Induction of Labor Early.ppt
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Transcript of Induction of Labor Early.ppt
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Early Induction of Labor
Jan C. Heller, Ph.D.
Ethics and Theology
Providence Health & Services
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Presentation Objectives
Introduction: Key question
When is induction not viewed morally as abortion?
Well move from easier to harder cases, and considercontroversial issues along the way
Early induction
After viability
Prior to viability
Discussion and Questions
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Abortion
Human life should be respected from conceptionto death
Mothers and fetuses are of equal moral worth
Issues with early induction generally turns on theERD definition of abortion, which puts a greatdeal of moral weight on viability
Direct abortion is always and everywhere wrong Abortion defined as the directly intended termination ofpregnancy before viability or the directly intended destructionof a viable fetus (ERD, 45).
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Abortion
The moral weight of viability
Viability is defined as that point when, if born,
a fetus has a chance of surviving outside itsmothers uterus.
Given the availability of certain medical expertise
and technologies, this point is currently about 23-24
weeks gestation. But, is viability always relevant? Are some fetuses never
viable?...Well come back to these questions below.
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After Viability
For a proportionate reason, labor may be
induced after the fetus is viable (ERD 49).
At issue here: What counts as a proportionatereason?
When the benefit of the induction for the
mother, the fetus, or both is proportionate to therisk to either or both stemming from the
induction
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After Viability
People of good will will disagree, however
Some relatively clear examples
Renal failure Congestive heart failure
Hypertension
Some less clear examples
Premature and irreversible rupture of membranes, before
evidence of chorioamnionitis
Normal grief or emotional distress due to news about fetal
condition, but notsuicidal or clinically depressed
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After Viability: Controversial Cases
Must the conditions of the principle of doubleeffect be satisfied afterviability?
Does a proportionate reason require double-effect?
People of good will will disagree
NCBC argues yes.
The early induction of labor should be attempted only whenthere are no other feasible options available, that is, when thedegree of the mothers or the fetus pathology is serious oreven life-threatening.
Vs. permitting the mother and her physician to determinetogether what counts as a proportionate reason
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Prior to Viability
Operations, treatments, and medications
that have as their direct purpose the cure of
a proportionately serious pathologicalcondition of the 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
child (ERD, 47).
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Prior to Viability
This directive is usually interpreted as meaningthe induction must satisfy the four conditions ofdouble effect
The act itself must be good or neutral, independent ofits consequences
Agent intends only the good effect (and merely foreseesthe bad effect)
The bad effect must not be a means to the good effect The good effect must (proportionately) outweigh the
bad effect
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Prior to Viability
In language from the Vatican Lives of both mother and child threatened by diagnosed
pathological condition
No possibility of saving the child remains Early induction is the only alternative to certain death
of the mother and the child But, does this language satisfy the conditions of double-effect?
Some examples Chorioamnionitis due to premature and irreversible
rupture of membranes
Severe preeclampsia
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Prior to Viability: Controversial Cases
Cases that are usually induced in secular settings
but are usually prohibited in Catholic settings
E.g., Fetuses with anencephaly or trisomy 13 or 18 Prior to viability, these conditions should not lead to
induction, unless other, relevant pathological conditions
are also present
But, are there some conditions for which viability is notrelevant?
Counter-claim: Innocent life should not be shortened without
the presence of a pathology that threatens maternal health
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Discussion and Questions