Emergency abortion denials by Catholic hospitals put woman in danger, after her water broke at 17 weeks, lawsuit claims

o_mlly said:

Can cause! A rupture of the amniotic membrane does not always proceed to an infection and may heal allowing the pregnancy to continue. If infected, and even before signs of infection, antibiotics can be administered to prevent infection.

If the infection of the amniotic membrane does in fact occur and fulminates, Catholic hospitals bioethics do allow the administration of drugs to induce contractions of the mother's uterus in order to expel the infected membranes. Therapeutic interventions on the mother's body to save the mother's life are good. The death of the premature child is bad but tolerated under the principles of the Double Effect.

Click to expand...

MarkSB said:

This is an interesting point. Apparently, there are cases where the mother can try to continue the pregnancy until it becomes viable, and then do an early (very early) delivery. However, in addition to the risks to the mother which were already stated (infection and death), it sounds like the fetus/child is also at risk for long term lung issues and facial deformities, among other things I imagine. I did a Google search and there is actually a story on Reddit of a mother that this happened to. She managed to carry the baby to the point of viability, the baby spent a very long time in the NICU, and was now 5 years old with (if memory serves me correctly) some minor breathing issues.

The problem with this, however, is that when faced with those circumstances, I hope that we would all agree that it should be the mother's choice. (Made in consensus with the father, one would hope). In the absence of laws which say the emergency medical facility must provide that care, the mother is left to travel from hospital to hospital to see who will provide the care. This delay in care puts the mother at greater risk - not only for infection/hemorrhaging and other health consequences, but her future ability to bear children as well. And, all on the likely very slim chance that the child would survive.

I wouldn't ever want to have to make that choice, and I imagine none of us would. But I still think that is a decision which should be in the hands of the mother. I doubt that anyone really wants to force the hand of a doctor in such circumstances (I know that I don't), but unfortunately I think that is something that you need to take into account before you enter certain fields (gynecology, EMT) within the profession. Either that, or allow there to be specific medical facilities where it is well known that emergency care is not provided in such circumstances. AND I would propose that those facilities should then be required to be completely independent from government funding. Those are my initial thoughts, at least.

Click to expand...

o_mlly said:

If the Catholic hospital refused any kind of care to the mother and child then the hospital did not follow the Catholic prescribed bioethics guidelines in emergency pregnancy cases. We may have to wait for a trial (if the case goes to trial) to get the salient facts.

Click to expand...

johansen said:

I suspect it will take dozens of dead moms before the state requires catholic hospitals to manage care properly.

Click to expand...

o_mlly said:

Are you an emergency room physician? If not then I don't think you are qualified to prescribe what is the proper care for pregnant women in need of emergency care.

Click to expand...

johansen said:

man if you read the thread, we're talking about women bleeding to death, or close to it.

send them away the lawyers say! we can't handle the liability of dealing with the featile heartbeat.

Click to expand...

o_mlly said:

Do you have knowledge that the woman was "bleeding to death, or close to it"? All I know from the article is that her amniotic membrane ruptured.

Click to expand...

johansen said:

In a repeat of her past experience, her lawsuit alleges, staff members told her they could not provide the care she sought due to the fetal heartbeat. She was able to access care at another hospital, her complaint says, but experienced sepsis and heavy blood loss in the process.

Click to expand...

o_mlly said:

We don't know what care the Catholic hospital offered but she claims "they could not provide the care she sought due to the fetal heartbeat". If the care she sought was a direct abortion of her living child then of course the Catholic hospital guidelines forbid that act.

If the non-Catholic hospital preformed a direct abortion then blood loss is to be expected and perhaps subsequent sepsis as well.

Click to expand...

Based on Catholic moral teaching, the moral response to a woman's water breaking at 17 weeks focuses on protecting and preserving the lives of both the mother and the unborn child to the fullest extent possible. Since the fetus is not viable at 17 weeks, this creates a complex situation guided by the principle of double effect. [1, 2, 3, 4]


Here is a breakdown of the moral considerations and options from a Catholic perspective.
1. Wait and observe ("expectant management")
The initial moral action is to closely monitor the health of both the mother and the child.

• Preventing infection: The primary risk after premature rupture of membranes (PROM) is infection (chorioamnionitis), which is life-threatening for both the mother and child.
• Antibiotics: Expectant management will likely involve administering antibiotics to the mother to prevent the onset of a dangerous uterine infection.
• Pray and hope: This approach respects the life of the unborn child as long as possible, in the hope that the pregnancy can continue safely, even though the chances of survival are extremely low at this stage. [5, 6, 7, 8, 9]

2. The principle of double effect
If the mother's health deteriorates and her life becomes endangered by an infection, the principle of double effect provides a moral framework for intervention. This principle allows for a good action that has a foreseen but unintended bad outcome. [1, 2, 10, 11, 12]
For an intervention to be morally permissible:

• The action itself must be morally good or neutral (e.g., treating an infection).
• The good effect (saving the mother) is intended, while the bad effect (the death of the fetus) is not.
• The bad effect cannot be the means to achieve the good effect.
• There must be a serious reason for allowing the bad effect to occur. [1, 2, 13, 14, 15]

3. Inducing labor to treat a pathology
If an infection develops, it creates a "proportionately serious pathological condition of a pregnant woman". Under the principle of double effect, a doctor could induce labor to expel the infected tissue and membranes from the mother's body, which is a morally acceptable act.

