Most Holy Father: Stephen Mary Alphonsus Sonnois, Archbishop of Cambrai, humbly submits the following: Dr. Titius, when called to a pregnant woman, who was very ill, observed repeatedly that the only cause of her deadly disease was her pregnancy, i. e., the presence of a fetus in her womb. Hence there was but one way open to him to save the patient from certain and imminent death, namely, to cause abortion. On this course he usually decided in similar cases, taking care, however, to avail himself of such remedies and operations which would not of themselves, or not immediately kill the fetus in the womb, but, on the contrary, would, if possible, deliver the child alive, although, not being able to live, it would die soon afterward. But after reading a rescript from the Holy See to the Archbishop of Cambrai, dated August 19, 1888, that it was unsafe to teach the lawfulness of any operation which might directly kill the fetus, even though such were necessary to save the mother, Dr. Titius began to doubt the lawfulness of the surgical operation by which he had not unfrequently caused abortion to save pregnant women who were very ill.
Therefore, in order to set his conscience at rest, Dr. T. humbly asks whether, on recurrence of the like circumstances, he may resort to the aforesaid operations.
To this urgent request the Cardinals of the Holy Roman Congregation of the General Inquisition, after advising with the theological consultors, have decided to answer: No; according to other decrees, namely, those of May 28, 1884, and of August 19, 1888.
Furthermore, esteemed sir, the Sacred Congregation, besides referring to the decree quoted herewith, has declared that it is unlawful to cause abortion also when the woman's pelvis is so narrow that even a premature delivery is not considered possible. (Response of the Holy Office to the Archbishop of Cambrai, July 24, 1895; AAS 28, 383ff., Denzinger, n. 3298)
1. "Is it permissible to accelerate birth, so long as, on account of the narrowness of the woman's pelvis, it would be impossible for the fetus to emerge at the natural time?"
2. "And if the woman's pelvis is such that a premature birth is also not judged impossible, will it be permissible to provoke an abortion or to perform a caesarean operation in its time?" 3. "Is laparotomy permissible when there is question of extra-uterine pregnancy, or ectopic conceptions ?"
Ad 1. The acceleration of birth is not in itself wrong, as long as it is done for right reasons, and at such a time and in such a manner, that the life both of the mother and the fetus is provided for according to ordinary contingencies.
Ad 2. As regards the first part, the response is negative, according to the decree of July 24, 1895, on the illicitness of abortion. To the second part, there is no obstacle to the woman's undergoing an caesarean operation in its time.
Ad 3. In case of urgent necessity, laparotomy is permissible for the extraction of ectopic conceptions from the maternal bosom, provided earnest and timely care be taken, as far as is possible, for the life of both fetus and mother. (Response of the Holy Office, July 25, 1898; Denzinger, 3336-3338)
"Is it ever allowed to extract from the body of the mother ectopic embryos still immature, before the sixth month after conception is completed?
No; according to the decree of May 4, 1898, which declares that, as far as possible, earnest and opportune provision is to be made for the life of the fetus and of the mother. As to the time, let the questioner remember that no acceleration of birth is licit unless it be done at a time, and in ways in which, according to ordinary contingencies, the life of the mother and the child be provided for. (Response to the Theological Faculty of Marianopolis, March 5, 1902; Denzinger, 3358)
"Never and in no case has the Church taught that the life of the child must be preferred to that of the mother. It is erroneous to put the question with this alternative: either the life of the child or that of the mother. No, neither the life of the mother nor that of the child can be subjected to an act of direct suppression. In the one case as in the other, there can be but one obligation: to make every effort to save the lives of both, of the mother and of the child.
It is one of the finest and most noble aspirations of the medical profession to search continually for new means of ensuring the life of both mother and child. But if, notwithstanding all the progress of science, there still remain, and will remain in the future, cases in which one must reckon with the death of the mother, when the mother wills to bring to birth the life that is within her and not destroy it in violation of the command of God - Thou shalt not kill - nothing else remains for the man, who will make every effort till the very last moment to help and save, but to bow respectfully before the laws of nature and the dispositions of divine Providence." (Pius XII, Allocution to Large Families, November 26, 1951. From The Human Body, Papal Teachings, by the Monks of Solesmes, St. Paul Editions 1979, No. 323, 324).
"But, it is objected, the life of the mother, especially the mother of a large family, is of incomparably greater value than that of a child not yet born. The application of the theory of the equivalation of values to the case which occupies us has already been accepted in juridical discussions. The reply to this harrowing objection is not difficult. The inviolability of the life of an innocent human being does not depend on its greater or lesser value. It is already more than ten years since the Church formally condemned the destruction of life considered to be 'without value'; and whosoever knows the sad events that preceded and provoked that condemnation, whosoever is able to weigh the direct consequences that would result, from measuring the inviolability of innocent life according to its value, can well appreciate the motives that determined that condemnation.
