“Dear Father,

I am seeking your thoughts on the issue of selective reduction of embryos. As I understand it, the Church teaches that if on those rare occasions a pregnant mother’s life is threatened by the baby in her womb, it is permissible to abort the baby to save the mother’s life.  However, in selective abortion of embryos we seem to have a similar situation. By selective reduction of embryos (abortion) the doctors are trying to ensure that at least one embryo will be born alive. Do we not have a parallel here?”


            Firstly, in answer, let us define our terms. “Selective reduction” is a modern euphemism for aborting some of the children in a multiple conception and keeping the rest. Medics advocate it for multiple pregnancies, occurring either naturally or after the use of fertility drugs, or after IVF when several embryos have been transplanted back into the womb.

            The alleged justifications for “selective reduction” are twofold: firstly, when the mother wants only one or two babies, and regards the rest of the multiple litter as surplus to requirements. Secondly, the delivery of six or seven multiplets can be very difficult. Gynaecologists advocate killing off some in the womb, to increase the survival chances of the others. This looks at best a very tendentious calculation. The abortion of one sibling necessarily puts at risk also the lives of others, to say nothing of unconscious psychological effects.

            The basic principle is this: It is never morally licit, it is a grave evil, directly to take the life of an innocent human being. The qualifying words in this principle are deliberately chosen: “innocent” and “directly.” This moral law stems directly from natural justice and from the Decalogue command “Thou shalt not murder.” The Hebrew verb ratsach does not signify simply “to kill,” it specifies the unjust killing of a human being. The Old Testament allowed killing in self-defence, in a just war, capital punishment for certain heinous crimes, and the killing of animals.

            My correspondent is therefore mistaken to think that the Church allows the abortion of a child to save the mother’s life. This would contradict the principle above. The Holy Office has condemned the opinion that one may directly kill the child in order to save the mother. We cannot automatically assume one life is more valuable than the other. The mother has had a bite at the cherry of life. The child has not.

            The film “The Cardinal” dramatises the dilemmas of conscience this can lead to. The leading character, a priest, refuses to give permission for his sister to undergo an abortion. Consequently she dies. However tragic, his decision was the right one. No one may licitly do evil (kill a child) in order to achieve good. The ends do not justify the means. We are not allowed to take life in order to save life. There are moral ideals which have higher value than physical life itself. Our acts in this world have supernatural consequences in the next. We would be foolish to neglect them.

            The Church is called by the Holy Spirit, the Lord and Giver of life, to defend the absolute principle of the sanctity of life. It was always an exceedingly rare case when the child’s life was pitted against the mother’s. In fact, abortion is now never medically indicated: it is always more dangerous for the mother, both physically and psychologically, than carrying a child to viability. In this connection it is wise to remember the legal maxim “Hard cases make bad laws.”

            Pro-abortion arguments have frequently adduced this painful dilemma of the mother’s life versus the child’s life. In reality, with routine Caesarian births, this dilemma is now non-existent. Typically 2 out of 180,000 abortions per year in Britain fall under this heading, and even they are doubtful.

            This refusal to take “the easy way out,” killing babies in order to “save” their mothers, has stimulated medical progress. Good morals encourages good medicine. Bad morals leads to the terrible perversion of medicine we saw in Nazi Germany between 1938 and 1945.

             Once a society begins to justify the killing of certain human beings, declaring them non-persons, it slowly and inexorably widens the net to include others who are deemed genetically sub-standard, socially worthless, a burden to themselves, or not really human.

            There always comes a point in medicine where we have to let nature take its course – even if this means the distress of watching helplessly as someone perishes. But this is far, far better than killing another innocent person. There are mothers who have refused cancer therapy, for instance, in order to give their babies the chance of life – to their own detriment and even at the cost of their own lives. Here is great holiness and Christian courage.

            More common nowadays is the ectopic pregnancy, frequently a result of contraceptive use. When the embryo implants in the Fallopian tube, instead of in the womb, a pathological situation develops. As the embryo grows, it damages and may suddenly rupture the tube, leading to a rapid and possibly fatal haemorrhage. Some, but very few, ectopic pregnancies have been brought to viability.

            When the Fallopian tube has suffered serious pathological damage and rupture is imminent, the Principle of Double Effect allows the excision of that part of the affected tube. Here the death of the foetus, which could not have come to term, is an unintended and indirect side-effect of the removal of the tube. In any case, such situations should be treated conservatively. The tube containing the foetus should not be removed until it is seriously pathological, and it is certainly impossible to preserve the child’s life until viability (21-22 weeks). The same applies to pregnancies in the abdominal cavity.

            The “selective reduction” of twins, triplets or multiplets in the womb poses the same moral challenge, of killing one in the hope of saving another. It is gravely sinful. The deaths of several siblings are possible in a normal delivery, but by no means certain. The doctors should do their best to save all they can.

            The proper vocation of medicine is to heal and save life, not to sit in judgment about whom to kill. There is a dreadful moral abyss between, say, three septuplets dying naturally, leaving four survivors, and three being pre-selected and killed in the womb by a salt injection into the heart, to enable four to be born intact. The gap between these is as wide and deep as the chasm between heaven and hell, and whoever cannot see it is spiritually blind.

            Some accuse the Church of preferring that all 5 or 6 or 7 in a multiple conception die, than that a killing be executed in order to save two or three. Physical life is a great good, but rather lose it than commit a mortal sin and forfeit one’s eternal heritage. What does it profit a man if he gains three or four children and yet loses his soul?

            Ultimately, all babies are God’s creatures. He created them. He forbids us to kill them. We must place our trust in Him, pray, and leave the rest to Him. Who lives, lives. Who dies, dies, and may the Lord take them to himself. Let there be no blood on doctors’ or parents’ hands.   

          A related question concerns the Siamese twins in Manchester. There are different grades of Siamese twins. In each case much depends on the actual medical prognosis as regards the chances of a successful separation. Some very brilliant surgical separations e.g. of the spinal column, have been achieved. In the Manchester case, Jodi and Mary have only one heart and set of lungs between them. One of the two is not viable, and separation means automatic death for her. It would be helpful to know the % survival chance for the other twin too. Too often such separations end in the death of both twins.

                The procedure of separating these Siamese twins ranks as “extraordinary treatment” treatment which imposes a disproportionate burden of cost and difficulty and pain and suffering, with little chance of a successful outcome. It is not morally obligatory to undergo such treatment. The courts should respect the parents’ wishes and religious convictions. One wonders to what extent the surgeon’s egos are involved in the drive to achieve a satisfactory separation, even at the cost of a life. Our medical establishment sometimes seems to be intoxicated by its own technology and dreams of prestige.

            It was very heartening to hear Cardinal Tonini’s offer of accommodation and medical care in Italy for the twins and parents as long as they need it, “in a country where their wishes will be respected.”



Fr Marsden is willing occasionally to answer readers’ questions in this column. Please write via the Catholic Times or e-mail: fmarsden@stjosephs43.freeserve.co.uk 



PS. 8.20 am Thurs. Dear Tara,

Tried to ring but the switchboard weren’t answering. I’m out all day in York. I wanted to ask if you had a main article or something on the M/C Siamese twins. I’ve just mentioned it in the last  three paragraphs, since it is topical, but if you have already covered it in depth, you may wish to cut these out. Email me if you need to and I’ll get it tomorrow about lunchtime. Fr Francis.


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