CHAPTER 10

Biomedical Ethics:
Ectopic Pregnancy And The
Principle of Double Effect

Presentation by:
Macaraig, Jhena S.
 If the fetus is said to be where it should
not be in the case of ectopic pregnancy
INTRODUCTIO and is threatening the life of the mother,
N can it be treated as an unjust
aggressor?
What is an
ectopic
pregnancy?
Ectopic Pregnancy is when a
fertilized egg can’t travel
smoothly through the
fallopian tube to the uterus
where a normal pregnancy
develops, it may try to
implant somewhere else. In
98 percent of ectopic cases,
the fertilized egg implants
and grows inside the
fallopian tube. The other 2
percent develop in other
areas of the abdominal cavity
or in the cervix.
Ectopic Pregnancy And The Principle of
Double Effect
James Keenan reported a discussion on the question of ectopic
pregnancy as early as 1893, an interesting point was raised in the
discussion of the theological named Aloysius Sabbetti. If the fetus is said
to be where it should not be in the case of ectopic pregnancy and is
threatening the life of the mother, can it be treated as an unjust
aggressor? A more precise nuanced is even arrived by presenting it as
“materially unjust aggressor,” that is, even without intention simply
because it is in the wrong place, the immature fetus is grave threat to the
life of the mother. It is likened to someone under the influence of the drugs
or alcohol who may be so drunk that clear intentions are no longer present
but nonetheless severely threatens to kill.
Ectopic Pregnancy And The Principle of
Double Effect
A better analogy is even presented in a case when a soldier
who belongs to an invading army is detected by a sniper who is
defending a particular territory. While unseen, the sniper is not
intentionally threatened by the soldier but simply because he is in
the place where he should not be, self-defense demands action on
the part of the snipe. Given such logic of self defense against a
“materially unjust aggressor”, is a abortion of the fetus acceptable?
Ectopic Pregnancy And The Principle of
Double Effect

Ethicists who belong to the catholic communion were given as

instructions clearly defining that is a matter of faith for this
particular Church that is not allowed to use the category of unjust
aggressor, formal or material in questions involving fetal life. The
case of ectopic pregnancy occasions the principle of double effect.
 What is
Principle of
Double Effect?
Principle of
Double Effect
It is absolutely true that the
Catholic Church bans direct
abortion in all cases.  However,
the mother’s life may be saved
by surgery that does
not directly attack the preborn
baby’s life, even if the child may
die as an indirect result of the
procedure. This ethical principle
is known as the principle of
double effect.
In such cases, under the principle of double effect,
physicians must do everything in their power to
save both the mother and the child.  In the case of an
ectopic pregnancy, if the doctors decide that the
mother’s life can only be saved by removing the
Fallopian tube, and with it the preborn baby, or by
removal of some other tissue essential for the preborn
baby’s life, the baby will most likely die.  But this kind of
surgery would not be categorized as an abortion.  This
is the critical and fundamental difference between
abortion and unintentional death.  The intent is not to kill
the preborn child, but to save the life of the mother.
Abortion

● defined as intrinsic evil act that is unacceptable in any direct and

intended form as a human action
● In medicine, an abortion is a loss of pregnancy due to the premature
exit of the products of conception (the fetus, fetal membranes, and
placenta) from the uterus due to any cause.
● abortion may occur spontaneously (termed a miscarriage) or may be
medically induced. 
● The miscarriage of three or more consecutive pregnancies is termed
habitual abortion or recurrent pregnancy loss. 
“For the fetus, though enclosed at the womb of its
mother, is already a human being, and it is
monstrous crime to rob it of the life which it has not
yet begun to enjoy. If it seems more horrible to kill a
man in his own house than in a field, because a man’s
house is his place of most secure refuge, it ought
surely to be deemed more atrocious to destroy a fetus
in the womb before it has come to light. “

-John Calvin
Ectopic Pregnancy And The Principle of
Double Effect

If personalist ethics is applied to biomedical issues, in this

instance, the option that upholds the value of the fetus as that who
“ought to be treated as a person” should be maintained. It may be
considered that imputing aggression albeit materially (without
intention) to a fetus is indicative of an objectification of one who is
deserving of better consideration.
 Conditions of the Principle of Double
Effect
The goal of the surgery The good effect (saving In the case of the There must be a
itself must be good or the mother’s life) is removal of an ectopic sufficiently grave reason
at least morally not caused  by the bad pregnancy, the surgeon for permitting the evil
neutral. In this case, effect (the death of the does not intend or want effect to occur. In this
the goal of the surgery preborn child).  By to kill the baby; the case, the reason is to
is to remove a baby’s death is an save the life of the
contrast, in the case of
pathological organ direct abortion (surgical unintended and mother when all other
which presents an or chemical abortion), unwanted side effect of options for saving her
imminent threat to the the surgery.  By life have been
the death of the child is
life of the woman—a contrast, the intent of exhausted, a good that
wrongly considered to
good goal.  be the “good” effect. abortion is to kill the is greater than or equal
preborn child. to the evil effect of the
baby’s death.