Besides, who can judge with certainty which of the two lives is in fact the more precious? Who can know what path that child will follow and to what heights of achievement and perfection he may reach? Two greatnesses are being compared here, one of them being an unknown quantity." (Pius XII, Allocution to Large Families, Nov. 26, 1951. From The Human Body, no. 325.)
It has been our intention here to use always the expressions "direct attempt on the life of the innocent person" [and] "direct killing." The reason is that if, for example, the safety of the life of the future mother, independently of her state of pregnancy, might call for an urgent surgical operation, or any other therapeutic application, which would have as an accessory consequence, in no way desired nor intended, but inevitable, the death of the fetus, such an act could not be called a direct attempt on the innocent life. In these conditions the operation can be lawful, as can other similar medical interventions, provided that it be a matter of great importance, such as life, and that it is not possible to postpone it till the birth of the child, or to have recourse to any other efficacious remedy. Both for the one and the other, the demand cannot be but this: To use every means to save the life of both the mother and the child. (Pope Pius XII, Address to the Family Front Congress on November 27, 1951. Published in Matrimony, Papal Teachings. Boston: St. Paul Editions, 1963, pages 437 to 440). Also in The Human Body, no. 326.
58. ... Especially in the case of abortion there is a widespread use of ambiguous terminology, such as "interruption of pregnancy", which tends to hide abortion's true nature and to attenuate its seriousness in public opinion. Perhaps this linguistic phenomenon is itself a symptom of an uneasiness of conscience. But no word has the power to change the reality of things: procured abortion is the deliberate and direct killing, by whatever means it is carried out, of a human being in the initial phase of his or her existence, extending from conception to birth....
It is true that the decision to have an abortion is often tragic and painful for the mother, insofar as the decision to rid herself of the fruit of conception is not made for purely selfish reasons or out of convenience, but out of a desire to protect certain important values such as her own health or a decent standard of living for the other members of the family. Sometimes it is feared that the child to be born would live in such conditions that it would be better if the birth did not take place. Nevertheless, these reasons and others like them, however serious and tragic, can never justify the deliberate killing of an innocent human being. (Evangelium Vitae, 1995)
2271 Since the first century the Church has affirmed the moral evil of every procured abortion. This teaching has not changed and remains unchangeable. Direct abortion, that is to say, abortion willed either as an end or a means, is gravely contrary to the moral law.
[In the case of multiple pregnancies], some affirm that they cannot arrive together at term, either because of the spontaneous death of the embryos in the uterus, or because of the premature birth of the foetuses without hope of life. In addition, moreover, it is said that if the unborn children arrive to term, the obstetrical difficulty (and the consequent danger for the mother) is increased. On this basis, they arrive to the conclusion that the selection and the elimination of a few embryos would be justified in order to save the others or at least one of them. It was for this reason that the technique called "embryonic reduction" was introduced.
In this regard, one must note what follows: since every embryo must be considered and treated as a human person in respect to his eminent dignity (Cong. for the Doct. of the Faith, Inst. Donum vitae, I, 1), from the first moment of conception, the fundamental human rights and foremost that of the right to life, must be given recognition to the unborn child, and this right must not be violated in any away. Beyond all confusion and ambiguity, it must therefore be affirmed that "embryonic reduction" constitutes a selective abortion: it consists in fact in the voluntary and direct elimination of an innocent human being (John Paul II, Encyclical Evangelium Vitae, 57). Whether it be sought as an end or used as a means, "embryonic reduction" always constitutes a grave moral disorder (John Paul II, Encyclical Letter Evangelium vitae, 62). Because it refers to a truth always accessible to simple reason, the unlawfulness of such behaviour imposes itself as a valid norm for all, even for unbelievers (John Paul II, Encyclical Letter Evangelium vitae, 101). The moral prohibition remains even in the case where the continuation of the pregnancy involves a risk to the life or to the health of the mother and of the other twin. It is forbidden in fact to do evil even as a means to a good end (John Paul II, Encyclical Evangelium Vitae, 57).
...The embryonic selection which consists in the voluntary elimination of a human life, cannot be justified neither on the basis of the so-called principle of the lesser evil, nor in basis of that of double effect: neither one nor the other, in fact, finds application in this case.
(Declaration by the Pontificate Council for the Family regarding "Embryonic Reduction")
45. Abortion (that is, the directly intended termination of pregnancy before viability or the directly intended destruction of a viable fetus) is never permitted. Every procedure whose sole immediate effect is the termination of pregnancy before viability is an abortion, which, in its moral context, includes the interval between conception and implantation of the embryo. Catholic health care institutions are not to provide abortion services, even based upon the principle of material cooperation. In this context, Catholic health care institutions need to be concerned about the danger of scandal in any association with abortion providers.
47. Operations, treatments, and medications that have as their direct purpose the cure of a proportionately serious pathological condition of a pregnant woman are permitted when they cannot be safely postponed until the unborn child is viable, even if they will result in the death of the unborn child.
48. In case of extrauterine pregnancy, no intervention is morally licit which constitutes a direct abortion (Cf. Directive 45).
49. For a proportionate reason, labor may be induced after the fetus is viable.