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St. Alphonsus Ligouri, crippled with arthritis |
1. MICROSCOPY and EARLY MICROBIOLOGY: 1.1 Leeuwenhoek; 1.2. Hooke; 1.3. Enduring Theories and Therapies (1.3.1. humoral theory; 1.3.2. emetics; 1.3.3. phlebotomy)
2. PHARMACOLOGY: 2.1 Cinchona; 2.2 Digitalis
3. MEDICAL DOGMATISM; LAY SCEPTICISM
4. ALPHONSUS LIGOURI: 4.1. End-of-Life Issues; 4.2. Beginning-of-Life
1. MICROSCOPY and EARLY MICROBIOLOGY
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1.
MICROSCOPY
and |
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THE seventeenth and eighteenth centuries were, for the science and practice of medicine, a paradoxical era of potential advancement and practical retrenchment. On the one hand, increasingly-widespread use of microscopes laid the foundations of the science of microbiology: on the other, physicians categorically refused to believe that the microorganisms (“animalcules”)
observed in decaying organic material had anything to do with the diseases they diagnosed and treated.
1.1
ANTON Van
LEEUWENHOEK
(1632-1723)
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Leeuwenhoek's Simple Microscope |
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Rods & Cocci - Bacteria, c. 1670 | "Animalcules" |
1.2.
ROBERT
HOOKE, 1635-1703
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Hooke's Compound Microscope | Micrographia, 1665 |
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vinegar eels | Cork "cells" |
1.3.
ENDURING
THEORIES
and THERAPIES
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Medieval
Elements: fire, air, earth water |
Elizabethan Humors |
DESPITE advances in anatomy and physiology, medical treatment in the early nineteenth century remained appallingly similar to that of classical antiquity and the middle ages. The most famous and celebrated American physician and humanitarian of his day, Benjamin Rush (d. 1813), strongly encouraged aggressive bleeding and purging (drug-induced vomiting and diarrhea) for almost every disease.
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Medieval phlebotomy (c. 1350) | Phlebotomy in 1804 |
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Medieval Emetic Therapy (c. 1250) | Emetic Therapy in 1804 |
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2.
PHARMACOLOGY: |
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2.1 CINCHONA
BARK
= QUININE:
Treatment for Malaria
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PERUVIAN CINCHONA BARK | Sebastian Bado's Book (1663) on Cinchona bark |
THE Jesuits were among the first Europeans to appreciate the pharmacological efficacy of cinchona bark. Malaria may not have existed in the New World prior to the arrival of Europeans, and there is no clear evidence that the indigenous peoples ever used cinchona as a remedy for fever. The Jesuit Barnabé de Cobo (1582-1657), who explored Mexico and Peru, may have been the first to take Cinchona bark (dubbed the Cobæa plant) back to Europe. The Jesuit theologian and moralist Juan de Lugo was entrusted by Pope Innocent X with the project of studying Cinchona and reporting back. De Lugo may have been the first to recommend a tincture of the cinchona bark for treating the fever of “ague” in 1640: his physician, Sebastiano Bado, published a treatise on Cinchona in 1663 that was widely read. The pope's subsequent approval and the association of Cinchona with the Jesuit order slowed its acceptance in Protestant countries, where it was not-infrequently described as part of a “popish plot”. By the early nineteenth century it was widely employed throughout Europe; however it was not appreciated that it was effective only against Malaria, and it continued to be regarded as a general remedy for fever.
2.2 WILLIAM
WITHERING
and
DIGITALIS:
Treatment for
Congestive Heart Failure (dropsy)
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WILLIAM
WITHERING 1741-1799 |
FOXGLOVE Puerpera digitalis |
An Account of the Foxglove 1785 |
3. MEDICAL DOGMATISM; LAY SCEPTICISM
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3.
MEDICAL
DOGMATISM 18th Century “Magnetic” Therapy |
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THE satires of Molière (Jean-Baptiste Poquelin, 1622-1673) illustrate the extent to which patient autonomy was remained dominant factor in health care at the beginning of the Enlightenment.
