Abortion

It is usual to treat here of abortion, and of certain surgical operations concerned with child-bearing. Abortion is the premature ejection of the living fetus. The human fetus reaches maturity about nine months after conception, but it is capable of living even if born a considerable time before maturity. A child may live when born at seven months or even somewhat earlier, especially if artificial means are taken for preserving its life. When the foetus is ejected at such a time that in the judgement of a skilled medical man it will probably live, this is called acceleration of birth rather than abortion in the strict sense. We are here concerned with the lawfulness of procuring abortion and of performing such operations as craniotomy and embryotomy, which destroy the life of the foetus. There is only question of the living, not of the dead, foetus, as is obvious.

Inasmuch as it is never lawful directly to kill the innocent, it is never lawful directly to procure abortion at a time when there is no probability that the foetus can live outside the mother’s womb. This is clear, for the foetus is a human being, with a human soul, which, as is commonly held by theologians, is infused into it by God at the moment of conception; it has, then, as much right to live as anyone else, and it certainly is innocent of all personal crime. To deprive it directly of the medium in which alone it can live is to kill it directly, just as to deprive a man of air by plunging him under water is to kill him directly. The direct procuring of abortion, then, is never allowed, inasmuch as it is the direct killing of the innocent, and intrinsically wrong. In the same way, anticipated homicide and a grievous sin are committed whenever means of whatever sort are taken to prevent conception.

However, just as the indirect killing of the innocent is lawful for a just cause, as we have seen, so a pregnant woman who is suffering from disease or tumour, or any complication which threatens life, may lawfully adopt the necessary means to save herself, even if what is a remedy for her causes the death of the foetus, In all these cases we have but the application of the principle of a double effect; the mother is not bound to sacrifice her life by abstaining from adopting the remedy indicated, especially as her own death would also involve the death of the child. Thus we may approve of the following solution by Dr. Capellman of the “ case where the uterus with the foetus is locked in the upper strait, as may happen through retroversion, sinking, and prolapsus of the pregnant womb. If all other known means of turning or replacing the uterus fail, I believe it to be allowable to induce abortion indirectly, by procuring the discharge of the waters, or by the perforation of the foetal membranes.”¹ On the same principle P. Antonelli thinks that it is lawful to remove an ulcerated womb which is threatening the life of a pregnant mother though the operation cause the death of the foetus, as also to remove an extrauterine foetus whose further growth would cause the certain death of the mother.²

All who unlawfully procure abortion incur the penalty of excommunication, the absolution of which is reserved to the Bishop by Canon 2350.

¹ Pastoral Medicine, p. 16.

² Medicina pastoralis, p. 220.

Effectu.—F or the censure to be incurred, it must be certain that abortion followed from the means used. Canon 2385 V. Religiosus, apostata areligione, ipso jure incurrit in excommunicationem proprio Superiori majori, vel, si religio sit laicalis aut non exempta, Ordinario loci in quo commoratur, reservatam.

Before we speak about abortion, some things must be noted beforehand.

By the name fetus is understood the ovum of a woman fertilized by the semen of a man. Now it is freely disputed whether the rational soul, apart from a miracle, is infused at the very instant of fertilization or afterward; afterward, I say, that is, after the fetus has grown to the due organism of a human body.¹

A fetus regularly cannot live outside the uterus unless after seven complete months of gestation. Yet if artificial incubation takes place, sometimes there is hope that a fetus may go on living outside the uterus after six complete months of gestation. In these matters one can stand by the judgment of an expert.

¹ Those who deny that the soul is infused at the first instant of fertilization admit a miracle with respect to Christ and the Blessed Virgin Mary.

I. Notion. Abortion is the expulsion from the mother's uterus of a fetus not yet viable outside the uterus.

Abortion differs from acceleration of birth, or from premature delivery, which consists in this, that the offspring is brought forth artificially before nine complete months of gestation, but when it can live outside the uterus.

II. Division. Abortion is distinguished into direct and indirect. It is direct when the act of ejecting the offspring as such is either intended as an end, or is assumed as a means by which another end is obtained. Otherwise it is indirect.

III. Morality. 1. Direct abortion is to be judged as follows:

a) Direct abortion of an animated fetus is always gravely illicit. This is clear from the constitution Effrenatam of Sixtus V;¹ likewise from the encyclical Casti connubii of Pius XI;² likewise from the decrees of the Holy Office;³ finally from reason: namely, if the fetus is animated, direct abortion involves the killing of offspring, that is, its tearing away from the maternal uterus, whereby it happens that it can no longer live; it involves direct killing of offspring, because it involves an act which, insofar as it is killing or insofar as it is tearing away and expelling the offspring from the mother, is assumed as the means by which another end, for example the safety of the mother or avoiding disgrace, is obtained. It is commonly added that the fetus about to die is not baptized (St. Alphonsus, III, 394).

b) Direct abortion of a fetus not yet animated is likewise gravely illicit; for if the fetus is not yet animated, there is an action which is directly opposed to the good of the species, equally as is the disordered use of semen; indeed even more, because a fetus not yet animated approaches more closely to man than semen does. Hence abortion of a fetus not yet animated is reduced by some to homicide, and is called by them imperfect or anticipated homicide. There is added proposition 34 condemned by Innocent XI: it is lawful to procure abortion before the animation of the fetus, lest a girl discovered to be pregnant be killed or disgraced⁴ (St. Alphonsus, loc. cit.).

Objection 1. He who procures an abortion does not kill the offspring, but merely ceases to preserve its life.

Resp. I deny the assertion, since he who procures abortion positively places the offspring in that condition in which it cannot live. Such a manner of acting cannot be called a mere cessation from preserving the offspring.

Objection 2. A fetus which creates danger for the mother can be regarded as an unjust aggressor.

Resp. Since the fetus is merely present to the mother, and indeed with nature itself directing the matter thus, there can be no discussion of an aggressor of the mother.

What if it is doubted whether the fetus is dead?

Resp. Doubt about the death of the fetus easily persists. Some indeed judge that the death of a sufficiently developed fetus can be established by means of a stethoscope, which demonstrates that the pulsations of the heart have ceased; but from the recent opinion about apparent death, the said certainty does not seem to be had unless it is established that for a sufficiently long time, for example for an hour, the pulse of the heart has altogether ceased. With these things noted, I answer: in doubt whether the fetus is dead, direct abortion is gravely illicit, because, to use the words of St. Alphonsus, "it is intrinsically evil positively to expose an innocent person to danger of direct death" (III, 394), or because it is illicit to place an act which probably is directly killing an innocent person.

2. Indirect abortion likewise is per se gravely illicit; it becomes lawful if a grave cause is present, provided, however, that the hope of baptizing the offspring is not diminished.⁵ For the things said about indirect killing have force, since such killing is had in the case (n. 731). Moreover, a cause is required that is graver in proportion as the means employed has more influence on the abortion (St. Alphonsus, III, 394).

Corollary I. For saving the life of the mother, it is lawful to use a medicine which of itself tends equally to the cure of the disease and to abortion, because the act of taking medicine is not employed as a means of saving the mother insofar as that act is killing. Likewise it is lawful to extirpate a uterus infected with cancer, even if the death of the fetus must follow from this, because the extirpation is not assumed as a means insofar as it is killing the fetus (St. Alphonsus, III, loc. cit.).

Corollary II. Incision or puncture of the membranes of the fetus, so that the uterus may be replaced, seems illicit, because the act of cutting or puncturing is assumed as a means insofar as it is killing, that is, insofar as it is expelling the fluid without which the fetus cannot live, indeed also insofar as it is expulsive of the fetus. Make an exception if, as they contend can sometimes be obtained, the incision or puncture can be done in such a way that only part of the fluid flows out and ejection of the fetus does not follow.

Corollary III. Mothers sin gravely, objectively, who, with their condition considered, induce grave danger of abortion: by carrying heavy burdens, undergoing hard labors, indulging in vehement sadness or anger, dancing, riding, and so forth; likewise those who strike a pregnant woman, afflict her with vehement pain, or excite her to vehement anger. But if in the aforesaid cases abortion is intended, there is guilt of direct abortion.

Note 1. Since the illicitness of feticide carried out to save the mother is not so evident, good faith is not always excluded either among physicians or in the mother. Moreover, if good faith is present and there is no hope of fruit, the priest can be silent, unless there is danger of apparent connivance and thus harm can also be done to the common good. For the rest, baptism of the fetus should always be provided for as much as can be done. But those who procure abortion to avoid the disgrace of a girl, to forestall more numerous offspring, to strengthen the health of the mother, or to remove a light danger of death, should ordinarily be instructed, and, unless they are willing to renounce the perverse practice, should be sent away without absolution. The same must be said of those who induce abortion when sufficient provision can be made for the mother by acceleration of birth.

Note 2. Medicines which are usually prescribed for diseases commonly cannot influence abortion except remotely, so that, provided some good effect is intended, there is scarcely an obligation of abstaining from them. Several causes which are assigned by some, such as violent disturbances of the mind, excessive fatigue, riding in a carriage, and so forth, although for the most part they do not induce abortion, nevertheless are not done without moderate danger. But more dangerous are extensive abuse of intercourse, the wearing of garments constricting the uterus, baths that are too hot, and so forth.⁶

Note 3. Today indirect procurement of abortion is rarely necessary for saving the life of the mother, since provision can be made for both mother and offspring by Caesarean section, symphysiotomy, pubiotomy, and so forth.

¹ October 29, 1588.

² December 31, 1930.

³ July 24, 1895, decree of the Holy Office de abortus illiceitate; May 4, 1898 (Collect., n. 1898).

⁴ Denzinger-Bannwart, n. 1184.

⁵ This hope is commonly not diminished, since the fetus can usually be baptized either in the uterus (cf. treatise on Baptism) or after abortion has followed.

⁶ Surbled, La vie sexuelle, p. 230.

IV. Penalties against the crime of abortion. 1. Those are irregular by reason of delict who have procured the abortion of a human fetus, the effect following, and all cooperating (can. 984, 4°).

2. Those procuring abortion, not excepting the mother, incur, the effect following, excommunication latae sententiae reserved to the Ordinary; and if they are clerics, they are besides to be deposed (can. 2350, § 1). These matters are more fully explained in the treatise on ecclesiastical penalties.

Moreover, the following contract an excommunication reserved to the Ordinary:

I. Catholics: 1° who enter marriage before a non-Catholic minister against the prescription of canon 1063, § 1; 2° who are united in marriage with an explicit or implicit agreement that all or some of the offspring be educated outside the Catholic Church; 3° who knowingly presume to offer their children to non-Catholic ministers for baptism; 4° parents or those holding the place of parents who knowingly hand over children to be educated or instructed in a non-Catholic religion (canon 2319, § 1).

1. The prescription of canon 1063, § 1 is this: "Even if a dispensation has been obtained from the Church over the impediment of mixed religion, the spouses cannot, either before or after the marriage entered before the Church, also approach, whether by themselves or by proxy, a non-Catholic minister as one dedicated to sacred rites, in order to give or renew matrimonial consent." Hence it is not prohibited, indeed as § 2 has it, "it is not disapproved that, when civil law commands it, the spouses present themselves, even before a non-Catholic minister, performing only the function of a civil official, and that only for accomplishing the civil act, for the sake of civil effects." The censure is contracted, however, whether matrimonial consent is entered or renewed before a non-Catholic minister as one dedicated to sacred rites.

2. An implicit agreement is had, for example, when the Catholic party obliges himself to fulfill all the wishes of the non-Catholic party concerning religious education. The excommunication is incurred at the moment at which the marriage is contracted with the agreement, whether previously entered and not retracted or now entered.

3. On the word "knowingly" see what was said in n. 858. Since it is said "their children," for example, a midwife who offered another's offspring to a non-Catholic minister for baptism would be immune from the excommunication. For the rest, the excommunication is incurred also in a case in which baptism would probably be conferred invalidly.

4. Those holding the place of parents can be tutors or even others who are endowed with the right and office of looking after education or instruction.

Note. Those mentioned under 2, 3, and 4 are moreover suspected of heresy (canon 2319, § 2).

II. Whoever makes false relics, or knowingly sells, distributes, or exposes them to the public veneration of the faithful (canon 2326). The word "knowingly" refers to the acts of selling, distributing, and exposing to public veneration. Since it concerns false relics, one does not incur the excommunication who distributes or exposes for veneration relics whose document of authenticity has perished, or concerning whose genuineness he doubts (cf. canon 1285).

III. Whoever has laid violent hands on the person of other clerics, that is, clerics inferior to Bishops, or of religious of either sex (canon 2343, § 4). What violent laying on of hands imports, see p. 766 under X. For the excommunication to be incurred, it is required that the delinquent lay hands on the person of another, not on his own person, and that he know that person to be a cleric, religious, etc. The persons whose violent handling is punished with excommunication are:

1. Clerics, that is, those who by at least first tonsure have been assigned to divine ministries (canon 108, § 1), and have not been deprived of the privileges of clerics; hence even excommunicated, suspended, interdicted, and deposed clerics (cf. canon 2303, § 1), but not those perpetually deprived of the right of wearing ecclesiastical habit (canon 2304, § 2), the degraded (canon 2305, § 1), and all who have legitimately been reduced or have returned from the clerical state to the lay state (canon 213, § 1).

2. Religious of either sex, that is, those who have pronounced vows, whether solemn or simple, perpetual or temporary, in some religion (canon 488, 7°).

3. Male and female novices (cf. canon 614), but not postulants.

4. Members of either sex without public vows, living in common under the governance of Superiors according to approved constitutions (canon 680).

Note. The Ordinary should moreover punish the delinquent with other penalties, if the matter requires it, according to his prudent judgment (canon 2343, § 4).

IV. Those procuring abortion, the mother not excepted, the effect having followed (canon 2350, § 1).

1. Abortion is to be taken in the strict sense, that is, for the ejection of a fetus not yet viable (volume I, n. 733). Therefore the so-called acceleration of birth, the ejection of a dead fetus or a mere mole, and the expulsion of received semen, likewise embryotomy and similar illicit operations, are excluded. But no distinction is to be made between an animated and an unanimated fetus.

2. Those procuring abortion are understood to be the mother and others, whether female or male, who intend abortion and either physically cause it, or by command or by fear induced cause another to cause it. It is said, who intend abortion; hence one is immune from excommunication who, not intending abortion, for example, strikes his wife from anger, even if he foresees abortion. It is said, either by command or etc.; but if you were to deny that those commanding and those inducing fear come under the name of procurers, nevertheless one commanding, as the principal author of the delict, and one inducing fear, as inducing to the delict, are subject to the excommunication. Counselors and others concurring proximately are not counted among procurers, although as cooperators they contract the excommunication if the delict would not have been committed without their work (canon 2209, § 3). Those selling means do not ordinarily incur excommunication, both because ordinarily even without their work, namely with another selling the means, the delict would have been perpetrated, and because the concurrence is remote.

3. The effect having followed, that is, certainly followed; hence in doubt whether a fetus or a mere mole, whether a living or dead fetus, was ejected, the excommunication does not hold.

Whether one whom it repents of the committed crime before the effect follows incurs the excommunication, see p. 723.

Note 1. If the delinquent is a cleric, he is moreover to be deposed (canon 2350, § 1).

Note 2. Those who have procured the abortion of a human fetus, the effect having followed, and all cooperators, are irregular from delict (canon 985, 4°).

V. A religious, apostate from religion, incurs by the law itself an excommunication reserved to his own major Superior, or, if the religion is lay or non-exempt, to the Ordinary of the place in which he is staying (canon 2385).

1. One is called an apostate from religion who is professed from perpetual vows, whether solemn or simple, and who illegitimately leaves the religious house with the intention of not returning, or who, though having left legitimately, does not return with the intention of withdrawing himself from religious obedience (canon 644, § 1). The malicious intention mentioned in § 1 is presumed by law if the religious within a month has neither returned nor manifested to the Superior his intention of returning (canon 644, § 2).

2. The excommunication is reserved to his own major Superior if the religion is clerical exempt; if the religion is lay or non-exempt, it is reserved to the Ordinary of the place in which the delinquent is staying (canon 2385), that is, actually staying, even if he has domicile or quasi-domicile elsewhere.

Note. A religious apostate from religion is excluded from legitimate ecclesiastical acts and deprived of all privileges of his religion; and if he returns, he perpetually lacks active and passive voice, and moreover must be punished by the Superiors with other penalties according to the gravity of the fault, according to the norm of the constitutions (canon 2385).

VI. Professed members of perpetual simple vows, both in Orders and in religious Congregations, who presume to contract marriage even only civilly, both they themselves and all who contract with them (canon 2388, § 2). Note that the excommunication does not affect professed members of temporary vows. For the rest, see p. 772 under IX.

Canonical Penalties for Homicide and Abortion.—(a) Homicide, if voluntary, produces irregularity (Canon 985, n. 4) and subjects the guilty party to exclusion from legitimate ecclesiastical acts or to degradation from the ecclesiastical state (Canon 2354). Moreover, a church is violated by the crime of homicide (Canon 1172). (b) Abortion of a human fetus, when the effect is produced, brings irregularity on those who procure it and also on the cooperators (Canon 985, n. 4). Moreover, those who procure abortion effectively, the mother not excepted, incur excommunication latae sententiae reserved to the Ordinary, and, if clerics, they are to be deposed (Canon 2350).

What about legitimate and illegitimate, natural and adoptive children? - Some children are legitimate and natural, others natural, others legitimate. Legitimate and natural children are those who are born from a man and his wife. Those are presumed by law legitimate and natural who are born from a mother joined in lawful marriage, unless it is juridically certain that their origin is from another than the husband of the mother. For he is held as father whom marriage points out. The mother indeed is certain; but the father is presumed. And this presumption also has force in the forum of conscience. C. B. 1591, 1717, 1720; C. L. 101 seqq.; C. He. 252.

The fetus is usually brought forth in the ninth month from the time it was conceived, sometimes at the beginning of the seventh, sometimes at the full tenth, namely not before 180 days, nor after 300 days. C. I. 161 seqq.; C. G. 315; C. H. 108; C. A. 138, 163; C. B. 1592, 1717; C. L. 101; C. He. 252, 254.

Hence, of him who is born either after the seventh month from the marriage entered, or before the tenth month from the marriage dissolved, he is the father whom marriage points out, unless something else is most evident. C. L. 103; C. He. 254, 255. Nor indeed does it at all stand in the way that the mother was adulterous, C. I. 165; C. G. 313; C. H. 109; C. A. 158, or that she herself has declared the son adulterine, C. A. 158, unless she brings forward such indications as would suffice in the external forum, Lugo, de Iust., d. 12, n. 26, although she be most worthy of faith, and sworn, and assert this while dying; for no one deserves belief when alleging his own baseness. C. Inter 8, § ult., de Donat.; L. 654, 924.

A fetus brought forth before the seventh month from the marriage entered is held legitimate only if the husband either married the woman knowingly and willingly while she was pregnant, or, since he was present, did not altogether repudiate the child born. C. I. 161; C. G. 314; C. H. 110; C. L. 102. A fetus brought forth later after the tenth month from the dissolution of marriage is held as illegitimate, unless the health and morals of the mother and the circumstances of things suggest otherwise. C. I. 169; C. G. 315; C. H. 111; C. L. 102 seqq.

Natural or illegitimate children are those who are born outside marriage. These by canon law are irregular; by civil law they are distinguished from legitimate children chiefly as to succession to paternal inheritance. C. A. 155, 165; C. H. 114, 127, 134, 139. These natural children, if they were born from a man and woman between whom marriage could not have been entered, whether by natural law or by divine and canon law, by the same canon law are called spurious, or born from condemned intercourse. C. 3, 10, Qui fil. sint legit. And they are adulterine, sacrilegious, incestuous, and nefarious, if they were born from ascendants and descendants. But by civil law all are called illegitimate, and if they are adulterine or incestuous, they cannot be recognized. C. I. 180; C. G. 335; C. He. 304.

Other illegitimate children can be acknowledged and legitimated. C. I. 179, 195; C. G. 331, 334. They are acknowledged by the confession of parents, in civil law, authentic, C. I. 181; C. G. 334; C. H. 131; C. He. 503; in canon law, simple and bare, C. 10, de Probat.; and after they have been acknowledged they follow the condition of the one acknowledging, whether of the mother, or of the father, or of both. C. I. 185. But those acknowledged are legitimated by subsequent marriage by the law itself, C. I. 194; C. G. 331; C. H. 120, 121; C. He. 258 seqq.; C. A. 161; C. B. 1719; and they can also be acknowledged after the marriage has already been contracted. C. I. 197; C. H. 121; C. L. 119. Cf. C. G. 331.

By Canon Law, C. 1, 6, Qui filii sint legitimi, and C. H. 119, by marriage only children are legitimated from parents who freely could contract marriage between themselves. But whether those legitimated by dispensation of the Supreme Pontiff, as to canonical effects, are also legitimated as to civil effects, some affirm, others deny.

But from the time when they have been legitimated, they are held as if they had been born from lawful marriage. C. 6, Qui fil. sint leg.; C. I. 194; C. G. 333; C. H. 122; C. A. 161; C. He. 263. Cf. Benedict XIV, de Syn., l. 13, c. 24, n. 16. But one merely acknowledged is understood as the child only of him who acknowledged him. C. I. 182; C. G. 336; C. H. 129, 134. From C. B. 1589, 1705, a natural child and father are not reputed blood-relatives; and on the contrary, in his relations with the mother and the mother's blood-relatives he has the juridical condition of a legitimate child. But the same code admits investigation of the natural father and obligations, arts. 1708, 1717. Almost the same is had from C. He. 302 seqq., which also admits investigation of the natural father and obligations. C. H. 135 and C. L. 130 admit investigation of the father in a limited way, and the same codes admit investigation of the mother in the following articles. C. I. 189, 190, 193 admits investigation of maternity. But investigation of paternity is limited to the case of abduction and seduction. C. G. 340, 341, 342 likewise admits investigation of maternity, but investigation of paternity is restricted to the case of abduction. But by each Code and by C. L. 132, investigation of paternity and maternity is forbidden to adulterine and incestuous children whose recognition is prohibited; and by C. H. 141 investigation of paternity is prohibited to children in whom the legal condition of natural children does not concur. In doubt whether someone was born from legitimate marriage, he is to be presumed legitimate. C. I. 120; L. l. 3, n. 951.

Legitimate children are natural children legitimated, and adoptive children. C. I. 737. Adoption is an act by which one is taken into the place of a child who is not such by nature. From more recent laws, the adopted person is held as the legitimate and natural child only of him who adopted him, and he acquires the right of succession to him. C. I. 202, 204, 210, 737; C. G. 343, 344, 350; C. B. 1741, 1757; C. L. 124, 129; C. He. 268. But he is not withdrawn from the power of his natural father, nor does he pass into the power and family of the adopting father. C. I. 210, 212; C. G. 348, 349. But it is otherwise from C. A. 183; C. H. 177; C. B. 1765. This adoption is perpetual and is not dissolved even by mutual consent. C. I. 217. And so also the French Jurists. It is otherwise from C. A. 185; C. B. 1768; C. He. 269.

Legitimate and natural children, as to receiving donations and as to the right of succession, are held such from the time when they were truly conceived, provided they are afterwards born viable. C. I. 724; C. G. 725; C. A. 138. He is born viable who is born after the 180th day from conception, C. I. 160, 162; C. G. 312, 314; C. A. 138, and is perfectly born. In doubt, one who was brought forth alive is presumed to have been born viable. C. I. 724. Abortive children, if they do not survive, are held as born dead.

Natural children only, whether legitimated or acknowledged, acquire the right of succession from the marriage entered by the parents, or from that later time when they have been acknowledged. C. I. 197; C. H. 124. Merely legitimate children acquire the right of succession from the time when they were adopted, as if they had then first been conceived. C. I. 210, 217; C. B. 1754, 1757. From C. H. 177, an adopted person acquires no right of succession except from a testament, or from a previous agreement. From C. B. 1767, the right of succession can be excluded in the contract of adoption. To spurious, incestuous, and adulterine children the laws concede only support, namely when their filiation is duly established. C. L. 134, 135, 136; C. G. 762; C. I. 193, 752; C. H. 139, 140, 141.

What is abortion? Abortion is commonly defined: the ejection of an immature fetus. Immature, that is, not yet fit for vital birth, in such circumstances of the time of gestation that the fetus, although still living when it comes forth into the light, nevertheless must necessarily die soon. Therefore abortion is not really the same thing as mere acceleration of birth. In acceleration of birth the fetus is not immature, and although it comes forth into the light before the completed time of gestation, nevertheless it can naturally live. Abortion properly has place in the first seven months of gestation; in the remaining two months it is mere acceleration of birth, commonly speaking and according to the general rule. The ejection of the fetus; hence abortion is properly distinguished from any action which is not per se primarily ejective of the fetus, but injurious to that same fetus, such as that surgical operation which is called craniotomy and embryotomy, because it is the cutting of the cranium of the infant, or fetus, in order to extract him from the mother's womb.

E. M. According to the general rule. Absolutely speaking, the fetus can live outside the womb after six months, six and a half months, and even before this term, if extraordinary means for nourishing the fetus are present. But in order that the moral danger of the death of the fetus be excluded, the term of seven months must be awaited. Cf. here 663.

How many kinds of abortion are there? - The ejection of the fetus can be procured in two ways: 1. Directly and per se. 2. Indirectly and per accidens. Direct procurement of abortion or of the ejection of the fetus is had by applying a means or medicine per se efficacious and per se primarily ordered to expelling the fetus, as are those local causes which have an action on the womb for ejecting the fetus; such is the perforation of the secundina, or of that leathery membrane in which the fetus is enclosed and swims in fluid, which, when removed, he can no longer live there, but is necessarily ejected. Therefore direct procurement of abortion here is understood not only by direct intention, insofar as someone intends the ejection of the fetus, but also by direct exterior action, insofar as this per se primarily tends efficaciously to expelling the fetus.

Indirect procurement of abortion is had by applying a means or medicine per se primarily ordered to conferring health on the mother, from which, however, the expulsion of the fetus also follows, or also by using a means or medicine from which equally the health of the mother and the expulsion of the fetus are had. Of the former kind are certain irritating and violent drugs, which per se primarily tend, by their own efficacy, to correcting bad humors and bad dispositions of disease, but consequently also procure abortion. Of the latter kind are those remedies which cause relaxation of the fibers, such as a bath, flow and emission of blood; whence at the same time that health is being provided for, abortion is produced, by one and the same cause. This indirect procurement of abortion is indirect both in action and at the same time in intention. But someone can, with a direct intention for procuring abortion, use a means indifferent in itself and per se ordered to another honorable end. Antonelli, Medicina Pastoralis, ed. 2, vol. 2, p. 193, n. 396.

Is indirect procurement of abortion lawful? - It is sometimes lawful indirectly to procure abortion, or rather to permit it, namely by supplying to a mother laboring under grave disease remedies per se suitable for curing the disease, even if consequently abortion can follow, or remedies equally per se suitable for curing the disease and harmful to the fetus.

This is proved first from the common doctrine of theologians. L. l. 3, n. 394; Struggl tr. 7, q. 3, n. 15; Sanchez de Matr. l. 9, d. 20, n. 13 seqq.; Diana tr. 6, de Abortu, r. 38 seqq. Besides, when some remedy, by itself and with one and the same efficacy, can produce both effects at once, namely of healing the mother and killing the offspring, whether primarily the health of the mother and consequently abortion follows, or whether these effects are parallel to each other, one is not necessarily assumed in reality or intention as a means for procuring the other. Therefore there is then the case of a good or indifferent action, from which a double effect follows, one good and the other evil, which it is lawful to posit, if the end of the agent is honorable, namely if he does not intend the evil effect, and if there is a proportionately grave cause. It is lawful sometimes; namely if the matter concerns a lethal disease of the mother, whose life to be preserved is a proportionately grave cause with respect to the temporal life of the offspring. "It is certain," says St. Alphonsus, l. c., "among all, that it is lawful to give a remedy to a pregnant woman directly for curing her, even with danger of abortion, if the disease is mortal, but otherwise if it were not such." And below: "If the remedy tends directly to preserving the life of the mother, as would be purging of the body, cutting of a vein, a bath, etc., these are certainly lawful, when otherwise it is judged morally certain that the mother will die with the offspring," namely if the remedy is not used; or when the danger of abortion would be equal, whether the remedy is used or not; or when it is morally certain that the fetus is not yet animated, as at least for the first days of conception can be held. 1 Kings 1:19, 20. The reason is that then the safety of the mother is provided for without a greater danger to the offspring; and because, in equal necessity, the mother can provide more for herself than for the offspring. And the necessity is equal, for there is no hope of procuring baptism for the offspring in the first and third case; but that hope in the second case is equal. Antonelli, Medicina Pastoralis, ed. 2, vol. 1, p. 1, c. 19, p. 2, c. 4.

