Question Three: On the Procuring of Abortion

I. Abortion (ab-oriri, to be prevented from arising), according to its etymology, indicates that which is prevented from arising or being born. Hence it is the premature expulsion from the maternal uterus of an immature, nonviable fetus, from a natural or artificial cause. In the present place, the discussion concerns the artificial procuring of abortion, whose definition is explained in little work A, I, q. 5, n. I.

It was known to Hippocrates, but was discouraged because of the dangers to the mother; it was prohibited by law, but in fact was commonly practiced among the Romans. Today this crime is widely propagated; it is an immense evil, notwithstanding the multiplication of contraceptive means. At Moscow, in the Russian empire, there is an official institute of abortion, in which recently 30,000 women in a year were subjected to abortion. In France, according to the statistical computation of the year 1923, there are 500,000 abortions per year, of which 425,000 are criminal; in Germany, according to the statistics of 1929, 1,000,000 abortions were procured in one year, and these brought death to 44,000 women.¹ Hence Dr. Burkhard said that there were more abortions than births.

¹ Thus Professor Liepmann in Schönere Zukunft, 1929, p. 405.

And although the procuring of abortion is punished by civil law, not every abortion is always punished; and if it is performed with the intervention of a physician, even a criminal abortion easily escapes punishment.

II. The causes of abortion can be reduced to these heads:

1. A tearing of the membranes in which the fetus is enclosed, or a rupture effected by means of an instrument, whereby, once the amniotic fluid in which the fetus floats has been withdrawn, the fetus cannot live there for long but is necessarily expelled and, if he is not viable, although living, necessarily dies.

2. Force externally applied by blows or compressions, which would strike even an infant already born and deprive him of life, such as electrical force.

3. Violent concussions, which can have either an extrinsic or an intrinsic cause, for example, convulsions.

4. A relaxation of the fibers, whereby the fetus, pressed by his own weight, is prematurely expelled; this relaxation can indeed have natural causes or can be obtained artificially, for example, by baths, medicated potions, and so forth.

III. There have been diverse opinions concerning the liceity of abortion. We read in St. Alphonsus, Theologia Moralis, bk. III, n. 394:

1. Many said that it is licit directly to procure abortion if the fetus is not animated. Thus Laymann, Sanchez, Henriquez, and others, because, since that fetus is a part of the mother's viscera, the mother is not bound to preserve him with danger to her own life.

2. Others deny this, such as Lessius, Lugo, Pontius, and very many others, because such a fetus is not a part of the mother, nor does he pertain to the integrity of the maternal body, but he is an incipiently distinct human individual.

But in practice, says St. Alphonsus, this second opinion, as the safer one, is altogether to be held. And the same holds if there is doubt whether or not the fetus is animated, because then it is intrinsically evil directly to expose an innocent person to the danger of death.

3. After St. Alphonsus, some said that the direct procuring of abortion is sometimes licit even if the fetus is animated, namely, if otherwise he could not be baptized, or the mother could not be saved. Thus Ballerini, Opus Theologicum Morale, II, n. 910 ff.; D'Annibale, Summula Theologiae Moralis, II, n. 284; Lehmkuhl, Theologia Moralis, 7th ed., I, n. 848, and so forth. This is also found in Gury, Casus conscientiae, 1878 ed., in one case, n. 402; but it was added by the editor, for Gury died in the year 1866.

IV. The Catholic doctrine is that directly procured abortion is always illicit and unjust, even if the fetus could not otherwise be baptized; although indirectly procured abortion can be licit for a proportionately grave cause. This is certain.

That directly procured abortion is always illicit is established:

1. From the responses of the Holy See related above, which explicitly concern the direct procuring of abortion or the expulsion of an immature fetus (Holy Office, 19 August 1889, 24 July 1895, 4 May 1898), and indeed concern a case in which there is no other means of saving the mother and both mother and fetus would otherwise perish. Previously, Sixtus V, in the Constitution Effrenatam of 25 October 1588, inflicted excommunication upon those procuring the abortion even of a fetus not yet, as the common opinion then held, animated by a rational soul; this penalty supposes that the action is gravely sinful. And although Gregory XIV removed this penalty, he nevertheless did not wish, nor was he even able, to remove the intrinsic malice of the act; but now, from the Constitution Apostolicae Sedis, that censure has again been restored (cf. canon 2350).

