Abortion (ABORTO) - Catholic Encyclopedia, Vol. I, p. 89

Machine translation of the 1948–1954 Italian original. The original text is authoritative.

ABORTO. –

1. MORAL THEOLOGY

It is the expulsion of the ovum, embryo, or immature, that is, nonviable, fetus; in other words, one not yet naturally or artificially capable of extrauterine life.

“Ovum” is the term used to designate the product of conception from its beginning through the completion of the second week; “embryo” is used for the period extending from the second week to the fourth; “fetus” for the months between the fourth week and regular delivery.

The act of abortion must be distinguished: a) from the mere acceleration of delivery. The fetus cannot live outside the maternal womb except, generally, after the completion of the seventh month of gestation; exceptionally, also after the sixth, when the means are available for the special care necessary for the newborn, for example, the artificial incubator. It should be noted, however, that in forming a judgment concerning the viability of the fetus separated from the mother, the number of months is not as important as its physical development and condition. The expulsion of the fetus between the seventh (or sixth) and ninth months of gestation is designated by the term premature delivery or acceleration of delivery; b) from feticide or embryotomy in its various forms (craniotomy, evisceration, passage of electric current), which kills the fetus in the maternal womb in order to make its extraction possible; c) from contraceptive practices, which are intended in advance to prevent fertilization (v. CONTROLLO DELLE).

Abortion may occur spontaneously through various pathological causes affecting the father or mother, for example syphilis (involuntary or natural abortion), or through human intervention (voluntary or artificial abortion). In the latter case it is direct if the means employed are by their nature aimed at procuring it; indirect if neither the intention nor the act performed is aimed at this, but at another purpose, for example treating an illness of the mother; so that the abortion is merely a permitted and not properly intended consequence, even if foreseen.

Abortion may be desired and practiced for unworthy and perverse selfish motives (criminal abortion), or on medical grounds to save the mother (therapeutic abortion), or to prevent the birth of defective offspring (eugenic abortion), or to preserve honor or avoid economic damage (abortion for social reasons).

It is painfully well known how widespread the practice of abortion is in our times, to the point of becoming the most common solution to so many situations and the first recourse; indeed, to the point of being legalized in certain States. This is due above all to growing irreligiousness and to the materialistic conception of life, which drives people to seek pleasure always, at any cost and by any means, and to evade any duty that may be burdensome.
PRINCIPLES. - a) It is gravely illicit directly to kill the ovum, embryo, or fetus in the mother’s womb. This follows from the natural law confirmed by the fifth divine commandment: “You shall not kill.” The innocent creature opening itself to life has the right to live like any other human person. Such killing remains gravely illicit even when it is intended only as a means of saving the mother, because the end does not justify the means, nor is it ever licit to do evil so that good may result from II. Feticide or embryotomy therefore remains forbidden in all its forms. Thus the replies of the S. Uffizio of 28 May 1884, 19 Aug. 1889, and 25 July 1895 (Denz.-U., nos. 1889, 1890, 1890 a. Cf. also Pius XI’s encyclical Casti connubii, 31 Dec. 1930: Denz.-U., nos. 2242, 2243).

b) It is gravely illicit to procure the direct a. of a living embryo or fetus (if the fetus were already dead, it would naturally be licit to extract it). For this is equivalent to direct killing; a creature is in fact expelled from the mother which, once separated from her, cannot live. The illicitness remains even when the a. is procured as a means of saving the young woman’s honor, avoiding the disgrace of the mother or the husband’s vengeance or the burden of offspring, or safeguarding the mother’s own health; this is always by virtue of the same reason that the end does not justify the means and that one must not do evil in order to obtain a real or presumed good. Thus condemned is not only criminal a., but every other direct a. performed for therapeutic, social, or eugenic indications. Thus the S. Uffizio in its reply of 25 July 1895 (Denz.-U., no. 1890 a. Cf. also the most solemn words, considered by some to constitute an infallible definition, of the encyclical Casti connubii, Denz.-U., nos. 2242, 2243, 2244). Also gravely illicit, at least because of the evil intention, are all attempts at a., to which people commonly resort through the most diverse means and remedies, even if in fact they lead to nothing.

