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The patient had pulmonary hypertension, a rare and often fatal condition in which a pregnancy can cause the death of the mother. Sister Margaret McBride was the on-call member of the Catholic hospital’s ethics committee. She was part of a group, including the patient and doctors, who approved the termination of the pregnancy. Because of her participation in that decision, Sr. McBride is currently excommunicated from the Catholic Church.

Stories like this make the Catholic Church seem so very unreasonable . Who would not prefer to save the life of a woman who is already “here,” one who can be touched and seen and appreciated, over the life of a great unknown, the dependent creature in the womb? Other faiths allow abortion in a case such as this; only the arrogant Catholic Church, it seems, is so blind to reason, so narrow and unnatural.

But the position of the church is actually born from humility, from daring to believe that God knows what he is doing. The church is not blind; she sees with eyes that are not fixated on the corporeal. Her perceived narrowness of perspective is actually so broad, it reaches into mystery. Far from being unnatural, she remains supernatural. She dares to trust that God’s plans really are “of fullness, not of harm.”

Although details are scarce, we are told there was an “urgency” to this 11-week pregnancy, and that there was a “nearly certain” risk of death to the mother. “If there had been a way to save the pregnancy and still prevent the death of the mother, we would have done it,” the hospital told The Arizona Republic . “We are convinced there was not.”

The adverb is the bugaboo. A “ nearly certain, risk” is where reason, faith and ethics collide. Man trusts what man knows (in this case science and human flesh) and because he likes that illusion of control, he ignores the qualifier and calls the risk “certain.” It is easier to move on a pure certainty than on a “near” one that muddles everything up.

Having subjected these difficult, seemingly no-win situations to serious and prayerful thought, the Catholic Church gleans that”in obedience to God”this is where trust , that most difficult thing, must enter into the picture. She teaches that as we are all loved into being (and precious in the sight of God) a mother’s life, and the life of her baby, are of equal value; therefore each circumstance”and all available treatments and possible outcomes” must be individually considered.

Where both mother and child will surely perish”as in the case of an ectopic pregnancy threatening to burst a fallopian tube, or a uterine cancer or hemorrhage necessitating the whole removal of the uterus”the death of the child is a secondary (and unintentional) result of the life-saving treatment. This “indirect” abortion is made distinct from a “direct” (and therefore illicit) abortion, by intention.

Trained to value feelings over fine distinctions, moderns may not like it, but there is a difference between a procedure that “saves the mother’s life but (indirectly) destroys the baby in the process,” and one that “destroys the baby (directly) to save the mother’s life.”

To some, that may seem like splitting hairs, or debating over how many angels dance upon the head of a pin, but, as Chesterton wrote, “It is the fact that many a man would be dead today, if his doctors had not debated the fine shades about doctoring. It is also the fact that European civilization would be dead today, if its doctors of divinity had not debated fine shades about doctrine.”

Asked if the church position prefers the mother and child to die, rather than sparing the life of one of them, [James J Walters, professor of bioethics at Loyola Marymount University in Los Angeles] said the hope is that both would survive.

Exactly right. The church hopes for nothing but life, lived in love, but with the clear-eyed understanding that pain is a part of the whole.

Putting it more simply: aborting the child results in one certain death”not a “near” event, but a sure-thing; what the world might call a “win-lose.” Allowing the child to live, and supporting the mother with all due diligence throughout the pregnancy may result in the death of one, (another “win-lose”) or both, (a “lose-lose”) but because of that qualifier, “ nearly ,” and because even the best doctors cannot wholly insure or predict any outcome, there is also the possibility that no one will die, that both mother and child will live. A “win-win.”

If the church errs, she errs on the side of life. If she regrets the necessity of a “win-lose” in the case of an indirect abortion, she rejects outright the irrevocable “win-lose” of a direct-abortion in order to dwell in the possibility of a win-win.”

“When I first [was diagnosed with pulmonary hypertension] I was told, ‘You need to abort the pregnancy,’” [JoShara Rodgers] Rodgers said. “‘You need to abort. You’re going to die. You’re going to die.’ That’s when I finally said, I was like, it’s in God’s hands. If it’s His will we’ll make it through OK.”

Nationally, two-thirds of pregnant woman with pulmonary hypertension will not go home with their newborn. To avoid this outcome, just about any medical textbook or study reads the same.

[ . . . ]

[Dr. Dianne Zwicke] is the director of the pulmonary hypertension clinic at Aurora St. Luke’s Medical Center and has developed a recipe of sorts for helping a mother with pulmonary hypertension survive after childbirth. While the top medical centers in the country have a 50 percent to 60 percent death rate, Zwicke has a 100 percent success rate. She has helped 40 women worldwide.

“These guys . . . They’ve all been told, ‘You’re going to die.’ And you don’t have to die,” Zwicke said. (Excerpted from an interview with ABC affiliate WISN, Wisconsin)

Trying circumstances such as these are an invitation to ponder all we do not know. We believe that God wants both mother and child to live, but accept the possibility of other plans and even other”to us shocking”ideas, such as this one: What if that was all the life the mother was meant to have?

That unthinkable question, asked in light of the promise of Jeremiah 29:11, is where, for Christians, the rubber may well meet the road. Can we accept and wholly trust that God “has a plan” for each of us, if only we do not impede his access into our lives? We are meant never to forestall God’s possibilities.

Our society loves time-travel stories. We love to tease the notion that one change in the time-continuum can have drastic and far-reaching consequences, even for peripheral characters, and for generations. A quantum slip, and the whole world may be forever altered.

But we never wonder (and indeed, some will hate me for daring to do so, here): what happens, within that continuum, when a woman who perhaps, in God’s plan, was supposed to die, instead chooses to kill the baby and remain alive?

If we believe that God has indeed has loved us into being, and for a purpose, what happens when the purpose is thwarted? Suddenly everyone in the mother’s world, even those on the periphery, may see their lives tilted away from the original “plan” God had for them. Perhaps lessons that need learning go unlearned. Perhaps a gadget that needs inventing in order to feed millions in the third world must be invented later. Perhaps a child meant to grow up formed by the knowledge that her own mother loved her so much that she risked death for her is not born at all, and a love that needs manifesting and expressing, goes undiscovered, and unshared.

If God is love, that last might be reason enough to choose life over abortion, even when the struggle is most heartfully sincere, the possibilities are complicated and frightening, and the illusion of control seems so tantalizingly near and clear.

Elizabeth Scalia is a contributing writer for First Things . She blogs at The Anchoress .

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