2. From reason: The direct procuring of abortion, in distinction from the indirect, is an action which immediately produces nothing except the separation of the fetus from the mother, and thus directly brings death to the fetus, who is a man, or at least on the way to being a man. Hence it is the direct killing of a man, or is equivalent to it, as tending directly toward the deprivation of human life; and therefore the same is to be said of it as of the killing of an innocent person, namely, that it is always illicit, intrinsically evil, and unjust. For it directly deprives the fetus of the function of the placenta, by which he adheres to the mother and receives nourishment and the purification of his blood; therefore, to deprive him of these is truly to kill him, just as to kill a man by starvation, lethally to wound him, or to deprive him of blood.

It is one argument, but fundamental and the best: it is illicit to place a cause which immediately produces only an evil effect, and through the evil effect a good effect; for evils are not to be done that goods may come about.

They say: It is only a cessation from preserving the fetus, whereby the mother allows him to slip from her womb and permits him to perish; consequently, it is not to kill him, but to remove him from a place in which he can no longer live and to place him in another in which neither can he live. But the mother is not bound to preserve the fetus with danger to her own life.

Response. It is in no way a cessation or omission, by which it is indirectly permitted, that is, not prevented, that the fetus not be preserved (as in natural abortion, nature ceases from preserving the fetus); rather, it is a positive, death-dealing action: to break off the preservation of the fetus by the mother, violently to disturb the natural condition of the fetus, and positively to act so that he is separated from the mother and placed in a state of necessary death. Therefore death is not permitted, but is directly procured, and for this reason the action is directly lethal: to introduce the proximate cause of death, as by inflicting a lethal wound.

The other arguments they bring forward are the same as those they brought forward for embryotomy (q. 2, nn. II and IV): that it is not a direct killing if it is not intended but done from necessity; that the lesser of two evils is to be chosen; that it is only an acceleration of death; that in a conflict of rights the right of the mother prevails; and that in the case the fetus is an unjust aggressor. But, as Cangiamila already said, the infant is not an unjust invader, but one compelled by nature, whose author is God; indeed, compelled by the mother herself, as Dr. Hubert says.²

² Thus in Eschbach, Disputationes physiologico-theologicae, disp. 3, prop. 6, who treats excellently of the unjust aggressor. See also Creusen, Le foetus, injuste agresseur?, in Miscellanea Vermeersch, I, p. 49; and A. Janssen, Leergang van bijzondere Moraalphilosophie, 3rd booklet, a. 3.

That indirect abortion can be performed licitly in some cases, we sufficiently demonstrated in little work A, I, q. 5, n. IV, where various corollaries of the present doctrine are also handed down in n. V.

V. The occasion of the error, which even now endures among some, is an obscuring of doctrine, whose cause is both the laxer opinion of certain theologians before the Roman responses and the defective, ambiguous, and diverse terminology which physicians and theologians use, indeed theologians among themselves, so that often not even the definition of direct abortion is correct or clearly stated, as we noted above, q. 2, n. V, note 1.

Hence physicians say: the distinction between direct and indirect abortion is a mere subtlety to which we cannot attend.

VI. Is abortion homicide? The solution of this point depends upon the question: Is the fetus animated by a rational soul from the beginning of conception? Formerly this was commonly denied, but now it is generally affirmed, although not on account of certain arguments; concerning this see little work A, II, q. 4, n. I.

While the doubt remains, abortion has the malice of homicide, because it exposes one to a probable danger of killing; for neither can anyone licitly expose himself to the danger of directly killing a man. But even if the fetus certainly were not animated by a rational soul, and therefore direct abortion were not homicide, it would nevertheless be illicit and intrinsically evil. For: 1. the fetus cannot be regarded as the viscera of the mother, but is an individual distinct from the mother, having his own vital principle; 2. man does not have direct dominion over the life and body of a man, nor therefore over the principle of life; consequently, neither over human seed, which is "man in potency,"³ and much less over the fertilized ovum, which is man in the most proximate potency.

