Hence, if some Catholic hospitals have policies that prohibit salpingostomy and the use of methotrexate, this is not because these procedures are forbidden by Church teaching or by the ERDs. Rather, it is because an individual or individuals decided either to take the safer course or personally believed that salpingostomy and the use of methotrexate constitute direct abortions and are, therefore, in conflict with Directives 48 and 45. However, given the on-going debate, it is permissible for Catholic hospitals to employ both the third and fourth approaches. As the editors of the National Catholic Bioethics Center’s Catholic Health Care Ethics note: “Resolution of this debate will depend on further specification of the exact nature of these medical procedures and further refinement of the arguments about the moral object of each act. Generally, if there are two competing but contrary bodies of theological opinion about a moral issue, each held by experts whose work is in accordance with the magisterium of the Church, and if there is no specific magisterial teaching on the issue that would resolve the matter, then the decision makers may licitly act on either opinion until such time that the magisterium has resolved the question."