Embryotomy

EMBRYOTOMY. - Fetal mutilation, which aims at the completion of a delivery obstructed by the mutual disproportion between the diameters of the pelvis and the fetus or by the abnormal presentation of the latter (shoulder presentation).

It consists in perforating, with special instruments, the head or the body of the fetus, still in the uterus, emptying it of its contents (evisceration), reducing its volume by crushing it with suitable forceps, and, thus mangled, extracting it from the maternal womb. One thus arrives, according to circumstances, at craniotomy, cephalotripsy, decollation, basiotripsy and basiodastia (crushing of the base of the skull), rachiotomy, detruncation.

E. can be practiced on a dead fetus and on a living fetus. The former, for which no questions of moral licitness arise, presents multiple and legitimate indications, sparing the mother suffering and grave dangers with only the sentimental sacrifice of the integrity of the dead body of the fetus. E. on a living fetus, on the contrary, still represents a painful humiliation and a moral stain on obstetrics; therefore it is increasingly losing ground, defeated by the progress of obstetric and surgical technique, which replaces it with symphysiotomy, pubiotomy, cesarean delivery; a reasonably broader application of premature delivery, by inducing it at a time when the fetus, though no longer in the abortive period, has not yet reached the diameters and volume of its full development; and versions, aimed at rectifying the presentation of the delivery.

Even availing oneself, however, of such means, circumstances of time, place, and evolution of the delivery can render the aforementioned operations impossible, operations capable of saving the mother and the fetus together.

Giuseppe de Nismo

EMBRYOTOMY AND MORAL THEOLOGY. - 1. Historical notes. - The ancients were not ignorant of the direct killing of the fetus. That the matter was frequent in Rome is told to us by Ovid (Amores, II, 14, 5-38) and Juvenal (Satires, 6, 594-97): although from their texts it is not clear to what extent they dealt with procured abortion (v.) and to what extent with e. or similar operations.

Also in Catholic theology, from the ancient fathers and apologists down to the most recent times, the two questions of e. and of direct abortion are the object of a single treatment and generally of a single condemnation (St. Zeno, Tractatus, I, 9: PL 11, 326-27; St. Augustine, De nuptiis et conc., I, 17: CSEL, 42, 230).

From the condemnation e. is often excluded, as is abortion, in the case of the inanimate fetus (c. 8, C. XXXI, q. 2). With regard to the animate fetus, on the other hand, the only discordant voice in antiquity is perhaps that of Tertullian (De anima, 25: CSEL, 20, p. 343).

2. Illicitness of e

But the lively and close debate on the licitness of e., when the life of the mother would otherwise be in danger, was kindled in the last century, when D'Annibale undertook to apply to these operations the principle of legitimate defense (v.), considering the human fetus, which endangers the life of the mother, similar to a material aggressor, against whom it is licit to defend oneself, even by killing.

Also resorting to the principle of authority, D'Annibale further argued from the silence of the Holy See on the licitness or otherwise of such operations. Indeed, when questioned, the Sacred Penitentiary replied on the matter (28 Nov. 1872), referring to the doctrine of ancient and recent authors. But D'Annibale's thesis, founded on this silence, was soon dismantled by another reply of the Holy Office (28 May 1884), which declared that the licitness of craniotomy and similar operations could not be taught in Catholic schools (19 Aug. 1889). And since some, splitting hairs, interpreted the reply in a restrictive sense, as if it concerned only the certainty or otherwise of the doctrine and not the licitness of the operation in itself, the same Congregation with a new reply (24 July 1895) specified the illicitness of recourse to e.

Moreover, even the argument from reason put forward by D'Annibale did not withstand more careful criticism. The situation that comes about in the womb of the pregnant mother is provoked only by a process that is voluntary at the outset on the part of the mother and thereafter purely natural, due to malformations either pre-existing or subsequent in the mother and the unborn child; but the aggression, if one may speak of it, would rather have to be imputed to the mother, at least for that part of the voluntary acts that have matured such a situation, never to the unborn child, a completely innocent creature. Nor can one speak of a conflict of rights and of priority, since all human beings have an equal right to life; nor of a "right of extreme necessity," which can never extend so far as to legitimize the sacrifice of an innocent person (cf. encycl. Casti connubii, 31 Dec. 1930; AAS, 23 [1931], pp. 562-63). For these reasons, after an initial momentary confusion of ideas, Catholic theology soon agreed on the illicitness of e., to which the prohibition of the divine precept "Ne occides" had to be applied.

Nevertheless it is licit to resort to the surgical operation of e., and similar ones, when the fetus is certainly dead. This some authors would wish to extend also to the case of doubt concerning the vitality of the fetus, applying (though it does not seem apt) the principle of double effect. Given, moreover, the dramatic nature of the circumstances in which these problems agitate the conscience of the physician and of the pregnant woman, it is opportune not to disturb their good faith, should they without malice deem necessary and licit the recourse

(fol. Archives Phalagrophiques)
EMBRUN - Interior of the Cathedral (10th-13th century).

to an operation of e. or similar; but it is always well to admonish that the best possible provision be made for safeguarding the life of the mother and of the fetus. All the more so since civil legislation on the matter, partly contrary to Catholic morality, eliminates in such emergencies the responsibility of whoever performs such operations, justifying them, as in Italian law, by the state of necessity (Penal Code, art. 54). But even in Italian law the elimination of responsibility does not go so far as to make the medical intervention a legal obligation or an official act (cf. V. Palmieri, Medicina legale caustistica, Città di Castello-Bari 1946, pp. 307-309). In any case the problem no longer seems of great topicality. Already in 1931, in the inaugural address at the XXX Italian Congress of Obstetrics and Gynecology, Prof. Pestalozzi asserted that "owing to the progress of science, the indication for e. on the living fetus has disappeared." The state of necessity would thus be eliminated at its root, and anyone who still wished to resort to certain operations could no longer justify his destructive intervention even before civil law.

3. E. and canonical censures

Another problem was agitated in the last century with regard to e.: whether whoever practiced it or permitted it incurred or not the censures pronounced for abortion.

The question was discussed for the first time in the treatises and commentaries that appeared after the constitution Apostolicae Sedis of Pius IX (1869). The majority excluded craniotomy and similar operations from the censure (Berardi, Hilarius a Sexton, Cornelisse, D'Annibale, etc.) and this remained the common opinion until the CIC. The principal reason is that here it is not a question of expulsion as in abortion, but of extraction, after prior killing.

Even after the CIC there are few authors who assert the contrary (Eichmann, Coronata, Wernz-Vidal, Stockams). For some, the crime takes on the character of homicide and is therefore subject to the irregularity referred to in can. 985 n. 4, and is liable to the penalties referred to in can. 2354. But perhaps the criterion to be followed in judging how far it is a question of abortion or of s. is to be inferred, rather than from the method or technique used in the operation, from the viability or non-viability of the fetus: there is abortion, and therefore the relative penalties, if the expelled fetus is not viable; if it is viable, whatever the technique used in the killing, there is e., which may rightly be considered homicide with all its moral and juridical consequences.

For operations on the ectopic fetus, v. ABORTO.

Giuseppe Palazzini