could follow. The reason is that experience establishes that abortion very rarely follows from ordinary remedies, at least most of them. - Thus commonly.

403. Resolves. - 1. It is not lawful for a pregnant girl to take a drug for expelling the fetus, lest she lose her reputation, or lest she be killed by a furious father, because abortion would be procured directly ². This is also clear from proposition 34 condemned by Innocent XI.

² In order that you may lawfully place a cause of death, say the same of any damage of another, it is also necessary that you intend the killing neither as the end, nor assume it as a means to another end, for in either manner you would will it directly; but that you bring it about only indirectly, namely by placing the cause of that death not on account of the connection which that same cause has with that effect or death of the innocent, but only on account of the connection which it has equally immediately with another effect. For thus you do and intend it insofar as it is joined with an effect lawfully desirable, not insofar as by accident it is connected with another effect which you cannot intend, although you can permit it from a just cause. Moreover, in the hypothesis of the Author, abortion is assumed as a means directly chosen for obtaining another end, to which moreover abortion has no order per se at all as to its own effect. In these things a twofold reason shines forth on account of which the proposition was condemned by Innocent XI, n. 34: "It is lawful to procure abortion before the animation of the fetus, lest a girl detected as pregnant be killed or made infamous."

2. It is not lawful, when a woman is pregnant, to kill the fetus ³ for freeing the mother from death. - St. Alphonsus, n. 394.

³ Take this resolution also in the sense set forth in the preceding note, namely that it is not lawful directly to will the death of the offspring. For if otherwise the death both of the mother and of the offspring is certainly imminent, the mother is in no way bound to undergo a death which does not save the offspring from simultaneous death. And to this surely pertains what the Salamancans (tr. XIII, cap. 2, n. 60) attribute to more than twenty Doctors, that in certain circumstances the fetus conducts itself after the manner of an innocent aggressor, whose death according to the doctrine of St. Thomas remembered above, in the note to n. 402, follows only indirectly.

3. It is not lawful for a pregnant mother, even in certain danger of death, to take, or even for medicine to be furnished to her, from an intention directly ordered to the ejection of the fetus. Yet if death is certainly or almost certainly going to happen if the medicine is not applied, and on the contrary the mother is certainly or probably to be saved if it is applied, this does not seem illicit, especially since either from the acceleration of birth or in some other way the eternal salvation of the offspring, otherwise going to be endangered, can be provided for through Baptism ⁴.

⁴ You may rightly say that the two parts of this resolution conflict with each other. You will reconcile them if in the first part, rather than saying from an intention directly ordered, you substitute directly ordered of itself; for so room is left for the sense in which the second part also must be understood, namely that the death of the offspring only follows indirectly, and is permitted.

4. It is lawful for a physician to furnish a remedy of itself ordered to curing the disease of the mother, if it is certain that, the remedy not being given, the mother otherwise is going to die, and the fetus will perish without Baptism; for thus both the mother and the fetus are helped in the better way in which they can be; but very rarely will there be certainty about each. But if there is equal danger of abortion whether the remedy is taken or not, it is lawful to apply it; because the life of the mother is consulted for without greater danger to the offspring. - St. Alphonsus, n. 394.

5. They are homicides who strike a pregnant woman, or terrify her, so that abortion follows. Likewise pregnant women who with grave imprudence place in various ways the proximate cause of abortion, for example by devoting themselves to excessive labors, carrying heavy burdens, washing the feet in cold water, etc.

6. A fortiori girls pregnant from fornication are guilty of homicide who apply repeated efforts to attempt abortion by potions, jumps, burdens, strong striking and compression of the belly, etc. When women of this sort confess, they must be questioned diligently, but not abruptly, about abortion desired or attempted.

Concerning the penalties against those procuring abortion, it will be said in the Treatise on Censures. - See Cases, n. 399 and following.