³ St. Thomas, Q. D. de Malo, 15, a. 2.

Hence Billuart, De iure et iustitia, diss. 10, a. 7:

"To procure the abortion of a fetus, whether animated or unanimated, directly and from intention, is a most grave sin which can be rendered honorable by no good end.... It is proved:

"1. Because if the fetus is animated, his abortion is corporal and spiritual homicide; if he is not yet animated, although it is not properly homicide, it is nevertheless reduced to homicide. For just as, says Estius, one who prevents another from acquiring something, although it is not properly theft, nevertheless sins against the seventh precept and his sin is reduced to theft; so one who prevents a future man, although he does not properly kill, nevertheless sins in the same genus, namely by that sin which is reduced to homicide; hence it is called by Tertullian a hastening of homicide.

"2. Directly and intentionally to procure pollution is never licit..., because it is contrary to the end of seed intended per se by nature, namely, the generation of offspring.... But the procuring of abortion carries this malice..., for it is contrary to the end of generation not only as intended by nature, as is pollution, but as already actually attempted and proximately to be attained."

VII. Observations.

1. The distinction between direct and indirect abortion is not a mere subtlety, but is founded in reality, so that the action is very different according as two effects, one good and the other evil, are obtained equally immediately from it, or only one evil effect is immediately obtained.

2. In the signs by which direct abortion is distinguished from indirect, the following are to be considered:

a. not so much the end of the agent, but rather the nature of the operation;

b. not the outcome of the operation itself, but the operation itself and its immediate terminus: it is to be asked whether the operation immediately reaches the fetus or the placenta, or, on the contrary, the mother or the uterus; whether it is performed only given the pregnancy, or would also be performed otherwise;

c. not the certainty of the harmful effect; not whether it is per se or per accidens; not the chronological order between the effects, or which one precedes in time, but the order of causality, so that the evil effect either is, or is not, the cause of the good effect.

3. Premature or accelerated birth is carefully to be distinguished from abortion properly so called; it is the expulsion of a fetus who is already viable but not fully mature.⁴ It can occur naturally or be artificially induced before the pregnancy is complete. Hence acceleration of birth is the artificial expulsion from the mother's uterus of a fetus who is not fully mature but is already viable, so that he can live outside the mother's womb. From this it is evident that it is not illicit, provided it is performed for a grave reason. We have spoken sufficiently of this in little work A, I, q. 6.

⁴ Vermeersch nevertheless notes, Theologia Moralis, II, n. 662, that for physicians abortion is rather the expulsion of a fetus not yet formed; hence they understand acceleration of birth more broadly, even of the expulsion of an immature and nonviable fetus.

4. Abortion, whether direct or indirect, would have to be regarded as illicit for a special reason if by this cause the infant were prevented from Baptism or deprived of a reasonable hope of receiving this sacrament. In this case, it would include not only the malice of corporal homicide, but also of spiritual homicide.

5. There is a grave obligation to avoid the causes of abortion, as we noted in little work A, I, q. 5, n. VI, 2.

6. Likewise, there is an obligation to avoid cooperation in abortion, whether it is effected by a positive attempt and endeavor, by counsel given, or by means furnished for it; positive cooperators also incur excommunication.

7. In confession, women made pregnant by a sinful act are discreetly to be questioned, as are men who have fornicated, whether they have attempted abortion.

VIII. There still remain several disputed cases, as to whether they constitute direct abortion or, on the contrary, can be considered indirect abortion. Besides the cases concerning ectopic fetuses, of which the following question will treat, three in particular are numbered:

1. excision of the diseased pregnant uterus;

2. puncture of the amnion;

3. cleansing of the entire pregnant uterus to prevent hemorrhage.

These must be treated individually.