On the contrary, the necessity is not equal when the death of the mother is indeed certain if she does not take the medicine; but, if she takes it, the death of the offspring is certain not only temporal, but also eternal, because baptism will not be able to be administered to him, which certainly could be administered to him if the mother abstained from the medicine, because the offspring of the certainly dead mother will survive her; and then "the mother is certainly bound from the order of charity to abstain from the medicine, and to prefer the spiritual life of the offspring to her own bodily life." L. l. c. And "so also from the same charity she is bound to abstain, when there is doubt concerning the safety of the mother and the offspring." L. l. c.; namely when there is doubt whether, the medicine being neglected, the mother can be healed; and whether, the mother perishing, the offspring can survive and be baptized. "And even if the death of the mother were morally certain, if she does not take the remedy, not even then would I dare to permit her the medicine, if some reasonable hope shone forth that, the mother having died, the offspring might survive and be baptized; because it is lawful for no one, for protecting his own temporal life, positively to expose a neighbor constituted in necessity to the danger of eternal death. But otherwise I think one must say, if there were no reasonable hope concerning the life of the offspring after the death of the mother, so that he could be led to the grace of baptism, because then charity does not seem to oblige the mother placed in extreme necessity to neglect her own life by abstaining from remedies, because of a slight and very remote hope of the life of the offspring." L. l. c. And here, as regards practice, the Holy Doctor, l. c., observes that "physicians, as to drugs to be supplied to mothers, are not to be troubled scrupulously, because it is most probable that the case is exceedingly rare, and morally impossible, so that it is almost a miracle, that, the mother perishing, the offspring survive so that he can receive baptism." Nevertheless this matter is not to be so neglected; because it has happened more than once that, because of the skill of surgeons, as soon as the mother breathed out her spirit, the mother's womb was opened, and the offspring was extracted alive and baptized. Consequently mere acceleration of birth is lawful, namely when the fetus will be able to live outside the womb from ordinarily occurring things, and provided that seriously and suitably, as much as can be done, provision is made for the lives of the fetus and of the mother, and that there is grave necessity for that acceleration, whether this is on the part of the life of the mother, or on the part of the life of the offspring itself. E. M. 742, 745.

Is direct procurement of abortion lawful? - In no case ever, or for any cause, is it lawful directly to procure abortion, even if the fetus were supposed still unanimated. Proof: For if the discussion is about direct procurement of abortion improperly so called, namely through means or medicines by which one tends directly to injuring and killing the fetus or infant, as, for example, when physicians with the help of forceps crush the cranium of the little infant in the mother's very womb, in order afterward violently to extract the dead fetus, there is had a very true homicide, directly intended and directly exercised, which is never lawful.

If the discussion is about direct procurement of abortion through means or medicines which directly cause only premature acceleration of birth, from which the offspring, necessarily, by the very laws of nature, must succumb to death, "after animation this would be directly to kill the infant, which is never lawful"; for by a positive action to eject an immature infant outside the womb is positively to withdraw from him the means instituted by nature itself for the conservation of his life, which is directly to kill someone. "But before animation it is not lawful directly to procure this either, just as it is not lawful to procure the emission of seed even to save life, in which case Tertullian seems to speak in Apol. cap. 3; for he gives a universal reason: he who will be a man is a man, he says, for the fruit is in the seed." Lugo de Iust. et Iure d. 10, n. 130. Therefore, since even the non-animated fetus is ordered to forming a man, its ejection is anticipated homicide. Hence Ithur. Cas. 21, n. 5 says, "it is most certainly always infected with grave malice, direct procurement of abortion."

There are indeed grave and many doctors, whom Sanchez de Matr. l. 9, d. 20, n. 9 and Struggl tr. 7, q. 3, n. 16 follow and report, who judge that directly procured abortion, where nevertheless the matter concerns only the mere premature ejection of a non-animated fetus, is not so intrinsically unlawful that at least in the case of preserving the life of the mother, extremely endangered from present disease, it is not lawful. Indeed doctors are not lacking who defend the direct procurement of abortion even of an animated fetus in the aforesaid case, "which opinion once the illustrious D'Annibale judged not improbable," p. 2, n. 284, ed. 4. But this opinion is altogether excluded by the Decrees of the Holy Office concerning the unlawfulness of craniotomy. Indeed, between the killing which is had through craniotomy and abortion of this sort there is in fact no difference. For who would deny that he equally kills a man who pierces him through, and who casts him down from a tower, and who drowns him in the sea? Besides, that opinion is rejected by the Decree of the Holy Office, 24 Jul. 1895, by which the unlawfulness of abortion itself is expressly declared. E. M.

Hence it is clear that laparotomy also is unlawful for extracting from the bosom of the mother ectopic or extrauterine fetuses, still immature. On the contrary, necessity compelling, laparotomy is lawful for extracting from the bosom of the mother ectopic conceptions, provided that the lives both of the mother and of the fetus are seriously and suitably cared for, as much as can be done. Since they cannot be born, they often carry death with them also for the mother. E. M.

To n. 742 ff. ON THE PROCUREMENT OF ABORTION

1. Abortion is commonly defined: the ejection of an immature fetus. It is said immature, i.e., not yet apt for vital birth, in such circumstances of the time of gestation that, although the fetus may still come forth into the light living, nevertheless it must necessarily die soon. Wherefore, as is clear, abortion and the mere acceleration of birth are not in reality the same. In acceleration of birth the fetus is not immature, and although it comes forth into the light before the completed time of gestation, nevertheless it can naturally live. Certainly there are those who wrongly confuse abortion with the mere acceleration of birth. They do this, departing from the common manner of speaking of theologians, so that they may more easily conclude, from the mere acceleration of birth, the lawfulness of the direct procurement of abortion. Every abortion is a certain acceleration of birth, but not a mere acceleration of birth; every acceleration of birth is not truly abortion. Abortion properly has place in the first seven months of gestation; in the remaining two months there is mere acceleration of birth, commonly speaking and from the general rule.

2. It is said besides, ejection of the fetus; wherefore abortion is properly distinguished from any action which per se and first is not ejective of the fetus, but injurious to the same fetus, such as that surgical operation which is called craniotomy and embryotomy for the reason that it is the cutting of the skull of the infant, or fetus, for extracting him from the mother's womb. From the general rule. Absolutely speaking, the fetus can live outside the womb after six months, six and a half months, and even before this term, if extraordinary means for nourishing the fetus are present. But, so that the moral danger of the death of the fetus may be excluded, the term of seven months is to be awaited.

3. The ejection of the fetus can be procured in two ways: 1. directly and per se, 2. indirectly and per accidens. Direct procurement of abortion or of the ejection of the fetus is had by applying a means or medicine effective per se and ordered per se and first to expelling the fetus, as are those local causes which have action on the womb for expelling the fetus, such as the cutting or rupture, by the help of some instrument, of the afterbirth, or of that leathery membrane in which the fetus is enclosed and floats in fluid; when this is removed, he can no longer live there, but is necessarily ejected. Wherefore direct procurement of abortion is understood here not only by direct intention, insofar as someone intends the ejection of the fetus, but also by direct exterior action, insofar as this tends effectively per se and first to expelling the fetus. Indirect procurement of abortion is had by applying a means or medicine ordered per se and first to conferring health on the mother, from which nevertheless the expulsion of the fetus also follows; or also by employing a means or medicine from which equally there is had the health of the mother and the expulsion of the fetus. Of the former kind are certain irritating and violent drugs, which per se and first tend, by their own efficacy, to correcting bad humors and bad dispositions of disease, but consequently also procure abortion. Of the latter kind are those remedies which cause the relaxation of fibers, such as a bath, a flow and emission of blood; whence while health is at the same time being cared for, abortion is produced by one and the same cause. This indirect procurement of abortion is indirect at once in action and in intention. But nothing prevents someone, with direct intention toward procuring abortion, from employing a means indifferent of itself and ordered per se to another honorable end.

4. From the common opinion of the older doctors, and from the practice of the S. Penitentiary, the fetus is said to be animated after a space of 40 days, if male, 80 if female. From the view of several more recent authors, with no distinction of sex made, the fetus is said to be animated from conception itself, as soon as he begins to be formed, which indeed they judge to happen immediately from the fertilization of the ovum. Their reason is this, that from experiments made it is established that even from the beginning of conception the fetus lives, and gives signs of life by his motion. But this reason does not demonstrate the matter; for one thing is that the fetus lives, another that he lives by a rational soul. Wherefore we adhere in this matter to the doctrine of St. Thomas, which is in no way obsolete, as several pretend. First the soul only vegetative informs the embryo, and thus sufficiently are explained all the phenomena of motion and life which are observed from the beginning in the embryo. Then, when the embryo has arrived at greater perfection, the sensitive soul succeeds, through which the vegetative is expelled. For "since the generation of one thing is always the corruption of another, it is necessary to say that ... when the more perfect form arrives, the corruption of the prior form occurs; yet in such a way that the following form has whatever the first had, and still more; and thus through many generations and corruptions one arrives at the ultimate substantial form, both in man and in other animals.... Thus therefore it must be said that the intellective soul is created by God at the end of human generation, which is at the same time both sensitive and nutritive, the preexisting forms having been corrupted." S. Thom. 1 p., q. 118, a. 2 ad 2. Cf. Contra Gent. l. 2, c. 90. Nor indeed in the present matter is this question to be despised, nor with excessive facility is that to be asserted as certain which is not certain, since the matter concerns protecting the very life of the mother and also the bodily and spiritual life of the infant, with a most grave collision of rights standing on either side. St. Alph., l. 3, n. 394, question III, asks when offspring is judged informed by a soul, and says: "Proposition 25 was condemned by Innocent XI, which said: It seems probable that every fetus, so long as he is in the womb, lacks a rational soul, and that he first begins to have the same when he is born; and consequently that homicide is committed in no abortion. Conversely, some have spoken badly in saying that the fetus is animated in the first instant in which he is conceived, because the fetus certainly is not animated before he is formed, as is gathered from Sacred Scripture, Exod. 21, where according to the version of the Seventy it is said: He who strikes a pregnant woman, and she miscarries, if it was not yet formed, shall be fined with money. It is certain, therefore, that the fetus is not animated immediately." This is confirmed from the theses contained in the doctrine of St. Thomas, and most recently approved. For the soul requires organic disposition, or heterogeneous parts. Thesis 13. The human soul is then created by God and infused into the body, when the subject is sufficiently disposed. Thesis 15. S. C. of Studies, 27 July 1914, A. A. S. v. 6, p. 385.

5. It is sometimes lawful indirectly to procure abortion, or rather to permit it, namely by supplying to the mother, laboring under a grave disease, remedies suitable per se for curing the disease, even if consequently abortion can follow, or remedies equally suitable per se for curing the disease and harmful to the fetus. It is proved: 1. from the common doctrine of theologians. S. Alph. l. 3, n. 394; Struggl, Tr. 7, q. 3, n. 15; Sanchez de Matr. l. 9, D. 20, n. 13 ff.; Diana Tr. 6 de abortu, Res. 38 ff.; Gury n. 402; Scavini, etc. 2. For when some remedy, by itself and by one and the same efficacy, can produce both effects at once, that of healing the mother and that of killing the offspring, whether primarily the health of the mother and consequently abortion follows, or whether these effects are parallel to one another, one is not necessarily assumed, either in reality or in intention, as a means for procuring the other. Therefore there is then present the case of a good or indifferent action, from which there follows a twofold effect, one good, but the other evil, which it is lawful to posit, if the end of the agent is honorable, namely if he does not intend the evil effect, and if a proportionately grave cause is present.

6. Hence it is said, it is sometimes lawful, namely if the matter concerns a lethal disease of the mother, whose life to be preserved is a proportionately grave cause with respect to the temporal life of the offspring. "It is certain," says St. Alph. l. c., "among all that it is lawful to furnish a remedy to a pregnant woman, directly for curing her, even with danger of abortion, if the disease is mortal, otherwise if it were not such"; and below: "If the remedy tends directly to saving the life of the mother, as would be purging of the body, cutting of a vein, a bath, etc., these are certainly lawful, when otherwise it is morally certainly judged that the mother will die with the offspring," namely if the remedy is not employed; or when there would be equal danger of abortion, whether the remedy is employed or not; or when it is morally certain that the fetus is not yet animated, as can be held at least for the first days of conception. 1 Reg. 1, 19, 20. The reason is because then the safety of the mother is cared for without greater danger of the offspring, and "because, as Busembaum has it in the same St. Alph. l. c., in equal necessity the mother can look out for herself rather than for the offspring." And the necessity is equal; for no hope indeed is present of procuring baptism for the offspring in the first and third case; but that hope in the second case is equal.

7. On the contrary, the necessity is not equal when indeed the death of the mother is certain if she does not take the medicine; but if she takes it, the death of the offspring is certain, not only temporal but also eternal, because baptism will not be able to be administered to him, which, however, certainly could be administered to him if the mother abstained from the medicine; because the offspring will certainly survive the dead mother: and then "the mother is indeed held from the order of charity to abstain from medicine, and to prefer to her own bodily life the spiritual life of the offspring." Thus St. Alphonsus l. c., who there continues, saying: "so also from the same charity she is held to abstain, when there is doubt about the safety of the mother and of the offspring," namely when it is doubted whether, the mother dying, the offspring can survive and be baptized. And the same holy Doctor soon adds: "And even if the death of the mother were morally certain, if she does not take the remedy, not even then would I dare to permit medicine to her, if some reasonable hope shone forth that, the mother dead, the offspring would survive and could be baptized: because it is lawful for no one, for protecting his own temporal life, positively to expose a neighbor constituted in necessity to the danger of eternal death. But conversely I think it must be said with Sylv., Tourn., etc. and the common opinion, if there were no reasonable hope concerning the life of the offspring after the death of the mother, such that she could be brought to the grace of baptism; because then charity does not seem to oblige the mother placed in extreme necessity, that she neglect her own life by abstaining from remedies, on account of the slight and most remote hope of the life of the offspring."

8. "And here, as far as regards practice, the same holy Doctor notes, l. c., that physicians, as regards furnishing drugs to mothers, are not to be tormented scrupulously, because it is most probable that the case is most rare and morally impossible, that it is almost a miracle, that when the mother perishes the offspring should survive so that he can receive baptism." Yet this matter is not so to be neglected; because it has happened more than once that, on account of the skill of surgeons, immediately when the mother had breathed forth her spirit, the womb of the mother having been cut open, the offspring was extracted living and baptized. Consequently, mere acceleration of birth is lawful when the fetus can live outside the womb, from ordinarily occurring circumstances, and provided that provision is made seriously and opportunely for the life of the fetus and of the mother, as far as can be done, and a grave necessity for the aforesaid acceleration is present, whether the necessity is on the part of the life of the mother or on the part of the life of the offspring himself.

9. In no case ever, or for any cause, is it lawful directly to procure abortion, even if the fetus were supposed still inanimate. It is proved. For 1. if the discussion is of direct procurement of abortion improperly so called, namely through means or medicines by which there is a direct tendency to injuring and destroying the fetus or infant, as, for example, when physicians, by the help of forceps, crush the skull of the little infant in the mother's womb itself, afterward violently to extract the dead fetus; there is had most truly a homicide, directly intended and directly exercised, which is never lawful.

10. Nor indeed is it valid in any way to say that in reality the death of the infant is not intended, but the health of the mother. For although the death of the infant may not be explicitly intended, nevertheless it is implicitly intended; since that surgical operation is directly killing of the fetus or infant. Wherefore any intention, even implicit, of not killing the infant is retracted by the fact itself, since in fact the infant is directly killed; and the intention, at least in the exercised act, is had of direct killing of this sort. Anyone acting in a human mode always intends to do that which in reality he does, in at least some way, either explicitly or implicitly.

11. Nor likewise is it valid to say that that action is not directly killing of the fetus. For that compression of the skull, in an infant already born and in an adult man, is certainly directly killing of the infant and the man. Therefore also of the fetus and infant still existing in the maternal womb; for the nature of that action is not changed thereby. But, the adversaries insist, it is changed: for that action becomes from that circumstance an action merely extractive and bringing out of the fetus and infant from place to place. But this is altogether nothing: since that action first by nature and time is lethally injurious and killing, and then extractive; by this means the fetus and infant is extracted, by lethal compression of the skull; and thus the life of the mother is saved. Now evils are not to be done that goods may come.

12. Defenders of craniotomy appeal to the collision of the rights of the life of the mother and the life of the infant: and the right of the mother in that matter, as the more important and more effective, ought to prevail. But this doctrine concerning the collision of rights is of no assistance to the adversaries. For in a collision of rights, the more important and more effective right ought indeed to prevail; if it can prevail without an intrinsically evil means being assumed for that prevalence. But in the case, so that the right of the mother may prevail and her life be preserved, there is assumed as means that which is intrinsically evil, the direct killing of an innocent.

13. If the discussion is of direct procurement of abortion through means or medicines which directly cause only the premature acceleration of birth, from which the offspring, necessarily, from the very laws of nature, must succumb to death, "after animation this would be directly to kill the infant, which is never lawful": for to eject by positive action an immature infant outside the womb is positively to withdraw from him the means instituted by nature itself for the conservation of his life, which is directly to kill someone. "But before animation it is not lawful directly to procure this either, just as it is not lawful to procure the effusion of seed even to save life, in which case Tertullian seems to speak in Apol. cap. 3; for he gives the universal reason: he is a man who is going to be one, for the fruit is in the seed." Lugo de Iust. et Iure, Disp. 10, S. 5, n. 130. Wherefore, since even the non-animated fetus is ordered to forming a man, his ejection is anticipated homicide. Hence Ithur., Cas. 21, n. 5, says that direct procurement of abortion "most certainly is always infected with grave malice."

14. There are indeed grave and several doctors, whom Sanchez follows and reports, de Matr. l. 9, D. 20, n. 9, and Struggl, Tr. 7, q. 3, n. 16, who think that abortion directly procured, where nevertheless the matter concerns only true premature acceleration of birth, but by no means direct injury to the fetus, is not so intrinsically illicit that it is not lawful at least in the case of saving the life of the mother, who is in extreme danger from present disease. But Sanchez limits this opinion to the single case of an inanimate fetus. "Where," says the praised Theologian, "it has been established that the fetus is already animated, or this is doubtful, it is established among all authors to be referred to in this whole disputation that this is by no means lawful"; n. 7. But his reason and that of others is, both because since that fetus is part of the viscera, the mother is not held to preserve him with so great a danger to her life, and all the more because, if the mother perishes, the fetus will by no means be animated; and because the mother in that case can expel him as an aggressor against her own life. Hence the same Sanchez expressly limits that opinion still more and excepts a twofold case, n. 10. The first case is if the mother, by giving birth at another time, had experienced danger of death; and on account of this it is not lawful to expel the fetus, as the common opinion of theologians teaches, because in that case there is no present aggressor, since the danger is much distant, and the mother will be able meanwhile to die from another cause. And this is confirmed from another common doctrine, which the same Sanchez hands down there, n. 2 and 10, namely that it is never lawful for a mother, on account of any danger whatever, to take a potion for impeding conception. The other case is when the mother, unless she expelled the fetus, would undergo danger of being killed by relatives, or of her own reputation; that this is altogether illicit is established from the condemned proposition 34 by Innocent XI: "It is lawful to procure abortion before the animation of the fetus, lest a girl discovered pregnant be killed or defamed." But the reason is that, even with that reason admitted which is taken from the aggressor, or from the fact that he is part of the viscera, one thing is that the fetus be an aggressor per se and intrinsically in the case of the lethal disease of the mother; another that he be so per accidens and extrinsically. For anyone can kill an aggressor lest he be killed by him; nevertheless he cannot kill another lest he himself be killed by an enemy. Likewise the fetus, says the same Sanchez, considered as part of the viscera of the mother, has an order per se to the conservation of the whole; whence, just as it is lawful to cut off a member, so also to expel the fetus, if the conservation of the whole demands this. But to that killing to be inflicted by relatives, and to that infamy, one can oppose by other means and by sought pretexts. This opinion, enclosed within all these restrictions, St. Alph. indeed affirms probable, adding that "the opposite is altogether to be embraced as safer," since the former can serve nothing for practice. Cf. Struggl, Tr. 7, q. 3, n. 16; Laymann l. 3, Tr. 3, C. 4, q. 2; Tamburini, Explic. Decal. l. 6, C. 2, § 4.

15. Now then, to omit extrinsic authority, as regards the reasons on which that opinion rests, Sporer, de matr. P. 4, C. 4, S. 1, n. 706, says these things shrewdly: "The fetus," he says, "is not properly part of the mother, nor on account of the mother; but has another end intended per se by nature; indeed, inchoatively, in becoming, he is already a human individual distinguished together with her. Certainly seed is more clearly and more properly part of man, and at least in some respect on account of man, since it itself also is nourishment of contiguous parts according to the teachings of physicists: therefore, etc. But if by reason of aggression it is lawful to procure abortion of an inanimate fetus, certainly abundant seed attacks human life far more violently in those most acute diseases than that little substance of a fetus still inanimate. Therefore, a fortiori, why would it not similarly be lawful in that case to procure the emission of seed? Indeed, why not also the abortion of a fetus already formed by a soul, since an innocent can no less defend himself from an animated aggressor than from an inanimate one?" But in no way indeed is the fetus an unjust aggressor. For one who from the mere course of natural causes becomes naturally the cause of death to another cannot be called an aggressor, whether formally or materially unjust; for an aggressor inflicts unjust force, and that force cannot be called unjust which proceeds from the very course of natural causes. Indeed, neither is he simply an aggressor. For an aggressor is per se the cause of death; but the fetus does not per se threaten death to the mother, but this happens altogether per accidens. And for the most part it is not the fetus, of small bulk and inert, but rather the mother who is the aggressor, either on account of narrowness of the womb, or because of the grave disease from which she suffers, or because of another inconvenience.

16. Lugo expressly attacks and refutes the doctrine of Sanchez, l. c. n. 130, 131, "because," he says, "even in the latter cases (namely when death would be feared from the future difficulty of birth, or from infamy), the fetus is an aggressor, since by the effort by which he will try to come forth from the womb, the mother is to be brought into manifest danger of death. Add that, if this is rendered lawful by reason of the invasion by which the mother is invaded by the fetus, it would also be lawful to procure his abortion after the fetus is animated, since an innocent can no less defend himself by any way from an animated invader than from an inanimate one. But that the danger is not present matters little, both because even the infirmity against which it is lawful to procure abortion can bring danger of death not today, but after a month, and nevertheless today a means for abortion can be applied, nor is the last article of necessity and danger to be awaited, but one ought to forestall, remedies being employed in time, because afterward medicine is prepared too late, and perhaps it will not be useful after the disease has by longer delay become too strong. Whence in the same way one could forestall by procured abortion against death to be inflicted from outside after some months, if the crime is published; and also because the danger can be present in the latter case, as if a husband soon to arrive, if he should find his wife pregnant, is believed about to kill her. Finally, that in these cases one can oppose the danger by other means does not solve the difficulty. For the question is when, other means having been tried, no other occurs, nor is any useful one hoped for, except abortion alone.

17. "Therefore it is better universally to deny that this is ever lawful, which Vazquez also universally taught, Cap. 3 de rest. § 2, dub. 6, n. 52, which the example brought forward seems to prove concerning the obligation never to procure the effusion of seed. To this, however, the same Sanchez, n. 12, responds that the reason why effusion of seed is never lawful is not the harm of generation, but because nature has denied every administration of seed outside intercourse for generation, on account of the imminent danger from the excessive pleasure which is felt in its effusion; and this reason has no place in abortion. But if it is weighed rightly, the same reason can be applied to this, that the procurement of abortion is never lawful: because just as nature never permitted the effusion of seed outside copulation for generation, because if sometimes it could lawfully be procured outside copulation, there would be danger that men, content with that pleasure outside copulation, would care less for begetting offspring; so also, much more, the procurement of abortion ought to have been altogether prohibited, because if that were ever lawful, there would also be danger that men would seek the pleasure of copulation with this mind and confidence, that afterward, from some supervening cause, abortion could be procured, so that birth might be impeded; and great occasion would be given for fornications and rapes, from which fear of offspring and future birth deters, and this fear would cease in great part if afterward, from some cause, it were lawful to procure abortion. Therefore it must be admitted that nature has reserved to itself the administration of the fetus just as of seed, with the faculty denied to parents of disposing of seed or fetus except for the end of generation intended by nature itself; because any other administration granted to them could easily bring inconveniences against the end of generation." Cf. Salmant., Tr. 13, C. 2, n. 58-66.

18. The authority of the older theologians in no way favors the more recent theologians in this controversy. For the ancient theologians who defend the lawfulness of abortion commonly restrict it to the abortion of an inanimate fetus. But the more recent theologians, defending the lawfulness of abortion, defend it indiscriminately; indeed, with the new views standing, of which they are very keen supporters, they almost altogether reject the hypothesis of an inanimate fetus.

19. But they enter upon another way to demonstrate the lawfulness of abortion. First they confuse abortion with acceleration of birth, and use one for the other. Then they reduce direct procurement of abortion to procurement of abortion by direct intention, with the nature of the action by which abortion is procured put aside. Moreover, they assume as a certain principle that the question concerning acceleration of birth does not look to whether it is lawful to deprive the offspring of life, but rather to how far the mother is held to conserve the life of the offspring. Finally, 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 help of a little siphon can certainly touch the fetus immediately, and therefore we can be wholly certain concerning the validity of Baptism conferred in this way on infants enclosed in the womb, the difficulties and questions moved by the older doctors concerning the dangers which the mother is held to undergo so that provision may be made for the eternal salvation of the offspring almost cease.

20. Hence, they say, the lawfulness of abortion is easily shown. For what the Doctors commonly hold 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 outside the intention and per accidens; this very thing can have place in acceleration of birth, namely when the will tends directly not to the temporal harm of the offspring, which follows per accidens and outside the intention, but to another end.

21. Therefore, where 1. the death of the mother is certain unless the fetus is expelled, and the matter concerns only the temporal death of the offspring, because, for example, Baptism can be conferred upon him according to what has been said, the mother is not held to die so that she may conserve temporal life for her son. "The mother," says Lugo, De Iust. et Iure, D. 10, n. 133, "is not held, with so great danger and detriment of her life, to procure and conserve the fetus: just as neither is she held, with danger to life, to nourish and retain a son already born, nor even to preserve milk in her breasts for nursing him, when for protecting her own life it would be necessary for her to dry up her breasts."

22. 2. 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 help of medicine it can be effected that the fetus come forth living into the light, and thus, if not temporal life, at least eternal life, he will obtain, then an expulsion of this sort seems not only lawful, but commanded. The reason is that the danger and death of the mother would profit nothing for the temporal life of the offspring, and moreover would cast the offspring itself into very grave danger of eternal salvation. Nor ought it to obstruct that perhaps the death of the offspring is accelerated a little. For first, according to Lugo, the mother is not held with so great a danger to conserve the life of the offspring further. Then "in that case," says St. Alph., l. 6, n. 106 at the end, "that small loss of life can be neglected, so that the infant may obtain eternal life."
23. 3. If from the force of the disease there probably threatens a danger of abortion, and at the same time there presses the danger lest, if abortion in fact follows from the disease, the offspring die in the womb; but, on the contrary, probable hope shines forth that, birth having been accelerated through medicines, the offspring may come forth living into the light, and thus provision can be made for his eternal salvation: the 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. And this indeed must be said to be valid, even if the disease brings no danger to the life of the mother, but the matter concerns only the better good of the offspring.

24. The preceding doctrine of the more recent theologians is indeed such that it cannot approve itself. Let us weigh each point gradually and briefly. Abortion cannot be confused with acceleration of birth. This new manner of speaking about abortion as acceleration of birth is proved false from the constant doctrine of the older theologians, which is altogether to be retained unless a grave reason recommends a new way of speaking. If theologians have constantly spoken of abortion in an altogether different way, this certainly must have been done not without a grave foundation. To consider abortion as acceleration of birth is certainly not a subtle consideration which could have escaped the keenness of the older theologians. Moreover the Supreme Pontiffs do not speak of abortion in such a way as to regard it as acceleration of birth. They speak of abortion as of the ejection of an immature fetus, namely one not yet apt for life outside the mother's viscera. Among others, let the Constitution of Sixtus V, Effraenatam, 29 Oct. 1588, be consulted, which expressly treats of abortion and turns wholly around this matter. Now Sixtus V defines abortion: "the ejection of an immature fetus, both animated and also inanimate, formed or unformed." Ib. § Nos igitur. Besides, from reason itself it is established that simple acceleration of birth is a thing well diverse from abortion; as birth itself is a thing well diverse from abortion. For acceleration of birth, although it is accelerated birth, is still birth, and therefore imports offspring already so formed and perfected that it can live outside the mother's viscera. Abortion, on the contrary, from its concept and from the most common acceptance of all, even vulgar, imports offspring which, from premature exit from the maternal womb, is unformed and imperfect, so that it is altogether unfit for life outside the mother's viscera; whence in this same sense the word abortion is also accustomed to be used metaphorically.