c) Acceleration of labor is not illicit in itself, provided that there is a grave cause and that it is carried out at a time and under conditions assuring the life of the fetus and the mother (S. Uffizio, 4–6 May 1898, 5 March 1902: Denz.-U., no. 1890 b-1890 c). The grave cause may consist in saving the life of the mother or the fetus, when acceleration of labor is the only or the best remedy for attaining the end. The cause must always be proportionate to the danger (Cf. L. A. Muñoyerro, p. 92 and the extensive corresponding bibliography).

d) Indirect a. is licit when there is a grave cause. This follows from the principle of double causality: it is licit to perform a good or indifferent action from which a double effect follows directly: one good, which is intended; the other evil, which is merely tolerated or permitted, provided that there is a proportionately grave reason. It is therefore licit to administer a remedy to a seriously ill mother, even if this were detrimental to the fetus, when the following conditions are present: the mother’s illness must be more serious in proportion as the danger of a. is greater; there must be no other harmless remedies; the remedy used must directly benefit the mother, and therefore the possible death of the fetus must not be intended but avoided insofar as possible. If a. should occur, the fetus must be baptized (cf. L. A. Muñoyerro, p. 93).

e) The same principle may be applied in several other cases of grave danger of death for the mother, when the danger cannot be averted except by surgical intervention. Thus: 1) when there is a cancerous pregnant uterus or a tumor that cannot be removed without at the same time removing the pregnant uterus, hysterectomy is licit, because the consequent death of the fetus is neither the end intended (finis operationis; the aim is to remove the uterus not insofar as it is pregnant, but insofar as it is infected), nor the object of the action (finis operis; here, the object is simply the organ to be removed). Cf. J. Aertnys and C. A. Damen, Theol. mor., I, 14th ed., Turin 1944, pp. 471–72. - 2) when there is acute hydramnios or an incarcerated and retroflexed uterus that otherwise cannot be restored to its proper position, puncturing the membranes to let the amniotic fluid escape and thereby facilitate the necessary procedures is not demonstrably illicit. Cf. ibid., pp. 472–73; H. Davis, II, p. 189. - 3) when there are extrauterine pregnancies or ectopic fetuses. Extrauterine pregnancy occurs when the fertilized ovum has implanted in the peritoneal cavity, on the ovary, or more frequently in the uterine tube. Such a pregnancy rarely reaches term, and even in these cases surgical intervention is necessary; it usually ends in the first months through the onset of hemorrhage or rupture of the tube and detachment of the placenta. All this causes the death of the fetus and constitutes a very grave danger for the mother. What conduct should be followed? If the ectopic fetus is already viable, acceleration of labor may be undertaken (S. Uffizio, 4–6 May 1898: Denz.-U., no. 1890 b). If the fetus is not viable and is presumed alive, and there is no urgent danger of hemorrhage, one must wait and watch attentively in order to intervene in time. When hemorrhage has occurred or is imminent, one may then intervene directly against the hemorrhage and remove the tumor, even if it is a fetal sac and the fetus will consequently die. In this case the possible a. is neither the finis operis nor the finis operantis (cf. H. Davis, II, pp. 171 ff.; L. A. Muñoyerro, p. 93 and append. XVI, p. 191; J. Aertnys and C. A. Damen, op. cit. I, pp. 472–73, E. Bon, pp. 395 ff., and their excellent citations. V. also col. 111, no. 4: Obstetric indications). Naturally, it is never licit to act directly upon the fetus and kill it, because that would constitute direct homicide.

f) Other operations are licit when the fetus is viable, because they do not directly kill the fetus (cesarean section, Porro operation, symphysiotomy, laparotomy, and the like); but the following conditions are required: that the death of the mother or child cannot otherwise be avoided; that there be a probable hope of saving the mother; and that provision be made for the spiritual and temporal welfare of the offspring (cf. L. A. Muñoyerro, p. 94, with the relevant citations).

