Section 8: Duties with Regard to the Bodily Life of Others

¶3.

Murder, like conscious and voluntary suicide, is an act of criminal interference with the supreme prerogatives of Almighty God (crimen laesae maiestatis divinae), a most grievous sin against justice and charity, and a crime against society.³

³ St. Thomas, Summa Theol., 1a 2ae, qu. 100, art. 5, ad 5; cf. 2a 2ae, qu. 73, a. 3; qu. 122, a. 6, ad 4: “Homicide in itself is not something desirable, but rather something horrible, because it does not of itself have the character of any good.”—Ibid., qu. 47, a. 6, ad 3: “He who kills a man does injury not only to the man killed, but also to God and the commonwealth.”—Cfr. Cat. Rom., P. III, c. 6, qu. 15: “For murderers are the bitterest enemies of the human race, and therefore of nature; insofar as lies in them, they overthrow the whole work of God when they take away man, for whose sake He testifies that He made all things whatsoever that were created; indeed, in Genesis (v, 9), when it is forbidden that a man be killed because God created him in His image and likeness, he who removes His image from the midst does an extraordinary injury to God and seems as though to lay violent hands upon Him.”

¶4.

Murder may be either simple or qualified.

¶5.

Simple murder (homicidium simplex) is the killing of a person towards whom one has merely the general obligations of justice and charity. Qualified murder (homicidium qualificatum) is voluntary homicide aggravated by circumstances which alter the nature or degree of the crime.

¶6.

Such circumstances are: (a) the position or rank of the victim; (b) the latter’s relation towards the murderer, for instance, of husband to wife, father to child or child to father (parricidium), priest to layman (sacrilegium), ruler to subject (regicidium); (c) the conditions under which the crime is committed, for example, its object and purpose (robbery; latrocinium) or the means used in committing the crime, e. g., poison (veneficium), treachery (homicidium proditorium). All these circumstances increase the guilt of the crime, make it more atrocious and deserving of severer punishment.⁴

⁴ 2 Kings III, 27; 1 Mach. VII, 14–18.

¶7.

a) The involuntary killing of a human being (homicidium involuntarium), commonly called manslaughter, is usually committed in a moment of passion and is imputable and punishable in proportion to the measure in which the use of free will was not hindered. Infanticide, i. e., the killing of an illegitimate child by its own mother during or soon after birth, is classed as manslaughter by the criminal law of some countries. But as passion does not always diminish imputability, the moralist must judge each case on its own merits. Morally equal to infanticide is the exposure of an infant, i. e., the intentional abandonment of the same in a helpless condition, unless there is the greatest probability that it will be picked up and cared for.

¶8.

In regard to the killing of babies by their own mothers it should be remembered that this crime is quite often committed under compulsion, rather than voluntarily, for which reason the civil law usually deals with it le- niently. Great excitement, a delirious condition, bodily weakness, loss of blood, pains, the feeling of being deserted, worry about the future, fear of disgrace,—all these and other circumstances may conspire to create an exceptional state of mind in which the responsibility for the crime is realized either not at all, or but dimly.⁵

⁵ Huber, Hemmnisse der Willensfreiheit, 2nd ed., p. 234, note 1.

¶9.

b) Accidental killing (homicidium casuale) i. e., homicide not by direct intention, but as a consequence of some dangerous act (voluntarium in causa), is imputable to the agent if he is aware of the danger of killing some one at the time he performs the act, e. g., driving at great speed in a crowded street, handling a gun carelessly, letting dangerous animals run amuck, and so forth. When no such probable danger exists, or when it is not adverted to, casual homicide is not imputable in conscience, although if the act is legally forbidden, even on other grounds than the chance of causing another’s death, and some one is killed by it, the secular law in many countries punishes it as manslaughter.

¶10.