25. The other point which is brought into the middle concerning procurement of abortion by direct intention, with direct procurement of abortion on the part of the action itself put aside, is altogether most false and most pernicious. Most false, for when on the part of the thing there stands an action directly procuring abortion, only illusorily can someone affirm that he does not intend abortion, but, for example, the health of the mother, and merely permits abortion. For it is impossible that someone acting in a human way not intend that to which his action is directly ordered, as a means per se and first conducing to it. Most pernicious, for there is no sin perpetrated by exterior work which could not be made honorable by that doctrine.

Although, by an action directly procuring pollution, someone procures this in himself, nevertheless if he does it with the intention, for example, of health, then certainly he would not sin at all. The same can be said about any other matter.

26. The third assertion likewise is altogether alien from the truth: namely that in this question the matter concerns the obligation of the mother to conserve the life of the offspring. As is most evidently clear from the Constitution itself of Sixtus V, Effraenatam, here the matter concerns homicide; it concerns the deprivation of the life of the infant. To eject an immature fetus from the bosom of the mother is not simply not to conserve the life of the fetus, but positively to deprive him of life, through a positive action tending and ordered by its nature to the destruction of the offspring. If it were otherwise, it would have to be said that immature offspring can live equally in the womb of the mother and outside it, which is altogether absurd, with attention to the physical laws of nature; it would have to be said that to eject an immature fetus is only not to help him in prolonging life, and to bear oneself merely negatively as regards his death.

27. Lastly, what is said in the fourth place about the invention of that instrument does not remove the difficulties and questions in this matter, but increases them. For the invention of that instrument can be praised as altogether useful for conferring Baptism on an infant in the best way in which it can be done, if the offspring survives after the death of the mother, or where the matter truly concerns mere acceleration of birth. Nevertheless, where the question is instituted about abortion itself, the adversaries assume as certain that, even in this case, without any controversy, it is lawful to confer Baptism by the help of such an instrument. But this is in no way certain. For since with the introduction of that instrument the afterbirth is cut, and that fluid in which the fetus floats and lives flows out, already that action, by nature and time first, is direct procurement of abortion, and then the conferral of Baptism; just as in craniotomy that action of bringing out the infant from the maternal bosom by forceps is first killing of the infant, and then extractive. Wherefore if it is lawful directly to procure abortion and to kill the infant in order to baptize him, then indeed it will also be lawful to confer Baptism in that way. Now St. Alph., l. 6, n. 106, says: "It must altogether be held ... commonly against some, that it is never lawful to throw an infant into a river in order to baptize him, although he is soon to die without Baptism; because it is never lawful for any cause whatever directly to kill an innocent.... And for the same reason it is not lawful to cut the belly of a mother very near death, so that her infant may receive Baptism, as they also commonly say ... from St. Thomas, who in 3 p., q. 68, a. 11 ad 3 expressly teaches this, saying: A man ought not to kill the mother in order to baptize the child; if, however, the mother has died, with the offspring living in the womb, she ought to be opened so that the child may be baptized.... With respect to the surgeon I say that then he can cut the mother if the danger of her death is remote; otherwise if it is proximate or probable. For just as it is illicit to kill the mother so that the child may be baptized, as we have seen with the common opinion from St. Thomas, so also it is illicit to expose the mother to probable danger of death.... But with respect to the mother ... I say that if the danger of her death is probable, she is neither held, nor can she by her positive consent concur in the incision; only she could and would be held to suffer it, if the surgeon, without her consent, while she bore herself altogether negatively, cut her, and probable hope were present that the offspring would be baptized, and the death of the mother were not certain; for in doubt probable on both sides she is held to prefer the spiritual life of the offspring to her own temporal life. But if her death is certain, and the salvation of the offspring doubtful, namely if the offspring is not certainly to be baptized, she is not held to lose life certainly." Now if it is not lawful to kill the mother in order to baptize the infant, if it is not lawful to kill the infant himself in order to baptize him, neither is it lawful directly to procure abortion in order to baptize the infant. For direct procurement of abortion is evil by its intrinsic nature, as homicide is evil by its intrinsic nature. Wherefore just as it is not lawful to throw a child into the sea in order to baptize him, so neither is it lawful, in order to baptize him, to eject him immature from the maternal bosom, by cutting the membrane in which he is enclosed; whence abortion must necessarily then follow. Nor indeed must it be passed over that, at least practically, it cannot be held as altogether certain that Baptism has been conferred on an infant still enclosed in the maternal womb. Benedict XIV, De Synodo, l. 7, C. 5; S. Alph. l. 6, n. 107; Billuart, Tr. de Bapt., D. 3, a. 3; S. Thom. 3 p., q. 68, a. 11 c. and ad 1.

28. Therefore what is deduced as though a corollary, the lawfulness of abortion, must be converted into the opposite corollary, of the unlawfulness of abortion. But the confirmation which is taken from the doctrine of St. Thomas and the common doctrine of theologians concerning the unjust aggressor either proves nothing or proves the contrary. Truly what is assumed, namely 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, is altogether false, and shows that Doctors of this sort have not understood, and perhaps have not even read, this question in the Angelic Doctor. The reason why it is lawful to kill an unjust aggressor is because it is lawful to repel force by force. That which is lawful is not to kill the unjust aggressor, but to repel force by force, which is an action well diverse: since it is an action which has a twofold effect, the defense of oneself and the killing of the aggressor. And thus the death of the unjust aggressor in just defense follows only indirectly, not because the direct intention of the killer is borne only toward his own defense, but because that action, to repel force by force, is an action indifferent of itself, having a twofold effect: the good of defending one's own life, the evil of offending the life of another; the good effect is intended, the evil is permitted. And indeed natural right and positive right, and all positive rights, do not proclaim that it is lawful to kill an unjust aggressor; but all rights proclaim that it is lawful to repel force by force. Whence commonly is added that well-known phrase concerning the moderation to be preserved of blameless defense, and this moderation certainly would have no place if it were lawful per se to kill an unjust aggressor, and if something else were not rather lawful per se, namely to repel force. C. Si vero 3, De Sent. excomm., says in so many words: all laws and all rights permit force to be repelled by force.

29. Let St. Thomas be heard. 2. 2, q. 64, a. 7. The Angelic Doctor asks "whether it is lawful for someone to kill someone by defending himself"; and in order to resolve the question he establishes this principle: "It must be said that nothing prevents one act from having two effects, of which one alone is in the intention, but the other is outside the intention. But moral acts receive their species according to that which is intended, not from that which is outside the intention, since it is per accidens." With this principle established concerning the objective indifference of an action having two effects, and concerning the specification of the human act which turns around it, immediately the holy Doctor concludes as regards the act of repelling force by force: "Therefore from the act of someone defending himself a twofold effect can follow: one indeed, the conservation of his own life; the other, the killing of the invader. Therefore an act of this sort" - namely of self-defense, certainly not of killing the invader, as it would have to be according to the interpretation of the adversaries - "from this, that the conservation of one's own life is intended, does not have the notion of the illicit, since it is natural to each that he preserve himself in being as far as he can." But so true is it that the holy Doctor is not speaking of the lawfulness per se of killing the invader, but of the lawfulness per se of defending oneself, or of repelling force by force - for this is to defend oneself - that immediately he notes: "Nevertheless some act proceeding from a good intention can be rendered illicit if it is not proportioned to the end. And therefore if someone, for defending his own life, uses greater violence than is necessary, it will be illicit. But if he repels violence moderately, it will be lawful defense: for according to the rights, it is lawful to repel force by force, with the moderation of blameless defense. Nor is it necessary for salvation that a man omit the act of moderate defense in order to avoid the killing of another; because a man is held to provide for his own life more than for the life of another." Wherefore again that which is properly lawful is not the killing of the invader, but moderate protection, or repelling force by force; and this act is lawful, since, as is fitting, man intends in it the conservation of his own life, but by no means the killing of a man, even an unjust aggressor; for the killing of a man by private authority is altogether illicit. And that this, in reality, and not another, is the mind of the holy Doctor is clear not only from the preceding things, but also from those things which he soon adds; for he says: "But because it is not lawful to kill a man except by public authority on account of the common good, it is illicit that a man intend to kill a man in order to defend himself, unless he is one who has public authority; and he, intending to kill a man for his own defense, refers this to the public good, as is clear in a soldier fighting against enemies, and in a minister of the judge fighting against robbers; although these also sin if they are moved by private passion." Therefore no argument can be taken for the direct procurement of abortion from the common doctrine concerning the unjust aggressor, and in particular from St. Thomas, who, speaking generally of abortion in 4 Sent., D. 31, in the exposition of the text, affirms abortion to be a grave sin, to be numbered among malefices, and against nature. Let the adversaries see whether an act against nature can, from an otherwise honorable intention of the agent, become an action according to the order of nature.

30. But as regards the first practical case: concerning the conferral of Baptism by the help of a little siphon, it has already been said. But what is asserted, that the mother is not held to undergo death so that she may conserve temporal life for her son, is most true if the matter concerns mere non-conservation of the life of the son, which indeed is verified in indirect procurement of abortion. And thus, where the necessity of mother and son is equal, we ourselves said above, cf. n. 6, from the common opinion of theologians, that it is altogether lawful indirectly to procure abortion. Lugo l. c. speaks of mere non-conservation of the life of the offspring. But if the matter concerns the positive deprivation of the life of the offspring, which is had in direct procurement of abortion, it is altogether illicit for the mother, whether on account of her own bodily health, or even on account of the spiritual salvation of the son, as we have already seen from St. Thomas, from St. Alphonsus, and from the common doctrine, to destroy the offspring by positive action. Through direct procurement of abortion, the mother by positive action ejects immature offspring from the womb, and does not merely cease to retain him in the womb. As regards Lugo, from what has already been said it can be sufficiently clear what his doctrine is.

31. But so that it may be manifested more, how falsely Lugo is brought forward for direct procurement of abortion, and how false from the same Lugo is that doctrine concerning illicit procurement of abortion direct in intention, but not direct also in action, it is worthwhile to bring forward the entire sentence of Lugo, and it will also appear in what sense the words of Lugo, reported by the adversaries, are said by him. "If a drug," he says, l. c. n. 130-132, "is taken, and the same is true of the emission of blood by cutting a vein, directly for abortion, it is lawful in neither case" - namely of an inanimate and animated fetus. "But when a drug or remedy would not be taken directly for that end, but for protecting the health and life of the mother, again a distinction must be made according to what has been said above; for if it conduces to the life of the mother in no other way except insofar as it excuses abortion, then abortion is already directly intended, although it is not intended for its own sake, but on account of another end, as above we were saying about an action which can be useful for killing an enemy in no other way except insofar as it kills an innocent, and the same will have to be said in our case. But if that drug is useful for the life of the mother, yet consequently causes abortion, and outside the intention, then if the fetus is not animated, that remedy will be lawful, just as also that which is taken for health, although consequently, outside the intention, it is foreseen to bring the expulsion of seed, which is not intended, nor conduces to health, but is caused by that remedy through which health is obtained from another source, insofar as it purges other harmful humors. For the reason is the same as regards this concerning the expulsion of seed and of the fetus not yet animated: so that neither can be procured, each can be permitted indirectly on account of health, and in this almost all agree. The difficulty is whether also after the animation of the fetus it is lawful to take or apply such a medicine.... It must be said, speaking per se and with attention to the order of nature alone, that this can be done, because the mother is not held, with so great danger and detriment of her life, to procure and conserve the fetus; just as neither is she held, with danger to life, to nourish and retain a son already born, nor even to preserve milk in her breasts for nursing him, when for protecting her own life it would be necessary for her to dry up her breasts. Nevertheless the moderation pleases which Vazquez later added to this doctrine, saying that this is to be understood of emission of blood, a bath, or remedies of this sort, which do not tend to the killing of the fetus except negatively, by the withdrawal of fluid necessary for his sustenance, but not of remedies which would positively concur to the death of the fetus, such as a potion which by a 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"; such also would be to cut the membrane in which the fetus is enclosed and to eject him immature from the maternal womb; for this would be positively to deprive the fetus of life, so that you may preserve your own, which likewise is never lawful. It would certainly not be lawful to throw into the sea a man infected with plague, in order to free others from plague, or to throw him down from a high tower, although he would not be killed by iron. For it would always be directly to kill a man. But the matter is most clear: Lugo speaks only of indirect procurement of abortion; and if he moves a special difficulty in the case of an animated fetus, this certainly is not because he thought direct procurement of an animated fetus could be lawful, after he had affirmed the unlawfulness of direct procurement of abortion even of an inanimate fetus; but because even in only indirect procurement of abortion of an animated fetus there is a special difficulty, which can render the very indirect procurement of abortion of an animated fetus illicit. And thus Lugo, in affirming that lawfulness, restricts the question to the matter merely inspected per se, with attention to the order of nature alone, and so, speaking only generally, he affirms the lawfulness. Nor indeed can that withdrawal of fluid make difficulty; for as is clear from the whole context, Lugo certainly does not speak of that withdrawal of fluid, or rather outflow of fluid, which is had from the cutting of the membrane in which the fetus is enclosed, by the help of the more recent little siphon or another instrument. For he speaks of withdrawal of fluid which would be had by weakening the powers of the mother through emission of blood, through a bath, and remedies of this sort; and the cutting of the afterbirth through the aforesaid little siphon of the more recent authors certainly does not pertain to remedies of this sort.

32. The other case concerning abortion directly to be procured in order to baptize the offspring cannot be admitted. The reason is clear from what has been said, from which it is also clear what must be said to the reason brought from Lugo. But as regards the reason brought from St. Alphonsus, from what has already been said it is first established what the opinion of the holy Doctor is concerning direct procurement of abortion. Whence it becomes clear that the reason of the holy Doctor, like the reason of Lugo, can be brought forward altogether beside the point for direct procurement of abortion, since St. Alphonsus, like Lugo, holds it to be illicit. But in order that the reason brought by the holy Doctor may be understood, it is necessary to weigh the whole context. The holy Doctor, l. 6, n. 106, teaches: "it must altogether be held that it is never lawful to throw an infant into a river in order to baptize him, although he is soon to die without Baptism." How then, in the same place, could he assert the very contrary, contradicting himself so openly, that a small loss of life can be neglected so that the infant may obtain eternal life? He indeed asserted this without any contradiction, because he was treating another question, of conferring Baptism through an action indifferent per se, having a twofold effect; and thus, with an action supposed that is not evil per se, as directly killing, but indifferent, the holy Doctor reasoned excellently, saying that in the case there is a sufficient reason for permitting or neglecting, namely by not impeding, that brief loss of life. But on the contrary, in the preceding question, concerning an infant to be thrown into a river in order to baptize him, the holy Doctor regarded that action as directly killing of the infant, and therefore illicit even for conferring Baptism on the infant. For immediately he added this reason: because it is never lawful for any cause whatever directly to kill an innocent. Hence in the following question he said: "But although it is not lawful to throw the child into a river, nevertheless it is lawful to baptize a child soon to die with water even cold, if no other can be had, even if it were feared that death would be accelerated from this: both because death then would not occur per se, but per accidens, since such an action per se tends not to killing but to ablution"; and with this supposed, then because, he afterward added another then because, saying: "then because in that case that small loss of life can be neglected, so that the infant may obtain eternal life." Wherefore the argument from St. Alphonsus can excellently and better be turned back. The expulsion of the fetus from the maternal womb, like his throwing into the sea, in order to baptize him, is not only not commanded, but altogether illicit, although the infant is soon to die without Baptism, because it is never lawful for any cause whatever, on account of any good intention whatever, directly to kill an innocent.

33. It follows from what has been said that neither can the third case be admitted. What nature does by force of the natural laws which God has established, it does well; but we cannot always lawfully do that very same thing. It is altogether natural that man die, yet therefore it is not lawful to kill a man, or to accelerate his death, even by the briefest time, although he himself may suffer immense pains, and there perhaps would be proximate danger of death for others on account of the pestiferous infection of the disease. Pollution also is often natural; yet it is not lawful therefore to procure it directly. Similarly, although abortion follows from the laws of nature, and from the same laws the offspring dies before he is ejected from the womb, it is not therefore lawful to procure abortion directly. Cf. Gury-Dumas, Compend. Theol. Mor., T. 1, n. 402 ff.; Cas. Consc., T. 1, n. 402, 403, etc.

34. Hence it is clear that laparotomy for extracting ectopic or extrauterine fetuses, still immature, from the bosom of the mother is also illicit. On the contrary, when necessity compels, laparotomy is lawful for extracting ectopic conceptions from the bosom of the mother, provided that the lives both of the mother and of the fetus are seriously and opportunely cared for, as far as can be done. -

Since they cannot be born, they often bring with themselves the death also of the mother.

35. And the preceding doctrine, which already several years ago was publicly proposed in print, was afterward confirmed by several Decisions of the Holy Office, which are had in the Enchiridion Morale, ed. 4, p. 99, 100.

II. Those procuring abortion, the effect having followed.

Those procuring are properly said to be those who directly intend abortion and by an exterior work of itself efficacious deliberately strive so that it really follows. Procuring by immediate and proximate action. Procuring: nothing is distinguished; therefore all, and accordingly pregnant women themselves if they procure abortion in themselves. Lugo, Resp. Mor., book 2, dub. 4; L., book 3, n. 395. Procuring either by themselves or through others; therefore also those commanding, but not also those counseling, helping, etc. Abortion is the ejection of an immature fetus. Therefore surgeons exercising craniotomy, although they sin gravely, do not incur this censure. Abortion: said absolutely; therefore at whatever time it is done after conception, whether the fetus is animated or inanimate, namely in the first days of conception. L., book 3, n. 396. The effect having followed. Therefore the present censure is not incurred if, although someone procured abortion, he nevertheless did not procure it efficaciously. L. 40, 368; Lugo, De Poenit., disp. 16, n. 444; Paludanus, disp. 4, part 7, n. 15; Bonacina, disp. 2, q. 2, part 10; Ithur., case 21, n. 30 ff.

You will resolve: "It is certain that if someone wounds mortally, however much, if death does not follow, he does not incur irregularity, because none is assigned in Law because of an attempt at killing, but only because of homicide or mutilation." L. 368. One commanding or counseling, in doubt whether the command or counsel was or was not the efficacious cause of the homicide, does not incur irregularity, because irregularity is not incurred unless it is expressed in Law.

But the laws speak of those who certainly are the cause of homicide by commanding or counseling, or who doubtfully commit homicide, not of those who only doubtfully concur toward it. L. 371. "He who kills another in defense of himself with the moderation of blameless defense, it is certain that he is excused from irregularity, as is clear from chap. Significasti 18, § fin., de Hom. and from Clementina Si furiosus, same title...

He is also excused from irregularity who kills the unjust invader of another innocent person... because irregularity from private homicide is not incurred except with mortal sin." L. 388. Hence irregularity is not incurred if another is killed unjustly for the defense of liberty, honor, chastity, or temporal goods with the moderation of blameless defense. L. 389. Nor does a physician become irregular if by chance the sick person dies from the medicine furnished, without grave negligence of the physician. Chap. Ad aures, de Aet. et qual. ord.; L. 384. If homicide is committed by chance, or by repelling force with force, the matter is committed to the Ordinary of the place, who, after knowing the cause, can dispense for sacred orders, for the ministry of the altar, and for any benefices and dignities whatsoever, from Trent, sess. 14, chap. 7, de Ref. They become irregular: "all who excite themselves to homicide, although one alone kills; all who fight in an unjust war, if someone is killed in it, even if they do not intend this, for then at least they incur the irregularity of accidental homicide; all who furnish arms or money for perpetrating homicide or an unjust war; all who unjustly accuse, or testify, or judge, so that a man is killed; all who accompany the killer by increasing his courage." L. 374, 459. He becomes irregular who procures the abortion of a fetus animated with a rational soul; otherwise if it is not animated, or if it is doubtful whether the fetus is animated, since in this case irregularity is nowhere found expressed. Chap. Maiores 32, q. 2; L., book 3, nn. 395, 396; Benedict XIV, Inst. 101, n. 8.

1. Sempronius, wearied of his wife, made espousals with another. Wherefore, in order to free himself from his present wife, while she was on a journey, in a certain solitary place, he pierced her with a bullet; and seeing her as though struggling with death, he commanded his servant, whom he had taken with himself as a companion of the journey, under penalty of death to be inflicted immediately upon him likewise, to slaughter the still-breathing mistress with a sword, and without delay to commit her, slaughtered, to the earth.

Q. 1. Is homicide ever licit? 2. Could the servant in this case licitly obey his master?

R. To the first. Cf. I. M. 719 seqq., 736 seqq.; E. M. 722. - To the second. The servant could not obey his master by slaughtering the mistress with a sword; nevertheless he could licitly obey by committing her to the earth after death. The reason for the disparity is this: because to commit a dead woman to the earth is not evil, but rather good, or certainly indifferent of itself. But what is good, or at least indifferent, we licitly do from a just and grave end, namely that of escaping death or another grave evil threatened to us. On the contrary, to slaughter an innocent person was evil, intrinsically such, forbidden by natural and divine right. But an evil intrinsically such may never be committed, however grave a fear of death may impend over us. - Elbel, De Act. hum. 43.

Hence another case is resolved: whether, at the time of the Paris Commune, and generally, whether in a time of anarchy, regular soldiers of the preceding Government, from fear of death, could fire upon religious, clerics, and honest citizens, and slaughter them. Altogether negatively, since neither by private nor by public authority is it licit to kill the innocent. And this is intrinsically evil; and accordingly it remains evil even when most grave fear of death stands.

2. "The Catholics of this diocese are inexorable in vengeance, and this because there is no one in those regions who administers justice. Therefore it is asked: 1. Whether, every other means of obtaining redress for their wrongs being excluded, Christians can consider themselves with respect to this point as if they were in the natural state. 2. Whether they are capable of the sacraments so long as they persist in this desire of vengeance. The reason which they bring forward to prove the necessity in which they are of avenging themselves is that the killer and his supporters would become fiercer and more intolerable against the relatives of the killed man, and would commit new homicides, if these did not resist and did not oppose force to force.

R. Negatively to each part." S. C. de P. F., 21 May 1759; Collectan., n. 2092, 2094, 2098.

3. A popular disturbance having been made in a certain great city, the Prince is expelled, and Anarchy is proclaimed for several weeks. Meanwhile thieves and highway robbers commit thefts, robberies, and homicides with impunity. Carolus, a powerful and honest man, judging that crimes ought to be punished, in order to protect honest citizens, public authority being lacking, himself assumes this office for himself. Hence, when he hears that either thefts and robberies or homicides have been committed by someone, judging that no other punishment in the present circumstances is possible and efficacious except the punishment of death, by night he himself with his servants kills thieves and homicides. And the matter always succeeds prosperously for them, so that it is altogether unknown by whom they were killed. What of Carolus?

R. Carolus acts altogether badly. For he himself has no power of exercising public vindication of crimes, since he has no authority in civil society. But citizens, for protecting themselves, can rightly use, if thieves and homicides attack them, the natural right of defense, repelling force by force, with the moderation of blameless defense. For indeed, "to kill evildoers is licit insofar as it is ordered to the safety of the whole community; and therefore it belongs only to him to cut off a rotten member, when the care of the safety of the whole body has been committed to him. But the care of the common good is committed to Princes, having public authority, and therefore it is permitted only to them to kill evildoers, not to private persons." St. Thomas, 2. 2, q. 64, a. 3. Nor indeed does it avail to object from the same Holy Doctor, ibid., q. 108, a. 1, that vindication is a virtue of a private person, and accordingly that it is also permitted to private persons at least to avenge injuries inflicted on themselves. For it is singular in this virtue of vindication that the person who is the subject of the virtue cannot through himself consummate the proper action of that virtue because of the necessity of the matter; because namely its matter is the evil of punishment, which requires coercive power in the author; and accordingly, although vindication is a virtue of a private person, nevertheless a private person cannot consummate his action unless public power is joined, on account of the condition of the matter to be rendered, namely the evil of punishment for the evil of the inflicted injury. Cajetan, in l. c. Cf. St. Thomas, 2. 2, q. 66, a. 8.

4. Gaspar, a physician, gave a drug to a certain woman to impede conception, namely in order that he might remove the most grave danger of death which he knew from experience threatened her; and accordingly he intended this only, that is, to procure her safety. But that woman, already made pregnant, is in reality placed in the highest danger of life, together with the offspring, which consequently would die without baptism together with the mother. Hence Gaspar, in order to save the mother from death and to procure baptism for the offspring, at the suitable time procures abortion by medical art. And thus the mother is in reality saved, and the offspring, having come forth alive, dies only after baptism.

Q. 1. Is it licit to procure abortion? 2. Has Gaspar acted rightly?

R. To the first. Cf. I. M. 742 seqq.; E. M. 742, 745; Comment. Theolog. Moral., fifth commentary, De Procuratione Abortus; sixth commentary, De Responso S. Officii circa craniotomiam.

To the second. Gaspar first sinned gravely by impeding generation, which in reality he himself intended, although he illusorily asserts that he intended only to procure the woman's safety. He indeed intended this as an end; but as a means to obtaining that end, he assumed this means: to impede generation by a drug, whence the woman's safety, from asserted experience, was being brought into danger. Therefore he intended this also. G. 400.

Gaspar also sinned gravely by directly procuring abortion, which from its intrinsic nature is true homicide. Nor indeed can he be excused from the excellent end of saving the mother and baptizing the offspring; for evils must not be done so that goods may come. But in the case the abortion is procured directly; for abortion is assumed and is intended in itself as the means to each. G. 400 seqq.

Hence Gaspar, on account of the direct procurement of abortion, incurs the excommunication reserved to bishops from the Constitution Apostolicae Sedis. Moreover, he becomes irregular; for since the question concerns a fetus which is so harmful to the health of the mother, it cannot be doubted that it is now informed by a rational soul. Cf. I. M. V. 2, n. 1204, 1335.

5. Hortensia, pregnant and now near birth, seized by a grave disease in the West Indies, dies. Richardus, a new missionary, judging himself obligated to perform the Caesarean operation, soon carries it out and baptizes the offspring still alive, which then continues to live. But as soon as the matter is made known, he is nearly slaughtered by the inhabitants of the place as the murderer of the mother. Immediately Richardus flees, and no further report of him is had in that place.

Q. 1. Whether and when can the Caesarean operation be done, and what precautions are there in practice? 2. Has Richardus acted rightly?

R. To the first. Cf. I. M. V. 2, 469 seqq. - To the second. Richardus did not act rightly. For, as appears from the case itself, the most grave danger of scandal was not lacking. Besides, there is the prohibition made to missionaries by the decree of the Holy Office, 15 Feb. 1760. Cf. Enchir. Moral. 471.

If, the mother now being dead, the Caesarean operation cannot be done, then the infant in the mother's womb can be baptized in the best way in which it can be done, namely by the aid of a small siphon or another instrument by which the infant in the maternal womb may be reached and water poured upon it. Hence, by the aid of an instrument of this sort, the membranes in which the fetus is enveloped must be cut, so that the water may immediately reach the fetus. This operation is easy and can rightly be done by a midwife or by another woman. - If, as is gathered from the case, a surgeon or another skilled man was truly lacking for carrying out the Caesarean operation, Gaspar could have procured that baptism be administered to the infant through some experienced woman in the way said. - G. v. 2, 218, 220; Gennari, Consultazioni, etc., p. 1, cons. 21.

1. Caius, a priest, opened a vein for a pregnant woman so that abortion would follow; and since it was not established that there had been an abortion, he gave her counsel of immersing her feet in hot water for half an hour; nor nevertheless, even this time, could it be established that there had been an abortion. Is Caius irregular?

R. "Diana says with Nav. etc. that if a physician opened a vein for a pregnant woman so that abortion would follow, but afterward it is not established that an abortion followed, he is not to be judged irregular... because proceedings are not taken against someone for penalties unless the body of the crime is established. But otherwise it must be said if the means applied for abortion were so efficacious that from them the effect commonly follows, because then presumption is made from things commonly occurring." St. Alph., l. 7, n. 347, dub. 3. But since even that washing of the feet is not a remedy altogether efficacious for procuring abortion, it does not seem that Caius incurred irregularity. But a fortiori he is to be excused from irregularity if it is not established that the fetus was animated, and still much more if the pregnancy itself is not established. St. Alph., l. 3, n. 395, 396; I. M. 1330.

2. Sempronius, a priest, doubts whether by his counsel he procured an abortion that in fact followed. Is Sempronius irregular?

R. Negatively. St. Alph., l. 3, n. 396, says: "What must be said if there were doubt whether someone by his counsel or work cooperated in the certain death of a fetus now certainly animated? See what is to be said, l. 7, n. 371." Now in that place the Holy Doctor raises the general question whether one commanding or counseling homicide is irregular in doubt whether the mandate or counsel was or was not the efficacious cause of the homicide. And then he brings forward two opinions, one more common, affirming, the other, which does not seem to have to be called improbable, denying. Wherefore Sempronius, in the Case, can probably be excused from irregularity. I. M. 1318.

3. Fuscus, a priest, so that he might sin more freely with a certain woman without danger of infamy, persuaded her to procure for herself the perfect excision of each ovary by a surgical operation, so that she would thus be made sterile or impotent with no danger of generation. That woman did this, and thus both continued in sin for several years. On the occasion of the Holy Year Fuscus is converted to good fruit, and asks whether he ought to be dispensed from irregularity.

