-
1. Human Actions
- The Catholic University of America Press
- Chapter
- Additional Information
8 1 | Human Actions Section 1.1. The Problem Traditionally, Catholic moralists have drawn a sharp distinction between two similar cases in medical ethics. In the craniotomy case, the head of the fetus is too large to pass through the woman ’s pelvis, so that natural labor will not result in delivery but will continue indefinitely, probably resulting in the death of both the mother and the child. With the current medical technology of Csections , the situation poses no difficulty, but a century ago there was no sure way to save the life of the mother without killing the fetus. Standard procedure amongst non-Catholic doctors was to perform a craniotomy on the fetus, crushing his head, so that his body might then pass through the mother’s pelvis. When petitioned on the issue, however, the Vatican replied that this procedure was unacceptable;1 Catholic doctors were then faced with the unpleasant choice of allowing both the unborn child and the mother to die. The only alternative, so it seemed, was killing one person in order to save the life of another.2 While the first choice was painful , the second was morally abhorrent. 1. Or rather, that it was unsafe to teach that it was acceptable. John Finnis et al. (“Direct and Indirect,” 1–44, at 26–27) argue that the Church has not taught that the craniotomy is immoral, but that it could not be taught to be licit. On the other hand, Kevin Flannery argues that it cannot be taught because it is in fact not morally acceptable; see “What Is Included in a Means to an End?” Gregorianum 74 (1993): 499–513, at 508–10. 2. The discussions throughout this book will operate under the assumption Human Actions 9 In the hysterectomy case, on the other hand, a pregnant woman is found to have cancer of the uterus, standard treatment of which may include a hysterectomy, which will result in the death of the fetus. Yet in this case, according to the standard Catholic view, the doctor may perform the hysterectomy because she does not kill the baby. She merely removes the womb with the result that the baby dies. The two cases are similar in many respects. In both, the continued pregnancy poses a threat to the life of the mother; in both, the baby will almost certainly die; in both, a procedure may be performed that saves the life of the mother but in which the baby dies sooner than would naturally occur. Despite these similarities two contrary ethical conclusions are reached. The craniotomy is considered killing the baby in order to save the life of the mother , while the hysterectomy is considered saving of the life of the mother with the result that the baby dies. The two cases are distinguished through the action that the doctor performs. In the craniotomy case, she performs an act of killing a baby; in the hysterectomy case, she performs an act of removing a diseased organ, with the result that a baby dies. While killing an innocent human being is never permissible, removing diseased organs is not only permissible but also praiseworthy. 1.1.1. Hairsplitting Casuistry Such reasoning, some protest, exhibits the worst of casuistry. This minute hairsplitting has nothing to do with the lives involved; it is a game of mental gymnastics designed to justify the conclusions we have already reached. In whatever manner we describe the actions involved, the same upshot results. In both instances a baby dies and a woman is saved. No line can be drawn separating the craniotomy from the hysterectomy. We need only look at the results of both actions to see that they are morally equivalent. This that an unborn child is a human person, deserving of equal respect with other human beings. [34.238.143.70] Project MUSE (2024-03-28 20:00 GMT) 10 Human Actions objection seems to suppose that any attempt to distinguish different kinds of actions, as opposed to the consequences of actions, is abusive casuistry, and ipso facto, morally irrelevant; all that matters, morally speaking, are the consequences of an action. Casuistry may be irrelevant to the consequentialist, but if we reject consequentialism with its reductive calculations, then somehow what we do must matter. Consider a soldier whose wartime mission is to destroy a certain bridge over which the enemy troops will soon cross in their path of slaughter and destruction. He has laid the explosives and has just removed himself sufficiently...