Exceptions

ECTOPIC PREGNANCY

OR OTHER DIRECT ENDANGERMENT TO THE PHYSICAL LIFE OF THE MOTHER

An "ectopic pregnancy" occurs when the blastocyst is implanted in an improper position, usually in one
of the Fallopian tubes. The typical diagnosis in such cases is that if growth continues, the blastocyst will
rupture the tube. This will result in the death of the individual in the womb, and will threaten the life of the
mother. In other words, an ectopic pregnancy lacks a biocontinuum. Whether the pregnancy is allowed
to continue or not, the individual in the womb will die.

It could be said that this does not take cases of misdiagnosis and miracles into consideration. That is
true. The same is also true for a great number of other situations in medicine which, despite a lack of
absolute certainty, demand that a decision be made based on appearances and probable
consequences of action or non-action.

Abortion is permissible in the case of ectopic pregnancies, as the least harmful of two options (that is, it
is better to end one life, via the abortion, than to let two lives end, by doing nothing). However, particular
care ought to be taken to ensure that the diagnosis of ectopic pregnancy is accurate.

The same principle may be invoked in other cases of direct physical endangerment of the mother's life.
Again, however, the importance of accurate diagnosis must be emphasized. Also, in some cases of
endangerment to the mother's life, it is feasible that the individual in the womb may reach a stage of
viability. When medically advisable, the option of sustaining the pregnancy to that stage, and then
relieving the endangerment via birth (typically by Caesarean-section) -- thus attempting to preserve both
lives with a fair probability of success -- is preferable to abortion.

CASES OF RAPE AND/OR INCEST

In some cases of rape or incest which have resulted in a pregnancy, the mother's psychological well-
being is endangered -- sometimes in proportion to the advancement of the pregnancy. This situation
creates a moral equation, so to speak, with several factors that are different than the equation
presented by an ectopic pregnancy. At least three factors are distinct:

(1) After implantation, the embryo/fetus appears to be in a sustained biocontinuum.

(2) Other options (especially counseling) exist which may remove the danger.

(3) It seems dubious to claim to reduce psychological harm by adding the experience of undergoing
an abortion to the trauma of rape or incest.

Christians ought to subscribe to the notion that it is generally better to suffer unjustly than to cause
unjust suffering or victimization. Being a victim does not justify victimizing others. Also, Christians
should acknowledge that God is able to salvage a blessing even from a sinful and unjust victimization.
As Joseph said to his brothers, who had sold him into slavery, "Fear not: for am I in the place of God?
But as for you, ye thought evil against me; but God meant it unto good." (Genesis 50:19b-20a). Rape
victims who become pregnant and give birth may receive a sense of consolement along the same
lines.

For these reasons, the least-worst option in cases of rape and incest which have resulted in
pregnancy is to allow the pregnancy to continue. After the fetus is ten weeks old, especially, abortion
would be equivalent to unjustly punishing a child ~ by death ~ for the sin of his/her father.

However, the "social continuum" in this scenario should not be disregarded. Rapists and those who
initiate incest are acting outside the social order prescribed by God. Since God has commanded
that pregnancy should only be the result of a union of husband and wife, it seems fair to assume -- until
there is a particular indication to the contrary -- that He does not want pregnancy, and subsequent
childbirth, to occur by other means. So, following a rape or incest, and preceding any sign of
implantation, the victim's womb may be cleansed to prevent implantation.

ANENCEPHALICISM (AN IMMINENTLY FATAL AND UNTREATABLE CONDITION)

In rare cases (about 1,000 each year in the USA), fetuses are diagnosed as "anencephalic,"
meaning that the fetus' brain is severely underdeveloped, to the extent that the cerebral cortex has no
potential to function properly. In other words, the individual has a brain stem, but no "higher brain." A
very reliable diagnosis of this condition is ascertainable with special tests. Anencephalicism is not
reversible and always leads to the death of the child except in cases of miscarriage or abortion.
About 55% of born anencephalic babies are stillborn. Anencephalic babies who survive after birth
normally die a few days or weeks later. Some have survived for more than a year, however, with
intensive care.

A secondary issue regarding anencephalic fetuses involves organ donation: is it justifiable, in the
second half of a pregnancy, to abort an anencephalic fetus (whose life, if unaborted, would be very
brief), and donate the fetus' organs to a child who needs them (whose life may thereby be
sustained)?

Because human consciousness resides in the brain, the potential of anencephalic fetuses to develop
personality and personhood is in question. But a new question emerges beyond the question of the
presence or absence of personhood: what does God want to accomplish through these
circumstances?

Regarding this I recommend a careful consideration

of the testimonies of those who have hospitably

welcomed anencephalic babies into their lives.

This is in harmony with the sentiment of

Hebrews 13:2 ~ "Be not forgetful to entertain

strangers: for thereby some have entertained

angels unawares."

"FETAL REDUCTION"

Occasionally, and especially in cases in which fertility-drugs have been taken, a woman may be
pregnant with more fetuses than her womb has the ability to sustain to childbirth. Although some
mothers have given birth to four, five, or (in one famous case) even seven babies, not all pregnant
women are physically capable of doing so. These situations are similar, to an extent, to ectopic
pregnancies, except that instead of endangering the life of the mother, each fetus is endangering the
life of the other fetuses.

The risks of attempting to continue the pregnancy, without intervention, to the point of viability and
birth by Caesarean-section ought to be considered, and special circumstances may affect one's
calculations of those risks. Generally, though, when physicians confidently diagnose that to continue
the pregnancy of all the fetuses would substantially risk the loss of them all, and that to take the life of
one (or more) of the fetuses would substantially increase the probability of the others' survival, the
abortion of one fetus (or of more than one) to preserve the lives of the others may be considered, as
a defensive act, the least-worst option.

However, it should be noted that this scenario often arises because of the use of fertility drugs.
Christians ought not to intentionally contribute to the creation of situations in which there is a relatively
high probability that an innocent life will be taken. For this reason the use of fertility drugs which tend
to produce multiple-fetuses should be avoided.