Early induction of labour likely to be deemed ethical for some high-risk pregnancies

By 
  • March 26, 2009
{mosimage}TORONTO - An upcoming revision of the Catholic Health Association of Canada ’s ethics guide will likely specify that early induction of labour is morally and ethically justified in certain cases of high-risk pregnancy, said the president of the Ottawa-based organization.

James Roche told The Catholic Register that a team of ethicists has not finalized its recommendations on the precise circumstances in which early labour can be induced, but the report is expected to include provisions for early induction in some acute-care cases.

In particular, the report is expected to address cases in which a mother’s health is critically threatened by full-term delivery of a baby with a potentially lethal anomaly.

Early induction is opposed by some pro-life groups that believe fetuses should be carried to full term regardless of the possible health implications to the mother.

 The revised guide is expected to be completed in coming months and approved by the Canadian Conference of Catholic Bishops by November. It will be the first time the health guide will include a specific section on early delivery.

“I think what that piece will address is making the distinction that ... early induction is not abortion,” Roche said.

The ethics guide review began two years ago and involves 45 ethicists from Canada, the United States, Britain and Australia. Roche said the guide would specify the situations when early induction is “morally and ethically sound” in keeping with Catholic teachings.

A scrutiny of early induction policy became part of the ethics guide review following complaints in February from pro-life groups which accused St. Joseph’s Hospital in London, Ont., of practising “eugenic abortions.”

Mary Ellen Douglas, national organizer of Campaign Life Coalition , said there are no circumstances when early delivery is morally justifiable.

“It’s not our place to decide that we have this happen, that we will remove (the fetus) from the womb. It’s not our place. It’s not the theologian’s place. It’s not the doctor’s place,” she said.

According to the hospital’s current guidelines, labour can be induced early in certain conditions, including if the life of the mother or child is threatened and if the baby has a chance of surviving an early delivery.

A review of these guidelines is currently underway and was launched in London by Bishop Ronald Fabbro in late February.

Roche said his association is closely watching the review of the London diocese and those results will have an impact on the association’s own ethics guide review.

Fabbro’s office said no date has been set to conclude the review.

Experience south of the border may shed some light on the issue.

Dr. John Haas, president of the National Catholic Bioethics Centre in Philadephia, said the centre’s 2004 statement cited the 2001 Ethical and Religious Directives for Catholic Health Care Services of the United States Conference of Catholic Bishops (USCCB) , which said treatments that seek to cure “a proportionately serious pathological condition of a pregnant woman are permitted when they cannot be safely postponed until the unborn child is viable, even if they will result in the death of the unborn child.”

“For a proportionate reason, labour may be induced after the fetus is viable,” the USSCB document said.

The centre is participating in the review in London, but Haas said he was unable to comment because it is a confidential matter.      

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