R. Irregularity here would be first by reason of mutilation. St. Alph., l. 7, n. 380, raises the question: "Whether he is irregular who cuts off the testicles of another." And he responds: "Bon. etc. deny it, because, as they say, those are not a member, but part of a member. But Roncaglia etc. more probably affirm it, because the testicles now have their proper operation." Now the same seems to have to be said concerning the ovaries. Moreover, not only he who mutilates another incurs irregularity, but also he who proximately cooperates in that mutilation, as in homicide, because mutilation is equated to homicide. "Hence," says Reiffenst., l. 5, t. 12, n. 57, "by the same reason the doctors commonly hold that in those cases in which he contracts irregularity who counsels, commands, cooperates toward an unjust homicide, or does not prevent it, or ratifies it, in the same cases one counseling, commanding, etc. mutilation also contracts the same irregularity." Therefore Fuscus, as one commanding or at least counseling mutilation, contracts irregularity in the Case.

But Fuscus would have to be punished with still graver penalties. For "Sixtus V in the year 1588 issued a Bull which begins Effraenatam, in which he subjected all knowingly procuring abortion of a fetus, whether animated or inanimate, and in any way consenting in this or furnishing to women poisons of sterility, to all penalties which are owed to homicides by civil and canon law, such as privation of every clerical privilege, dignity, or ecclesiastical benefice, and also inability to obtain them in the future, etc." St. Alph., l. 3, n. 395. Fuscus indeed did not procure abortion, nor did he furnish poisons of sterility for killing a fetus. But did he not furnish more than poisons of sterility, by commanding or counseling that excision for impeding generation?

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.

72. IV. On abortion and craniotomy². It is known that voluntary destruction of the fetus flourished among the Pagans; but the Christian religion, zealous for human life and the salvation of infants, strictly prohibited it as true homicide. Yet in our days not a few physicians have attempted to make honorable abortion and embryotomy or craniotomy (i.e., the destruction of a living fetus)³, at least in the case in which the life of the mother otherwise cannot be saved. Now as regards abortion, the violent ejection of an immature fetus, at the time when it cannot live outside the uterus, must be distinguished from acceleration of childbirth, which takes place when the fetus, already conceived for seven months, can live outside the uterus. - These things being posited, we set forth the responses of the Congregations on this matter:

² Eschbach, op. cit., pp. 273-286; 381-476; Surbled, op. cit., vol. II, p. 184-258; Dissez, Craniotomy from the theological point of view.

³ Embryotomy etymologically means the cutting of the embryo, craniotomy the cutting of the skull or head.

73. (A) On craniotomy. In the year 1884, on May 28, the Holy Office recalled for examination the doubt proposed by Cardinal Caverot: "Whether it can safely be taught in Catholic schools that the surgical operation which they call craniotomy is licit, namely when, it being omitted, the mother and son would perish, but on the contrary, it being admitted, the mother would be saved, the infant perishing"; it judged that it must be answered: that it cannot safely be taught⁴. But when there was dispute concerning the sense and extension of this decree, especially in the Catholic Faculty of Lille, the Archbishop of Cambrai proposed new doubts concerning certain surgical operations akin to craniotomy; after three years, the Holy Office, on August 14, 1889, confirmed the first response, and declared that it cannot safely be taught that "any surgical operation directly killing the fetus or the pregnant mother" is licit⁵.

⁴ Apud Eschbach, op. cit., p. 461-462; Acta S. Sedis, XVII, p. 556.

⁵ Eschbach, p. 464-467; Acta S. Sedis, XXII, p. 748.

74. (B) On abortion of the immature fetus. Since procurement of abortion differs from craniotomy, some thought, even after the aforesaid decrees, that abortion was licit for saving the mother.

Therefore a new case was proposed to the Holy See: "Titius, a physician, when he was called to a pregnant woman lying gravely ill, everywhere observed that there was no other cause underlying the lethal disease except the pregnancy itself, that is, the presence of the fetus in the uterus. Therefore there was one way at hand for him, that he might save the mother from certain and imminent death, namely of procuring abortion or ejection of the fetus. He was accustomed to enter upon this way, having employed means and operations nevertheless not indeed tending of themselves and immediately to this, that they should kill the fetus in the maternal womb, but only that it should be brought to light alive, if it could be done, although it would soon die, as being still altogether immature." Now the Holy Office, on July 24, 1895, decreed that this could not be done¹.

¹ Eschbach, p. 468-469.

75. (C) On acceleration of childbirth. Wherefore nothing remained except to inquire concerning acceleration of childbirth; therefore the following doubts were proposed by the Bishop of Sinaloa (Sinaloa, in the Mexican region): "1. Will acceleration of childbirth be licit whenever from the narrowness of the woman the exit of the fetus at its natural time would become impossible? - 2. And if the narrowness of the woman is such that not even premature childbirth is judged possible, will it be licit to provoke abortion or to perform the Caesarean operation at its own time? - 3. Is laparotomy (i.e., section of the abdomen) licit when there is question of extra-uterine pregnancy, or of ectopic conceptions?"

Moreover the Holy Office on May 4, 1898 responded: "To 1. Acceleration of childbirth is not illicit of itself, provided it is performed from just causes and at that time and in those modes by which, from ordinary contingencies, care is taken for the life of the mother and fetus. - To 2. As regards the first part, negatively... But as regards the second, nothing prevents the woman concerning whom there is question from being subjected to the Caesarean operation at its own time. - To 3. Necessity compelling, laparotomy is licit for extracting ectopic conceptions from the womb of the mother, provided that for the lives of both fetus and mother, insofar as can be done, serious and opportune provision is made."²

² Eschbach, p. 470-471; Acta S. Sedis, XXX, p. 704.

The Holy Office again confirmed this response on March 5, 1902, renewing the prior decrees³.

³ Ami du Clerge, XXIV, 1902, p. 478.

76. From the aforesaid decrees it is permitted to infer a threefold rule: (A) It is not licit directly to procure immature abortion⁴ or to perform craniotomy; for each action is directly killing of an innocent. Therefore the following sin gravely: (a) pregnant girls who procure abortion lest they lose reputation or suffer some other grave evil; or women who, fearing lest they are pregnant, take potions or employ other means in order to induce abortion; (b) physicians who directly procure abortion, even for saving the mother; for evils are not to be done that goods may come¹; moreover there are other suitable means for helping the mother, namely acceleration of childbirth and the Caesarean operation, which today, especially in great cities, where skilled surgeons are found, is performed easily and safely².

⁴ This indeed is true even if it were admitted that the fetus, although living, is not yet informed by a rational soul; for by Innocent XI, March 2, 1679, this proposition 34 was condemned (apud Denzinger, n. 1051): "It is licit to procure abortion before animation of the fetus, lest a girl found pregnant be killed or defamed." - The excommunication imposed against those procuring abortion is set forth in the Treatise on Censures.

¹ Nor can it be said that the fetus is an unjust aggressor; for, as Cangiamilla already said in his time, the infant is not an unjust invader, but compelled by nature, whose author is God; indeed compelled by the mother herself, as D. Huber says. Cf. Eschbach, op. cit., p. 424.

² Hence today many physicians, even non-Catholics, reject immature abortion and craniotomy as something scientifically antiquated: "To kill the fetus, under pretext of favoring delivery, is to misunderstand the certain resources of modern obstetrical surgery; it is to be behind the times." Thus Dr. Guerinoprez, apud Eschbach, op. cit., p. 389.

77. (B) It is licit indirectly to procure abortion from a proportionately grave cause; e.g., if the mother labors under a lethal disease which cannot be cured unless a remedy is furnished from which abortion will follow by accident; provided these conditions concur: (a) that the disease be truly lethal; (b) that the remedy be directly employed for curing the disease, not for expelling the fetus; (c) that in the best way possible provision be made for the baptism and salvation of the animated fetus.

(C) It is licit directly to procure acceleration of childbirth, when it is foreseen that the infant can live, provided there is a grave cause; for by such a manner of acting the life of the infant is not taken away, but only exposed to danger; and this indeed is licit whenever it is required for averting a greater danger of the infant itself or of death.

78. Note for practice. Since in some Schools of physicians it is taught that craniotomy is licit and expedient for saving the life of the mother, certain surgeons in good faith perform it when from various circumstances the Caesarean operation seems less opportune; in which case, as regards the past, they are indeed excused from sin, but they are prudently to be instructed as regards the future, according to the rules handed down in the Treatise on Penance.

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3. 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.).

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.

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.”

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.

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.

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

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.

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.

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.”

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.”

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.

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.

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.

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.

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.

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.

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.

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.

The Encyclical treats as a crime all attempts upon the life of the child in the womb of his mother.¹

¹ Pp. 40-42.

It means not only a child whose body is already formed, but also a child in the fetal or embryonic stage, in other words every fertilized ovum. In fact Canon 747 of the Code of Canon Law in prescribing the baptism of every fetus, however small, enjoins that every fetus be treated as a human being.

It includes in the first place feticide, that is the cruel operation which crushes the skull of the fetus or cuts his little body to pieces according to the need for saving the mother. Besides, it includes every direct abortion. Not only the majority of the more modern moral theologians, but the Holy Office itself consider direct abortion as similar to feticide.¹ For abortion

is not merely the placing of a child outside the surroundings which are indispensable for him to live, but it is the violent tearing away of the membranes and tissues by which the child is as it were one with his mother, and through which he breathes and receives nourishment—membranes which, at least in part, belong to him as an organ developed by his own growth. Abortion directly produced is a deadly wound inflicted on an innocent human being.

¹ See the reply of the Holy Office, August 19, 1889.

Catholic teaching is today unanimous in condemning all feticide and all abortion directly produced upon a fetus, unless it be morally certain that he is already dead. Outside of this Catholic tradition, some, holding that the unborn child has no rights,¹ allow the father or mother to decide his fate; others allow feticide only in case of imminent danger, where it is the only way to save the mother's life, or they allow abortion only for very grave medical, social or eugenic reasons. Such a determining reason of a medical nature would be to kill the child in order to solve the conflict which has arisen between the life or health of the mother and the existence of the child. Social reasons are to save the honor and reputation of the mother, or to leave her free to carry on her occupations and gain her livelihood. A eugenic reason is to prevent the birth of children who would be monstrous or idiotic. The idea of the required gravity of the motive is evidently more or less broad, according to the religion or “philosophical convictions” of the doctor or adviser. All of them, however, as the Encyclical goes on to state, demand that the “indication” which in one form or another they defend, be recognized as such by the public law and in no way penalized.² In other words, they insist that the law should conform itself to their theories and distinguish on the one hand between criminal feticide or abortion, punishable by legal penalties, and on the other, therapeutic or medical feticide or abortion, which should be legally authorized. In

fact, already a doctor is in no danger of prosecution as long as he is supposed to have acted according to the dictates of science. Worse still, it sometimes happens that a doctor is forbidden to practise laparotomy (cesarian section) in rural districts, although this operation might save both mother and child, while at the same time he is liable to prosecution for malpractice if he allows the mother to die under circumstances where he might have saved her by directly killing the child.

¹ They consider it as part of the organs of the mother, viscera matris.

² P. 40.

He opposes to them in the first place the peremptory argument embodied in the Divine commandment, “Thou shalt not kill”; and he rejects in passing the futile exceptions which have had a certain vogue. He declares that the right to take away life cannot be appealed to, since even public authority has no such power in the case of an innocent person; nor can the right of self-defense, since there is no question of an aggressor, even materially unjust, and the development of the child, even though it should become a fatal danger to the mother, does not violate objectively any of her rights, nor contain any injustice; nor the right of extreme necessity, since that never goes to the extent of killing a living person. The life of each of the two individuals is equally inviolable. Such a thing as a conflict in which one life might be regarded as of less value than the other, is an impossibility. We must, therefore, conclude with the Encyclical that physicians are bound to try to save both lives, both having an equal value in the eyes of God, the mother’s and the child’s. The physician has no right to set himself up as judge to pronounce a sentence of death. No diploma confers such power, which would exceed that of the most absolute monarch.

When the doctor abstains from interfering, he himself sacrifices no one; whereas if he does interfere by abortion or

feticide, he protects the life of the mother at the cost of committing a homicide. Here is a mere comparison, which we do not offer as an argument: suppose two men, for want

of provisions, are about to die of hunger; is it permissible for the stronger of the two to kill the weaker, in order to take his share of the provisions? That is the act of the physician who kills the weaker, the child, to save the stronger, the mother. If the parity is denied on the ground that in the supposed case the weaker person is not causing to the stronger any direct harm, whereas it sometimes happens that the fetal placenta poisons the mother, we answer in the first place that some good gynecologists have told us that the theory of placental poisoning is being more and more questioned. But suppose even that it is true, and return to our comparison. If the weaker person, forcibly held close to the other, involuntarily exhales a harmful vapor, is his right to life thereby impaired? May the stronger in that case resort to murder to free himself from this unhealthy environment? Besides, is it quite certain that unless an abortion is performed the mother and the child will die? It is very far from certain. There are not wanting cases in which a conscientious physician has saved both mother and child in spite of the medical indication of abortion. The doctor’s verdict is based on probabilities.¹

¹ See in the excellent little book of Dr. Clement, Le droit de l’enfant à naître (Bruges, Beyaert, 6th ed. 1931) the chapter, Vers la suppression de l’avortement thérapeutique.

It is not, when that principle is a saving one, which preserves greater values than those it sacrifices. Now faith in Providence assures us that every principle imposed by the law of God is a conserving force of higher values. In the present instance, one sees, it is true, some very sad, pitiable cases, in which a person dies, who might have been saved by abortion. But does not a more far-sighted vision see also a greater number of lives saved by the rigor of the principle? The severity intensifies the effort to save both lives; and this effort is sometimes rewarded with complete success. At the same time the spirit of invention is stimulated, and

this results in discoveries which render out of date even the medical indication for abortion or feticide. ‘‘Respect for the life of the child,” writes Dr. Clement,¹ “stimulates progress.” Is it not through this means that specialists now declare themselves able to control cases which were formerly despaired of, cases of so-called uncontrollable vomiting?² Let us in addition observe this psychological fact. When a physician who practices medical abortion is attending a woman who is pregnant and ill, everything conspires against the child. What reproaches are in store for the doctor if the mother dies when he had reason to believe he could save both her and the child! But the child, needlessly sacrificed, will make no complaint from beyond the grave! If one could get the statistics, we are persuaded that the number of real victims of medical abortion would be far greater than that of so-called victims who are supposed to have died for having been unwilling to consent to abortion.

¹ Work cited, p. 81.

² See for example one of the studies of Dr. Leven of Paris, Les vomissements au cours de la grossesse. La Médecine, April, 1929, in which he details the treatment which he finds successful. We have also direct assurances of the same fact from other gynecologists. Dr. Leven concludes with these words: “At a time when the birth-rate is so low, the fear of pernicious vomiting should no longer cause dread of pregnancy; nor should avoidable abortions any longer be practised.”

Because the death of the child may be a consequence, not willed, although foreseen and inevitable, of a medical treatment which is permitted in spite of this foreseen consequence. Although we may never do what is evil, still we have neither the obligation nor the power to prevent all evil from happening. We cannot be responsible for an evil consequence flowing from our good actions, when that consequence does not depend on us, and when the motive for acting is in proportion to the evil which is feared. In such cases the evil cannot be imputed to us as willed, because we do not will it; nor as permitted, because by our scrutiny of the reasons for acting, and by the precautions we have taken, we have fully satisfied our positive duty of removing, as far as is humanly possible, the accidental evil consequences of our action.

It is necessary that the abortion be not willed either as an end or as a means, but simply be permitted as occurring in spite of all, through the intervention of a factor which we cannot remove. It is, therefore, not sufficient that in an abortion the only purpose intended be to save the mother, if the abortion is a measure to that end, if the expulsion of the fetus is utilized as a means. In such a case, since the abortion is chosen, it is willed, and is, therefore, direct. Consequently, abortion will be indirect only in case the morbid condition of the maternal matrix requires the immediate removal of that organ, even though this removal necessarily entails the exit of the fetus which is enclosed in the uterus. The abortion, however, would be direct if the womb were to be emptied in order by that means to stop a hemorrhage. It is absolutely direct when it is practised because the mother is affected with tuberculosis or general weakness, or because it is feared that the child will be physically deformed or mentally affected.

It is notorious that in Soviet Russia, notably in Moscow, there is an official Institute where abortion is practised upon any woman who asks for it. About 30,000 abortions a year are performed there. But statistics supply us with precious information on the physical harm caused by these operations. Nature takes her revenge upon these unnatural mothers.¹

¹ Even outside of Russia, are not the statistics of abortion alarming? Take a single example. Already in 1923—and it is no better since then—there were in France 500,000 abortions a year, of which 85 per cent (425,000) were criminal, according to Doctors Pinard and Richet. (Speech of Mr. Zamanski at the Social Congress of Marseilles, 1929.) In Germany there are yearly one million abortions.

On the contrary, efforts and researches which tend to improve the health and vigor of the human race are in themselves praiseworthy. The Holy Father teaches that we may, and should, take account of the findings and recommendations of this science or art.

But the end does not justify the means. One cannot give to eugenics such primacy as to forget the law of God in order to satisfy its demands. On March 21 of this year (1931) the Holy Office, with the approval of the Holy Father, declared that we must absolutely reject and hold as false and condemned by the Encyclical “Casti Connubii” of December 31, 1930, the so-called “eugenic” doctrine, as well “positive” eugenics as “negative,” together with the means which it indicates for the improvement of the human race, by neglecting the laws of nature, of God, or of the Church, concerning marriage and the rights of individuals.¹ The Holy Father takes occasion in this connection to remind public authorities that it is their duty to protect the lives of the innocent, especially of those who cannot defend themselves. To deliver them to death, even at the hands of physicians, is to commit a crime that cries to heaven for vengeance.²

¹ Acta Ap. Sedis, Vol. XXXII, p. 118.

² P. 56.

We must distinguish between abortion (the moralists call it abortion when a child who is not viable is removed) and premature delivery. The latter will be allowed when it is practised at such a time and by such means that under ordinary conditions the lives of both the mother and the child will be provided for.¹

¹ Reply of the Holy Office, May 4, 1898, reply to question 2.

In the first place, the child must be already viable. At present, thanks to artificial incubators the child may be said to be viable after about six months of life within the womb. But this initial viability is a very different thing from full viability which requires at least eight months. Between these two periods viability goes through varying degrees, in which the chances of life are unequal. Moreover, premature delivery is more or less harmful to the child, according to his degree of maturity. Mere viability may not, therefore, always be a sufficient reason for delivering a child of six months. If there is imminent danger, the

operation will be legitimate as soon as the child has a chance to survive. If such a danger is not certain, then its probabilities must be considered, as well as the harm that would result from prolonging the pregnancy; and in the absence of a controlling reason of this nature, one should wait the full eight months. In short, the formula of the Holy Office gives us this rule: Consider the two lives, that of the mother and that of the child, as of equal value; and do what is for the best interests of both, everything considered, and without forgetting that the saving of the mother’s life is a very great benefit to the child himself.

132. - Most men alienated from the faith do not defend honorable morals in the matter of chastity in such a way as to exclude every exception from the rules which in themselves they approve and establish. Wherefore, if at any time conception is prohibited by health, if at any time the wife will be unable to bring forth a living fetus without danger, they will permit, or even advise, artificial sterility, indeed abortion or embryotomy, resting openly or tacitly upon these principles: that necessity is immune from law; that all things are to be weighed not by an absolute but by a relative rationale; and that accordingly, in individual actions, one must consider what prevails and what is to be preferred.

133. - They can be answered thus, in brief but efficacious words. Moral uprightness has either an absolute command or one subordinated to this condition: unless great difficulty excuses transgression. An absolute obligation suffers no exception; but a conditional one will consequently be tempered by exceptions in every kind of uprightness. For no reason can be alleged why it would lose its force only in the subject of chastity and when offspring is at issue. What, therefore, if the physical state of the body, or a prolonged separation, should prohibit even imperfect conjugal intercourse? Will they dispense the healthy spouse from the obligation of fidelity? What, moreover, if the gravest harm threatens unless a theft is committed? Very few indeed will admit this, and rightly and deservedly so, on account of the absolute dictate of conscience. But this dictate is general and ought to prevail in every moral matter. Indeed, do they not celebrate as the fruit of the most atrocious war which raged for more than four years the fact that the rationale of right is acknowledged to be absolutely inviolable and can no longer be passed over on account of an alleged excuse of necessity? Will not all confess that there are duties, for example of devotion to the fatherland, on account of which life itself is to be held of no account? Can they, therefore, without absurdity deny such force and efficacy to moral duties that, in order to observe them, less than life itself - a certain delight and pleasure of life - must sometimes be subordinated?

"What kind of philosophy is this," the pagan writer Cornelius Tacitus was already vigorously exclaiming, "which would not bring about the destruction of moral gravity, but would be content with a mediocrity of vices?" ¹.

¹ Annals, 14, 38.

But they deny that there is anything absolute for man, since he himself is wholly relative.

Yet, if man is constituted by an essential relation to God, and if all the things of this world are contingent and subject to relative considerations, nevertheless God is absolute, and by His authority He confirms and sanctions the absolute precepts of the moral order.

Yet we freely admit this: when faith in God has been lost and the hope of a future life has been cast aside, those accidental contrarieties between the honorable and the pleasurable lack a sufficient explanation, and the commands of absolute uprightness cannot be perceived well. But for us they assume the excellent form of divine worship and obedience by which we humbly acknowledge the dominion of God.

Nevertheless, all sensible men feel that nothing is more worthy of man than that, besides the impediments which he is forced to obey physically, so that he must confess, "I am unable," he should equally revere the moral impediments on account of which, without any exception, in private and public life, he says, "I cannot."

But the more vehement the venereal appetite is accustomed to be, the more the firmness of a purpose of this kind honors a man and renders him strong and capable of accomplishing great things.

What of the fact that difficulties concerning the begetting of offspring most often flow from the imprudent levity with which marriages are entered, while consideration of vocation or aptitude is neglected? Shall we say that it is lawful for a man to redeem his fault at the expense of uprightness? On the contrary, will it not be obtained by moral vigor, as a thing greatly to be desired, that marriages be celebrated more circumspectly, with greater happiness for the spouses and for their stock, between persons who are well suited?

Therefore let this be settled and deliberate for us: pleasure, perfect copulation, and solicitude concerning the offspring, if any is born from it, are so joined by nature that it is never lawful to tear these apart in the mind and to admit one while repudiating the others.

134. - But at the same time, to the best of our abilities, we shall procure that parents deter from matrimony a daughter unequal to the burdens of conjugal life, and that they nourish their offspring physically and morally from tender years in such a way that it may become of itself fully capable of matrimony.

It is also to be desired that young men be less solicitous concerning the dowry of a bride than concerning her physical and moral suitability.

For this is among the desires of nature: that those insufficiently suited abstain from matrimony and aspire by another road toward a holy fecundity of good works.

— To the society which perhaps has insured the life of the person killed; to the State or institution which, on account of that homicide, must pay a pension to the children or widow, nothing seems to have to be restored. For the action was not injurious to them. Nor does the response seem to have to be changed if the crime was committed with the intention of obligating the society or the State to pay those monies. For intention can indeed remove the excuse which is sometimes sought from an effect too distant; but it cannot make unjust an exterior action which is not opposed to objective right.

Noldin, II, 466, rather argues from this, that the public treasury and the insurance society perhaps do not urge the obligation of repairing the damage inflicted upon themselves: "for concerning cases of this kind, even if foreseen, nothing is provided in their statutes." That reason seems to us of little efficacy. For another's right which arises from a delict must be satisfied spontaneously, unless positive condonation can be presumed; but no indication of this is demonstrated.

But if someone should have wished, by the death of the insured person, to obtain for himself the promised money, from the contract itself he has no title for obtaining it.

Principle. From the time when the rational soul has been infused, the fetus, even in the womb of the mother, is a person distinct from the mother and equally inviolable. Therefore in no way can it be said to belong to the viscera of the mother, concerning which she may reasonably determine what she wishes. Nor less are the calculations of certain persons to be repudiated, who, comparing the utilities of both lives, that of the mother and that of the offspring to be born, strive excellently to gather which life in the conflict, as they say, is to be immolated.

Corollary. To exercise embryotomy upon a fetus certainly or probably living (by which, either by the head being broken or by the body being cut, it is killed) is never lawful. The contrary sentence cannot safely be taught from the Holy Office, May 28, 1884, and August 19, 1889. For that action is a certain or probable (by probability of fact) homicide of an innocent, which cannot be intended even as a means to the greatest good. Nor is it an obstacle that the loss of life would be slight, because it is never right directly to shorten life, even in the dying. Nor can the fetus which is naturally developed in its own place be held as a materially unjust aggressor.

Grave Doubt. In cases where the safety of the mother altogether requires that the fetus be expelled, and, on account of the narrowness of the opening, it cannot be expelled except by embryotomy, Catholic physicians were accustomed to wait for the moment at which, taught by the stethoscope, they judged the infant dead, so that then, without fault, they might cut its body into parts or bore through the head. But since a recently spread opinion concerning many cases in which death is only apparent seems to defer certainty of death in such a case at least for an hour; since it also happens that in the case of suffocation, artificial respiration seems, as it were, to restore life to those whose heart was already not beating, it is asked whether or not it is lawful for the physician to exercise embryotomy as soon as the heart has now ceased from beatings.

Certainly, if the case tolerated delay, one would have to wait longer. But in the present case the delay would be lethal for the mother. Again, no positive probability is present by which we could say of such an infant: "probably he lives." But the experiment of artificial respiration cannot be attempted.

Therefore, since we cannot be directed by a mere possibility, and the necessity of the mother urges, will there not be someone who judges it lawful that, content with the sign of which there is an abundance, the surgeon hold the infant as dead and treat it as such? We had in mind to propose the doubt rather than to resolve it.

Ferreres, I, 501, II, end, would permit the matter without hesitation, since he thinks the certain right of the mother is to be preferred to the right, as he says, doubtful, of a fetus probably or more probably dead; and Prummer, II, 136, where he has these words: "Sometimes, however, the fetus is not certainly dead, but more probably now does not live. Then also several authors rightly teach that craniotomy is lawful for saving the mother, because a living mother is not bound to give her life for a fetus more probably now dead." Yet rather than there being question of life to be given for the fetus, there is question in the case of conserving one's own life with the death of the offspring if this offspring is living, as is sufficiently probable.

Tolerance of Good Faith. In various words, authors warn that it is to be permitted to the prudence of priests that, in extreme cases which, alas! occur, they not disturb the good faith of the surgeon. For when otherwise the death of the mother is imminent, and the eternal salvation of the fetus has probably been consulted by baptism at least in the womb, the dishonesty of an action which, by suppressing a fetus certainly going to die, saves the mother, is not so evident that it has not been denied or recalled into doubt by certain highest moral theologians, such as C. d'Ann. (II, 284) and Ballerini (Ball.-Gury, I, 403, note 13). And observe that in the present danger of death, abortion would be attempted too late, so that then there can be question only of craniotomy or embryotomy.

Concerning this tolerance of good faith, cf. Lehmkuhl, I, 1002; Noldin, II, 340; Prummer, II, 136; Gennari, Cons. mor., T. I, Cons. 77, where he proves these things from Kenrick, Theol. mor., I, 130: "if the surgeon asks what is lawful, let him answer: 'I do not know how the life of the fetus can be taken away without fault'" (and therefore with mention of the resolutions of the Holy See omitted). If the mother asks what is to be done by her, it seems it must be said that she ought to ask the surgeon to consult the life of the fetus in every way he can.

Notions. 1. Definition. Abortion is defined as the ejection of an immature fetus, or of one which cannot yet live outside the mother; while acceleration of birth, theologically, is the premature expulsion of a fetus which nevertheless can now be brought forth viable. For physicians, abortion is rather the ejection of a fetus not yet formed, whence they understand acceleration of birth more broadly, even of the expulsion of an immature fetus.

Regularly, that a viable fetus may be brought into light, it must be contained in the body of the mother for at least seven months; nor is it expelled before 34 weeks without special danger.

Now, however, by the help of a certain special incubation, some six-month fetuses can be preserved.

2. When the Rational Soul Is Infused. The fertilized little egg morally begins at once to live physiologically for itself. Yet do not thence conclude with several writers of the nineteenth century that immediately also, or from the first moment, the rational soul is infused by God. That immediate infusion of the rational soul, as Prummer, II, 138, notes, cannot be proved by any solid argument. On the contrary, right philosophical teachings concerning the soul, the form of the body, demand, with a miracle excluded, such as followed the conception of Christ, that with St. Thomas, Summa theol., 1 p., q. 76, art. 3, ad 3; q. 118, art. 2, ad 2, and all scholastics, after several Fathers, we hold that this infusion is delayed for some time; and this is confirmed by more recent observations of physiology, entirely different, of course, from those which were admitted in the age of St. Thomas.

Cf. our De Castitate, 3rd ed. Nevertheless, immediate infusion of the spiritual soul remains sufficiently probable that, theologically, the fetus from the first instant must be baptized and treated as a man.

