Induction of Labor Early.ppt

7/29/2019 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

Induction of Labor Early.ppt

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