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Molière's play, The Imaginary Invalid Molière |
Lysetta. What will you do, sir, with four physicians? Is not one enough to kill any one person?
Sganarel. Hold your tongue. Four heads are better than one.
Lysetta. Cannot your daughter die well enough without the assistance of these gentlemen?
Sganarel Do you think people die through having physicians?
Lysetta. Undoubtedly; and I knew a man who maintained - and proved it, too, by excellent reasons - that we should never say, “Such a one has died of a fever, or a from an inflammation of the lungs,” but “Such a one has died of four doctors and two apothecaries.”
Sganarel. Hush! Do not offend these gentlemen.
Lysetta. Upon my word, sir, our cat had a narrow escape from a leap he took a little while ago, from the top of the house into the street; he was three days without eating, and unable to move head or paw; but it is very lucky that there are no cat-doctors, else it would have been all over with him, for they would have purged and bled him.
Sganarel. Will you hold your tongue, I say? What impertinence is this! Here they come.
Lysetta. Take care; you are going to be finely edified. They will tell you in Latin that your daughter is ill.
Molière
(1622-1673) Love is the
Best Doctor; tr. H. Van Laun, The
Dramatic Works of Molière,
vol III (Edinburgh, 1866), p. 211.
[Molière’s] four doctors were caricatured from real characters well known in Paris at the time - Guy Patin says they were Guénaut, Brayer, Des Fougerais, and Valot. They attended the fatal illness of Cardinal Mazarin in 1661, wrangled, and did not agree as to the cause of his trouble... At a later time when Guénaut was one day entangled in a crowd of vehicles in the street, a cart driver shouted “Let the Doctor go ahead. He’s the one who did us the service to rid us of the Cardinal.”
Logan Clendening, Source Book of Medical History (Dover, 1942) pp. 221-222
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Gary
M. Atkinson, Ph.D:
Chapter 7 of Moral
Responsibility in Prolonging Life Decisions ed. by McCarthy &
Moraczewski
(Pope John Center, St. Louis, 1981,
distr. by Franciscan Herald Press Chicago),
4.1.
END-of-LIFE
MORAL
PRINCIPLES
St. Alphonsus Liguori [reiterates]:
1. that there is no obligation to use costly or uncommon medicines;
2. that one need not move to a more healthful climate;
3. that one is not required to use difficult or extraordinary means of preserving life, such as the amputation of a leg;
4. that one might have an obligation to use ordinary medication if there were good hope for recovery.
[He also raises a point] not new with him, that[:]
A PERSON’S SUBJECTIVE REPUGNANCE TOWARD THE USE OF A MEANS MIGHT MAKE THAT MEANS NONOBLIGATORY FOR THAT INDIVIDUAL.
Alphonsus mentions the case of a woman (particularly a maiden) who might find examination by a male physician greatly abhorrent. This element of subjectivity in the assessment of the obligatoriness of means is firmly in the tradition of Vitoria and de Lugo.
... Evidently an amputation, at this period in history, was the perfect example of a terrible torture which no one ordinarily could be held to undergo....
[There were [only a very few] moralists who dissented from this opinion]... Vincent Patuzzi, an eighteenth century theologian, takes issue with de Lugo, and maintains that a maiden does possess an obligation to accept treatment from a male physician even at the cost of great embarrassment and shame... But it is the scarcity of such differences that is the most striking feature of this period.