Accidental killing is committed by physicians, surgeons, and midwives who cause the death of their patients by culpable incompetency or lack of attention; by druggists who through ignorance or carelessness compound deadly medicines; by nurses and attendants who do not give proper care to their patients; by factory owners and mine operators who omit to take reasonable precautions for the protection of their employees and thus become responsible for serious accidents,—in short by all who cause the death of others by acts which, in virtue of their position, profession, or office, they know or ought to know are dangerous to life.⁶

⁶ Ex. XXI, 28 sq.—St. Thomas, Summa Theol., 2a 2ae, qu. 64, art. 8.—P. G. Antoine, Theol. Mor. Universa, t. III, tr. De Iust. et Iure, P. III, c. 2, qu. 12: “Wholly accidental homicide, namely, that which is voluntary neither in itself nor in its cause, is not a sin, indeed not properly homicide, but a simple killing. Because sin is essentially voluntary, therefore that which is voluntary in no way is in no respect a sin. Hence one who kills another in inculpable drunkenness is not guilty of homicide, nor is he bound to restitution, because that killing is not voluntary, either in itself, since the use of reason is absent, or in its cause, namely drunkenness, since this was in no way willed or culpable. It is otherwise if the drunkenness was culpable and the drunk man foresaw or could have foreseen this event, for then the killing is voluntary in its cause and therefore imputable as guilt and damage.”—M. Cronin, The Science of Ethics, Vol. II, pp. 103 sqq.—For an interesting case at law see Pollock, Law of Torts, 8th ed. pp. 48 sqq.

¶11.

Midwives or nurses who receive children with the silent understanding that they dispose of them, and then let them starve to death, are guilty of premeditated murder, unless their conduct is attributable to carelessness.

¶12.

Mutilating another or injuring his health is sinful if done against his reasonable will. To this class of forbidden acts belong corporeal maltreatment, the infliction of unnecessary pain by beating or wounding, overburdening with work, cruel treatment, handing out insufficient or adulterated and consequently injurious food, etc. Strong emotions, too, such as, for instance, fear, anger, and even excessive joy, can injure the human organism and imperil its existence, nay, destroy it, by causing paralysis of the heart, or psychoses and serious derangements of the nervous system, such as epileptiform or hysterical convulsions, and so forth.⁷

⁷ Cfr. Maschka, Handbuch der gerichtlichen Medizin, Vol. I, pp. 809 sqq.

Mutilation Bodily Injury

¶13.

Any injury unjustly done to the health or members of another against his reasonable will is a violation of justice and a mortal sin, unless passion, previously suffered injury or smallness of matter (parvitas materiae) diminish the guilt. Mutilations which entail the loss of the procreative faculty (castratio, emasculatio) are inspired by greater malice and are therefore more severely punished by the civil law.

Mutilation Bodily Injury

¶14.

CRIMES AGAINST THE UNBORN.—Every morally forbidden act or omission which results in the death of an embryo or a fetus in the mother’s womb, from the time of conception until or during delivery, is morally equivalent to manslaughter.⁸ The Catholic Church has always regarded the value and dignity of human life so highly that she never permitted it to be destroyed or injured even in its incipient stages.⁹ Acts or omissions tending in that direction are imputable in proportion to the guilt involved, and it is owing to the influence of the Church that they are punished also by the civil law. In our neo-pagan age a movement has been started to make feticide legal.

⁸ St. Augustine, Enchiridion, c. 86: “From the moment a man begins to live, from that moment he is certainly already able to die.” (Migne, P. L., XL, 272).—Cfr. the propositions condemned by Pope Innocent XI, n. 35: “It seems probable that every fetus (as long as it is in the womb) lacks a rational soul and first begins to have one when it is born; and consequently it must be said that no homicide is committed in any abortion.” (Denzinger-Bannwart, n. 1185).

⁹ Doctr. XII Apost., c. II, n. 3: “[You shall not kill] a child by abortion, nor destroy one after it is born.” Funk, Patres Apost., Vol. I, 2nd ed., VIII, 1; Kirsopp Lake, The Apostolic Fathers, Vol. I, pp. 312 sq.); Epist. Barnab., c. 19, n. 5: “You shall not kill a child by abortion, nor again destroy it after it is born” (Funk, op. cit., p. 90, 22; K. Lake, op. cit., p. 404); Epist. ad Diognet., c. 5 n. 6: “They marry like everyone; they beget children, but they do not cast away those born” (Funk, op. cit., p. 398, 10; Lake, op. cit., Vol. I, p. 360); Tertullian, Apol., c. 9: “But for us, murder having once been forbidden, it is not permitted even to dissolve what has been conceived in the womb, while blood is still being drawn into a human being. To prevent birth is the hastening of homicide; nor does it matter whether one snatches away a soul already born or disrupts one being born. He too is a man who is going to be one; every fruit is already present in the seed.” (Ed. Leopold, Vol. I, p. 68).—Minucius Felix, Octavius, c. 30 (Migne, P. L., III, 333 sq.).