3. What Abortion Is Materially. Observe also that voluntary abortion cannot be described as an action by which the mother ceases to carry the infant otherwise unharmed, and, as it were, places him outside her womb, in a place where, however, with respiration lacking, he cannot live; but "first and per se the living fetus itself is attacked in the same way in which someone whom another pierces with a lethal wound is attacked. For violently to rupture the membranes and the ligaments by which the fetus has grown together with the maternal uterus is in reality nothing other than to inflict a lethal wound upon the fetus" (Lehmkuhl, I, 1008); "it deprives the fetus of the office of the placenta by which he adheres to the mother and receives nourishment and purification of the blood" (Aertnijs-Damen, I, 571).

4. Baptism in the Womb. Not long ago an instrument was invented by which the membranes by which the fetus is covered are so cut that water can be injected by means of a little tube, and in the very womb of the mother a probable baptism can be conferred upon the infant.

5. Medical Causes of Abortion are of three kinds. For either: a) the mother labors under a disease by which she will be cured with more difficulty, or not at all, unless pregnancy is suppressed. An example is pulmonary phthisis; b) or the gestation itself of the uterus brings disease with it. Inexsuperable vomiting is reported as the worst; c) or, on account of the narrowness of the opening, the mother cannot bring forth the mature fetus. This difficulty can not rarely be met either by Caesarean section (cf. 625) or by symphysiotomy. By this latter operation, the fibro-cartilage by which both bones of the pubis are joined is cut; after that cutting has been performed, the opening of the pelvis can be dilated by one or two centimeters.

Moral Judgment. Directly to procure abortion is held as equally illicit as feticide. Thus the classical doctors think; if any seemed to admit an exception, they supposed that the fetus was not yet animated. Thus St. Alph., l. 3, n. 394; thus most more recent authors; thus the Holy Office, which assimilated abortion to an operation directly occisive, which, in any case, it declared could not safely be taught to be lawful, August 19, 1889. Cf. response of July 24, 1895; for example, Analecta Ecclesiastica, III, 483. Concerning the force of the formula "cannot safely be taught," cf. Gennari, Cons. mor., t. I, cons. 77, in which he cites Bucceroni. For to expel an immature fetus, who will not be brought forth viable, is to inflict a lethal wound upon him. But he who has brought upon a man the proximate cause of death contracts the malice of homicide. And even if the fetus is not yet animated by a rational soul, it cannot be directly expelled without contracting a malice similar in genus, but graver in degree, than that which is in pollution or the onanistic use of marriage. For in each case, even if bodily safety is to be procured, a faculty which has been conferred on us immediately on account of the good of the species is directed, in an order inverted from the species, to a singular good. Therefore it is a sin against nature.

Not a few writers, for example Lehmkuhl, I, 1003, condemn direct abortion of a fetus not yet animated by this reason alone, that it is "anticipated homicide." We confess that it is not distinctly grasped by us what force is in that reason. For how is a man killed before he exists? Nor is there any right of a future man. Wherefore by that form of argument the proper malice of that abortion is not declared, unless you add with Aertnijs-Damen, I, 576, that it, more than pollution, is opposed to nature, and thus suggest the reason just given by us.

Before the last responses of the Holy See, some authors otherwise approved, such as Ball.-Palm., II, 910 ff., and Lehmkuhl, I, 818, though not after the seventh edition, in certain most grave cases thought more benignly: either that by the intention of saving the mother the direct nature of abortion was removed, or that the mother could, as it were, cease from conserving the fetus. But since the safety of the mother follows abortion and is obtained through it, an intention of this kind does not remove the direct procurement of abortion; and the mother does not merely cease from conserving the fetus, but by a positive and often difficult effort expels it. It will indeed be able to happen that in an extreme case good faith is not to be disturbed much, yet with insistence that they apply themselves to those operations which preserve the mother and the offspring together, and that they bear solicitous care concerning the eternal salvation of the offspring.

Observe also that for saving the mother in an extreme case there would rather be need, if it were lawful, of craniotomy than of abortion, which, in the present danger of death, would be attempted too late.

Because men of our age are persuaded less by philosophical reasons than by practical ones, it is opportune to show them how the severity of the Holy See spares several human lives, far from being the cause, even per accidens, why more perish. For if, to save the temporal life of the mother, you should say that killing the infant is lawful, this will be exercised even on account of a probable necessity, nor will all things be attempted with the same solicitude for saving both lives. And note that no worldly reprehension will be incurred by a physician who, alleging necessity, kills an infant who could have been saved with the mother; while if the mother dies in a dangerous birth, this death will easily be imputed to the more prudent physician. Therefore by the very utility of his own reputation, the physician will be impelled to follow the safer parts against the fetus, thus immolating many who could have lived with the mother. Experience itself clearly confirms this. Add also that from one excusing cause men are led to admitting others: it is enough to read academic reports to see how broad a field some wish already to lie open to feticide and abortion.

— It will be lawful to accelerate birth whenever, by this reason, better provision is made for the very life of the infant. But that it be done on account of the safety of the mother, it is necessary that it be performed "at that time and in those ways by which, from things ordinarily happening, provision is made for the lives of the mother and the fetus" (Holy Office, May 4, 1898, ad II). The reason is that the will of the infant, where there is question of the danger of his life, cannot be supplied by the parents except so that provision is made for his good and utility; by no means, however, contrary to what Lehmkuhl, I, 1007, judges, so that there be made an act even of indirect immolation of life, which an adult could make from heroic charity. Yet this can be understood somewhat more broadly, because the mother herself is necessary to the infant.

On Caesarean Section. Caesarean section is an incision of the abdomen and uterus of the mother performed for extracting the fetus. Thus, immediately after the death of the mother, Caesarean section will be licit, indeed per se obligatory, for extracting even an immature fetus, who thus is snatched from equally certain and more prompt death and will be able to be baptized. Here again worldly prejudices stand in the way of eternal salvation; and those who were preaching abortion for saving the temporal life of the mother will condemn the cutting open of the dead mother for procuring eternal beatitude for the infant. On account of penal laws today, the priest will be able only to warn the physician and the family of their office. But although absolutely he can with difficulty resist the will of relatives, the physician or surgeon nevertheless possesses in his very skill an authority by which he can perform that operation safely. The best counsel often will be that immediately, asking nothing, he extract the fetus, as though a natural complement of the care promised. If there is morally no hope of baptism, the reason ceases on account of which, even after the death of the mother, the fetus is to be extracted. But in the very womb of the dead mother he will soon perish by asphyxia.

A surgical operation, for instance a Caesarean section, which is necessary for procuring baptism for her infant, per se must be undergone by the mother, even with her own danger, if the baptism which otherwise cannot be conferred is sufficiently certain. For preserving temporal life, she will not have to admit that danger. Since today operations are made much more safely than before, and they bring no true horror to a person put to sleep, the mother is gently to be induced to obey the counsels of an upright physician. Yet we shall beware lest a woman who is foreseen as going to die be placed in bad faith. Therefore often her grave obligation will have to be passed over in silence.

On Ecclesiastical Penalties. "Those procuring abortion, the mother not excepted, incur, the effect having followed, excommunication latae sententiae reserved to the Ordinary; and if they are clerics, they are besides to be deposed" (c. 2350 §1). - "They are irregular from delict.... 4° Those who.... have provoked abortion of a human fetus, the effect having followed, and all cooperators" (c. 985, 4°).

They procure abortion who, by physical or moral action, efficacious and with direct intention, bring it about that a fetus not dead is expelled before seven months from conception. By the new law, from c. 2209 §§1-3, those commanding, and those furnishing positive and necessary cooperation, such as physicians, are comprehended by the censure; also those who, on account of a further good end, exercised an illicit abortion. Concerning the cooperation of a pharmacist who merely sells a potion, it will be more difficult to establish that it was necessary. The mother herself is no longer immune from censure. Yet one who has yielded to grave extrinsic fear escapes the censure. - But the censure is incurred from the moment at which the fetus is ejected, from the means applied. - If someone repents before the effect has followed, so that he has received absolution, he seems immune from the censure, which cannot now accede to the sin as accessory. If otherwise, without use of the sacrament of penance, he sincerely has grieved, today from can. 2209 §5 compared with 2229 §3, he seems to be held by the censure (cf. also c. 2231).

N. B. In interpreting the present censure, certain authors, although they wrote after the Code, seem to have passed over canons 2209, 2229-2231. Thus Pighi, Curs. theol. mor., l. 3, nn. 551, 552.

Craniotomy, although graver in itself, since it is plainly distinct from abortion, is not affected by this censure.

But irregularity today receives the same interpretation as the censure. Cooperators, however, seem to be positive cooperators only (from c. 2231), although Cerato (Censurae vigentes, n. 161, p. 229) also comprehends negative cooperators. Cf. Gen., I, 634; Pighi, l. 3, n. 602. But those who have exercised craniotomy do not escape irregularity from homicide.

— Indirect abortion, on account of a grave and proportionate cause, is admitted by all. For then another good effect is intended or chosen, which can be obtained by no other way, and the expulsion of the fetus is actively permitted.

But "in practice it is not always easy to discern whether a certain medical action is a direct or indirect killing of the fetus" (Prummer, II, 141). That it be indirect, no utility can be sought from the expulsion itself of the fetus, as such, or from the grave wound inflicted upon it.

Cases. 1. Therefore a mother affected by a lethal disease can use necessary remedies which, at the same time as they cure the disease, induce the danger of abortion; the very uterus morbidly affected, which cannot be tolerated longer without danger of life, can be taken away from her. And these things are certain.

2. But is it lawful, for replacing the uterus, to evacuate the liquid of the amnion? This is controverted. Certainly incision of the amnion is the most usual mode of procuring abortion. But, in the case, the incision is not made so that abortion may follow, but so that the uterus, which by its collapse brings the mother into danger of life, may be restored to its place. Hence you would say the matter is lawful. Yet a difficulty again arises from this, that that liquid is contained by a membrane which pertains to the fetus. Therefore the incision seems to have the nature of a lethal wound. Wherefore the matter is disputed, and the negative parts seem truer, unless, by an incision or puncture prudently made, by which only a part of the liquid flows out, the abortion itself can probably be avoided and follows only per accidens. And similar difficult cases can arise where the fetus itself seems to exercise an action positively and gravely harmful.

3. Therefore if, by new increases of science, similar difficult cases are proposed where the fetus itself, not simply as fetus, but, for example, as morbid, seems to exercise an action positively and gravely harmful, nothing is to be established precipitately, but the case is to be subjected to serious examination, with the principle always firm that no utility can legitimately be obtained through an action directly occisive as through a means.

Abortion, gentlemen, is the theme of my present lecture.

I. An important point to be determined is the precise time when the human embryo is first animated by its own specific principle of life, its human soul. It is interesting to read what various conjectures have been ventured on this subject by the learned of former ages. They were totally at sea. Though gifted with keen minds, they had not the proper data to reason from. And yet some of those sages made very shrewd guesses. For instance, as early as the fourth century of our era, St. Gregory of Nyssa taught the true doctrine, which modern science has now universally accepted. He taught that the rational soul is created by Almighty God and infused into the embryo at the very moment of conception. Still, as St. Gregory could not prove the certainty of his doctrine, it was opposed by the majority of the learned.

The Schoolmen of the Middle Ages, while condemning abortion from the time of conception, preferred the opinion of Aristotle, that the rational soul is not infused till the fœtus is sufficiently developed to receive it. The embryo lived first, they taught, with a vegetable life; after a few days an animal soul replaced the vegetative principle; the human soul was not infused into the tiny body till the fortieth day for a male, and the eightieth day for a female child. All this sounds very foolish now; and yet we should not sneer at their ignorance; had we lived in their times, we could probably have done no better than they.

It was not till 1620 that Fienus, a physician of Louvain, in Belgium, published the first book of modern times that came near the truth. He maintained that the human soul was created and infused into the embryo three days after conception. Nearly forty years later, in 1658, a religious priest, called Florentinius, wrote a book in which he taught that, for all we know, the soul may be intellectual or human from the first moment of conception; and the Pope’s physician Zachias soon after maintained the thesis as a certainty that the human embryo has from the very beginning a human soul.

Great writers applauded Fienus and his successors; universities favored their views; the Benedictines, the Dominicans, and the Jesuits supported them. Modern science claims to have proved beyond all doubt that the same soul animates the man that animated the fœtus from the very moment of conception. The “Medical Jurisprudence” of Wharton and Stillé quotes Dr. Hodge of the Pennsylvania University as follows (p. 11): “In a most mysterious manner brought into existence, how wonderful its formation! Imperfect in the first instance, nay, even invisible to the naked eye, the embryo is nevertheless endowed, at once, with the principles of vitality; and although retained in the system of its mother, it has, in a strict sense, an independent existence. It immediately manifests all the phenomena of organic life; it forms its own fluids and circulates them; it is nourished and developed; and, very rapidly from being a rudis indigestaque moles, apparently an inorganic drop of fluid, its organs are generated and its form perfected. It daily gains strength and grows; and, while still within the organ of its mother, manifests some of the phenomena of animal life, especially as regards mobility. After the fourth month its motions are perceptible to the mother, and in a short period can be perceived by other individuals on close investigation.

“The usual impression,” the authors add, “and one which is probably still maintained by the mass of the community, is that the embryo is perfected at the period of quickening—say the one hundred and twelfth or one hundred and twentieth day. When the mother first perceives motion, is considered the period when the fœtus becomes animated—when it receives its spiritual nature into union with its corporeal.

“These and similar suppositions are, as has been already shown, contrary to all fact, and, if it were not for the high authorities—medical, legal, and theological—in opposition, we might add, to common-sense.”

At present, gentlemen, there seems to be no longer any authority to the contrary. But many people, and some Doctors, seem to be several generations behind the times; for they still act and reason as if in the first weeks of pregnancy no immortal or human soul were in question.

Physicians worthy of their noble profession should strive to remove such gross and mischievous ignorance. In many of the United States the law casts its protection around an unborn infant from its first stage of ascertainable existence; no matter whether “quickening” has taken place or not, and consequently no matter what may be the stage of gestation, an indictment lies for its wilful destruction (Wharton and Stillé, p. 861). “Where there has been as yet no judicial settlement of the immediate question, it may be reasonably contended that to make the criminality of the offence depend upon the fact of quickening is as repugnant to sound morals as it is to enlightened physiology” (ib.). “That it is inconsistent with the analogies of the law is shown by the fact that an infant, born even at the extreme limit of gestation after its father’s death, is capable of taking by descent, and being appointed executor” (ib.). Dr. Hodge adds this sensible remark: “It is then only [at conception] the father can in any way exert an influence over his offspring; it is then only the female germ is in direct union with the mother—the connection afterwards is indirect and imperfect” (ib.). The fact, therefore, is now scientifically established that the embryo from the first moment of conception or fecundation is a human being, having a human immortal soul.

II. Now we come to the direct study of abortion. Abortion, or miscarriage, strictly means the expulsion of the fœtus before it is viable, i.e., before it is sufficiently developed to continue its life outside of the maternal womb. The period of arrival at viability is usually after the twenty-eighth week of gestation. When birth occurs later than that period, and yet before the full term of nine months, it is called premature birth, which is altogether different from abortion; for it may save the life of the child, which abortion always destroys. “Premature labor is frequently induced in legitimate medical practice, for the purpose of avoiding the risks which in some cases attend parturition at term.... The average number of children saved by this means is rather more than one-half of the cases operated upon,” say Wharton and Stillé (“Parturition,” p. 96). But they caution the physician against too ready recourse to this treatment; for, they add very truly, “The sympathetic phenomena of pregnancy are often more alarming in appearance than in reality, and will rarely justify any interference with the natural progress of gestation. In all cases the physician should consult with one or more of his colleagues before inducing premature labor; in this manner his humane intentions will not expose him, in case of failure, to reproach, suspicion, or prosecution.”

The first time my attention was practically called to the case of a child in danger of dying before the time of delivery occurred over twenty years ago, when the mother of a highly respected family, then in my spiritual charge, was wasting away with consumption during her state of pregnancy. You know that we Catholics are very solicitous that infants shall not die without Baptism, because we believe that heaven is not promised to the unbaptized. I therefore directed the lady’s husband to consult their family physician on the prospects of the case, and take timely precautions, so that, if death should come on the mother before her delivery, the infant might be reached at once and be baptized before it expired. The physician, a learned and conscientious practitioner, answered that we should not be solicitous; for that Nature had so provided that mothers in such cases rarely die before the child is born. He was right. The child was born and baptized; the mother died a few hours later; the little one lived several weeks before it went to join the angels in heaven. I learned from that occurrence the lesson which Wharton and Stillé inculcate that “the phenomena of pregnancy are often far more alarming in appearance than in reality, and we are rarely justified in interfering with the natural progress of gestation.”

To return to our subject. Abortion, or miscarriage, is often, as you know, gentlemen, the result of natural causes beyond human control; at other times it is brought on by unintentional imprudence on the part of the mother or her attendants. It is the duty of the family physician, when occasions offer, to instruct his pregnant patients and other persons concerned on the dangers to be avoided. A good Doctor should be to his patients what a father is to his children; very important matters are confided to him, and therefore grave responsibilities rest on his conscience.

III. We are now ready to consider the chief question of this lecture, namely, whether there can be any cases in which a physician is justified in bringing about an abortion, or in prescribing a treatment from which he knows an abortion is likely to result.

1. It is evident that, if he acts with due prudence, and yet, from some cause which he did not foresee and could not have been foreseen, his treatment brings about a miscarriage, he cannot justly be held accountable for what he could not help.

2. But what if he foresees that a drug or treatment, which, he thinks, is needed for the mother’s health, may perhaps bring on a miscarriage? Can he still administer that drug or prescribe that treatment? Notice the question carefully. It is not supposed that he wants to bring on the miscarriage. He does not; he will do all he can to prevent it. Nor will his treatment or drug directly destroy the life or the organism of the embryo; but it is intended to affect favorably the system of the mother, and it is applied to her own organism. Still the Doctor knows that the prescription may indirectly bring about abortion. Can he prescribe the drug or treatment from which he knows the death of the fœtus may indirectly result, the direct purpose being to remove an ailment of the mother’s?

There is a sound moral principle bearing on such cases; it is universally admitted in Ethics and Jurisprudence, and its application is so extensive that it well deserves careful study. It is this: “He who wilfully puts a cause is answerable for the effect of that cause,” causa causæ est causa causati. Therefore, if the effect is evil, he is answerable for that evil. This, however, supposes that he could foresee the danger of such evil effect.

That evil effect is said to be indirectly willed; for it follows from a cause which is directly willed. If, then, you should give a dose to a pregnant mother which is intended to stop her fever or other ailment, but may also bring on abortion, the stopping of her fever is directly intended, and the abortion is said to be indirectly intended or willed. Those are the received terms in moral science. It were more correct to say that the abortion in this case is an effect not intended at all, but only permitted. That, then, which is permitted to result from our acts is said to be indirectly willed.

Are we then always responsible for evil effects permitted or indirectly willed? The principle laid down seems to say so. But then that principle admits of important exceptions. If we could never do an act from which we know evil consequences may follow, then we could scarcely do anything of importance; a young man could certainly not become a physician at all, for he is almost certain to injure some of his patients in the course of his professional life. But if we had no Doctors, such a loss would be a much greater evil to mankind than their occasional mistakes. Here then we seem to be in a dilemma, with evil on both sides of us. And then we are reminded of that other principle of which we spoke before, that we may never do evil at all that good may come of it. What shall we do? The solution is this: we should never do evil, but we are often justified in permitting evil to happen; in other words, we can never will evil directly, but we can often will it indirectly: we can do what is right in itself, even though we know or fear that evil will also result from our good act.

This conduct requires four conditions: 1. That we do not wish the evil itself, but make all reasonable effort to avoid it. 2. That the immediate effect we wish to produce is good in itself. 3. That the good effect intended is at least as important as the evil effect permitted. 4. That the evil is not made a means used to obtain the good effect.

Now let us apply these principles to the case in hand.

1. If the medicine is necessary to save the mother’s life, and it is not certain to bring on abortion, though it is likely to do so, then the good effect is greater and more immediate or direct than the bad effect; then give the medicine to save the mother, and permit the probable death of the child.

2. If the medicine is not necessary to save the mother’s life, though very useful, for the sake of such an advantage, you cannot justly expose the child’s life to serious danger.

3. But if the danger it is exposed to is not serious but slight, and the remedy, though not necessary, is expected to be very useful to the mother, you may then administer the medicine; for a slight risk need not prevent a prudent man from striving to obtain very good results.

4. But what if the drug is necessary to save the mother, and as dangerous to the child as it is beneficial to her; can you then give the medicine with the moral certainty that it will save her and kill her child? When we know principles clearly we can apply them boldly. I answer then with this important distinction: you can give such medicine as will act on her system, her organs, in a manner to save her life, and you may permit the sad effects which will indirectly affect the child; but you cannot injure the child directly as a means to benefit her indirectly; that would be using a bad means to obtain a good end.

Suppose, then, what is said to be a real case of occasional recurrence in obstetrical practice, namely, that a pregnant mother is seized with violent and unceasing attacks of vomiting, so that she must die if the vomiting be not stopped; and you, as well as the consulting physician called in, can discover no means of relieving the vomiting except by procuring an abortion, by relieving the womb of its living burden. Abortion is then the means used to stop the vomiting. Are you justified in using that means? Abortion is the dislodging of the child from the only place where it can live and where nature has placed it for that purpose. Therefore abortion directly kills the child, as truly as plunging a man under water kills the man. Can you thus kill the child to save the mother? You cannot. Neither in this case nor in any other case can you do evil that good may come of it.

You notice, gentlemen, that I lay great stress on, this principle that the end can never justify the means. It is an evident principle, which all civilized nations acknowledge. Its opposite, that the end justifies the means, is so odious that the practice of it is a black stamp of ignominy on any man or any set of men that would be guilty of it. The Catholic Church has, all through her course of existence, taught the maxim that the end cannot justify the means. She has impressed it on the laws and hearts of all Christian peoples. She inculcates it in the teachings of all her theologians and moral philosophers and in all her channels of education. And since we Jesuits are among her leading educators and writers, we have maintained that thesis in thousands of printed volumes, as firmly as I am maintaining it before you to-day. No Jesuit ever, nor any Catholic theologian or philosopher, has taught the contrary. And yet even such pretentious works as the “Encyclopædia Britannica” have carried all over the earth the slander that we teach the opposite maxim, that the end does justify the means, and the odious term Jesuitry has been coined to embody that slander.

Is it not strange then, very strange, that they who thus falsely accuse us are often the very men who will procure an abortion to save the mother’s life, who will do wrong that good may come of it? And you find such men maintaining the lawfulness of abortion on the plea that the operation, whether licit or not, is a necessary means to obtain a good end.

IV. Gentlemen, if once you grant that grave reasons would justify abortion, there is no telling where you will stop in your career of crime. To-day, for instance, you are called to attend a mother, who, you think, must die if you do not bring on a miscarriage. You are urged to do it by herself and her husband, and perhaps by other physicians. There are money considerations too, and the possible loss of practice. Will you yield to the temptation? The next day you are visited by a most respectable lady; but she has been unfaithful to her marriage vow. The consequences of her fall are becoming evident. If her husband finds out her condition, he may wreak a terrible vengeance. Her situation is sadder than that of the sick mother of the preceding day. You can easily remove the proof of her guilt, we will suppose, and spare a world of woes. Will you withstand the temptation? The third day comes a young lady, a daughter of an excellent family; bright prospects lie before her; her parents’ lives and happiness are wrapped up in that girl. But in an evil hour she has been led astray. Now she is with child. She begs, she implores you to save her from ruin, and her parents from despair. If you do not help her, some other Doctor or a quack will do it; but you could do it so much better. If you should have yielded on the two former occasions, if you have already stained your heart with innocent blood, will you now refuse? Where are you going to draw the line?

The passions of men are insatiate, even in modern society; the more you yield to them, the stronger grows their craving. Let me illustrate my meaning by a fact that happened a few years ago in Russia. It is just to our point. During a severe winter, a farmer, having his wife and children with him on a wagon, was driving through a wild forest. All was still as death except the howling of wolves in the distance. The howling came nearer and nearer. After a while a pack of hungry wolves was seen following in the track of the wagon. The farmer drove on faster, but they gained on him. It was a desperate race to keep out of their reach. At last they are just back of the wagon. What can be done? The next moment the wolves may jump on the uncovered vehicle. The children, horrified, crouch near their trembling mother. Suddenly the father, driven to despair, seizes one of the little children and flings it among the pack of wolves, hoping that by yielding them one he may save the rest. The hungry beasts stop a few moments to fight over their prey. But soon they are in hot pursuit again, fiercer because they have tasted blood. A second child is thrown to them, and after a while a third and a fourth.

Human society, gentlemen, in this matter of sacrificing fœtal life is as insatiable as a pack of hungry wolves. Woe to any one of you if he begins to yield to its cravings; there is no telling where he will stop. In proof of my statement, let me read to you an extract from a lecture on Obstetrics, delivered by Doctor Hodge, of Philadelphia, to the medical students of the University of Pennsylvania: “We blush while we record the fact, that, in this country, in our cities and towns, in this city where literature, science, morality, and Christianity are supposed to have so much influence; where all the domestic and social virtues are reported as being in full and delightful exercise; even here individuals, male and female, exist who are continually imbruing their hands and consciences in the blood of unborn infants; yea, even medical men are to be found who, for some trifling pecuniary recompense, will poison the fountains of life, or forcibly induce labor, to the certain destruction of the fœtus and not infrequently of the parent.

“So low, gentlemen, is the moral sense of the community on this subject, so ignorant are the greater number of individuals, that even mothers, in many instances, shrink not from the commission of this crime, but will voluntarily destroy their own progeny, in violation of every natural sentiment and in opposition to the laws of God and man. Perhaps there are few individuals in extensive practice who have not had frequent applications made to them by the fathers and mothers of unborn infants (respectable and polite in their general appearance and manners) to destroy the fruit of illicit pleasure, under the vain hope of preserving their reputation by this unnatural and guilty sacrifice.

“Married women, also, from the fear of labor, from indisposition to have the care, the expense, or the trouble of children, or some other motive equally trifling and degrading, have solicited that the embryo should be destroyed by their medical attendant. And when such individuals are informed of the nature of the transaction, there is an expression of real or pretended surprise that any one should deem that act improper, much more guilty; nay, in spite even of the solemn warnings of the physician, they will resort to the debased and murderous charlatan, who, for a piece of silver, will annihilate the life of the fœtus, and endanger even that of its ignorant or guilty mother.

“This low estimate of the importance of fœtal life is by no means restricted to the ignorant or to the lower classes of society. Educated, refined, and fashionable women, yea, in many instances, women whose lives are in other respects without reproach—mothers who are devoted with an ardent and self-denying affection to the children who already constitute the family—are perfectly indifferent concerning the fœtus in utero. They seem not to realize that the being within them is indeed animate, that it is in verity a human being, body and spirit; that it is of importance; that its value is inestimable, having reference to this world and the next. Hence they in every way neglect its interests. They eat and drink, they walk and ride; they will practise no self-restraint, but will indulge every caprice, every passion, utterly regardless of the unseen, unloved embryo....

“These facts are horrible, but they are too frequent and too true; often, very often, must all the eloquence and all the authority of the practitioner be employed; often he must as it were grasp the conscience of his weak and erring patient, and let her know, in language not to be misunderstood, that she is responsible to her Creator for the life of the being within her.” (Wharton and Stillé’s Med. Jur., Parturition, p. 92.)

Dr. Walter Channing, of Massachusetts, refers to the difficulty of obtaining a conviction for abortion, and adds: “I believe there has never been one in this State, this moral State by eminence, and perhaps in none is this crime more rife.^†” (“Boston Med. and Surg. Journal,” April, 1859, p. 135).

V. We have, then, proved, gentlemen, two important and pregnant principles: 1. That we can never directly procure abortion, and 2, that we can procure it indirectly in extreme cases; or rather that we can take such extreme measures in pressing danger as may likely result in abortion against our will.

While these principles are clear and undoubted, there are cases in which the right application of them is beset with great difficulties. These often occur in connection with what is called ectopic or extra-uterine gestation, namely, when the nascent human form lodges in some recess not intended by nature for its abode. Of late years, Dr. Velpeau, of Paris; Dr. Tait, of Birmingham, and many other eminent physicians have shown that cases of ectopic gestation are more numerous than had been supposed; one practitioner reports that he had attended fifty cases, another eighty-five.

