Yep, to elaborate on this in one the baby is a co-victim of the situation a fellow human. In the other the baby is viewed as the source of the problem and almost like a disease or tumor to be extracted directly by method and intention. In one the removal of the tube kills the child in the other the doctor goes in and kills the child as a proposed method of healing.
To many the distinction may not be very clear or be viewed as too fine a point or even not a real distinction. But the acts are totally different.
A quote from my link in post #56 shows the distinction between different methods of treatment for an ectopic and may help to highlight where we see a difference:
Proposed Treatments
Catholic Theologians typically discuss the morality of three common treatments for ectopic pregnancies according to the principle of double effect.[4] One approach utilizes the drug Methotrexate (MTX), which attacks the tissue cells that connect the embryo to its mother, causing miscarriage. A surgical procedure (salpingostomy) directly removes the embryo through an incision in the fallopian tube wall. Another surgical procedure, called a salpingectomy, removes all of the tube (full salpingectomy) or only the part to which the embryo is attached (partial salpingectomy), thereby ending the pregnancy.
The majority of Catholic moralists reject MTX and salpingostomy on the basis that these two amount to no less than a direct abortion. In both cases, the embryo is directly attacked, so the death of the embryo is not the unintended evil effect, but rather the very means used to bring about the intended good effect. Yet, for an act to be morally licit, not only must the intended effect be good, but also the act itself must be good. For this reason, most moralists agree that MTX and salpingostomy do not withstand the application of the principle of double effect.
The majority of Catholic moralists, while rejecting MTX or a salpingostomy, regard a salpingectomy as different in kind and thus licit according to the principle of double effect. What is the difference?
A partial salpingectomy is performed by cutting out the compromised area of the tube (the tissue to which the embryo is attached). The tube is then closed in the hope that it will function properly again. A full salpingectomy is performed when implantation and growth has damaged the tube too greatly or if the tube has ruptured. These moralists maintain that, unlike the first two treatments, when a salpingectomy is performed, the embryo is not directly attacked. Instead, they see the tissue of the tube where the embryo is attached as compromised or infected. The infected tube is the object of the treatment and the death of the child is indirect. Since the child’s death is not intended, but an unavoidable secondary effect of a necessary procedure, the principle of double effect applies.
Dr. T. Lincoln Bouscaren,[5] an early 20th-century ethicist and canon lawyer, argues that though the pathological condition is caused by the presence of an embryo in the fallopian tube, nonetheless “the tube has become so debilitated and disorganized, or destroyed by internal hemorrhage, that it now constitutes in itself a distinct source of peril to the mother’s life even before the external rupture of the tube.”[6]
Bouscaren admits that this is a “fine distinction,” but he essentially argues that the infection in the tube, though related to the pregnancy, is sufficiently distanced from the pregnancy to constitute a pathological condition of its own. He maintains that the inevitable rupture is the final end of a single pathology, i.e., a diseased and ever-worsening tube.
Dr. Bouscaren arrives at the same conclusion as the majority of Catholic moralists, that both the partial and full salpingectomy is licit. Some critics of this conclusion argue that salpingectomy is morally indistinguishable from salpingotomy or MTX. Therefore, Dr. Bouscaren’s explanation is helpful and would benefit from further elaboration by contemporary moral theologians.
There are two circumstances that make the use of any of these treatments morally acceptable. The first occurs when an ectopic pregnancy has been diagnosed, but no signs of life exist. The morality of treatment for ectopic pregnancies concerns the absolute value of human life. Conversely, there is no such moral consideration if the embryo has succumbed—there is no taking of human life (assuming a reasonable effort has been made to detect life).
The second circumstance occurs when the fallopian tube ruptures, whether or not the embryo is alive. A ruptured tube presents an immediate threat to both mother and child. If nothing is done, both will die. The doctor is morally obligated to act, even though only one life can be saved. The rupture is the cause of the child’s death, not any procedure the doctor performs. These two circumstances, miscarriage and rupture, present fundamentally different moral questions from instances in which both mother and child are alive and the fallopian tube itself does not pose an immediate threat to the mother’s life.
Source