¶15.

a) Women who through their own fault, e. g., by an inordinate mode of life, by voluntarily produced or sustained excitement of the passions, or incautious physical exertion, bring about a miscarriage (abortus, i. e., a delivery before the twenty-eighth week of pregnancy) commit a mortal sin. Pregnant women, especially if they are disposed to miscarriage, are bound in conscience to avoid such occasions as hiking, dancing, driving over rough roads, long railroad or automobile rides, lifting or carrying heavy burdens, the abuse of alcoholic liquors, and the use of power machinery.

¶16.

It is sinful to maltreat a pregnant woman or to overburden her with work, etc., thereby causing a miscarriage or creating a disposition for it.¹⁰

¹⁰ Ex. XXI, 22 sq.—Gury, Comp. Theol. Mor., Vol. I, n. 380: “Parents are bound to exercise diligent care for their offspring from conception itself, to avert everything that can be harmful to it, and to keep watch lest it be exposed to any danger to life. Hence the following sin gravely of themselves: 1. women who do not take care lest the fetus be destroyed in the womb through disorderly sensuality, dancing, heavier burdens, running or a long journey, excessive anger, or more vehement grief; 2. men who treat their pregnant wives harshly, inflict serious wounds upon them, or impose greater labors upon them.”—Ibid., n. 415, 5: “Those who strike or terrify a pregnant woman so that abortion follows are murderers. Likewise pregnant women who through grave imprudence in various ways posit the proximate cause of abortion, v. g., by devoting themselves to excessive labors, carrying greater burdens, or washing their feet in cold water.”

¶17.

b) To procure abortion directly and intentionally, by the ejection of the fertilized ovum or the fetus from the uterus before it is viable, is a grievous crime, whether committed by the mother or by another person. Morally such an act must always be regarded as an intentional destruction of human life, since the distinction formerly made between foetus animatus and foetus inanimatus is physiologically untenable.¹¹

¹¹ Cfr. Prop. 34 among those condemned under Innocent XI: “It is permissible to procure an abortion before the animation of the fetus, lest a girl discovered pregnant be killed or disgraced.” (Denzinger-Bannwart, n. 1184).—Cfr. Gury, Comp. Theol. Mor., Vol. I, n. 414: “Direct abortion is never permitted, even if the fetus were supposed still unanimated, under any pretext of avoiding death, etc. 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 the fetus, even unanimated, is ordered toward the formation of a man; therefore its ejection is anticipated homicide.”—Ibid., n. 415, 1: “A pregnant girl may not take a drug to expel the fetus, lest she lose her reputation or be killed by an enraged father, because abortion would be directly procured.”—Cfr. Antonelli, Medicina Pastoralis, Vol. I, 3rd ed., pp. 190 sqq.; L. Knapp, Theologie und Geburtshilfe, Prague 1908, pp. 50 sqq.

¶18.

Intentional co-operation in bringing about abortion (procuratio abortus) is likewise strictly forbidden. What renders this sin all the more grievous is the fact that the fetus which is thus destroyed is robbed not only of life, but of the grace of Baptism, and that the crime, when committed by the mother or near relatives, partakes of the nature of parricidium.

¶19.

The assertion that every child “has the right not to be born” is contrary to Catholic teaching and therefore untenable.

¶20.

c) Medical science has devised certain artificial means for saving the life of both mother and child, or at least that of the mother, in cases where, on account of some physical obstruction, normal delivery is impossible. Such means are: medical abortion, artificially produced premature delivery, perforation, the Cesarian section, laparotomy, and symphyseotomy.¹²

¹² On these operations, see A. O’Malley, The Ethics of Medical Homicide, passim, N. Y. 1919.

¶21.

