1. In the rare case when preeclampsia seriously threatens a mother’s life, her baby is too undeveloped to survive outside the womb, and the only way to save one of the two lives is to directly attack the embryo, is the only moral solution to allow both mother and baby to die?
2.Would inducing labor of the previable fetus to save the mother’s life—when both would certainly die otherwise—be considered “directly attacking” the embryo?
I asked my friend, Dr. Anthony Dardano,* to respond to these questions: Obstetrics is a unique specialty, in that the physician has two distinct patients in one body at the same time—neither of whom is more important than the other. The physician is morally obliged to treat both and is never allowed to “directly attack” the fetus—for any reason.
Preeclampsia and eclampsia are serious but treatable conditions—at least until the baby can reach an age of reasonable viability and then be delivered. In all my years and thousands of deliveries, I’ve never seen the scenario described in the original question. Therefore, to answer your first question, no—one may not directly attack the fetus.
Your second question is more involved, ethically. The fetus is in the best incubator there is—the womb. In certain instances the physician must decide whether the fetus is better off remaining in the womb, or being delivered early and transferred to a neonatal intensive care facility, where there’s at least a chance of survival.
Therefore, the physician, acting on the principle of double effect, may take the child out of the fatal toxic intrauterine environment by inducing labor and sending the child to the NICU, when there’s any chance of survival. This isn’t a direct attack on the fetus; it’s an attempt to rescue the fetus. The intention is entirely different and ethically sound.
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