Hard case in Phoenix on abortion

This is the link to CNS on the story of a woman who was automatically excommunicated by consenting to an abortion at a Catholic hospital in Phoenix, sometime recently in May:

http://www.catholicnews.com/data/stories/cns/1002085.htm

I just want to talk about why this is a hard case for a moment. On my facebook page, someone posted a link to a similar story and claimed that this summarized his feelings about the Catholic Church. The implication seemed to have been that the whole scenario was bizarre and its very existence made the Church's position look absurd.

Let me first note that abortion rights are an area on which many intelligent people disagree, and everyone should respect thoughtful voices with which they disagree. At the same time, I want to talk a bit about why this issue is a genuinely hard case. From a point of view rooted in Catholic teaching, it is wrong to engage in aggression toward a defenseless being. That does mean that wars of aggression are categorically wrong.

Now, I don't know many of the specifics in this case, and it's clear that the nun in question was appealing to directive 47 of the Ethical Directives for Catholic Heath Care (http://www.usccb.org/meetings/2009Fall/docs/ERDs_5th_ed_091118_FINAL.pdf). That directive states: "Operations, treatments, and medications that have as their direct purpose the cure of a proportionately serious pathological condition of a pregnant woman are permitted when they cannot be safely postponed until the unborn child is viable, even if they will result in the death of the unborn child."

Even if the fetus is not viable, it still constitutes a human life, from a Catholic point of view. If it is viable, then the act of aborting it is tantamount to being an aggressor toward it. Consider a well known case in ethics at this point, from Kai Nielsen's "Against Moral Conservatism" (see Pojman's Moral Philosophy anthology). The case has it that a group of cave explorers is being led by a portly guide who gets stuck in the mouth of the cave as the tide is coming in. The tide will drown those below if they cannot climb to safety but the only way to safety is being plugged by our innocent guide, who can't get in or out. Luckily or unluckily, someone in the group has a stick of dynamite and the means to light it. Should you or should you not use the stick of dynamite to blow open the hole, thereby killing the man? This is supposed to be a case that helps decide whether we are consequentialists or not (do we determine our courses of action based on how the consequences shake out or do we steadfastly hold to our principles?).

The Catholic Church, as I understand it, does not side with consequentialism on this point. The reason for the clause about viability is that we don't want to have what philosophers call a "trolley problem" on our hands. The famous "trolley problem" is the case where a train cannot be stopped but it is drifting toward an area where five people are tied to the track. You, as the conductor, can throw the switch that will send the train down a track where only one person is tied up, but either way, someone will die.

If the fetus can live outside the mother, says the teaching of the Catholic Church, then we ought to try to save the fetus. If the death of the mother entails the death of the fetus, because the fetus has not yet attained viability, then we must try to save the mother (because otherwise both will die). The preference is for the child, because the mother is the one making the moral decisions, and she can't be an aggressor toward her child, but where the mother's death entails the death of the child, it can be possible to provide medical care whose intention is to heal the mother but whose indirect result is the death of the child.

I'm not going to weigh in on whether or to what extent this particular fetus was viable. More competent people than I make those decisions. One other thing that is important to note, and that non-Catholics may not understand: a person in a similar situation would need to confess the sin in the sacrament of reconciliation (confession) and the person would return to communion in the Church. I'm not sure what this particular nun's order will do about this, but that is another matter.