2. APOLOGETICS

In order somehow to contest the gravity of the crime of abortion, recourse is had to many pretexts. Some of these refer to the theory of birth control (for which V. NASCITE, CONTROLLO DELLE); others touch our subject more closely: a) The embryo, and the fetus in its earliest stages, is not yet animated by a rational soul; in this case, procuring an abortion does not constitute homicide. The response is: The S. Office (4 March 1679: Denz.-U., nn. 1184–85) already declared a direct abortion illicit on the pretext that the fetus is unanimated. And rightly so; for the view is now widely shared that the rational soul informs the ovum from the very first moment of fertilization. If the higher faculties lie dormant, this is because the organism does not yet permit them to act, since it is not yet sufficiently developed. But the most recent histological studies of the phenomena occurring in the fertilized ovum reveal that a vivifying principle is present, coordinating and directing everything. In every case the reasoning must be as follows: If the ovum, embryo, or fetus is already animated by a rational soul, direct homicide is involved; all the more reprehensible because very often the nascent creature is deprived of eternal life; if it were not yet animated, there would, if one wishes, be an imperfect homicide, but still homicide, because a vital process naturally ordered toward issuing in a human being is cut short. (Cf. R. Biot, pp. 121–23); b) The child is a mere appendage of the mother; now it is lawful to cut off one’s hand in order to save a life. No; from the beginning the child displays an organism in formation, but an autonomous one, with its own circulation, its own blood, and its own pulsations; it draws nourishment from the mother, but processes it by itself, through a vital principle proper to II. It is therefore not an appendage, but an individual sui iuris; c) The fetus is an unjust aggressor who threatens the life of the mother. The answer must be: No. In the same way, and with even greater reason, one would have to call the mother an aggressor when she is unhealthy, has hepatic insufficiency or endocrine dysfunctions, so that the fetus does not find in the maternal organism the conditions necessary for its development; besides, the fetus bears no blame for having come to life. (Cf. enc. Casti connubii: Denz.-U., n. 2242; R. Biot, p. 123); d) Must two lives therefore be lost? No, but both must be saved; the correct formula is not “the mother or the child,” but “both the mother and the child.” The rights of the mother and the child are the rights of two human persons of equal standing; one cannot be killed in order to save the other. In a shipwreck, one cannot tear the life belt from one person in order to give it to another; e) But it is horrible to let a mother die and deprive the family of its strongest support. The answer must be: Every possible care, concern, and assistance must be employed to avert this painful danger; and when these are properly administered, generally both mother and child are saved. But in the deplorable case in which no remedy whatsoever exists, there is nothing to do but bow one’s head and lament human impotence. In a fire, or when a submarine sinks, it is not always possible to save everyone; at times one is forced to contemplate another’s death without being able to intervene. To let someone die is not to kill; and one must let die, but never kill. In no case. (Cf. R. Biot, p. 124 ff.; G. Clément, 35 ff.); f) In the case of extramarital pregnancies, the honor of a girl or married woman and that of their families is at stake. And not only honor, but peace, harmony, and so forth. Abortion in these cases would save everything. We must observe, however, that honor is preserved by avoiding evil, not by doubling it; g) “A woman has the right to have an abortion just as she has the right to cut her hair and nails, to gain weight or lose weight” (Madéna Pelletier, in L’émancipation sexuelle de la femme, apud R. Biot, p. 118). The objection is too vulgar and unworthy; no comparison is possible between hair, nails, etc., and a human creature, especially when considered as destined to be a child of God and to enjoy eternal happiness.

For the evaluation of objections arising from medical indications, V. col. 111, n. 4: MEDECINA PASTORALE.

BIBL.: First of all, the treatises on Moral Theology. In particular: K. Cappellmann and W. Bermann, La Médecine pastorale, 19ª ed., Paris 1926; E. Hubert, Le devoir du médecin, Paris 1926; J. Pujula, Controversia sobre el aborto terapéutico, Murcia 1930; id. Ex licito el aborto?, Barcelona 1932; I. Antonelli, Medicina pastorale, 5ª ed., Rome 1932; A. Gemelli and A. Vermeersch, in Nouvelle Revue Théologique, 60 (1933), pp. 500–27; 577–620; 677–95; L. A. Muñoyerro, Deontologia Medica, Madrid 1934; F. Marcancini, Culte vuote, Turin 1935; G. Payen, Deontologie médicale d’après le droit naturel, 2ª ed., Paris 1935; A. Lanza, La questione del momento in cui l’anima razionale è infusa nel corpo, in Ballottino filosofico, 4 (1938), pp. 211–66; 333–67; 5 (1939), pp. 36–97, 206–73; R. M. Merkelbach, Quaestiones de embryologia, in Quaestiones pastorales, II, Liège 1937–38; R. Biot, A servizio della persona umana, Italian translation, Turin 1939; G. Clément, Il diritto alla nascita, Italian translation, Rome 1943; E. Bon, Medicina e religione, Italian translation, 2ª ed., Turin 1946; H. Davis, Moral and Pastoral Theology, II, 5ª ed., London 1946, pp. 166–98; L. Seremin, Appunti di morale professionale per i medici, 3ª ed., Rome 1947, pp. 7–39; 133–38; 199–200; 293–99. Celestino Testore