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MORAL
THEOLOGY |
THEOLOGIA MORALIS S. Alphonsi M. De Ligorio. TRACTATUS IV. DE QUINTO ET SEXTO PRAECEPTO. CAPUT I. QUID QUINOT PRAECEPTO PROHIBEATUR: Non occides. |
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DUBIUM
1. |
DUBIUM I. |
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366. Whether it is lawful to kill oneself, either directly or indirectly. |
366. An liceat directe occidere seipsum, et an indirecte. |
367. Whether it is lawful to exposes oneself to the danger of death, in order to avoid a worse death, etc. Whether it is lawful to burn ships and incur danger of death. |
367. An liceat se exponere periculo mortis ad vitandam mortem duriorem etc. An liceat navim incendere cum periculo mortis. |
368. Whether a virgin is bound to suffer death, rather than be violated. |
368. An virgo teneatur pati potius mortem, quam violari. |
369. Whether it is lawful, on instructions from a judge, for the accused to kill himself, or to attempt to take an antidote to the poison. |
369. An liceat reo ex praecepto judicis se occidere. An haurire venenum ad experiendum antidotum. |
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370. Whether it is permissible for a Carthusian to abstain from meat, especially in extreme circumstances |
370. An liceat carthutiano abstinere a carnibus, etiam in necessitate extrema. |
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371. Whether it is permissible to shorten life by afflicting one’s self |
371. An liceat macerationibus vitam sibi minuere. |
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372. Whether there is an obligation to preserve life by employing extraordinary remedies, even when they involve great hardships. |
372. An sit obligatio, ad servandam vitam, uti remediis extraordinariis, vel nimis duris. |
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373. Whether it is ever permissible to mutilate one’s self. |
373. An aliquando liceat se mutilare. |
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374. Whether it is permissible to castrate boys. |
374.An liceat pueros castrare, |
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375. Whether one who has committed suicide may be buried in sacred ground? |
375. An, qui occidit seipsum, posit sepeliri in loco sacro |
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370. 4°.WHETHER is is possible for a Carthusian [monk] who is gravely ill to care for his life by eating meat? |
370. - « 4°. Etsi Carthusianus in extrema aegritudine possit servare vitam, vescendo carnibus »; |
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[Certainly, when there is probable danger of death, thus Azor[a], Medina[b], Victoria, oppose Vasquez [c]Granado[*c] and Salmant.[*c], who say that the first opinion is sufficiently probable] |
[Etiam in probabili periculo mortis, ut Azor[a], Medina[b], Victoria, contra Vasquez [c]Granado[*c] et Salmant.[*c], qui tamen primam sententiam sat probabilem vocant] |
“They say that it is probably permissible (and he would not sin to the extent that he was ignorant that the food was meat (Sanchez [d], Diana 3) [but] that is [also] permissible and [indeed] praiseworthy to refuse [to eat meat] even when it entails certain danger of death.” |
«idque probabiliter ei tum liceat (atque adeo non peccet, qui inscio praeberet cibos ex carnibus: (Sanchez[d], Diana3); licite tamen et laudabiliter etiam tum omittit, cum certo periculo mortis »: |
[and Salmant judges this to be certain4]. |
[Et hoc certum esse censent Salmant.4] |
“So that, against Vasquez [*c] and Granado [*c], Diana teaches5, from Victoria, Lorca, etc: that it is reasonable to neglect life for the good of the common Order [i.e. monastic observance]. | « ut, contra Vasquez [*c] et Granado [*c], docet Diana5, ex Victoria, Lorca, etc: quia rationabiliter negligit vitam pro bono communi Ordinis. |
Card. de Lugo1; against Azor [a*] and Escobar 2, where he teaches in support of consuming meat, provided [all other] options are exhausted, and life cannot otherwise be maintained.. |
Card. de Lugo1; contra Azor [a*] et Escobar 2, ubi docet, teneri carnibus vesci, si exigit necessitas, ita ut aliter vitam conservare non possit. |
— Which Sanchez 3 together with six others distinguishes thus : | — Quod Sanchez 3 cum aliis sex ita distinguit: |
