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 CNS Story:

VATICAN LETTER Mar-18-2005 (980 words) Backgrounder. With graphic. xxxi

Moms' moral dilemma: When preserving life may mean death

By Carol Glatz
Catholic News Service

VATICAN CITY (CNS) -- Some Catholic women may have felt they were prescribed a hard pill to swallow when the Vatican openly praised an Italian woman who refused cancer treatment so she could carry her weeks-old embryo to term.

The story of Rita Fedrizzi made Italian and Vatican headlines in late January when she died of skin cancer just three months after delivering a healthy baby boy.

Doctors had recommended she undergo an abortion so as to pursue treatment for melanoma. She refused the abortion and all medical treatment, saying it would have been like "killing one of my other two children to save my skin."

The Vatican newspaper, L'Osservatore Romano, said her sacrifice was "a courageous gesture ... a gesture of love and faith in order to let life win."

The paper recalled a similar, heroic gesture of another Italian woman, St. Gianna Beretta Molla, the "pro-life saint," canonized last May by Pope John Paul II for having put her unborn child's life before her own during her struggle with a benign uterine tumor.

By putting these acts of self-immolation in such bold relief, the church underlines its unwavering respect of the sacred value of the life of the unborn.

But what of the life of the woman carrying the child?

Just one month after Fedrizzi's death, the Vatican sponsored a conference devoted to "The Quality of Life and the Ethics of Health."

The late-February gathering discussed many issues, including the right of every person to life, health and treatment.

How were Catholic women to reconcile what on the surface seemed like two contradictory messages? Forgoing treatment for a pathological condition brought praise, even sainthood, from the Vatican, yet in the background there was the reminder that people have a responsibility to look after their health.

In the case of St. Gianna and Fedrizzi, "It was within their right to undergo treatment," even if the treatment would have "indirectly compromised the pregnancy," said Bishop Elio Sgreccia, head of the Pontifical Academy for Life.

Following the principle of double effect, the church teaches it is morally acceptable to undergo treatment for a serious medical condition even if the therapy is potentially harmful, even lethal, to an unborn child.


The "bad effect" of harm or death occurring to the fetus is tolerated only as long as the aim of the medical intervention is to acquire the "good effect" of helping treat the patient.

For example, "It would be morally acceptable for a woman to ask to remove a cancerous womb" even if she were pregnant, explained Redemptorist Father Brian Johnstone, an Australian moral theologian at Rome's Alphonsian Academy.

"If (the cancerous organ) is not removed, she will die and the fetus will die. The intention is not to kill the embryo, but to remove the cancer," he said.

But a woman is also justified in opting to refuse any treatment for a condition that may put her fetus at risk, Father Johnstone said.

"It is not morally required" by the church, he said, but the church recognizes such an act to be "a heroic decision to sacrifice oneself for someone else."

A heroic act is, in fact, one that is not obligatory, said Bishop Sgreccia. If it were obligatory to give up one's life so that another could live, it would no longer be an example of heroism or martyrdom, he told Catholic News Service.

By praising the sacrifice made by St. Gianna and Fedrizzi, the church "is not necessarily saying that forgoing treatment for a disease that might harm the child is the right thing to do," said Father Tadeusz Pacholczyk, a neuroscientist and director of education at the National Catholic Bioethics Center in Philadelphia.

"The church is rather recognizing that a voluntary decision on behalf of one's unborn child is a powerful sign in the midst of a culture of death where the unborn child is routinely sidelined at the slightest provocation," he told CNS.

Father Pacholczyk also warned that each case needs to be looked at thoroughly.

How far along Fedrizzi's melanoma had progressed at the time of its diagnosis was never mentioned in the news stories. Since melanoma is very difficult to treat after a certain point, he said there would be the question of whether a regime of chemotherapy would have offered any real benefit.

On the other hand, St. Gianna did undergo treatment for her uterine fibroid. Though benign, it could have led to fetal abnormalities or complications if left alone.

Surgical procedures in the 1960s, however, called for removal of her entire uterus. St. Gianna was a doctor and instead insisted surgeons only remove what was necessary and allow her baby to live and reach term.

Seven days after she gave birth, she died of an infection that "almost certainly occurred consequent to the Caesarian" delivery of the baby, wrote Father Pacholczyk in an online essay describing St. Gianna's medical condition.

Franciscan Father Maurizio Faggioni, a moral theologian, agreed each woman's case is different.

If a pregnant woman discovers she has a medical condition needing treatment that may potentially harm the fetus, she has a range of options open to her, including giving birth early if possible so as to begin therapy immediately, said Father Faggioni.

Many factors should be considered in deciding whether to opt for full medical treatment to save one's own life or to refuse treatment for the sake of the life of the fetus, said the theologians.

For example, "it would have to be taken into consideration" if a woman already had other children who were dependent on her, said Father Johnstone.

"No other person outside herself ought to tell her to sacrifice herself," said the priest.

"The church does give forth these examples (of heroism), but it also recognizes that people do have to live their lives and will use practical reasoning," he said.

END


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