The S. Congregation of the Penitentiary, on Nov. 28, 1872, replied evasively to the question whether “the operation called craniotomy, or a similar operation aiming directly at the killing of the child in its mother’s womb were ever permissible,”¹³ but the Holy Office declared on May 28, 1884, that the permissibility of craniotomy “tuto doceri non posse,” i. e., cannot be safely taught in Catholic schools or practiced without danger of sin. This decision was followed by two others of the same S. Congregation, dated respectively, Aug. 13, 1889, and July 29, 1895, by which this prohibition was extended so as to include “all surgical operations aiming directly at the killing of the fetus or the mother.”¹⁴ The S. Congregation in making this decision had before it a case in which craniotomy (perforation) was the sole means of saving the mother.¹⁵ Hence the following principles must guide us in the moral appraisal of this obstetrical operation:¹⁶

¹³ S. Poenitentiario, decree of 28 Nov., 1872: “Having maturely considered the propositions, he answered: let approved authors, whether old or more recent, be consulted, and let it be done prudently.”

¹⁴ Denzinger-Bannwart, n. 1889 sq.; Cfr. Chas. Coppens, S. J., Moral Law and Medical Practice, ed. Spalding, N. Y. 1922, pp. 58 sqq.

¹⁵ “When, namely, if it [craniotomy] is omitted, mother and child are going to perish, but if it is admitted, the mother is to be saved while the infant perishes.”

¹⁶ Capellmann, Medicina Past., 5th ed., Aix-la-Chapelle 1893; B. M. Bergervoort, Direkter Abortus und Kraniotomie und deren Erlaubtheit, Munich 1896; F. Guermonprez, L’Assassinat Médical et le Respect de la Vie Humaine, Paris 1904; Chas. Coppens, S. J., Moral Law and Medical Practice, ed. Spalding, New York 1922; Stöhr-Kannamüller, Handbuch der Pastoralmedizin, 5th ed., pp. 461 sqq.; Antonelli, Medicina Past., Vol. II, 3rd ed., pp. 55 sqq.; A. Klarmann, The Crux of Pastoral Medicine, New York 1920.

¶22.

α) Artificial or medical abortion (abortus medicinalis), i. e., the ejection from the womb of an immature fetus or a fertilized but not yet viable embryo,¹⁷ is direct homicide and, therefore, a grievous crime against the fifth commandment. Abortion is, moreover, a more or less dangerous attack upon the life of the mother, and therefore an attempt upon two lives at once. Modern gynecology knows of but two diseases in which abortion may be indicated as a last resort.¹⁸ The causes of the first may be removed by the administration of chloroform, while the second (hyperemesis gravidarum), usually the result of hysteria, is of rare occurrence and as a rule not only ceases about the middle of the gestation period, but can be cured by rational therapy. Hence the first duty of the physician in such cases is to endeavor to remove the underlying causes. Abortion should be avoided for the additional reason that it is a very doubtful means, to say the least, of saving the life of the mother.

¹⁷ O’Malley, The Ethics of Medical Homicide, pp. 91 sqq.

¹⁸ J. P. Gury, Comp. Theol. Mor., Vol. I, n. 414: “Sometimes it is permitted indirectly to procure or permit abortion, namely, by administering to a mother suffering from a serious disease remedies harmful to the fetus, if the following conditions occur: 1. That it be a matter of a fatal disease; 2. That the remedies harmful to the fetus be directly and immediately efficacious of themselves for curing the disease; 3. That there be no hope of procuring eternal life for that fetus through Baptism. . . . It is permitted for physicians to give a pregnant woman suffering 18 suffering from most remedies customarily used for various diseases, although abortion can sometimes follow. The reason is that experience shows that abortion very rarely follows from most properly directed remedies.”—Ibid., n. 415: “It is not permitted for a pregnant mother, even in certain danger of death, to take, or even to give her, a medicine which by its own force is directed to the ejection of the fetus, although the death of both would certainly occur if it were not administered, and on the contrary she would certainly or probably be saved if it were administered. The reason is that abortion would be directly procured. . . . It is permitted for a physician to administer a remedy directed of itself to curing the mother’s disease, if it is certain that, if the remedy is not given, both the mother otherwise destined to die and the fetus will perish without Baptism, because thus both mother and fetus are assisted in the best way possible; but very rarely will there be certainty about both. But if the danger of abortion is equal whether the remedy is taken or not, it is lawful to take it, because the mother’s life is cared for without greater danger to the fetus.”

¶23.