If the necessity to eat is intrinsic, e.g. caused by an illness from which physicians determine that recovery is not possible without eating meat, he says it is commendable not to consume meat (even though it is probably permissible): for he would die naturally of the illness which he did not cause. |
Si necessitas vescendi sit ab intrinseco, v. gr. morbo, ex quo, judicio medicorum, convalescere non possit, nisi esu carnium; ait probabilius esse, eum non teneri vesci (tametsi licite possit): quia morietur naturaliter ex morbo, cujus ipse non est causa. |
But if the [necessity] is extrinsic, e.g. if due to the lack of other food he is about to die of hunger, he would support eating because the death which may be violent could be imputed to him. ». |
Si vero sit ab extrenseco, v. gr. si ob inopiam aliorum ciborum, fame moriendum esset, teneri vesci; quia mors illa cum sit violenta, ipsi imputaretur ». |
[and Salmant judges this to be absolutely certain.4] |
[Et hoc merito ut certissimum judicant Salmant.4]. |
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371. Whether it is permissible to shorten life by afflicting one’s self |
371. An liceat macerationibus vitam sibi minuere. |
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371. 5°. IT is permissible to moderately afflict the flesh by vigils and fasts. |
371. - « 5°. Licet carnem vigiliis et inedia moderate affligere. |
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However, anyone who acts against his life by significantly shortening it, although allowing it to continue, sins gravely: Laymann notes this,5 taking it from Cajetan. | Qui autem, advertens vitam iis notabiliter minui, nihilominus continuaret, peccaret graviter; ut notat Laymann 5 ex Cajetano. |
Although many are excused from this by their good faith and eagerness to please God. See Bonacina 6, Filliuccium 7, card. Lugo 8, etc. | Etsi hic multi ob bonam fidem et zelum Deo placendi excusentur. Vide Bonacina 6, Filliuccium 7, card. Lugo 8, etc. — |
Where he rightly notes that [:] | Ubi recte notat, |
[1] it is one thing to induce the shortening of life or to actively invite one’s own death; |
aliud esse procurare abbreviationem vitae, seu mortem positive sibi afferre: |
[2] while it is another [thing entirely] to permit one to undergo danger [of death] or to not employ means that would prevent it. |
aliud, permittere, vel periculum ejus subire, vel non adhibere media ad avertendam. |
He says that the first is illicit: if, for example, through indiscreet penances and by afflicting the flesh life were notably shortened; | Prius ait esse illicitum; v. gr. poenitentiis indiscretis carnisque macerationibus vitam notabiliter abbreviare; |
while the second is certainly often permissible.” | posterius vero, saepe licere ». |
[Thus Lugo9, continuing Tournely10, and Salmant.11 with Granado, Villalobos [a], Sayro, etc, If the affliction were undertaken after prudent consultation with a superior [“prelate”] or confessor and the life in question were shortened by twelve years, as others thus declare – |
[Ita etiam Lugo9, Continuator Tournely10, et Salmant.11 cum Granado, Villalobos [a], Sayro, etc, si macerationes fiant consilio prudentis praelati vel confessarii; esto vita etiam per duodecim annos esset abbrevianda, ut alii ibi dicunt. — |
And, indeed, (as Abbot Rancé, founder of the Trappist Reform asserts ): [1] if it is permissible for a blacksmith to shorten his life, being forced to work almost in the midst of fire which is not notably lessened by the final quenching [of hot iron in] moisture, and which [labor] human life nevertheless requires; |
Et revera, si licebit fabris ferrariis (dicebat Abbas Rancé, fundator Reformationis Trappensis) vitam sibi minuere, laborando quotidie pene in medio ignis, a quo nequit non notabiliter consummari humidum radicale, quo tam indiget vita humana; |
[2] if it is permissible for students to undermine their health in order to add to their knowledge; [3] if it is permissible for soldiers to expose themselves to hardships and danger of death, |
si licebit studiosis sanitatem labefactare ad scientias addiscendas; si licebit militibus exponere vitam tot aerumnis et periculis mortis: |
why should religious not be permitted to embrace corporal austerities in order to subdue their rebellious flesh to obedience?] |