3. LAW

The first reference to abortion as a crime is found in a passage of the Bible (Ex. 21:22), where, however, it is considered more as the consequence of personal injury than as a crime in its own right. In ancient Greece, the prevailing laxity of morals not only tolerated but even encouraged abortion, as can readily be seen from certain writings of Ippocrate and Aristotle. The Romans, convinced that the fetus represented merely a portion of the mother’s viscera, did not punish procured abortion as such (that is, apart from any harm or injury possibly inflicted upon the mother), either during the Republic or in the early years of the Empire; only from the time of Septimius Severus onward did they assimilate it to veneficium, repressing it by fines, exile, forced labor, and even capital punishment if it had caused the death of the pregnant woman.

From the earliest centuries the Church regarded procured abortion in the same light as homicide (recall: the Council of Elvira, 306, can. 63; the Council of Ancyra, 314, can. 21; the Council in Trullo, 692, can. 91; the Council of Worms, 869, can. 35), while distinguishing between the destruction of an animated fetus and that of an unanimated fetus (can. 8, C. XXXII, q. 2). This distinction was reaffirmed by Gregory XIV in the constitution Sedes Apostolica of 31 May 1591, but was subsequently abandoned by Pius IX in the constitution Apostolicae Sedis of 12 October 1869.

The current CIC (can. 2350, § 1) includes procured abortion among crimes against life, thereby resolving, in the manner most consonant with Catholic tradition and doctrine, the controversy that had long been debated, and is not yet entirely settled, concerning the juridical objectivity of the crime in question. For the canonist, therefore, the good protected by the penal norm is the life of the unborn child; it is irrelevant that this is intrauterine life and that the fetus cannot properly be called the subject of a right to life. Any member of the faithful, including the mother, may incur responsibility for this crime, whose material element consists in the violent interruption of pregnancy. The nature of the means used to commit it—internal or external, chemical, mechanical, or moral—is irrelevant.

The consummatory moment coincides with the destruction of the product of conception, occurring as a consequence of the abortive procedures; it is therefore a material offense, which admits of an attempt in both its forms, the frustrated attempt and the attempt proper. The psychological element consists in intent, that is, in the offender’s awareness and will to cause the abortion; consequently, so-called indirect abortion is not sufficient to constitute the offense.

The penalties prescribed by the CIC are as follows: « Procurantes abortum, matre non excepta, incurrunt, effectu secuto, in excommunicationem latae sententiae, Ordinario reservatam; et si sint clerici, praeterea depo-

nantur » (can. 2350, § 1). Three conditions are therefore required for incurring excommunication: a) that it be a true direct abortion (hence premature delivery, embryotomy, and other illicit procedures do not fall under the penalty). The distinction between an animated and an unanimated fetus is irrelevant; and the means employed are immaterial, provided that they are the true cause of the abortion; b) that it be a procured abortion, that is, one deliberately intended and carried out: consequently, under the term « procurantes » must be understood all those without whom the abortion could not have been obtained, namely, the mother, the physician, the assisting nurse, and the instigator (can. 2209 § 1, 3; 2231); c) that the abortion have actually occurred.

Moreover, under the same conditions, guilty clerics become irregular (can. 985, n. 4) and must be deposed (can. 2350, § 1).