Indirect abortion, on the other hand, is permissible in certain cases, i. e., if it results accidentally from the application of remedies which are per se intended and apt to cure the mother. It is permissible, therefore, in the treatment of pregnant women who are suffering from a disease, even if there is no immediate danger of death, to employ internal or external remedies which, in the common experience of the medical profession, are necessary or apt to cure the disease from which the mother is suffering, even though they may accidentally cause abortion.¹⁹

¹⁹ Gury, Comp. Theol. Mor., Vol. I, n. 415, 2: “It is not permitted for physicians or midwives, when a woman is pregnant, to kill the fetus in order to free the mother from death.”

¶24.

When there is immediate danger of death, such means may be used as will be necessary to cure the mother, even though it were certain or highly probable that abor- tion would follow, provided there is no other effective remedy to save the mother and all possible precautions are taken to prevent abortion.

¶25.

β) It is lawful to induce premature delivery by artificial means as soon as the fetus is viable, i. e., so far developed that it can live outside the womb. However, this operation may endanger the lives of both mother and child, and should, therefore, be resorted to only in urgent cases. Such an emergency would arise if the birth of the child at the end of the full period would necessitate a still more dangerous operation, or if the mother were suffering from a serious illness that could probably be cured by inducing a premature delivery. Though the latter process may not entirely comply with the final object of delivery, i. e., to bring into the world a fully developed and healthy child, it at least involves no direct destruction of life and makes possible the administration of Baptism in case the child should die.

¶26.

γ) Obstetrical operations that result in the destruction of the life of the child (craniotomy, cranioclasy, cephalotripsis, embryotomy [decapitation or exenteration]) are directly homicidal and therefore absolutely forbidden. Though the resultant death of the mother is not attributed to the operation, but to the disease which the operation was designed to cure, there is always involved a certain danger to the mother from the careless use of instruments or some other accident. If the fetus is dead, there is no objection to craniotomy. In case of doubt whether the fetus is dead or alive, the physician may operate if the mother’s life is in danger. In this extremely delicate question the principle of self-defense in the strict sense cannot be invoked in favor of the mother. However, the physician may consider himself in a state of perplexity from which he can extricate himself only by choosing the safer side, i. e., by saving the certain life of the mother. Besides he would make himself liable to prosecution if he omitted to use the means prescribed for such cases in the current text-books on obstetrics.²⁰

²⁰ P. A. Finney, C. M., Moral Principles in Hospital Practice, St. Louis, Mo., 1922; O’Malley, The Ethics of Medical Homicide, pp. 92 sqq.; Coppens, Moral Principles and Medical Practice, pp. 62 sqq.

¶27.

δ) The so-called Cesarian section (sectio caesarea), which consists in cutting open the womb (incisio ventris) to extract a fetus that cannot be delivered in the natural way, is in itself an immediate attack upon the life of both mother and child but its technique has been so perfected that it is no longer as hazardous as it used to be and may, therefore, be permitted, provided the danger to the mother is not so immediate that the operation would mean almost certain death. All possible precautions must moreover be taken to safeguard the lives of both mother and child.²¹ Note, however, that the favorable results referred to have for the most part been achieved in a comparatively small number of hospitals and clinics and that the percentage of mortality still remains rather high. The ordinary practitioner, according to Dr. O’Malley, is utterly unfitted to do a Cesarian section of any kind.²²

²¹ S. C. Offic., d. d. 4 May 1898: “1. Is acceleration of delivery permitted whenever, because of the narrowness of the woman, the exit of the fetus at its natural time would become impossible? 2. And if the woman’s narrowness is such that even premature delivery is judged impossible, will it be permitted to provoke abortion or to perform a Caesarean operation at the proper time? 3. Is laparotomy permitted when the case concerns extrauterine pregnancy or ectopic conceptions? Reply to 1: Acceleration of delivery is not in itself unlawful, provided that it is performed for just causes and at the time and in the ways by which, according to ordinary contingencies, provision is made for the life of the mother and fetus; to 2: As regards the first part, negatively, according to the decree of Wednesday, July 24, 1895, concerning the unlawfulness of abortion. As regards the second, nothing stands in the way, since the woman in question may be subjected to a Caesarean operation at the proper time; to 3: Under compelling necessity laparotomy is permitted for extracting ectopic conceptions from the mother’s womb, provided that, so far as possible, serious and timely provision is made for the life of both fetus and mother.”—Cfr. Knapp, Theologie und Geburtshilfe, pp. 70 sqq.

