Sabetti-Barrett[95] holds that craniotomy on a living child and the removal of an inviable extrauterine fetus are not abortion in the scope of this excommunication, because as a penal law these operations are not specifically mentioned. All mutilating operations, like craniotomy and the others enumerated above, first kill the fetus, then extract its body from the womb; abortion first extracts the fetus and then lets its die. The result is the same, but the operations differ technically, and a penal law is _ad literam_. A cleric who procures abortion of an inviable fetus at any time of gestation falls under the excommunication and suspension _a sacris_ perpetually, although he probably is not technically irregular canonically if he procures the abortion before the Aristotelian date of animation. The bull _Effraenatam_ makes the canonical irregularity at the Aristotelian date obsolete practically. [95] _Compendium Theologiae Moralis_, 1915, n. 1009. In the church the Holy Office (that is, the Inquisitors-General in matters of faith and morals) is the official authority which interprets, under the approval of the Pope, the morality of acts like abortion and related operations. In 1895 the following difficulty was proposed to the Holy Office for solution: A physician is treating a woman with a disease which will certainly be fatal to her unless cured medically, and the disease is due to the presence of a fetus in her womb. To save her it is necessary to empty the uterus, but the fetus is not yet viable. The question is, May the physician perform therapeutic abortion in such circumstances? On July 24, 1895, the Holy Office answered: "The Inquisitors-General in matters of faith and morals, with the vote of their Consultors, decree: _Negatively_, in accord with the other decrees of May 28, 1884, and August 19, 1888." In May, 1898, the following questions were proposed to the Holy Office: I. Is the induction of premature labor licit when a contracted maternal pelvis prevents the birth of a child at term? II. If the maternal pelvis is so narrow that premature delivery is impossible, is it licit to perform abortion, or to effect _cesarean_ delivery at the proper time? III. Is laparotomy in extrauterine gestation licit? May 4, 1898, the Holy Office answered, with the assent of Leo XIII: I. Premature labor in itself is not illicit, provided it is done for sufficient reason, and at the time and by such methods as will under ordinary circumstances preserve the life of the mother and the fetus. II. As to the first part, the answer is negative, according to the decree of July 24, 1895, on the unlawfulness of abortion. As to the second part, there is no objection to the cesarean delivery at the proper time. III. In a case of necessity, a laparotomy to remove an ectopic fetus from the mother is licit, provided the lives of both mother and fetus are, so far as is possible, carefully and opportunely preserved.[96]