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 Question

Dear Father Bellon,

I’m an anaesthetist. I am writing because I have questions on the issue of abortion, extrauterine pregnancy and interventions such as tubal ligation. I read other answers you have given and I would like to deepen them by rephrasing my questions. The questions arise from good intentions and come from the fact that we are involved in this every day putting our heart into it and also trying to safeguard ourselves as Christians and doctors. Our positions are often difficult because the environment is hostile and because a certain organisational discomfort is created that others do not understand or justify. Having said that, I want to follow the Church.

1 – Is it legitimate to make an anaesthetic visit to patients who intend to have an abortion with the intention of trying to dissuade women as much as possible in order to save the children? In my experience and that of Christian friends, we have sometimes managed to dissuade women by saving children. On the other hand, our non-participation in the visits did not save any children. This good reason (trying to prevent a murder), in a situation nearing its conclusion (after that, there is only surgery) and which I would therefore call urgent, can justify, or save, the evil of obliged participation in the pre-intervention visit? I use the mandatory term because the anaesthetic visit is the only and last moment for us to be able to enter into a relationship with patients without participating in the final abortion act. In other words, can the obligatory use of this illicit route, but to save a life in “last chance” situations, make it lawful?

2 – I found myself getting involved with the surgeon to put patients to sleep for urgent reasons such as bleeding for example due to ectopic pregnancy. Given that it is not the anaesthetist who makes the surgical indication and decides the surgical technique but the surgeon, so it is difficult to contradict it if appropriate, in case the surgeon intends to perform a direct abortion in cases of urgency that cannot be postponed or where the surgeon cannot allows a discussion, also considering the fact that the law does not allow objection, is it lawful to participate in the intervention with the intention of assisting the mother despite opposition to the abortive action of the surgeon?

3 – Should the objection be extended to tubal ligation cases?

I hope I was clear.

I sincerely thank you

 Answer

Dear friend,

Before answering you, I talked to a colleague who is an expert in Catholic bioethics and I proposed to him my solution. He kindly added his comments. Therefore, I answer your three questions by putting my answer first, and the expert’s second in italics. In the first two cases, I add my reply to my colleague’s reply.

1. For the first question: the situation does not seem to me different from that of participation in the public counseling center where – after having advised them to reflect – if the woman has decided to have an abortion, giving her the pass is an immoral participation in abortion: so my answer is no. Unless the anaesthetist has the determination to listen to the woman in an extreme attempt to dissuade her. If you dissuade her, no problem arises. But if the woman decides to go ahead, the anaesthetist cannot participate, he should withdraw and indicate someone who could do it. However, I don’t know if the health facility allows such behaviour.

The colleague replied: I consider this aspect: the woman is determined to have an abortion and therefore begins the process, including the anaesthetic visit. The anaesthetist has in front of him a person determined to make a messy gesture that he does not share. So he must invoke conscientious objection, which, moreover, the law 194/1978 recognizes. But if he has not invoked the objection and therefore if he is not registered with the ASL as an objector, he is called to participate. If  you did the anaesthetic visit, would you formally cooperate? I think not because it does not share the aim. Would you cooperate materially? Yes. But could this cooperation – which I believe to be remote – not be justified in consideration of the fact that the woman begins the anaesthetic examination being in any case determined to pursue the evil purpose and that the anaesthetist has the primary objective of dissuading her?

My reply: our actions receive their first moral qualification from the intrinsic objective of the action and not from the intention. If the intrinsic goal is immoral and in our case it is because it is anaesthesia as a premise to abortion, the good intention does not justify the action. What the colleague calls the primary objective is the intention, and not the intrinsic objective of the action.

2. For the second question: here it should be seen whether it is a direct abortion or an indirect abortion. In the second case, when a “piece of the fallopian tubes” or an ovary is removed, within which there is an embryo or fetus, since the operation is configured as an indirect abortion, you can participate. If it is a direct abortion: no. Clearly in this case the anaesthetist should ask the surgeon what this is about. It is in his rights to know.

The colleague replied: In the abstract, I agree with your answer. I understand the difficulty of emergency surgery and the relationships between anaesthetist, who is seen as an auxiliary, and a surgeon, who considers himself the main professional.

My reply: however, if the anaesthetist has registered as a conscientious objector, and it is a duty on his part, he cannot be summoned by the surgeon. He cannot participate in any way in the killing of an innocent person. Because that’s what it is.

3. For the third question: Yes, of course.

The colleague replied: I agree with your answer

4. Thank you for your trust and above all for the long wait. I will have a very special memory for you in my prayer and in particular during the Holy Mass. I wish you well and I bless you.

Father Angelo

Translated by Rossella Silvestri