²² The Ethics of Medical Homicide, p. 138.

¶28.

Porro’s operation, so-called, consists in the removal of the uterus after a Cesarian section to prevent further conceptions, and is altogether unjustifiable.²³

²³ O’Malley, Essays in Pastoral Medicine, p. 59.

¶29.

As regards the Cesarian section, a mother is, broadly speaking, not obliged to submit to it and should be counseled to do so only in view of the eternal salvation of her child. This consideration must not, however, always be urged in praxi, because it might lead to the commission of a mortal sin and consequently bring about the eternal loss of the mother.

¶30.

If a mother dies in the state of pregnancy, the Cesarian section should, if possible, be performed on the corpse, to save the eternal and perhaps also the temporal life of the child.²⁴

²⁴ Rit. Rom., tit. II, c. 1, n. 17: “If a pregnant mother has died, the fetus should be carefully extracted as soon as possible and, if it is alive, baptized.”—S. C. Offic., d. d. 13 Dec., 1899.—Cfr. Stöhr-Kannamüller, Handbuch der Pastoralmedizin, 5th ed., pp. 473 sqq.; Antonelli, Medicina Past., Vol. II, 3rd ed., pp. 71 sqq.

¶31.

ε) Symphyseotomy (sectio symphyseos) is a cutting of the maternal pelvic girdle through the symphysis pubis, the rigid joint at the front middle part of the pelvis, thus letting the bony girdle dilate. It has latterly been replaced by hebosteotomy or pubiotomy (a sawing through that joint to effect the dilation) because the rate of mortality is somewhat lessened by the latter method.²⁵ Both operations are to be judged in the same light as the Cesarian section, that is to say, they are licit only when they do not involve direct homicide.

²⁵ O’Malley, The Ethics of Medical Homicide, p. 135.

¶32.

DUELLING.—A duel is defined as a premeditated and pre-arranged combat with deadly weapons, between two persons, usually in the presence of witnesses, called seconds, for the purpose of deciding a quarrel, avenging an insult, or clearing the honor of one of the combatants, or of some third party, whose cause he has espoused.²⁶

²⁶ Slater, A Manual of Moral Theology, Vol. I, p. 316.

¶33.

A duel, therefore, differs from an ordinary fight, from single combat (by which the fate of a battle is sometimes determined), and from the so-called mensuren of European students. The latter as a rule exclude the motive of revenge and serious danger to life, and are mere sports, though they sometimes degenerate into real duels and must be judged as such.

¶34.

Duelling is in itself immoral because it is an illegitimate interference with God’s property right in human life.²⁷ It is a usurpation of justice, for which there is no legitimate excuse in a well-ordered State. As a means for deciding a quarrel or vindicating the honor of the combatants, it is totally inappropriate, because there is no intrinsic proportion between the means used and the end sought for.

²⁷ Ex. XX, 13; Deut. XXXII, 29; Wisd. XVI, 13 sq.; Rom. XIV, 7 sq.

¶35.

A duel would be an appropriate means for the preservation of honor if, as the ancient pagans and not a few medieval Christians believed, it represented a sort of divine ordeal in which truth and justice always triumph. But this is not the case. In a duel the victory does not depend on the justice of one’s cause, or the probity of one’s character, but on such extrinsic factors as greater strength or superior skill in the handling of deadly weapons.

¶37.

Duelling has been condemned as a detestable practice by the Council of Trent and the excommunication pronounced against the guilty parties, their seconds and abettors is renewed in the new Code of Canon Law. The latter also denies ecclesiastical burial to those who die as the result of a duel, unless they give signs of repentance before death, and refuses them public funeral services, exequial and anniversary masses.²⁸

²⁸ C. I. C., can. 2351, 1; 1240, 1, 4; 1241.

¶38.

As duelling is not a common practice in English-speaking countries (for which this Moral Theology is intended) we need not enter into details. Under English and American law duelling is illegal, and if it results in death, it is regarded as murder, and the seconds are liable to punishment as accessories.²⁹

²⁹ Slater, Moral Theology, Vol. I, p. 318.