1. We will first suppose the case of an interior growth occurring, the nature of which cannot be determined. It may be only a tumor, yet it may be the growth of a living fœtus. If no immediate crisis is feared, you will wait, of course, for further developments. If it proves to be a child, you will attempt no operation till it becomes viable at least. But suppose that fatal consequences are apprehended before the presence of a human being can be ascertained by the beating of the heart; suppose that delay would endanger the mother’s life; and yet if you undertake to cut out the tumor, you may find it to contain fœtal life. In such urgent danger, can you lawfully perform the operation? Let us apply our principles. You mean to operate on a tumor affecting one of the mother’s organs. The consequences this may have for the child are not directly willed, but permitted. The four conditions mentioned before are hereby verified, under which the evil result, the death of the possible fœtus, may be lawfully permitted; namely: (a) You do not wish its death; (b) What you intend directly, the operation on the mother’s organism, is good in itself; (c) The good effect intended, her safety, to which she has an undoubted right, overbalances the evil effect, the possible death of the child, whose right to life is doubtful, since its very existence is doubtful; now, a certain right must take precedence of a doubtful right of the same species; (d) The evil is not made the means to obtain the good effect (see “Am. Eccl. Rev.,” Nov., 1893, p. 353). This last condition would not be verified if it were proposed, not to cut out the cyst, but to destroy its contents by an electric current. Then, it would seem, the fœtus itself, if there be one, would be directly attacked.

2. The case would present greater difficulties if the growth in question were known to contain a living fœtus. Such a case is discussed in all its details, with remarkable philosophical acumen, and in the light of copious information furnished by prominent members of the medical profession, in the pages of the “American Ecclesiastical Review” for November, 1893, pages 331–360. The participants in this interesting discussion are writers who enjoy a world-wide reputation for keenness of intellect and soundness of doctrine in philosophical and theological learning. They are not at all agreed as to the practical conclusion arrived at, and even those who agree to the same conclusion do so for different reasons. Three of them agree that in the case of a cyst known to contain a living embryo, when a rupture most probably fatal to mother and child is imminent, the abdominal section might be performed lawfully, the cyst opened and the child baptized before its certain death. Two of these justify this conclusion on the principle that the death of the child is then permitted only or indirectly intended; one maintains that the killing of the embryo is then directly procured, but he considers that an embryo in a place not intended for it by nature is where it has no right to be, and therefore may be treated as an unjust aggressor upon the mother’s life. At least one of the disputants condemns the operation as absolutely unlawful.

Gentlemen, when such authorities disagree, I would not presume to attempt a theoretic decision. But then we have this other principle practically to guide us, that in matters so very doubtful we need not condemn those who differ from our view, as long as they feel convinced that they are acting wisely and prudently. In Jurisprudence, reason must be our guide when it affords us evidence of the truth. But when our reason offers arguments on both sides of the question, so that we can arrive at no certain conclusion, then we act prudently by invoking the authority of wiser minds who make moral questions a speciality, and we are perfectly safe if we follow the best authority obtainable.

I. The natural and physiological development of the fetus¹² is that which occurs in the maternal uterus, when the fertilized ovule descends into the uterus and there comes to rest. Moreover, in whatever place of the uterus it comes to rest, there it remains.

¹ We have taken the physiological notions especially from Antonelli, Medicina Pastoralis; we have before us the second edition (1906), which we follow in noting cited words. These can also usefully be consulted: Dr. Capellmann, Medicina Pastoralis; Eschbach, Disputationes Physiologico-Theologicae; Dr. Surbled, La Morale dans ses rapports avec la Medecine; Salsmans, Geneeskundige Plichtenleer; Dr. Vigouroux, Traite de medecine pratique; Vivat, Nederlandsche Encyclopedie; and other works of anatomical or medical science.

² It is so called from the moment at which it has human form, namely from the end of the third month, or the beginning of the fourth month, or, as others speak, after the face begins to be manifested, that is, after 6 weeks; before that it was called embryo (dier- or menschenkiem, lichaamsvrucht), when it acquires a certain development and characteristic form, so that the form of the body and members appears, after 15 days or a little more; at the beginning it is a fertilized ovule. We suppose it known how conception and generation occur. Our little work On Chastity and Lust, p. 13, can be compared.

It is covered by three membranes (eihulsels, eivliezen):

1. The first is called the decidua, from cadere, to fall, because in birth it falls from the mother (la caduque, netvlies or huntervlies).³ This is formed from the mucosa (slijmvlies) of the uterus, which is multiplied and grows around the ovule in such a way that gradually it covers it completely, and between the ovule and the wall of the uterus gives origin to a spongy body of red color which is called the uterine placenta of the mother (moederkoek) and serves for the nutrition of the fetus after the internal nourishment of the egg has been consumed.⁴

³ It is so called from Doctor Hunter.

⁴ The placenta at the time of birth has a thickness of about 3 cm., breadth 15-18 cm., and weight 500 grams.

2. The second is called the chorion, etymologically "envelope" (adervlies or vaatvlies). This is thicker, and on its whole external surface produces many villosities, which remain in one place only, namely toward the wall of the uterus above the placenta of the mother, where they are developed, divided into several branches, which partly penetrate into the placenta of the mother so that the fetus may be nourished, and partly into the blood-filled sinuses of the uterus so that they may bring blood to the fetus. Thus, by its extreme part, the chorion adheres to the wall of the uterus and keeps the whole fetus in the uterus; and since this part corresponds to the placenta of the mother, it is therefore called the placenta of the fetus, because it takes its origin from the ovule itself.

3. The third is the amnios (lamsvlies), which immediately surrounds the whole fetus and is very thin, and can be regarded as, so to speak, a continuation of the skin of the fetus. It contains a whitish liquid (liquide amniotique; lamsvocht, vrucht- or kinderwater), in which the child, immersed, wonderfully floats, and which serves to protect the fetus, and probably, according to some, also contributes to nourishment.

The fetus, however, communicates with the placenta through the umbilical cord (cordon ombilical; navelstreng), which proceeds from the navel all the way to the placenta, about 50-55 cm. long,⁵ 12-15 mm. in diameter. It consists of: a) two umbilical arteries, which are a continuation of the arteries of the hypogastrium (onderbuik) of the fetus, and carry blood from the fetus to the placenta; and b) the umbilical vein, which transfers blood from the placenta to the fetus. Hence the blood of the fetus is in no way mixed with the blood of the mother, but the circulation is altogether closed and independent of the mother's circulation.

⁵ Sometimes longer, and then it surrounds some part of the fetus, namely the neck, arm, leg, and trunk itself, while it is wound several times upon itself.

The first membrane is of maternal origin; the other two, like the cord, are of fetal origin.⁶

⁶ Concerning the preceding, see Antonelli, cited work, t. I, n. 238-239.

II. "The whole time during which the fetus remains in the uterus is called pregnancy (gestation, grossesse; zwangerschap), and ordinarily runs through a space of nine months or about 280 days, that is, ten lunar months.⁷ During pregnancy, the uterus generally preserves an oval form, because the infant is inverted, namely, it has the head lower and the rest of the body higher, the legs bent against the belly, the knees, which are somewhat disposed crosswise, against the legs, and the arms, after the manner of a cross, before the breast. This state of the fetus is ordinary and normal; sometimes, however, the fetus has the head higher and the rest of the body lower, or is situated transversely, so that it presents its side to the opening of the uterus. In these anomalies of position, birth requires the help of a surgeon. During pregnancy, the opening of the uterus is closed by a certain mucous covering."⁸ Meanwhile, around the fifth month, the breasts of the mother increase in volume and prepare the production of milk.

⁷ We are accustomed to make the computation in the vulgar manner in solar months, except under n. V, where the whole progress of fetal development is described more scientifically.

⁸ Antonelli, cited work, t. I, n. 240.

As to the signs of pregnancy,⁹ it must be said that in the first times there are not absolutely certain indications from which it can be affirmed that pregnancy is present, because the changes which occur at this time can have other causes.

⁹ Antonelli, cited work, t. I, n. 242-243. It is not useless to know these. For girls sometimes greatly fear that they are pregnant, sometimes to such a degree that they procure abortion for themselves, or prepare an end of life for themselves by suicide. Hence the confessor can render them tranquil.

Some signs are merely presumptive, such as a sense of languor, a certain general weakness, depression of spirit, pains of the head and teeth, and vomiting, especially in the morning.

Others are probable and quasi-certain, such as the suppression of the menstrual flow in a woman who previously had regular menses (regles: maandstonden);¹⁰ changes in the genitals and, in part, the size of the belly and uterus, which moreover can grow from other causes; greater secretion of the female genital canal and swelling of the breasts, which also can secrete milk. Yet this secretion of milk, although it is a very probable sign of pregnancy, nevertheless does not indicate absolutely that fertilization has occurred. For it is certain that sometimes women, after birth, preserve milk in the breasts for several months, years, and even the whole of life; sometimes women who have never conceived, and who were suffering from various diseases of the uterus, ovaries, tubes, and peritoneum, have been subject to this secretion of milk, which can be renewed as often as the aforesaid inflammations again have place.

¹⁰ Let it be noted, however, that the menses can cease also because of other causes, and that even during the time of pregnancy they can appear once or twice, because ordinarily, when a flow of blood is observed several times in pregnant women, it is not referred to the menses, but to uterine hemorrhages of an altogether diverse nature.

The certain signs are: 1. internal exploration to be made by a physician or midwife, from which the presence of a fetus in the uterus can be known; nevertheless deception can be possible because of certain diseases which can produce similar effects; 2. active motions of the fetus, which, when they are known with certainty, indicate certain pregnancy, at least from the sixth month; 3. pulsations of the heart of the fetus to be heard especially by means of the stethoscope, which is a certain instrument of auscultation, already in the fifth month.

III. Birth¹¹ (accouchement; bevalling) consists essentially in the expulsion of the fetus by contractions of the muscles of the uterus. These contractions rupture the membranes enveloping the fetus; from this it happens that the amniotic liquid begins to flow. Vehement pains accompany birth. The placenta and membranes of the fetus, after birth, are called the afterbirth, because after the birth they fall in the second place from the bosom of the mother (la delivre, l'arriere-faix; de nageboorte, het vuil).

¹¹ Antonelli, cited work, t. I, n. 241.

After birth, great fatigue holds the woman; a flow of blood follows for several days, 10-15, because of the placenta separated from the uterus; but the uterus, birth having been completed, immediately contracts. After six weeks or two months, it acquires almost its primitive volume.¹² The time which immediately follows birth is called the puerperium (couches; kraam, kraam- or kinderbed); at this time, the woman needs particular care.

¹² The ordinary dimensions of the uterus in the normal state differ from virgins to multiparas, namely from about 60 mm. to 68 mm. in length, and from 38 to 43 mm. in breadth.

When the infant has been born, the breasts become places of particular activity, by which they immediately secrete milk. This physiological labor brings about in the whole body of the woman a certain reaction, which is accompanied by a special fever, called from the milk. Namely, on the second or third day after birth, the breasts become hard, are affected by pain, and fever appears, which ordinarily ceases after 24 hours, or sometimes sooner. After this, the secretion of good milk is definitively established. The first milk is rather liquid, insufficient for nourishing, and is called colostrum (biest). Yet it is useful to the infant, for whom it serves, as a light purgation, to eject the meconium which, during the time of intrauterine life, the stomach and intestines contained. Colostrum, however, gradually undergoes some changes and becomes true milk, so that after two or three days the elaboration and secretion of milk becomes perfect.¹³

¹³ Antonelli, cited work, t. I, n. 241 and 479.

During the time of lactation, ordinarily, the menses are suspended; when lactation ceases, the milk gradually diminishes and the menses reappear. But if the menses begin to flow before the end of lactation, the secretion of milk is generally diminished.

IV. Abortion¹⁴ is the premature expulsion from the uterus of the mother of a fetus that is immature (onrijpe vrucht), namely, not viable (niet leefbare vrucht), from a natural or artificial cause (avortement, fausse couche; miskraam, misval, misgeboorte, vruchtafdrijving). Hence obstetrical abortion consists in provoking birth before the fetus is viable, and therefore when it can in no way live outside the uterus (kunstmatige vruchtafdrijving).

¹⁴ Antonelli, cited work, t. I, n. 416. Cf. below, Question 5 and II, Question 4.

On the contrary, premature or accelerated birth (accouchement premature; vroeggeboorte or vroegbevalling) is the expulsion of a fetus already viable but not fully mature. Artificial premature birth (kunstmatige vroeggeboorte) consists in provoking birth before pregnancy is complete, around the seventh or eighth month, or even sometimes in the sixth month, especially if special care is present by means of artificial incubation (couveuse d'enfant; broeikasje).

V. Phases of development. The egg which is expelled through abortion is ordinarily expelled enveloped in membranes, and has varying size according to the time of development¹⁵ (ontwikkelingsgeschiedenis).

¹⁵ Antonelli, cited work, t. II, n. 21. The numbers which are handed down for dimensions or weight have been taken from various authors compared with one another, and indicate a certain mean between various possible extreme cases.

In the first month: at the end of the second week, after 12-13 days, the embryo has a size of 2 mm. and the egg 6 mm.¹⁶ In the third week, the head is indicated in a round form; the members are indistinct, but the rudiments of extremities are visible; the heart probably already beats; no distinction appears from the embryo of animals, birds, reptiles. The embryo has a scaphoid form (forme de nacelle; bootvormig), length 4 mm. At the end of the month, the length is 7.5 mm. up to 11-13 mm., and the ovule has the size of a hazelnut.

¹⁶ We recall to memory that the ovule is 0.2 mm. and the zoosperm 0.05 mm.

In the second month, the head is very large, almost half the embryo; the extremities are perfectly articulated, and the face begins to be manifested. The length is found to be 13-16 mm. up to 2-3 cm. In the sixth week the placenta is formed.

In the third month, it is now nourished by the blood of the mother, whence it begins to be developed more rapidly. At the end of the month, the form of the body is perfect: the fingers and toes are well seen; the genitals, perhaps even the external ones, begin to be changed according to sex; the fetus is 7-9 cm. in length and 15-20 grams; the egg has the size of a common duck's egg.

In the fourth month, the sex is easily seen; the fetus is 10-13 cm. long, of 120-150 grams weight.

In the fifth month, hair appears on the head, and also nails on the members; if at this time it is brought forth alive, pulsations of the heart are perceived from its beating against the breast. Sometimes it breathes for a short time, but quickly dies. The length is 13-27 cm., the weight 250-300 grams.

In the sixth month, it has the eyelids open, the skin is covered with pigment, fat is formed under the skin. It makes some inspirations, moves the extremities, but almost immediately dies. The length is 28-34 cm.; weight 700-1000 grams.

In the seventh month, the form of the body appears more rounded, the appearance more beautiful. It acquires a stable position so that it no longer floats in the amniotic fluid. If alive, it cries with a thin voice; generally it dies; sometimes, however, with special cares applied, it is preserved. The length is 35-38 cm.; weight 1000-1500 grams.

In the eighth month, the length is 40-43 cm.; weight 1500-2000 grams. Those born at this time can live, although many die in the first hours or days after birth.

In the ninth month, the length is 46-48 cm.; weight 2500-3000 grams. There is a greater quantity of fat under the skin. Those born at this time ordinarily live, although their mortality is not very small.

In the tenth month, the length is 48-50 cm., indeed up to 53 cm.; weight 3000-3800 or even 4000 grams. The cartilages of the nose and ears are, at the beginning of the month, very soft; the nails increase; and finally the fetus exhibits the characters which are noted in perfect pregnancy. Complete maturity is present.

VI. Pregnancy can also be unnatural, namely extrauterine or ectopic (buitenbaarmoederlijke zwangerschap), by which the fetus is developed outside the uterus, for example in the tubes (eileiders), in the ovary (eierstok), or in the cavity of the abdomen, where it is applied to some intestine of the mother and thus begins to grow.¹⁷ In the first months it is very difficult to discern an extrauterine fetus from a tumor or from a uterine fetus. Generally before the fourth month it perishes from anemia or oppressed by the maternal viscera, or the pregnancy has an end before the time because of rupture of the membranes enveloping the fetus;¹⁸ sometimes the fetus pursues perfect development but cannot be born. In either case the life of the mother is constituted in great danger, though not always.¹⁹

¹⁷ Antonelli, cited work, t. I, n. 244-246.

¹⁸ From this there arises hemorrhage which can bring death to the mother through anemia.

¹⁹ Death is incurred in the proportion of 68%.

Both pregnancies, uterine and extrauterine, can exist at the same time. But the causes which induce extrauterine pregnancy are many: on one side, zoosperms can pass from the tubes into the ovary or into the abdomen, the latter of which is sufficiently understood from the fact that the tubes are not always perfectly adapted to the ovary; and on the other side, the ovule can be impeded from descending into the uterus; an ovule having descended into the uterus can enter the opposite tube; a fertilized ovule can pass from the uterus or from the tube, because of some rupture, into the cavity of the abdomen.

Let it be noted that such pregnancy supposes a uterus; if this does not exist or has been removed, no pregnancy is possible: the uterus is the necessary way for the passage of the sperm.

VII. False pregnancies²⁰ are appearances of pregnancy. Sometimes:

²⁰ Antonelli, cited work, t. I, n. 249.

1. a fertilized ovule after some time dies, and the placenta and other parts of the fetus grow in such a way that fleshy moles (vleeschklomp) are generated;

2. because of occlusion of the neck of the uterus, the menstrual blood, since it cannot flow, remains in the uterus, which is enlarged more and more, so that for some months it can feign pregnancy;

3. in the uterus certain vapors are accumulated by which the uterus is inflated, simulating pregnancy; the absence of pregnancy is very well known from the sound obtained by percussion of the belly.

Likewise imaginary pregnancies²¹ are not rarely noted in women. This occurs more often among women who vehemently desire or fear to become mothers, for example those who are close to menopause; unmarried women who are very nervous and hysterical; those who have lost their first children or, having been deprived of a first husband, think that they ought to be fertile with another man. The thought of maternity so disturbs them that they quickly come into the firmest persuasion that they must be pregnant, even though they experience the menses regularly,²² and with every effort they seek to persuade the physician concerning this supposed pregnancy; indeed, they observe the breasts to be enlarged, vomiting to appear, that they suffer nausea, and that they experience the desires of pregnant women.

²¹ Antonelli, cited work, t. I, n. 250.

²² Even by imagination the menses can be absent; then the time must be awaited, in order to remove every doubt, at which the pulsations of the heart of the fetus can be heard, that is, to the fifth month.

VIII. Anomalies which are sometimes noted in the body of man, and often generate horror, are called monsters, especially when in the fetus the species of the human body is totally or notably deformed.²³ For the human body does not always present all the regular anatomical and physiological organs which constitute a truly normal man, and often bears before itself several irregularities of greater or lesser moment, monstrosities, deviations from the normal type, which necessarily induce not slight physiological changes.

²³ Antonelli, cited work, t. I, n. 263 and 307. Anomalies can affect one or several organs, and be slight or grave. Cf. below II, Question 5.

They are distinguished into simple, and double or twinned, according as one fetus is born, or two twin fetuses adhering to one another, whether equally or unequally developed.

The causes are several: some preceding fertility, for example a morbid anatomical or physiological state of the parents, weakenings, alcoholism, heredity; likewise the physical state or conditions of the ovule or zoosperm or of both. Others are consequent, such as the action of the nervous system which, being moved by moral causes, can bring changes in the circulation of the fetus and in the contractions of the uterus; external mechanical pressures; diseases of the fetus and of the membranes; the development of several fetuses; the umbilical cord, which can surround and constrict several parts of the body; particular deviations and changes of development in the fetus.

137. Definition. Abortion is the ejection of an immature living fetus from the maternal womb.

It is said: of an immature fetus, i.e., one who outside the maternal womb will certainly and soon die. Physiologists are accustomed to call a man in the maternal womb up to the first month after conception an embryo,¹⁷² and afterward a fetus, which fetus indeed is considered viable, or able to live outside the maternal womb, around about the seventh month of gestation. For grave causes physicians sometimes licitly cause the artificial birth of a viable fetus, as will be said below. This birth indeed is the premature bringing-forth of a fetus, but it is not abortion properly speaking, because after such premature birth the fetus can live; on the contrary, the ejection of an immature fetus necessarily causes his death. Therefore one thing is acceleration of birth (artificial birth), another thing is abortion.¹⁷³

¹⁷² Some physiologists call the female ovule fecundated by semen, during the first two weeks, an ovum, and then up to the fifth week give it the name of embryo.

¹⁷³ In German the acceleration of birth is called Frühgeburt, but abortion is called Fehlgeburt.

138. Divisions. 1. A twofold abortion is distinguished: accidental, which occurs by chance without any intention on the part of man; artificial, which is procured intentionally. Moreover, the procurement of abortion is one thing direct, another thing indirect. It is called direct if the means employed of themselves and immediately kill and expel the fetus. But it is called indirect if the means employed of themselves and immediately are ordered to the health of the mother, but by accident and beyond the intention (although not beyond foresight) expel the fetus.

2. A twofold fetus is distinguished: animated and inanimate, according as it has or does not have a rational soul. Several Holy Fathers, e.g., Gregory of Nyssa,¹⁷⁴ Basil the Great,¹⁷⁵ likewise St. Maximus, Meletius, Tertullian, and all the Traducianists taught that the rational soul is in the fetus from the first instant of conception. The same is today admitted rather commonly by physiologists. But Aristotle and very many older theologians, e.g., Cassiodorus, Theodoretus, Gennadius, St. Anselm, Peter Lombard, St. Thomas, and almost all the Scholastics (who teach that the soul is the substantial form of the body) affirm that the rational soul is not infused into the embryo before it is sufficiently formed and capable of receiving its substantial form. Now this sufficient formation is had in a male fetus around 40 days, but in a female fetus 80 days after conception. Before this time the embryo indeed lives, and indeed even by a life of its own, but the vivifying principle is something vegetative or merely animal.¹⁷⁶ The Scholastics chose this determination of time chiefly because of the law of the Old Testament prescribing a purification of 40 or 80 days, according as women bore a boy or a girl.¹⁷⁷ The opinion of the Scholastics is more conformable both with the philosophical doctrine concerning the soul as the substantial form of the body, and with Sacred Scripture, where it is had according to the version of the Septuagint:¹⁷⁸ "If anyone strikes a woman having in the womb and she miscarries, if the fetus has not been formed, he shall be fined with money; but if it has been formed, he shall give life for life." Therefore there is given a formed or animated fetus and a non-formed or inanimate fetus. He who commits abortion of an animated fetus commits homicide, and consequently must give life for life. But otherwise homicide is not present, and consequently there is only a monetary penalty. Besides, this opinion is much milder. For if from the first instant of conception a rational soul is present, the number of infants dying without baptism is perhaps ten times greater, since abortions are much more frequent especially in the first weeks after conception. - Whatever may be the value of each opinion, this one thing is certain: that the rational soul is in the fetus before birth. For on March 2, 1679, Innocent XI condemned the proposition (35): "It seems probable that every fetus, as long as it is in the womb, lacks a rational soul, and then first begins to have it when it is born, and consequently it will have to be said that in no abortion is homicide committed."¹⁷⁹ Neither in theology nor in canon law is there now any further distinction made between an animated and a non-animated fetus.

¹⁷⁴ De hom. opif. c. 28.

¹⁷⁵ Canonical Epistle I to Amphilochius.

¹⁷⁶ Cf. S. theol. 1, q. 76, a. 3 ad 3, and q. 118, a. 2 ad 2.

¹⁷⁷ Lev. 12, 2.

¹⁷⁸ Ex. 21, 22. - The text of the Vulgate and the Hebrew text have another reading.

¹⁷⁹ Denz. n. 1185.

139. Principle 1. The acceleration of birth of a viable fetus is licit for grave reasons.

The reason is that in this way, indeed, the offspring is accustomed to remain weak throughout the whole life; indeed some danger of life arises both for the mother and for the offspring, yet that danger is not so imminent. But it is lawful from a grave cause to expose life to danger. - A sufficient reason for accelerating birth in this way is the infirmity of the mother, or the difficulty or impossibility of bearing a perfectly mature fetus. - Thus also the Holy Office responded on May 4, 1898: "The acceleration of birth is not illicit of itself, provided it is performed for just causes and at that time and in those ways by which, from ordinary contingencies, care is taken for the lives of the mother and the fetus."

140. Principle 2. For grave reasons it is lawful indirectly to procure abortion.

This principle follows from the rules given concerning the indirectly voluntary. For it is lawful to place a good or indifferent cause from which a double effect follows, one good, the other bad, if there is a good intention and a proportionately grave reason. Therefore it is lawful to provide to a mother laboring under a dangerous illness, which cannot be cured in another way, a remedy which directly and immediately tends to the cure of the disease, although abortion is sometimes connected with it by accident. Such remedies are certain medicines which are given by way of medicine; besides these, diverse baths, injections made under the skin or in other places, bloodletting (commonly, Aderlaß), etc.¹⁸⁰ Indeed, absolutely speaking, it is lawful to excise the pregnant uterus itself affected by disease, if, this operation being omitted, the death of the mother would certainly follow. For the sick mother has a strict right that her sick members be cured. But if from such a cure the death of the fetus follows, this death is caused not directly, but indirectly.¹⁸¹ - As is plain of itself, such remedies may not be employed unless true and ineluctable necessity exists.

But when by remedies of this kind abortion has occurred beyond the intention, the fetus brought forth is to be baptized at least conditionally as quickly as possible, that his soul may be saved. How such baptism is to be administered, see below III, n. 131.

¹⁸⁰ Cf. Capellmann-Bergmann, Pastoralmedizin 19th ed., p. 37 sqq.

¹⁸¹ Cf. Noldin, De praeceptis n. 341.

141. Principle 3. It is never lawful directly to procure the abortion of a living fetus.

It is said: of a living fetus. For if the fetus is certainly dead, it is lawful to extract it from the womb of the mother, as is plain of itself. But the death of the fetus ought not to be presumed, but proved. The enunciated principle is easily proved. For a) the direct procurement of abortion is the direct homicide of an innocent man. But it is never lawful directly to kill an innocent man. Therefore the direct procurement of abortion is never lawful. For a living fetus is a man consisting of body and soul; but according to the opinion of those who teach that the rational soul does not arrive except after 40 or 80 days, the fetus before this time has elapsed is a man in becoming and certainly will be a man unless it is impeded. Hence Innocent XI proscribed proposition (34): "It is lawful to procure abortion before the animation of the fetus, lest a girl discovered to be pregnant be killed or dishonored."¹⁸² - b) Through the procurement of abortion there is caused to an animated fetus not only death of the body, but also death of the soul, since baptism can very rarely be conferred, or at least in fact is conferred very rarely. - c) In the year 1889, on Aug. 19, the Holy Office responded to the Archbishop of Cambrai, who had set forth six diverse ways of procuring abortion: "In Catholic schools it cannot safely be taught that the surgical operation which they call craniotomy is licit, as was declared on May 28, 1884, nor any surgical operation whatsoever directly killing the fetus or the pregnant mother." - From all these things it is manifestly plain that direct procurement of abortion is never lawful. Thus today all Catholic theologians also teach, with some of the older ones contradicting, e.g., Caramuel,¹⁸³ especially if the fetus is not yet animated.¹⁸⁴

You ask what the direct procurement of abortion is. In practice it is not always easy to discern whether some medical action is the direct or indirect killing of the fetus. Let this be the rule: If by such an action or medicine the fetus is directly touched, it seems it must be called direct procurement, e.g., incision of the amnion,¹⁸⁵ which today is the most usual mode of procuring abortion. But if from such an action or medicine there arises indeed a greater or lesser danger of abortion, yet the fetus is not directly touched and abortion is not directly intended, it seems to be only indirect procurement.¹⁸⁶ - As has already been said above, even this indirect procurement of abortion is not lawful unless grave necessity demands it. Hence women sin (at least by a depraved intention) who, fearing that they are pregnant, provoke menstruation again in various ways, e.g., by washing the feet in water seasoned with salt or mustard, by taking expulsive drinks, by compressing the abdomen, by dancing in an excessive manner, etc.; nevertheless, since in the first months after carnal intercourse has been had it cannot be known certainly whether the woman has conceived, therefore the penalties passed against those procuring abortion are not incurred.

¹⁸² Denz. n. 1184.

¹⁸³ Caramuel, Theol. fund. n. 1653.

¹⁸⁴ Cf. St. Alphonsus, Theol. mor. l. 3, n. 394.

¹⁸⁵ Eihäutstich. I have written more broadly on direct and indirect procurement of abortion in Linz. Theol. Quartalschr. (1921) p. 565-576.

¹⁸⁶ Concerning this matter the response of the Holy Office on July 24 (25), 1895, must be noted: "Titus, a physician, when he was called to a pregnant woman lying gravely ill, commonly observed that no other cause underlay the lethal disease except the pregnancy itself, that is, the presence of the fetus in the womb. Therefore one way alone was at hand for him, in order to save the mother from certain and imminent death, namely to procure abortion or the ejection of the fetus. He commonly entered upon this way, yet employing means and operations of themselves and immediately not indeed tending to this, that they should kill the fetus in the maternal womb, but only that they should remove it from there, and that the fetus, if it could be done, should be brought forth alive to the light, though certainly about to die soon, since it is supposed still altogether immature.... Titus asks whether he can safely undertake the stated operations in the repeated said circumstances. Resp.: In the negative, according to the other decrees, namely of May 28, 1884, and Aug. 19, 1889. His Holiness approved." - Therefore the aforesaid operation is had as direct procurement of abortion. On account of this decree Lehmkuhl retracted the opinion previously proposed, namely that a violent invasion upon the fetus and its vital element could be done licitly in order to save the mother otherwise about to perish (cf. Lehmkuhl, Theol. mor. I, n. 1006).

