I was somewhat surprised to read about the position of the American Life League (ALL) regarding ectopic pregnancy. They also believe that treatment of EP is permissible, but only in a way which causes additional risk for the mother. Here is their statement:
Using the Thomistic Principle of Totality (removal of a pathological part to preserve the life of the person) and the Doctrine of Double Effect, the only moral action in an ectopic pregnancy where a woman's life is directly threatened is the removal of the tube containing the human embryo. The death of the human embryo is unintended although foreseen. Put another way, if there were a way to save both lives, which, of course, are of equal value, one would be obliged morally to do so. At this time, this is not possible.
It is acknowledged that it has become commonplace even in Catholic hospitals to open the tube and "suction out the human embryo" or administer methotrexate either via mouth or laparoscopy. Both of these procedures directly attack an innocent human life and are intrinsically immoral and never can be justified. In fact, they violate the Fifth Commandment, which under all circumstances prohibits a direct attack on innocent human life. There are absolutely no exceptions to the 5th Commandment as described.
While removing the tube containing the human embryo results in the death of a human being as does suctioning out the human embryo or administration of methotrexate, one cannot ethically conclude that all the actions have the same intended end result. The reason for this is that the "means" used to accomplish the "end" are not the same.
Refusal to make this distinction results in a Machiavellian approach employing any "means" to the "end" including the direct assault on the human being intended to result in his death. While it is acknowledged that removal of the tube containing the human embryo may result in sterility, it is not morally justified to directly attack human life by suctioning out the human embryo or administering methotrexate even though fertility is preserved.
Once again, it is important to remember that this child, although undeniably fully human and having intrinsic value, has no chance of living. I agree that if we could save both, we should do so. However, there is no chance that that can occur with today's technology.
Granted that the child cannot survive, it is standard surgical technique to treat a pathological process as conservatively as possible with as little damage to the surrounding tissues. In other words, if there are multiple ways to treat a certain pathology, the surgeon should consider which technique leaves the (God-designed) anatomy functioning as normally as possible.
In the ALL analysis, a surgeon has a moral obligation to perform this procedure in a way which can cause greater anatomical harm to the mother in order to avoid "directly touching" the child. They acknowledge that the end result for the child is the same, and although a salpingectomy has a greater chance of tubal mis function, it should be done.
I do not see how this makes sense.
If the child is doomed, why not perform the procedure that saves the mother in the safest way possible, which leaves her anatomy as untouched as possible? Why does it mitigate the child's death, which is an undeniable but unavoidable tragedy, by causing more harm to the mother?
What if I were attempting to save a very large man from drowning, and he unfortunately panics and pulls me down with him. Assume that there is no way he's going to make it. It seems via this analysis, it would be wrong for me to push him away in an effort to save my life, for this would be a direct action which causes him to go further under the water directly resulting in his death. However, it seems it would be permissible for someone to amputate my arm that the man had grabbed on to, for this would not directly result in his death. Of course, in both cases, he still died, and in the first, I would retain use of both arms. But according to this analysis, the second case would be morally preferable.
I'm interested in comments if I misunderstand this viewpoint, but if I have got it correct, I believe that ALL should seriously reconsider their point of view.