With regard to circumstances modifying imputability, it should be noted that, since this concerns an actus intrinsece malus, a state of necessity (of which the typical example is the case of the physician who believes that he cannot save the pregnant woman’s life except by procuring an abortion) does not eliminate the offense, but constitutes merely a mitigating circumstance to be assessed from case to case according to the circumstances (v. can. 2205, §§ 2 and 3). When there is grave fear, those guilty of direct abortion sin gravely but, according to several theologians, do not incur excommunication. It should nevertheless be borne in mind, for practical purposes, that here too, as with every other ecclesiastical offense, the principle established by can. 2218, § 2, applies, by virtue of which anyone found not to be gravely imputable is exempt from punishment.

The constituent elements of the offense of procured abortion are found, in almost identical form, in the majority of civil legislations, although its legal classification varies according to time and place. Some codes (such as the Tuscan Code of 1853 and the German Code) place it among offenses against life; others (for example, the French Code) among offenses against the person; still others (the Serbian Code of 1859 and the Belgian Code) among offenses against the order of families; and finally others (such as the Chilean Code) among offenses against public morality.

The Penal Code currently in force in Italy, introducing a change from the repealed code, places procured abortion in Title X, among « delitti contro la integrità e la sanità della stirpe ». It distinguishes, first of all, abortion of a non-consenting woman (art. 545) from abortion of a consenting woman (art. 546), providing in both cases for a considerable increase in the penalty where the abortion has resulted in the death of the pregnant woman or in personal injury (art. 549); it punishes more leniently the woman who procures her own abortion (art. 547); it treats as a separate offense the act of one who incites a pregnant woman to abort by administering suitable means (art. 548); and it further assimilates, quoad poenam, to the offenses of personal injury and preterintentional homicide abortive procedures performed on a woman mistakenly believed to be pregnant, where they result in injury to or the death of the woman (art. 550). In every case, the offense is aggravated when the guilty party is a person practicing a health profession (art. 555); while the penalties, ranging from a minimum of six months to a maximum of fifteen years’ imprisonment, are reduced by one-half to two-thirds if the act was committed to preserve the honor of oneself or of a near relative (art. 551).

BIBL.: In addition to general treatises, consult the following: for canon law: J. Teodori, Abortus, in Apollinaris, (1932), p. 251; J. Delmaille, Avertement, in DDC, I, coll. 1536 ff.; S. Woywod, The Crime of Abortion, in Homiletic and Pastoral Review, (1938), pp. 385 ff.; M. Cabreros, Sanción canónica del aborto, in Ilustración del Clero, (1939), p. 67; J. Palazzini, Jus fetus ad vitam cinque tutela in fontibus ac doctrina canonica usque ad saeculum XVI, Urbania 1943; for secular law: S. Du Morice, L'avortement, Parisi 1912; A. Visco, L'a. criminoso nel diritto penale, nella medicina legale, nella politica demografica, Milano 1941.

4. PASTORAL MEDICINE

Two eminently physiological episodes in a woman’s life, pregnancy and childbirth, may under particular conditions proceed abnormally, to the point of becoming the cause of illness and even death. In such circumstances, setting aside the moral problem, medicine, concerned to save at least the mother’s life, resorts to therapeutic abortion.

For a proper understanding of the problem from the medico-legal and moral points of view, it is necessary to know the physiological conditions through which pregnancy and childbirth proceed (v. the corresponding entries); the circumstances that may impair their mechanisms, the extent to which this may occur, and the harmful consequences for the mother and fetus; the role of medicine in such cases, concerned solely with saving the mother’s endangered life; and to conduct a critical examination aimed at showing the actual gravity of the danger faced by the mother and the presumed medical necessity of inducing an abortion.

The abortion induced for therapeutic (curative) purposes with which medicine is concerned is intended to remedy the harm and dangers to which the mother may be exposed in connection with a pregnancy that does not proceed physiologically.

A threefold order of indications for therapeutic abortion is distinguished: gynecological, obstetrical, medical.