cur non licebit viro religioso austeritates corporales amplecti, ut rebellem carnem in servitutem redigat?] |
“Accordingly a Carthusian is not obliged to avoid death by [:] |
« Ideoque non teneri Carthusianum |
[1] eating meat or employing other [means] such as |
carnibus vesci, nec aliquem alium |
[2] obtaining medicines that are expensive or difficult [to obtain] |
uti pretiosa et exquisita medicina ad mortem vitandam; |
[3] returning to secular life |
nec saecularem, |
[4] leaving his [monastic] residence |
relicto domicilio, |
[5] seeking a more healthy climate outside his native land.” |
quaerere salubriorem aerem extra patriam ». |
[Thus according to Lugo, Bonacina, Trullench, with Salmant.12 It is sufficient to make use of ordinary means | [Ut Lugo, Bonacina, Trullench, cum Salmant.12 . Sufficit enim uti mediis ordinariis]. |
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372. Whether there is an obligation to preserve life by employing extraordinary remedies, even when they involve great hardships. |
372. An sit obligatio, ad servandam vitam, uti remediis extraordinariis, vel nimis duris. |
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372. 6°. EXCUSED [from employing even ordinary means] are the sick who, shortly before death, on account of humility or setting a good example, ask to be laid on the ground; for they do not intend [thereby] to shorten their lives — See Vasquez 13. |
372. - « 6°. Excusantur aegri, qui paulo ante mortem, causa humilitatis vel boni exempli, petunt humi collocari; quia non non intendunt vitam abbreviare. — Vide « Vasquez 13. |
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Laymann adds 14 that the [sick] are not held to means that are extraordinary and entail great hardship: e.g., amputation of a leg in order to preserve life, unless the person is essential for the common good ». | « Addit Laymann 14 non teneri quemquam mediis extraordinariis et nimis duris, v. gr. abscissione cruris, etc, vitam conservare: nisi tamen [a] ea communi bono sit necessaria ». |
[in agreement with this are: Lugo, Sotus, Bañez, Bonacina with Salmant.15 Thus [further] Tournely 16together with Silvio teach the same. They add that a father, guardian, or superior could command [a subject] to endure the amputation of a limb if the pain to be endured could be controlled; against Henno [b]]. |
[Ita communiter Lugo, Sotus, Bañez, Bonacina cum Salmant.15 Idem docet [Contin.] Tournely 16cum Silvio. Addit tamen quod pater, tutor aut alius superior potest jubere abscindi membrum subditi, si hic moderatos dolores tantum sit passurus; contra Henno [b]]. |
« See Lessium 1, Sanchez 2. Where they say that a sick person in danger of death may not refuse medication if there is hope of a cure [c]. | « Vide Lessium 1, Sanchez 2. Ubi dicit infirmum in periculo mortis, si sit spes salutis, non posse medicamenta respuere [c] |
But it is not envisioned that a virgin who is ill would be obliged to submit to a physical examination by a physician or surgeon if this were very burdensome for her; and even more so if she dreaded it more than death [itself]. Escobar 3, ex Turriano [d] . | Non videtur tamen virgo aegrotans (per se loquendo) teneri subire manus medici vel chirurgi, quando id ei gravissimum est, et magis quam mortem ipsam horret. Escobar 3, ex Turriano [d]». |
Thus Salmant.4 with Lessio, Sanchez [*d], Diana, etc. — But the virgin might permit the examination, indeed she might be obliged to allow it, if she could be attended by a female physician, as Diana rightly says. |
Ita Salmant.4 cum Lessio, Sanchez [*d], Diana, etc. — Posset tamen virgo permittere tangi; immo teneretur sinere, ut ab alia femina curetur, ut recte ait Diana. |
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373. Whether it is ever permissible to mutilate one’s self. |
373. An aliquando liceat se mutilare. |
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373. resp. II°. IT is not permissible to mutilate oneself, unless it is necessary for the preservation of the whole body; for no one is the absolute lord of his members. — Lessius 5. |
373. - « Resp. II°. Non licet se mutilare, nisi sit necessarium ad conservationem corporis totius; quia nemo est suorum membrorum |
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From which it follows: |
« Unde resolves: |