• Intention: The intention is not to kill the baby but to cure the mother of a life-threatening infection. The baby's death is a tragic, unavoidable side effect.
• Action: The action is directed at treating the mother's pathology, not at harming the child.
• Distinction from direct abortion: This differs from a direct abortion, which intentionally ends the child's life and is never permissible in Catholic teaching. [2, 13, 16, 18, 19]

4. What is not permissible

• Direct abortion: It is not morally permissible to directly or intentionally terminate the pregnancy simply because the water broke. Catholic teaching holds that abortion is wrong from conception onward and is a direct attack on innocent life.
• Preemptive induction: Inducing labor before any risk of infection or other serious maternal complication has developed is considered a direct abortion and is not permissible. This is a key point of disagreement among Catholic ethicists, with some facilities more permissive than others. However, a manual for Catholic hospital ethics committees warns that "the mere rupture of membranes, without infection, is not serious enough to sanction interventions that will lead to the death of the child". [7, 20, 21, 22, 23]

In summary, the moral Catholic approach to premature rupture of membranes at 17 weeks involves:

1. Using expectant management and antibiotics to monitor the situation while trying to preserve both lives.
2. If the mother develops a life-threatening uterine infection, inducing labor to expel the infected tissue is considered a morally licit treatment of the mother's pathology, guided by the principle of double effect. [6, 13, 24, 25]

AI responses may include mistakes.
[1] Early Pregnancy Complications and the Ethical and Religious Directives
[2] Early Pregnancy Complications and the Ethical and Religious Directives
[3] Ethical directives and the care of pregnant women in Catholic hospitals - TheCatholicSpirit.com
[4] https://www.aapc.com/discuss/threads/induced-delivery-at-17-weeks-due-to-premature-rupture-of-membranes.182647/
[5] What It Means If Your Water Breaks Too Early in Pregnancy - Valley Perinatal Services
[6] https://www.pillarcatholic.com/p/what-is-the-catholic-response-to
[7] Managing Abnormal Pregnancies Prior to Viability
[8] https://www.rossfellercasey.com/news/is-the-intrauterine-infection-chorioamnionitis-preventable/
[9] Filing A Chorioamnionitis Lawsuit
[10] https://www.pillarcatholic.com/p/what-is-the-catholic-response-to
[11] https://www.pillarcatholic.com/p/what-is-the-catholic-response-to
[12] https://www.ncbcenter.org/messages-from-presidents/a-false-charge-against-catholic-health-care
[13] https://www.pillarcatholic.com/p/what-is-the-catholic-response-to
[14] https://bobcat-lilac-tcn4.squarespace.com/s/NCBCsummFAQ_EarlyInductionCORREX.pdf
[15] https://pmc.ncbi.nlm.nih.gov/articles/PMC6027086/
[16] What is the Catholic response to medical emergencies during pregnancy?
[17] Making Sense of Bioethics: Column 102: Ethical Directives and the Care of Pregnant Women in Catholic Hospitals — The National Catholic Bioethics Center
[18] https://www.detroitcatholic.com/news/ectopic-pregnancies-miscarriage-abortion-is-never-necessary-these-doctors-say
[19] Bpas
[20] Roman Catholic Church Quickening | Embryo Project Encyclopedia
[21] When There's a Heartbeat: Miscarriage Management in Catholic-Owned Hospitals - PMC
[22] The Bioethics of High-Risk Pregnancy — The National Catholic Bioethics Center
[23] Early Pregnancy Complications and the Ethical and Religious Directives
[24] https://www.cathmed.org/resources/ma-and-ncbc-respond-to-misleading-statement-from-the-american-college-of-obstetricians-and-gynecologists-and-physicians-for-reproductive-healthabortion-can-be-medically-necessary/
[25] https://bobcat-lilac-tcn4.squarespace.com/s/NCBCsummFAQ_EarlyInductionCORREX.pdf

Click to expand...

johansen said:

Im aware. There was another source quoted elsewhere to the effect that they sent her away with a great deal of pads to absorb the blood.

Click to expand...

o_mlly said:

Can you cite the source you refer to?

Click to expand...

Eureka hospital agrees to provide emergency abortions following lawsuit by state

Providence St. Joseph Hospital in Eureka, Calif., has agreed to provide emergency abortion services following a lawsuit filed by state Atty. Gen. Rob Bonta.

www.latimes.com

johansen said:

Eureka hospital agrees to provide emergency abortions following lawsuit by state

Providence St. Joseph Hospital in Eureka, Calif., has agreed to provide emergency abortion services following a lawsuit filed by state Atty. Gen. Rob Bonta.

www.latimes.com

Click to expand...

johansen said:

... maybe you should read all of it.

Click to expand...