Gynecological indications exist when the obstacle to the normal progress and completion of childbirth consists in congenital anomalies or acquired diseases of the mother’s reproductive system, particularly pelvic deformities and neoplasms (tumors) of the uterus and adnexa (ovaries and tubes). Pelvic deformities, by altering the shape and dimensions of the bony passage through which childbirth must take place, may, when severe, constitute a serious impediment to the expulsion of a fetus developed to term, resulting in consequences that may be fatal both for it and for the mother. The abortion formerly induced at an early stage of fetal development, so that its smaller size would permit extraction through the natural passages, is currently replaced, where environmental conditions and the physician’s technical skill permit, by operations intended to increase the diameters of the passages through which the fetus must pass (symphysiotomy, pubiotomy, pelvic resections), or by procedures aimed at extracting it directly from the uterus without passing it through the aforesaid passages (obstetrical laparotomy or Cesarean section); in this way, harm to both mother and child may be avoided.

Malignant neoplasms (cancers) developing in one of the organs constituting the woman’s reproductive system, particularly cancer of the cervix, require extensive surgical removal of these parts, which, when pregnancy is concomitant and has not yet reached at least the one hundred and eightieth day of gestation, entails the sacrifice of fetal life (indirect abortion).

The obstetric indications for a. arise from the abnormal course of pregnancy: repeated hemorrhages due to partial detachments of the placenta, spontaneous or following attempts at criminal a.; ectopic implantation of the ovum with the development of extrauterine pregnancies (particularly tubal pregnancy). In this eventuality, as the pregnancy progresses, usually in the second or third month, the mother is exposed to rupture of the organ in which the ovum has been implanted, which is incapable of following its development as the uterus would be; this results in severe internal hemorrhages, more or less sudden, such as to interrupt the pregnancy and place the mother, from one moment to the next, in grave danger of death. Only an extremely prompt laparotomy aimed at removing the lacerated adnexa in their entirety (ovary and tube), together with their fetal contents (which is equivalent to inducing a. if the fetus was still alive), can save the mother from death by acute anemia.

As regards the fate of the fetus in the various eventualities of ectopic pregnancy, it should be repeated that which was already mentioned under no. 1, namely, that in exceptional cases it may reach the end of its development; the possibility of its expulsion through the natural passages is nevertheless excluded, so that unless it is removed by laparotomy, it is condemned to die at the site of its implantation. Conversely, the ordinary outcome of an extrauterine pregnancy is the death of the fetus (internal a.) in the first months of pregnancy (2nd–3rd).

To avoid the grave risk, once the diagnosis has been established, if the woman cannot be kept under continuous observation so as to permit a prompt and rapid intervention in the event of sudden rupture of the tube and internal hemorrhage, preventive removal of the gestational sac is permitted, thereby interrupting the pregnancy abortively.

The medical indications for a. are connected either with diseases from which the woman was already suffering and which worsen with the onset of pregnancy, or with medical disorders, at times also extremely grave, whose cause is an intoxication connected with the pregnant state. In this case, the mother was or appeared to be healthy before the pregnancy, which proves to be the direct causal factor of the disorders that arose.

The first group includes certain serious nervous and mental diseases, pulmonary and laryngeal tuberculosis, and heart diseases; the second group includes hyperemesis, or uncontrollable vomiting in pregnant women (v. INTOSSICAZIONI GRAVIDICHE). In contrast to what was stated in the past, it is now admitted that in cases belonging to the first group, statistics demonstrate that «on the whole, a greater number of human lives are saved by never interrupting the pregnancy than by interrupting it» (Scremin, op. cit., p. 34), thus safeguarding both the interests of the fetus and those of the mother; and it may be maintained that «the application of the ethical norm saves more human lives than are actually saved or spared by therapeutic a.», although one cannot «deny that the application of that norm in certain particular cases also requires the sacrifice of life and that the pregnant woman’s refusal of therapeutic a. is in certain cases a heroic act» (Scremin, op. cit., pp. 35–36). As regards pregnancy intoxications, it may be said that in almost all cases they can be overcome through medicinal and psychotherapeutic treatment.

BIBL.: In addition to the works cited under no. 1, vedi: O. Viana e F. Vozza, L'ostetricia e la ginecologia in Italia, Milano 1933; E. Pestalozzi, Il bilancio scientifico della soc. ital. di ostetricia e di ginecologia nel primo trentennio della sua attività, Milano 1933; V. PALMIRA, Medicina forense, Città di Castello 1947.

Giuseppe de Ninnio