142. Penalties against those procuring abortion.

The antiquated laws being omitted,¹⁸⁷ according to the current ecclesiastical discipline, by common law the following penalties are inflicted upon those procuring abortion:

1. Excommunication reserved to Ordinaries.

The Code of Canon Law c. 2350, § 1 establishes: "Those procuring abortion, the mother not excepted, incur, the effect having followed, a latae sententiae excommunication reserved to the Ordinary; and if they are clerics, besides this they are to be deposed." For incurring this penalty it is required that the abortion has certainly followed. Hence if someone has vainly attempted to procure abortion, or if it is doubtful whether a fetus truly had been conceived (which happens very often), the excommunication is not incurred. In ancient times this censure was not present if the aborted fetus was inanimate, but today every direct procurement of abortion induces the penalty of excommunication. - Under the name "those procuring" are comprehended all who directly and proximately, but not those who remotely, produce the abortion. Hence, for example, he who merely advises abortion, or a pharmacist who prepares an abortive medicine prescribed by a physician, does not incur this censure; but if - as not rarely happens - the pharmacist himself, without the prescription of a physician, compounds a medicine for procuring abortion, he is a truly efficacious and principal cause of the abortion, and consequently incurs excommunication. But a physician doing a surgical operation for this end or prescribing a medicine is excommunicated. - Cooperators do not fall under this censure unless the delict would not have been committed without their work.¹⁸⁸ But those commanding, and all those who induce the woman by grave fear, seem to be excommunicated. Wherefore the father, husband, fornicator, seducer, etc., who command abortion, fall under this censure, because in reality they are the principal cause of this crime.

¹⁸⁷ Cf. Hollweck, Die kirchlichen Strafgesetze § 163.

¹⁸⁸ Code of Canon Law, c. 2231.

143. You ask: Whether craniotomy is to be equated with abortion as to the penalty of excommunication. Certain authors, as Haine,¹⁸⁹ Berardi,¹⁹⁰ Génicot,¹⁹¹ Bucceroni,¹⁹² think that craniotomy is not properly the procurement of abortion, and consequently that physicians perpetrating craniotomy and similar actions directly killing the fetus do not incur this excommunication. This opinion indeed seems probable. He who does craniotomy is indeed as evil a murderer as he who procures abortion. Not incongruously the latter is compared with a killer who throws an infant into water or suffocates him; but the former is similar to him who butchers an infant with a little knife. Then, both in abortion and in craniotomy there is had an occisive ejection or extraction of the fetus from the maternal womb. Yet since abortion is the ejection of an immature fetus, but craniotomy is the killing of a mature infant, there is some distinction between the procurement of abortion and craniotomy. Hence just as he who reads a heretical book is excommunicated, but he who hears such a book read is not judged to fall into excommunication, so he who procures abortion is excommunicated; but he who does craniotomy of a fetus (at least a mature one) is free from excommunication. For all censures are to be interpreted strictly. Nor let anyone say that craniotomy is something worse than abortion, therefore worthy of a greater penalty. For it is still worse to kill a king or father perhaps existing in the state of mortal sin, and yet the regicide or parricide is punished by no latae sententiae censure. Now the reason is the general rule: "It is not lawful to extend a penalty from case to case, although an equal reason is present, indeed a graver one."¹⁹³ But irregularity certainly arises from the perpetration of craniotomy, inasmuch as it is true voluntary homicide.

¹⁸⁹ Elem. Theol. mor. IV, 476.

¹⁹⁰ Praxis Confess. IV, n. 1094.

¹⁹¹ Theol. mor. II, 608.

¹⁹² Commentarii n. 81.

¹⁹³ Code of Canon Law, c. 2219, § 3.

144. 2. Irregularity from delict.

By this penalty indeed are punished not only those procuring, but also all culpably cooperating.¹⁹⁴ Therefore everyone who voluntarily procured the abortion of a fetus or culpably cooperated in this, e.g., by advising, preparing medicines, incurs irregularity in the same way as if he had committed homicide. Hence this penalty of irregularity extends more broadly than the excommunication inflicted, since it is borne also against cooperators, who nevertheless sometimes do not incur excommunication, as has already been said. In ancient times this irregularity was not incurred except by the procurement of abortion of an animated fetus; but now it is incurred by the procurement of abortion of any living human fetus whatever, the effect having followed.¹⁹⁵

Irregularity contracted from the procurement of abortion cannot be dispensed except by the Holy See (by the Sacred Penitentiary, if it is a question of occult irregularity; otherwise by the Sacred Congregation of the Sacraments) or by its delegate.¹⁹⁶ But in more urgent occult cases, when, namely, from the observance of this irregularity the guilty person would betray himself with great infamy or with scandal, then, although a proper faculty of dispensing has not been conceded as for other ecclesiastical penalties, nevertheless from epikeia any confessor in the sacramental forum can suspend the obligation of observing the irregularity, with the grave burden imposed of having recourse at least within a month by letter and through the confessor to the Sacred Penitentiary or to a bishop furnished with the faculty, and of standing by his mandates.

¹⁹⁴ Thus from the Constitution of Gregory XIV Sedes Apostolica, May 31, 1591, and from the Code of Canon Law c. 985, n. 4.

¹⁹⁵ Code of Canon Law, c. 985, n. 4.

¹⁹⁶ Code of Canon Law, c. 990.

145. 3. Deposition for clerics.

Thus from the Code of Canon Law c. 2350, § 1 cited above. This penalty is of ferendae sententiae.

Note. From particular law other penalties are still not rarely inflicted upon clerics and religious who have committed the immense crime of abortion.

Scholion 1. On civil laws concerning abortion. Most severe penalties are accustomed to be inflicted also by the criminal codes of diverse nations upon those who procure abortion by private authority;¹⁹⁷ but, marvelous to say, physicians procuring abortion on account of the illness of the mother are in no way punished by civil law, but on the contrary are praised.

¹⁹⁷ Cf., e.g., German Penal Code § 218 sqq.

146. Scholion 2. On ectopic fetuses. Ectopic or extra-uterine fetuses are called those who are found outside the maternal womb, e.g., in the Fallopian tubes. There exist two responses of the Holy Office concerning this matter: "Is laparotomy lawful when there is question of extra-uterine pregnancy or of ectopic fetuses?" The Holy Office on May 4, 1898, responded: "Necessity compelling, laparotomy is lawful for extracting ectopic conceptions from the womb of the mother, provided that the lives both of the fetus and of the mother, as much as can be done, are seriously and opportunely provided for." - But since this response could be badly understood, as if it were always lawful to extract ectopic fetuses, it was again asked: "Whether at any time it is lawful to extract from the womb of the mother ectopic fetuses still immature, the sixth month after conception not yet having been completed?" The Holy Office on March 5, 1902, responded: "In the negative according to the decree of May 4, 1898, by force of which the lives of the fetus and mother, as much as can be done, must be seriously and opportunely provided for; but as to the time, according to the same decree, let the petitioner remember that no acceleration of birth is lawful unless it is performed at the time and in the ways by which, from ordinarily occurring circumstances, the lives of the mother and the fetus are cared for." - These two responses indeed clearly show that ectopic fetuses are to be treated in altogether the same way as fetuses existing in the womb, i.e., they cannot be killed, but their birth after the sixth or seventh month of conception can be accelerated, grave necessity existing. The matter stands otherwise if outside the womb in some organ of the mother there has unexpectedly arisen a tumor or cyst, in which perhaps a living fetus is found, which cyst nevertheless now causes an instant danger of death. For just as it is lawful to excise a gravely diseased uterus, even if it contains a fetus - as was said above - so a fortiori it is lawful to excise a tumor lethal to the mother. For such an operation is not direct, but indirect procurement of abortion, because directly there is removed a gravely diseased organ of the mother, but indirectly the fetus perhaps existing in it perishes. Thus also teach Lehmkuhl,¹⁹⁸ T. Antonelli,¹⁹⁹ and others.

¹⁹⁸ Theol. mor. I, n. 1011.

¹⁹⁹ Medicina pastor. (1905) 224.

St. Alphonsus, III, 394; ed. G., I, p. 644; H. Ap., VIII, 22; Lupellus, de Castit., I, p. 348; Antonelli, Med. past., II, de 5 Praec., de Bapt., de Usu Matrim.; Eschbach, disp. III and IV, in the work Disput. physiol.-theol.; Berardi, Capellmann, Olfers, Surbled, and many others.

Things to be noted beforehand. 1. Conception of the fetus. According to physicians, ordinarily conception by no means concurs with copulation; indeed most often it occurs with several hours or days intervening. - 2. Animation of the fetus. That the fetus from the beginning of conception, or at least after some days, is informed by a rational soul, St. Alphonsus already taught (VI, 124), and today it is commonly admitted.² Yet the matter is not proved by an altogether certain argument. Cf. Antonelli, Eschbach, l. c. - 3. Viability of the fetus. The fetus after the seventh month of pregnancy is, as they say, viable, so that, without proximate danger of destroying it, it can be drawn forth to light. In the case in which they use artificial incubation, couveuse artificielle, the fetus could be drawn forth from the completed sixth month without proximate danger. It belongs to the physician to judge concerning viability in individual cases. - 4. Ectopic being of the fetus. Although ordinarily the fetus lives in the uterus of the mother, sometimes it can happen that pregnancy occurs outside the maternal uterus: then ectopic fetuses are had. - 5. Life of the fetus. It is established by experience, and because of reasons taken from embryology it must be admitted, that the fetus in the uterus of a dead mother can live for some time.

741. Definition. Abortion is the ejection from the uterus of an immature fetus. Thus in the Constitution Effraenatam of Sixtus V.

Division. Abortion, by reason of imputability, is voluntary or casual. Voluntary is direct or indirect. Abortion is procured directly if deliberately, from whatever operation, an immature fetus is expelled; but indirectly, if a cause is posited acting of itself on the mother, but from which detriment can arise for the fetus, for example a bath, venesection, a remedy by which the health of the mother is consulted. All these things can produce contractions in the muscular coverings of the maternal uterus.

Note. Physicians directly procure abortion for several causes: if, the mother being ill, birth is foreseen as difficult; if, although the mother is healthy, she cannot give birth because of narrowness without danger, etc. Sometimes also through diverse operations, concerning which below, they directly attack the life of the fetus, afterward intending to expel it lifeless. It is plain that that very evil mode of acting cannot be called abortion properly so called, although, as regards the gravity of the crime, it is not less than abortion; see Nouv. Rev. Theol., 1911, vol. 43, p. 599.

742. Principles. I. Direct abortion is never licit. The reason: homicide, whether real or attempted, will never be licit. But if the fetus is animated, real homicide is committed, and indeed the more atrocious because soul and body at once are cast into ruin. But if the fetus is said not yet animated, this always remains: that there is danger lest a man truly endowed with spiritual life be killed. Therefore attempted homicide is had. Therefore Innocent XI rightly condemned the 34th proposition: "It is licit to procure abortion before the animation of the fetus, lest a girl detected as pregnant be killed or defamed." Cf. Response of the Holy Office, 4 May 1898, ad 2, where the Decree of 25 July 1895 concerning the illicitness of abortion is confirmed. Nouv. Rev. Theol., vol. 31 (1899), p. 276; Anal., VI, 277.

Hence: 1. They are guilty of homicide: a) Those who so strike or terrify a pregnant woman that abortion follows. - b) Likewise pregnant women who, with grave imprudence, posit a proximate cause of abortion in various ways, say by washing the feet in cold water, carrying heavy burdens, indulging a violent commotion of mind, etc.³

2. Probably an oppressed woman does not commit sin who at once expels the seed emitted while she resisted. Cf. Lehmkuhl, I, n. 1013. - St. Alphonsus (III, n. 394; ed. G., I, p. 647; VI, n. 954) holds the contrary opinion. But there he supposes as certain what moderns often and more often think to be little probable: namely that conception happens immediately after emission. Indeed it cannot be denied that conception can happen at once, and therefore an unmarried woman who sinned voluntarily cannot expel the seed; but for the woman invaded the right of repelling aggression prevails.

3. Certainly they commit homicide who induce a falsely colored acceleration of birth, whether through puncture of the membranes or in another mode, at that time when the fetus certainly is not viable.⁴ For this is equivalent to direct killing, just as we are said truly to kill a fish if we draw it from the water. Thus from the grave Response of the Holy Office, 25 July 1895. After this Decree, let the controversy among authors have an end. Nouv. Rev. Theol., vol. 27, p. 599.

743. • II. Indirect abortion is sometimes licit.

It is said: 1. Indirect, that is, coming beyond the intention from an ambiguous action, for example by supplying to the mother a medicine indeed salutary to her, but dangerous to the offspring, as we have explained.

2. Sometimes, namely if the conditions from the indirect voluntary are present, and indeed: a) the remedy is of itself and directly curative of the illness; - b) another cannot be used; - c) provision is made for the extreme spiritual necessity of the fetus, as it can be provided.

The proposition is proved: The indirect voluntary, in which we are here, under due cautions, is no sin. The two prior conditions are required of themselves. The later condition here must necessarily be expressed, since charity and piety oblige the mother to prefer the spiritual life of the offspring to the health of her own body. - Now, abortion truly does not deprive the fetus of the hope of Baptism when, the remedy having been omitted, it would certainly die with the mother, or when it is hoped that it will be brought forth alive into the light, and therefore can be baptized, or finally if in fact it can be baptized in the uterus. - It is plain besides that it is licit to take such a remedy if the danger of abortion is equal whether it is taken or not: the condition of the fetus is not made worse from it (III, 394; H. Ap., VIII, n. 26).

Note. 1. Let the physician not be too anxious as regards medicines to be furnished to mothers. For it is morally impossible, the mother perishing, that the offspring can survive for a long time, unless the mother is near birth, or the disease is very brief (Antonelli, l. c.).

2. Nevertheless attention must be given to the cautions which we indicated above in the case in which, so that he may consult the mother, he wishes to diminish the volume of a sufficiently mature fetus (Lehmkuhl, I, 1009).

3. If the fetus is only probably viable, the timorous physician will wait, insofar as can be done, for the certain maturity of the fetus. But if from delay the danger for the mother or for the offspring becomes greater, it is sufficiently probable that acceleration of birth is licit. The reason: in a desperate case it is licit to use a doubtful remedy (cf. n. 84), the more so because here there is not lacking hope of conserving the fetus alive, which otherwise would be constituted in the highest danger.

744. • Corollaries. In our times, so that the very intricate question of very difficult and dangerous birth may be solved, physicians have recourse to various operations, in which, from the end of the one operating, the safety of the mother alone is sought, with no or almost no respect had to the rights of the infant. Of these: 1. certain ones directly offend neither the mother nor the fetus, for example compression of the abdomen, puncture of the membranes, by which birth is accelerated; - 2. others directly touch the fetus, as craniotomy and similar ones; - 3. finally others directly touch the mother, as symphysiotomy, Caesarean section, laparotomy, the Porro operation. It is licit to designate the whole series of these operations by the name: medical abortion.

The operations of the first genus we have already called back under the scales. Concerning others, some things. The hinge of the question is in this, that we see whether these operations can or must be reduced to direct or indirect abortion.

I. CRANIOTOMY, or EMBRYOTOMY. It consists in the perforation of the skull of the infant, and extraction of the cerebral mass. - Supposing that the fetus is not certainly dead, it is a most grave sin, even if it appears as the only remedy of saving the mother. For it is an action of itself and directly killing, and, since it is inflicted on an innocent person, intrinsically evil; nor can it ever be made honorable by the intention of saving the mother. Nor let it be said: only the death of the infant, otherwise certainly about to die, is accelerated; for is not this acceleration of death, willed in itself, although not for itself, true homicide? - Nor let the fetus be equated with an unjust aggressor: for one who from the sole natural course of things, for example a man infected with plague, becomes the cause of death to another cannot be held as an unjust aggressor. Whence, on 19 August 1889, the Holy Office declared: in Catholic schools it cannot safely be taught that the surgical operation which they call craniotomy is licit, as was declared on 28 May 1884, and any surgical operation directly killing the fetus or the mother carrying it. These things were confirmed by the Decree of the same Holy Office on 25 July 1895. Cf. A. S. S., vol. 17, p. 601.

Note. To this operation must be assimilated and therefore condemned the mode of acting of those who attempt directly to extinguish an ectopic fetus, concerning whose presence there is certainty, by injection of morphine or by applied electrical force (Lehmkuhl, I, n. 1011).

II. CAESAREAN OPERATION. It consists in incision of the uterus, to this end that the fetus can be drawn out. This operation, which formerly they named difficult, barbarous, today is often performed by physicians, and indeed happily, while the mother is living, so that more or less 90 percent of mothers are saved. Cf. the things which Antonelli, Eschbach, and Capellmann narrate in the cited works.

A double question can be posited: 1. Whether it is licit for the mother to permit such an operation? - 2. Whether the mother is held to this?

To the first one must respond thus: It is licit if on the one side, because of her robust constitution and the skill of the surgeon, the danger of death becomes only remote, and on the other side hope shines out that the life of the offspring, both temporal and spiritual, can be consulted. But it is not licit if the danger of death as regards the mother appears proximate or truly probable, because such a danger must be equated with death (VI, 106; ed. G., III, p. 84). See the cited Response of the Holy Office, year 1898, ad 2 and 3.

To the second it must be said that if there is present a founded hope of drawing out the infant viable, of itself, from the precept of well-ordered charity, the mother is obliged to undergo the operation, which in our times, as we said, no longer remains an extraordinary means (cf. Lehmkuhl, I, n. 758, note, where he cites St. Alph., II, n. 26, 27); and even if it is supposed extraordinary, is not the eternal salvation of the infant worth so much? (cf. above n. 483). Yet let the prudent confessor see whether, with the natural horror of the mother toward such operations standing, the intimation of this obligation can be urged.

Note. a) What we said concerning the licitness of this operation can equally and under the same cautions be affirmed of SYMPHYSIOTOMY, by which narrowness of the pelvis must be removed through the cutting of the cartilage joining two bones. - For the rest, Antonelli adds (II, n. 94) that this operation and another similar one are not approved so commonly by surgeons.

b) The same must be said concerning LAPAROTOMY, by which a tumor is cut out so that an extrauterine fetus can be drawn out, or concerning the PORRO OPERATION, by which the uterus and ovaries are cut out. The Holy Office declared, 4 May 1898, that all these things are licit, provided that serious and opportune provision is made for the lives of both the fetus and the mother (Nouv. Rev. Theol., vol. 31, p. 276). The Holy Office confirmed these previous Decrees on 5 May 1902 (ibid., vol. 45, p. 161).

c) The pregnant woman having died, nothing prevents the Caesarean operation from being performed. In this case a strict obligation urges. But whatever some have said, it is certain that the priest is not obliged to this. The Holy See expressly declared that on 15 Dec. 1899, confirming the things which it had already prohibited on 15 Feb. 1780 (A. S. S., vol. 32, p. 503). Cf. Antonelli, II, n. 103.

III. DOUBTFULLY PROHIBITED OPERATIONS. Three very difficult cases are especially given, in which the licitness of the operation is not established: 1. The uterus of a pregnant woman sometimes prolapses and cannot be reduced except through puncture of the covering, so that the amnion flows. But from this abortion certainly follows. 2. Sometimes also the very uterus of a pregnant woman is so infected by malignant tumors, or in a healthy uterus such tumors are formed, that the health of the mother can be restored only by removal of the whole uterus. But removal of the uterus, in the case, unhappily draws with itself the extraction of a fetus perhaps immature. 3. Finally sometimes, in the case of extrauterine conception, the tumor will cast the mother into highest risk, and, if the organs rupture, into certain death; which seems to render removal of the tumor necessary.

Concerning the three aforesaid cases, there is no consensus of authors. There are not lacking those who think that puncture, removal, in the case in which the fetus is immature, is not licit, according to the Decree of the Holy Office, 5 May 1902, in which the Eminent Fathers refer themselves to the Response of 4 May 1898 cited above. But others judge that discussion of direct abortion cannot be instituted here, but of abortion which is procured only indirectly; and that the excusing cause is the highest and certain risk of life in which the mother is placed. Nevertheless all agree in this, that these things are in no way licit as long as true and certain danger for the mother does not exist. Cf. Lehmkuhl, I, n. 1011, who says the Response of the Holy Office of 1902 lacks pontifical approval; Nouv. Rev. Theol., vol. 44 (1912), p. 590; vol. 45 (1913), p. 154; Antonelli, II, n. 110.

745. • CONCERNING PENALTIES IMPOSED ON THOSE PROCURING ABORTION. I. From canonical right they are the following: 1. Papal excommunication reserved to the Ordinary (cf. n. 1349). Nevertheless those do not incur this who commit the crime of craniotomy. Cf. Noldin, de Poenis eccl., n. 93; Linz. Quart. Schr., 1910.

2. Irregularity, if nevertheless the fetus is animated (cf. n. 1946). 3. Inability for ecclesiastical titles, which is incurred ipso facto, but probably can be removed by the Bishop. 4. Privation of benefice, office, etc., but after a sentence declaratory of the crime (III, 395-397).

II. From civil right this crime is punished with grave imprisonment. Cf. French Penal Code, a. 317; Italian, a. 381; German, a. 218, 219, 220; Spanish, a. 425-428. It happens more and more often that physicians indiscriminately consider all those things which happen in birth, for rescuing the mother from certain death, as necessary consequences of their function.¹

Practical rules. 1. Good faith can be given concerning the licitness of medical abortion, whether in parents, or in mothers, or in physicians. The confessor, if he is not asked, should speak prudently concerning these matters: for his admonition, for the most part useless, indeed frequently harmful to those to be admonished, will become so, since it draws with it danger of formal sin. Asked by a physician, let him reprove the operation as illicit, yet without always making mention of the prohibition of the Church. - Asked by a mother, in many cases he will satisfy his function if he exhorts her that she herself say to the surgeon, in the best mode by which she can, that the life of the infant must be consulted. Let him not impose on the mother without consultation that she refuse the operation, nor indiscreetly manifest the prohibition of the Church. Yet sometimes, for example if a physician not very scrupulous advises a falsely colored acceleration of birth for avoiding inconveniences that are not grave, the confessor cannot be silent (Card. Gennari, Cons. mor., t. I, n. 77; cf. Nouv. Rev. Theol., vol. 45, 1913, p. 160 seqq.). 2. Physicians, especially if they are called unexpectedly, often are placed in a state of perplexed conscience. Therefore they must be judged according to the rules fitting this state, and, if fruit is hoped, admonished and instructed. 3. Sisters of Charity, if some hospital proper to them exists, are held to choose truly upright men. If the manner of acting, on the part of the physician, is less conformable to the Decrees of the Holy See, they are not held to resist his work, unless in the case in which his intention of prevaricating would evidently disclose itself (S. Poen., 7 July 1911; Nouv. Rev. Theol., vol. 44, 1912, p. 35 and Rev. Eccl. de Metz, 1911, p. 588).

Abortion is the lethal expulsion of the ovum, embryo, or fetus from the maternal womb. Mar.

474. Principles. - I. It is never licit directly to procure abortion, even if the fetus were supposed to be still inanimate; which supposition today, especially now that the dogma of the Immaculate Conception of the B. V. M. has been proclaimed, lacks foundation.⁵ 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 not animated is ordered to forming a man; therefore its ejection is anticipated homicide. St. Alphonsus,¹ Lacroix.²

II. Sometimes it is licit indirectly to procure abortion, or better, to permit it, namely by administering to a mother laboring under grave disease remedies harmful to the fetus, if the following conditions concur, namely 1° that there is question of a lethal disease; 2° that the remedies harmful to the fetus are directed of themselves to curing the disease; 3° that there is no hope of procuring for the fetus eternal life through Baptism. But hope of this sort can be absent in a twofold case: namely in the earlier days of conception; or where it is morally certain that the fetus, when the mother dies, will die at the same time or before. - St. Alphonsus,³ Lacroix,⁴ Billuart.

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

475. Questions. - Quaer. 1° Is embryotomy, or the killing of an infant in the mother's womb, ever licit?

Resp. 1° It is certainly illicit, if either by a Caesarean operation, of which in the Treatise on Baptism, one can certainly consult the life of the infant and probably also of the mother, or if the fetus is soon to perish, and, its natural death having been awaited and it then extracted, some hope still probably remains of saving the mother. For where the good effect can be had from a certainly licit cause, it is illicit to use a cause concerning the liceity of which at least there is doubt.

Resp. 2° Since embryotomy is an action of itself or directly killing, but the direct killing of an innocent is licit in no case ever, embryotomy, although the sole remedy remains by which the life of the mother can certainly be provided for, cannot be permitted. And this is the common sentence of Theologians. Cf., if you please, Acta⁵ and Revue des sciences ecclés.⁶

Quaer. 2° Is at least the so-called medical abortion ever licit, or the acceleration of birth before the completed 28th week of gestation induced by art?

Resp. It is controverted. There are those to whom it seems the direct killing of an innocent, because from the very acceleration of birth before the seventh month of gestation the death of the fetus ought to follow of itself; for before that time it cannot live outside the mother's womb; therefore to extract it from that womb is the same as positively depriving it of precisely that thing without which it cannot live. Those who think the contrary say that in this case the fetus is only removed from a place in which it cannot live longer, and is placed in another in which it cannot continue life for long; wherefore they permit that acceleration of birth if the conditions are present of which in n. 474. II. Adhering to the former with Capellmann,¹ we apply the following admonition of Kenrick concerning embryotomy also to the acceleration of birth. If the mother asks what is to be done by her, it seems one must say that she ought to beg the surgeon to consult the life of the fetus in every way that he can.² (a) p. 469.

476. You will resolve. - 1° It is licit to expel a dead fetus, because the expulsion is no longer lethal. - Likewise, in the very violent oppression it will be licit to impede conception, yet not to expel a fetus actually already conceived.³ (b) p. 430.

2° It is not licit for a pregnant girl to take medicines (although these are generally taken in vain) for expelling the fetus, lest she lose reputation, because abortion would be directly intended. This is also clear from proposition 34 condemned by Innocent XI, p. XVI.

3° It is licit 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, both the mother otherwise will die, and the fetus will be extinguished without Baptism; for thus both the mother and the fetus are helped in the better way in which they can be helped; but most rarely will there be certainty concerning both. But if the danger of abortion is equal, whether the remedy be taken or not, it is licit to apply it; because without greater danger to the offspring the life of the mother is consulted. - But if the danger becomes greater from the medicine, certainly one must proceed cautiously, since it is not lawful, in order to protect temporal life, positively to expose one's neighbor to the danger of eternal death. Yet it must be noted that, in order that this prohibition urge, there ought to be present a reasonable hope of saving the life of the offspring after the death of the mother, not indeed that a slight and most remote hope suffice; but most rarely does the offspring survive the pregnant mother. Hence the physician should weigh the circumstances conscientiously, yet not scrupulously.¹

4° They are homicides who strike a pregnant woman, or terrify her, so that abortion follows. Likewise pregnant women who with grave imprudence in various ways posit a proximate cause of abortion, for example by giving attention to excessive labors, by carrying heavy burdens. In both cases foresight of the danger is required.

5° A fortiori those girls are guilty of homicide who, pregnant from fornication, apply repeated attempts to try for abortion, by potions, jumps, burdens, strong striking and compression of the belly, etc. ... When women of this sort confess, they are to be questioned about abortion desired or attempted carefully, but not abruptly.

363. Corollaries. - 1. Especially illicit are embryotomy and the direct procurement of abortion, namely, a) to kill the fetus in the womb in order to save the mother; b) to cast the fetus out of the womb, for that reason soon to die; c) to divide the fetus into parts. - For it is directly to destroy human life, or at least directly to impede it in a subject which is not an unjust aggressor.¹⁰ This, for the same reason, holds concerning ectopic or extrauterine fetuses.¹¹

¹⁰ Holy Office, 19 Aug. 1889, 24 July 1895, 31 May 1884. - Cf. our Questions on Embryology A, q. 4 and 5; B, q. 2 and 3. Some at one time judged feticide licit, such as Ballenni, Avanzini, Constantini, or abortion, as even Lehmkuhl himself.

¹¹ Holy Office, 4 May 1898 and 5 May 1902. Cf. Questions on Embryology A, q. 7; and B, q. 4. Some try to elude the responses of the Holy Office.

For it is a question of the life of an innocent person, which is equally sacred in a little infant and in an adult mother; whence no reason making the act honorable is present: neither the social power of protecting the common good against crimes, nor legitimate defense against aggression, nor the extreme necessity of the mother.

As Pius XI most recently sanctioned in the encyclical Casti connubii, 31 Dec. 1930: "What cause could ever avail in any way to excuse the direct killing of an innocent person? For this is what is at issue in this place. Whether it is inflicted upon the mother or upon the offspring, it is against the precept of God and the voice of nature: You shall not kill. For the life of each is an equally sacred thing, for the crushing of which there can ever be no faculty, not even to public authority. a) Most ineptly, moreover, is this repeated against the innocent from the right of the sword, which has force only against the guilty; b) nor does any right of bloody defense here prevail against an unjust aggressor, for who would call an innocent little child an unjust aggressor?; c) nor is there present any right of extreme necessity, as they call it, which could reach even to the direct killing of an innocent person."

