Essays In Pastoral MedicineWalsh, James J. (James Joseph)
Religion
Essays In Pastoral Medicine
Walsh, James J. (James Joseph)
First aid in illness and injury; Medicine
(4) The _circumstances are_: (a) that possibly, through mere luck, the
woman's condition is not necessarily hopeless: a few women have
escaped in this seemingly imminent peril--but that chance of escape is
not soundly probable; the stronger probability by far is on the side
of a fatal issue; therefore the chance for escape may be neglected,
and the woman's case may be regarded as hopeless if operation is
foregone.
(b) The quickest possible work on the surgeon's part is necessary, and
there is no time or chance to examine the foetus's condition before
tying the maternal arteries. Before he opens the mother's abdomen he
can tell nothing whatever of the foetus's condition, but the
probability is all in favour of the fact that the foetus is already
dead or moribund.
(c) The _means_ are coeliotomy, and the ligation of the {25} uterine
and ovarian arteries to stop the mother's bleeding. This ligation, in
the contingency that the foetus is still attached to the Fallopian
tube, will also shut off the blood from the foetus, yet the uncertain
shutting off of the foetal blood-supply is not intended by the surgeon
as a means toward his end in any degree direct or indirect, but it is
an evil circumstance associated with the action which may hasten the
foetal death--even here the hastening is uncertain.
(5) The _action has two effects_,--one, the saving of the mother, is
directly intended and evidently good; the other, the possible indirect
hastening of the foetus's death, may or may not be evil. The moral
centre of the whole case is this possible hastening of the foetus's
death. If that possible hastening is licit the whole action is licit;
if it is not permissible it will vitiate the entire action.
Suppose that there is no doubt that the ligation of the maternal
arteries in this case really hastens the foetus's death some minutes:
it would still be an indirect volition. Father Lehmkuhl also calls it
indirect and licit. Father Sabetti denied that it is indirect, but he
held that it is licit for another reason. Sabetti said (_Aner. Eccl.
Rev_., August, 1894): "It is evidently false to say that a means which
is _directly_ adopted for obtaining an end is only _indirectly_
contained in the intention of the agent who so adopts it." That is
true, but the minor proposition in a syllogism drawn from that
statement is to be emphatically denied. The cutting off of the foetal
blood is a fact associated with the means, not a means direct or
indirect toward the end, which is to save the mother--the means to
save the mother is the stopping of her bleeding.
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