2. On the contrary, abortion indirectly procured can be licit, if a) there is present in the mother a lethal disease, b) the means employed is immediately efficacious for curing the mother even when not pregnant, c) no other remedy is present, and d) provision is made for the Baptism of the infant. A fortiori, acceleration of birth can be licit if the infant can live outside the mother's womb, and a grave reason is present.

An action, namely, one bringing danger of death and directly affecting the fetus itself, or some organ or element pertaining to it, such as the placenta, the membranes enveloping it, or the amniotic fluid, cannot be legitimized by the fact that it is necessary for saving the mother, because it immediately harms only the offspring and procures the good of the mother only by means of the evil of the offspring, and thus is directly harmful and lethal; - on the contrary an action which is exercised not directly upon the fetus, nor upon any instrument or element of it, but upon the mother or an organ of the mother, say upon the uterus or tube, can be licit, provided that a) it directly procures the good of the mother, b) it is necessary here and now for saving her life, c) the danger does not proceed from the fetus alone.

3. Concerning accidental homicide, St. Thomas teaches, art. 8: He who posits an action from which, accidentally and not of itself, frequently and probably, death follows, is not guilty of homicide, provided that he has used ordinary solicitude: thus a hunter, by employing due diligence, accidentally kills a man. On the contrary, per accidens he can be guilty of homicide "who does not remove those things from which homicide follows, if he ought to remove them." This happens in two ways: a) if he is guilty of negligence, not employing due diligence, for example, by imprudently playing with a firearm, and then he sins gravely or lightly according as the negligence is grave or light: thus imprudent pregnant women, and physicians negligent in caring for the sick; b) if the action of itself is unjust and includes danger of homicide, for example, by striking a pregnant woman, or by employing dangerous materials or machines from which the life of workers is placed in great danger.

Abortion is the expulsion of an immature fetus from the womb of the mother; but a fetus is called mature when, with no other danger supervening, it can live by itself, even if it comes forth into the light before the ninth month.

I say 1st. It is never licit directly to procure abortion, even if the fetus were supposed to be still inanimate. The reason is that if it is animated, it is homicide properly so called; but if it is not animated, it is anticipated homicide, because an inanimate fetus is ordered from its own nature to forming a man. - Cf. St. Alphonsus, n. 394. - Lacroix, n. 823. - Kenrick, tract. 3, n. 127. And this which we say concerning the expulsion of an immature fetus from the womb is likewise to be said concerning the extraction of an immature ectopic fetus from the cavity of the mother.

The placenta, as must be noted, together with the umbilical cord, is the organ of nutrition of the fetus in the cavity of the mother. Any expulsion separating the fetus from the placenta and umbilical cord destroys the anatomical relations necessary for the very existence of the fetus; for the placenta can be considered as a certain intimate union between the vascular system of the mother and of the fetus. To destroy this union is to destroy the fetus itself.

To expel the fetus is not only to put it in another place, but is to destroy the marvelous mechanism which makes, between the fruit of the mother and the mother, an internal vital communication, and therefore to kill the infant itself. Nor should you say, in fact it will die; you say rightly, but this does not give the right to kill it. - Cf. Besson., Nouvelle Rev. Theol. v. 45, p. 154, where he sets forth the argument excellently.

I say 2nd. Sometimes it is licit indirectly to procure abortion, or better to permit it, namely by supplying to a mother laboring under a grave disease remedies harmful to the fetus, if the following conditions concur, namely: 1st. that it concern a lethal disease; 2nd. that the remedies, harmful to the fetus, be of themselves directly and immediately efficacious for curing the disease of the mother; 3rd. that the administration of the remedies not impede the conferral of baptism, because the spiritual life of the fetus prevails over the temporal life of the mother. - Cf. St. Alphonsus, ibid. Lacroix, n. 826. - Kenrick, tract. 3, n. 128.

Question 1. What is to be said of the craniotomic operation, which many physicians nowadays employ to save the mother?

Response. An operation of this kind is true homicide, and accordingly always and intrinsically evil. For if, according to St. Thomas, "a man ought not to kill the mother in order to baptize the child," a fortiori the child ought not to be killed so that the temporal life of the mother may be saved.

Nor should you say that an obliquely positioned fetus, or one presenting too large a head, can be compared to an aggressor, at least materially unjust; for the response is that it is so disposed by the sole course of nature and accordingly can in no way be called an aggressor. Otherwise both the mother herself, in relation to the fetus, and those who labor under a contagious disease, in relation to those who are well, would have to be called aggressors, and accordingly it would have to be lawful to kill them.

Nor should you appeal to authority, because if this was hitherto doubtful and slight, now it certainly will be none in Catholic schools, since the Sacred Congregation of the Holy Office, on May 31, 1884, declared that the liceity of craniotomy cannot be safely taught. But recently, namely Aug. 19, 1889, it was signified to the professors of the medical faculty of the Catholic University of Lille: "In Catholic schools it cannot safely be taught that the surgical operation which they call craniotomy is licit ... and any surgical operation directly killing the fetus or the pregnant mother." Cf. St. Thomas, p. 3, q. 68, art. 11, ad 3. Kenrick, tract. 3, n. 128. - Analecta jur. Pont., fascicle 133, p. 547, May 1876. - Ciarmadori, Opusculum de craniotomia. - Nouvelle Revue Theologique, vol. 17, p. 13; vol. 16, pp. 95 and following; pp. 62 and following; pp. 293 and following; vol. 22, p. 74. Amer. Eccl. Review, vol. 9, pp. 360 and following, and vol. 23, pp. 128 and following.

Question 2. Whether at least it is licit to accelerate birth when otherwise the life of the mother would be brought into danger?

Response 1st. If this acceleration takes place after the seventh month, it is entirely licit; indeed by many it is said also to be worthy of praise; for it profits not only the mother, but also the fetus, which can then be judged mature. - Cf. O'Kane, n. 213. - Dublin Review, No. 87, art. Obstetric. Morality, p. 118.

Response 2nd. But if birth is accelerated during that period of gestation in which the fetus can in some way be cast forth alive, yet necessarily must afterward die because it has not yet arrived at substantial maturity, it must be said that such acceleration scarcely, or not even scarcely, differs from craniotomy, and therefore is altogether to be condemned. For in that case to extract the fetus from the womb, or from the cavity of the mother if the conception is ectopic, is an action killing by its own nature, not otherwise than withdrawing air from an adult.

Nor should you say that the death of the fetus follows only indirectly, from the fact that it itself is not touched but only the membranes by which it is enveloped are torn, or the fibers are relaxed, or from the fact that such expulsion is not intended as an end: for the response is that someone is directly killed whenever his death is taken up as a means, whatever may be the kind of action by which it is procured.

Nor should you say that the weight of authority can be brought in favor of this acceleration; for although St. Alphonsus says: "it is licit, with cold water, if another cannot be had, to baptize a child soon about to die, even if it were feared that from this death would be accelerated," he permits this only because "such an action does not tend to killing but to ablution." But other Doctors speak either of a drug given directly for curing the disease of the mother, as Cardinal de Lugo, or of an inanimate fetus which, erroneously indeed, some thought to be as a part of the viscera of the mother. - Cf. St. Alphonsus, de Sacram. Baptis., n. 106. Lugo, de just. et jur., disp. 10, n. 133. - Salmant., tract. 13, cap. 2, n. 60. - Crolly, vol. 3, nn. 118 and following. - This solution, which has always been certain to us, receives special strength from the notable Response of the Holy Office, which has itself thus:

"Stephen Mary Alphonsus Sonnois, Archbishop of Cambrai, most devotedly prostrate at the feet of Your Holiness, most humbly sets forth what follows:

"Titius, a physician, when he was called to a pregnant woman lying gravely ill, commonly observed that no other cause of the lethal disease was present except the pregnancy itself, that is, the presence of the fetus in the womb. Therefore, in order to save the mother from certain and imminent death, one way was at hand for him, namely that of procuring abortion or the expulsion of the fetus. He was accustomed to follow this way, yet using means and operations which, of themselves and immediately, indeed did not tend to this, that they should kill the fetus in the maternal cavity, but only that, if it could be done, it should be brought forth alive into the light; although very soon to die, since it was still altogether immature.

"Now indeed, after reading what the Holy See wrote back to the Archbishop of Cambrai on August 19, 1889: 'it cannot safely be taught that any operation directly killing the fetus is licit, even if this would be necessary for saving the mother,' Titius remains doubtful concerning the liceity of the surgical operations by which not rarely he had hitherto procured abortion, in order to save gravely sick pregnant women.

"Wherefore, that he may consult his conscience, Titius suppliantly asks whether he can safely undertake the stated operations in the aforementioned repeated circumstances.

Wednesday, July 24, 1895.

"In the General Congregation of the Holy Roman and Universal Inquisition, the above-written petition having been proposed, the Most Eminent and Reverend Lord Cardinals, General Inquisitors in matters of faith and morals, the vote of the Reverend Lord Consultors having first been had, decreed that the response should be: Negative, according to the other Decrees, namely of May 28, 1884 and August 19, 1888.

"But on the following Thursday, July 25, in the audience granted to the Reverend Father Lord Assessor, Our Most Holy Lord approved the resolution of the Most Eminent Fathers reported to Him.

L. + S. J. Mancini Can. Magnoni

Notary of the Holy Roman and Universal Inquisition."

And the subsequent decree solves various doubts concerning the liceity of acceleration of birth, of the Caesarean operation, and of laparotomy.

"The Bishop of Sinaloa, prostrate at the feet of Your Holiness, humbly asks the resolution of the following doubts:

"I. Will acceleration of birth be licit whenever from the narrowness of the woman the exit of the fetus at its natural time would become impossible?

"II. And if the narrowness of the woman be such that not even premature birth is judged possible, will it be licit to provoke abortion or to perform the Caesarean operation at its own time?

"III. Is laparotomy licit when it concerns extrauterine pregnancy, or ectopic conceptions?

Wednesday, May 4, 1898.

"In the General Congregation held by the Most Eminent and Most Reverend Lord Cardinals, General Inquisitors against heretical depravity, the above-written doubts having been proposed, and the vote of the Reverend Lord Consultors having first been had, the same Most Eminent and Most Reverend Fathers judged that it should be written back:

"To I. Acceleration of birth is not illicit of itself, provided it is performed for just causes and at that time and in those modes by which, according to ordinary contingencies, provision is made for the lives of the mother and the fetus.

"To II. As to the first part, negatively, according to the decree of Wednesday, July 24, 1895, concerning the illiceity of abortion: but as to the second, that nothing stands in the way that the woman in question be subjected to the Caesarean operation at its own time.

"To III. When necessity compels, laparotomy is licit for extracting ectopic conceptions from the cavity of the mother, provided that provision be made seriously and opportunely for the lives of both fetus and mother, as far as can be done."

"But on the following Friday, the 6th day of the same month and year, in the usual audience granted to the Reverend Father Lord Assessor of the Holy Office, a report concerning all these things having been made to Our Most Holy Lord Leo XIII, Pope by Divine Providence, His Holiness approved the responses of the Most Eminent and Most Reverend Fathers.

J. C. Mancini, Notary of the Holy Roman and Universal Inquisition."

To the Question: "Whether it is sometimes licit to extract from the cavity of the mother ectopic fetuses still immature, before the sixth month after conception has been completed?" the Holy Office responded on March 5, 1902:

"Negatively, according to the Decree of May 4, 1898, by virtue of which provision must be made seriously and opportunely, as far as can be done, for the lives of the fetus and mother; but as to the time, according to the same Decree let the Orator remember that no acceleration of birth is licit unless it is performed at a time and in modes by which, according to ordinary contingencies, provision is made for the lives of the mother and the fetus."

Question 3. What is to be answered practically to those who question confessors about this matter?

Response. The whole truth must be manifested with a courageous spirit, if the question is made in good faith, and the person who questions is foreseen to wish to acquiesce; otherwise it is better to be silent and to permit only the material evil.

Question 4. Is it licit for a girl, immediately after fornication, to take a drug for expelling an inanimate fetus, lest she be killed by her father or lose her reputation?

Response. Negatively, altogether, both because this would be directly to procure abortion, and because it was condemned by Innocent XI in prop. 34, which has itself thus: "It is licit to procure abortion before the animation of the fetus, lest a girl, detected as pregnant, be killed or disgraced." - But those women who immediately after freely had copulation wash themselves to expel the semen lest they conceive, although they do not seem to be condemned for abortion, both because semen as soon as it is received cannot be called a fetus, and because that means does not seem efficacious, nevertheless would sin most gravely by another kind of sin, namely of onanism, or of frustrated nature.¹

¹ Cf. Addenda, p. 1087, n. 4.

Question 5. Would women violated by force be condemned in the same way if they attempted immediately and altogether, without any interval at all, to reject the received semen by washing themselves?

Response. Negatively, at least probably, and the reason is that it is licit to repel force unjustly inflicted as long as the infliction itself morally perseveres. - Cf. Lehmkuhl, vol. 1, n. 849.

Question 6. What if the very uterus of the pregnant mother is infected with a lethal disease?

Response. It is licit, as it seems to us, to remove the uterus, and although by that very fact the fetus dies, nevertheless the extraction itself of the uterus has a double effect, a good one, the health of the mother, and an evil one, the death of the infant. It is like the case of procuring indirect abortion, which, as we have seen, is licit under given conditions.

Question 7. Is it licit in any case to place an action having death alone as its effect, e.g., to kill a fetus by an electric needle?

Response. Negatively: for such an action is intrinsically evil. And hence for this reason it is not licit to destroy an ectopic fetus.

Question 8. What is to be said in doubt whether that which a woman carries is a fetus or rather a tumor, e.g., in ectopic cases?

Response. It seems it must be said that if the physician, truly and sincerely, after investigation has been made, doubts, and the mother is placed in danger of life, it is licit to remove that thing. For the mother is in possession; her right is certain, nor would men, with the principles of natural law considered, force this mother to undergo this death; in other words, it is not known whether that thing is the subject of a right, and it seems cruel to prefer it to the pregnant woman. But if it is established that a fetus is present, its right must be held equally certain, nor is it licit to perform the operation until it is morally known that death has occurred. In judging all these operations, the principle often stated must be kept before the eyes, namely concerning an indifferent or good action with a double effect, good and evil. - Cf. above, n. 8. Evils are not to be done that good things may come about. Finally: nor are means to be employed which tend directly to the killing of the fetus, and by which, when they have been employed, the evil effect, in certain cases, has the good as its immediate effect. - Cf. Response of the Holy Inquisition, July 24, 1895, concerning Titius, the Physician, n. 273.

You Will Resolve. - A pregnant woman is at the point of becoming blind, insane, or paralytic; pregnancy is the cause of the insanity, etc.; the fetus is not viable. A surgeon cannot advise abortion, nor does he have the right of extracting the fetus from the cavity of the mother. In the same circumstances a non-viable fetus is at the point of dying, indeed has entered into agony. There is besides a danger lest the infirmity of the mother become incurable, or there is some other grave motive. It is not licit for the surgeon to perform an operation by which the death of the infant is more quickly induced for improving the condition of the mother: i.e. the quicker death of the fetus is not to be employed as a means for the safety of the mother: the infant will die, but this does not give the right to kill him.

A woman carries her fruit, but the fetus is extrauterine. While the physician performs a grave operation upon her, he notices the abnormal seat of the pregnancy. He also understands that the fetus is viable. It seems to us that it must be said that the surgeon can licitly, for grave causes in this case, extract that viable extrauterine fetus, even if it has not yet attained the normal term of fetal life, provided that, using the operation begun for another end, he does not perform upon the fetus any death-dealing act.

A woman is pregnant, but the fetus is extrauterine. While the physician performs a grave operation upon her, he notices the abnormal seat of the pregnancy; the fetus is alive, but not viable. The surgeon cannot bring forth the fetus from the cavity of the mother, because this action would kill the fetus. The mother is at the point of dying from hemorrhage or eclampsia and the fetus is viable. Certainly artificial birth can be induced, provided that by this operation provision is made for the life of the mother and of the infant. But this birth cannot be so induced that the death of the infant is the natural effect of the operation and the means for removing the urgent danger of the woman in labor; i.e. it is not licit to kill the fetus in order to save the mother. The mother is at the point of dying; the fetus is viable. The mother is in agony and few moments of living remain to her, but the fetus probably will live beyond an hour. It is not licit for the surgeon, in order that the infant be brought forth into the light under better conditions, to perform an operation which by its own nature would kill the mother, so that her death would be the means of improving the condition of the infant.

The mother is at the point of dying. The proximate cause of death is hemorrhage, eclampsia, or another disease arising from pregnancy. The fetus is not viable. It is not licit to procure abortion nor to advise it. In the same circumstances, a fetus not yet viable is destined to imminent death. Besides, it has already entered into agony while several hours of probable life remain to the mother. It is not licit for the surgeon to perform an operation tending directly to the very death of the fetus, as a means for placing the mother in a better condition: in other words, it is not licit to procure abortion so that the mother may be saved.

A pregnant mother is at the point of becoming blind, or paralytic, or insane, or infirm in some other way. The cause of the blindness, paralysis, etc., is pregnancy. The fetus is viable. Certainly the surgeon can advise premature artificial birth, provided that provision is made for the lives of both mother and fetus. But in the same circumstances, on account of the imminent danger lest the infirmity of the mother become incurable, there does not belong to the surgeon the right of employing a means which by its own nature determines the death of the infant, so that premature birth may be induced.

That operation is called Caesarean by which the uterus of the mother is cut so that the infant may be extracted. Not rarely it happens that the fetus, on account of the narrowness of the mother, cannot be brought forth by the natural way; in this case either the mother is to be cut, or both she and he are to be left to the course of nature. Therefore the question is about section in these most grave circumstances. These things seem to be established. 1st. The operation is never licit if the incision would be killing of the mother, because it is not licit to kill the mother so that the infant may be baptized. 2nd. It is never licit if, while the mother is living, the infant outside the uterus probably at least could not live. For this would be to kill the offspring. 3rd. While the mother is living, it can licitly be done when these conditions have been verified: 1) that the mother cannot give birth naturally, or is about to die before birth with the greatest danger of the death of the infant before he can be baptized; and 2) that from the incision there does not arise for the mother a proximate danger of death. 4th. While the mother is living, the operation ought to be done if it is certainly established that the infant cannot be baptized unless the operation is done. But the greatest prudence is needed in imposing this obligation, lest the mother, abhorring such an incision, make shipwreck of both her own and her offspring's eternal salvation, dying in a state of mortal sin, good faith having been changed into bad faith. 5th. The mother is not bound to undergo the operation when baptism can be conferred upon the infant in the womb with solid probability, which can often be done; nor is she bound when she alone is about to perish; nor, if there is probable hope that the offspring will survive her once she has died, and therefore can be baptized; nor is the mother bound to permit the operation for preserving the temporal life of the infant; nor in uncertainty of a happy outcome. But if, 6th, the case is as it were desperate and it is certain that mother and offspring are about to die, in these most difficult circumstances the operation is licit, provided that from it there arise some probability of saving both mother and offspring; for thus provision is made for the life of both this one and that one in the best way possible.

If a pregnant mother has died, let the fetus be extracted as soon as possible, cautiously, and, if it is alive, let it be baptized: Rit. Rom. tit. II, cap. 1, n. 17. Therefore as soon as the mother is dead, the operation can licitly be done. Indeed, the mother being dead, the operation also ought to be done, for there is a grave obligation by reason of the office of assisting a neighbor placed in extreme necessity: Holy Inq., Feb. 15, 1780. The section must be done with careful solicitude, lest the mother, being only apparently dead, be killed, or lest the offspring die. What must be said concerning the duty of the parish priest or missionary is clear from the response of the Holy Inquisition given on Dec. 13, 1899, first commemorating the decree of Feb. 15, 1780: "This extraction of the fetus from the womb of the pregnant and deceased mother, although it is to be made known and urged, nevertheless His Holiness expressly cautions and prohibits that missionaries involve themselves in particular cases in ordering the section, much less in performing it. Therefore it will have been enough for missionaries to have published knowledge of it and to have taken care that those laymen who apply themselves to surgery learn thoroughly the manner of performing it; and then, when the case occurs, to have left the practice of the same to their burden and duty."

TO PROCURE AN ABORTION is most cruel if the fetus is living; for it not only destroys the body, but also loses the soul. Thus St. Bonaventure solemnly warns in the Dieta, tit. 3, cap. 4, and in the Confessionale, cap. 2, part 13.

I ASSERT that it is not lawful to procure the abortion of a living fetus, even to save the mother's life.

IT IS PROVED by Fagundez, because the offspring possesses life without injury to the mother: therefore a grave injury is done to it if it is destroyed in order to save the mother's life.

FURTHERMORE, because we are bound to prefer spiritual life to bodily life: therefore, if the offspring is believed to be living and to be born, grave sin is committed when, deprived of Baptism, it is killed.

So with St. Bonaventure; Lessius, Tom. 1, L. 2, dub. 10, num. 67; St. Antoninus, part 3, tit. 7, cap. 2; Sayrus, lib. 7, cap. 12, num. 22; Petrus Navatus, Lib. 2 on restitution, cap. 3, num. 138 and 143; Aragon, 2. 2, question 64, art. 7; Fagundez, Lib. 5, cap. 12, num. 19; Bassaeus, V. Homicidium, 1, num. 58; Diana, tract. 5, miscel. Resol. 11, part 5.

Fagundez, moreover, ADDS that in doubt whether the offspring is living, remedies may be applied, because the condition of the possessor is better; but the mother is in possession of her certain life: this holds a fortiori if the offspring is not animated. So too Covarruvias on the Clementine si furiosus, part 2, §. 3; Sylvester, V. medicus, question 4; St. Antoninus, part 3, tit. 7, cap. 2, §. 2; Lessius, and Petrus Navarrus, cited above.

But the FETUS, if it is a male, is animated on the fortieth day; if a female, on the eightieth. So Navarrus, Sum. Lat., cap. 15, num. 14; Covarruvias, cited place; Lessius, num. 67; Sà, V. homicid. But in doubt whether it is a male or a female, it is to be believed a male, as Covarruvias and Sà say.

Certain ANATOMISTS give thirty days for the male and forty for the female. See the Hexaëmeron on Anatomy, disputation 4, question 22.

YOU WILL ASK: Whether it is lawful to cut open the belly of a pregnant mother, whose life is despaired of, so that the child may be drawn out alive.

IT IS ANSWERED: Negatively, with St. Thomas in 4. dist. 6. quaest. 1. art. 1. quaestiuncula 1. ad 4, and 3. part. quaest. 68. art. 11; Domitol. lib. 1. quaest. 14; Corduba quaest. 38. dub. 2; Lopez p. p. Instruct. cap. 63; Alensis 4. quaest. 8. memb. 7. art. 1; Gabriel in 4. dist. 4. q. 2. art. 3. dub. 2; St. Antoninus 3. part. tit. 4. cap. 13. §. 1; Sylvester V. Baptismus, 4; Soto in 4. dist. 5. quaest. unic. art. 11; Angelus V. Baptismus, 6; Tabien. num. 5; Armilla num. 38; Victoria de sacer. quaest. 33. The reason is, because that section is a killing: Evils are not to be done that good may come of them. But a dead body may be cut open, L. Posth. ff. de inoffic. test.

It is also illicit to give remedies for sterility. See Fagundez L. 5. cap. 13; Sanchez l. 9. disput. 20. Sixtus V forbids this de abortu, §. 5, and cap. si aliquis, and homicid. For it is against the end of generation. Nor should you say that abortion in the unanimated is closer against that end.

For I say the fetus is an aggressor against the mother's life; but not fertility.

You will object: the emission of seed is never lawful. Therefore neither is that of the fetus, which is closer to generation.

I say neither is abortion directly intended. But if it be probable that the mother also would die together with her living child; whereas with the remedy given the mother can be saved; Bassaeus says a potion may be given to her.

Caia, a Catholic mother of a family and already four months pregnant, was suffering from almost continual vomiting. The physician summoned to her declared that the indicated remedy for the vomiting was abortion, and that unless she procured it, she herself with the fetus would most certainly die within one or two months. If abortion were procured in time, the fetus could be baptized, and the mother herself would very probably be saved. Caia asked her confessor whether in the stated circumstances she could bring about abortion. Hence it is asked:

1. By what principal arguments is it defended that abortion is lawful in order to save the mother?

2. How is it proved that abortion is always intrinsically evil?

3. What is to be said of the case?

1. What were the chief arguments by which it was argued that abortion is allowed in order to save the mother’s life?

We are not concerned here with the arguments used by materialists, who look upon the child before birth as a portion of the mother which may be destroyed if it threatens her life, and see no difficulty in killing one in order that the other's life may be preserved when both can not be saved. We are only concerned with theologians, some of whom thought that in such cases as we are now discussing medical abortion may be permitted. They defended this view on the following grounds: Abortion is usually caused by puncturing the membranes, and this may be done to relieve the mother when pregnancy is threatening her life, though the puncturing also causes abortion and the consequent death of the fetus. In a collision between the right to life of the mother and that of the fetus, the fetus may be said to cede its right in favor of the mother, especially as otherwise both would perish, and the fetus would not be baptized; whereas if aborted, it can be baptized.

2. How is it shown that abortion is always intrinsically wrong?

Direct abortion is always intrinsically wrong because it is direct killing of the innocent. For to cause abortion is to deprive the fetus of the medium in which alone its life can be preserved, which is to kill it directly just as much as thrusting a man under water or into a chamber exhausted of oxygen is killing him directly. As, then, the puncturing of the membranes is the direct killing of the fetus, it is not allowable, even when necessary to save the life of the mother; for evil may not be done that good may come. Nor can the fetus renounce its right to life in favor of the mother, and permit itself to be killed directly ; for not man but God alone is the Lord of life and death. In a collision of rights the owner of the better right takes something to himself which is his; his better right gives him no title to take away that which is another's, and so collision of rights can not be applied to justify direct abortion; it takes away the life of the innocent victim.

3. The case. From what has been said it is clear that Caia may not consent to abortion, as the fetus is not viable. She must ask the doctor to prescribe some other remedy or palliative which will at least save her conscience if not her life. This solution is confirmed by the decree of the Holy Office, July 24, 1895, which declared that such medical abortion as is described in this case is not lawful.¹

1 See Lehmkuhl, Theol. Mor., vol. i, n. 844, ed. 9.

Titius, a young Catholic physician, asked Paul, his confessor, whether he could safely follow the doctrine commonly handed down in medical schools concerning the manner of treating ectopic fetuses. For sometimes a fetus is conceived outside the uterus and begins to grow, and it cannot always be distinguished from a tumor. Its growth, however, constitutes a grave danger to the mother, especially when the enclosing membrane is ruptured. According to the doctrine handed down in medical schools, an electric fluid is introduced into the cyst, and thus the fetus, if any is present, is deprived of life, ceases to grow, and the mother’s life is saved. Titius therefore wished to know whether it is lawful to act thus, and, if it is not lawful, what must be done when the mother’s life is endangered by a tumor which probably is an ectopic fetus, or which certainly is an ectopic fetus. Hence Paul asks:

1. What is an ectopic fetus, and why is it dangerous?

2. How are the direct and indirect killing of a human being distinguished, and when is it lawful?

3. What is to be said of the case?

1. What is an ectopic fetus and why is it dangerous? The proper place for the fecundated ovulum to settle and grow to maturity is the uterus, but sometimes it remains in the ovaries, sometimes in the Fallopian tubes, sometimes it falls into the abdominal cavity, and in these cases it is c called ectopic or extrauterine. An ectopic fetus can not be delivered in the ordinary way, and its growth becomes a serious danger to the life of the mother, chiefly on account of blood vessels being ruptured in the mother’s body by the continual growth of the ectopic fetus.

2. The first part of this question is answered above, p. 226.

Direct homicide is lawful by public authority in punishment of crime, or in a just war, and by private authority in self-defence. Indirect homicide may be permitted for some object of great importance.

3. The case. It is obvious that if an ectopic fetus is living, it will be direct and unlawful homicide to kill it with electricity. If it is uncertain whether a cause of danger to a woman is an ectopic fetus, or a tumor, or some other growth, laparotomy may be performed and the cause of danger removed as soon as the danger becomes imminent. For in that case the certain danger of the woman must be considered and guarded against in preference to the danger to the life of a fetus which is only probable and perhaps non-existent. Even when the danger certainly comes from the presence of an ectopic fetus, the same operation may probably be performed when its growth causes the danger to the mother to be imminent and the fetus is already viable.¹

1 See Antonelli, Medicina pastoralis, vol. i, n. 338; Lehmkuhl, Theol. Mor., vol. i, n. 1011, ed. 11.

On the other hand, when abortion is procured directly, the fetus is killed directly, and this is never lawful.