1°. It is not permissible to castrate oneself in order to preserve chastity or quiet temptations; for this [act] is not necessary in order to attain that end. — S. Thomas 6, Lessius, Molina [a], Filliuccius 7, etc. ». |
« 1°. Non licet se castrare ad conservandam castitatem vel sedandas tentationes; quia hoc ad eum finem non est necessarium. — S. Thomas 6, Lessius, « Molina [a], Filliuccius 7, etc. ». |
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375. Whether one who has committed suicide may be buried in sacred ground? |
375. An, qui occidit seipsum, posit sepeliri in loco sacro |
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375. QUESTION: can one who has committed suicide be buried in sacred ground? |
375. - « Quaeres: an sepeliendus sit in loco sacro, qui seipsum occidit? |
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RESPONSE: This is forbidden by the canons of the Church: however, this should not be thought [to apply] to those who commit [suicide] out of rage, madness, passion, profound sadness, disturbing hallucinations, or who truly suffered from these before death. |
« Resp. Id vetant Ecclesiae canones: qui tamen non sunt intelligendi de iis qui ex furore, amentia vel passione gravissimae tristitiae, turbata phantasia, id fecerunt; vel qui ante mortem vere de hoc doluerunt. |
But if it is established that he committed suicide, and there are doubts whether it was deliberate or resulted from mental confusion [disturbance of soul] in practice he is denied ecclesiastical burial, it being presumed that the external work occurred voluntarily; unless, however, the contrary should be ascertained. |
« Quod si constet, quempiam se ipsum occidisse, et dubitetur utrum deliberate, an ex animo turbato factum; in praxi privatur sacra sepultura, cum praesumatur, secundum opus externum voluntarie esse factum: nisi tamen ex circumstantiis contrarium colligatur. |
If there exists doubt whether he did it himself or someone else did it, for example if he is thrown into water, the sin is so heinous and against nature that it cannot be presumed [to be murder rather than suicide] without obvious evidence. [a] Molina 1 See Laymann2. |
— Si vero dubitetur, a seipso an ab alio, v. gr. sit praecipitatus in aquam, delictum tam atrox et contra naturam non praesumitur sine evidentibus indiciis [a]. Molina 1 Vide Laymann 2. |
«See, also Escobar 3, where he says that the one who dies from a wound received in a duel, if he is still alive when he leaves the place, is not denied ecclesiastical burial, [b]. |
« Vide etiam Escobar 3, ubi dicit, eum, qui moritur ex vulnere in duello accepto, si vivus ex loco discessit, non esse privandum sepultura ecclesiastica [b]». |
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4.2.
BEGINNING-of-LIFE
MORAL
PRINCIPLES
St. Alphonsus Liguori clarifies:
1. Abortion is never permissible, whether the fetus is animate (ensouled) or not.
2. In the case of an animate fetus, abortion is the moral equivalent of homicide; if inanimate it approximates (is morally close to) the killing of a human being.
3. If there is no other way to save the mother's life, she may take medication to treat a life-threatening illness that has the unintended side-effect of causing an abortion.
4. However, medications that have the primary effect of causing an abortion (i.e. do not primarily treat an illness of the mother) may never be used.
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MORAL
THEOLOGY |
THEOLOGIA MORALIS S. Alphonsi M. De Ligorio. Bk 4, Tract. 4, De Quinto Praecepto Decalogi (Bassano 1831), vol. 1, pp. 247-248 |
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CHAPTER
3. |
Caput III |
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22.(Q.3). Whether it is licit to procure an abortion |
22. (q.3). An liceat procurare abortum? |
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RESPONSE: IT is never lawful in itself to directly [procure abortion], whether the fetus is animated (ensouled) or not: |
R. per se, & directe nunquam licet, sive foetus sit animatus, sive non: |
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For the first [i.e. abortion of an animated fetus] is homicide | primum enim est homicidium, |
while the second [i.e. abortion of an inanimate fetus] approximates [tends towards] the killing of a human being and is against the nature of generation. |
& secundum tendit ad occisionem hominis, & est contra naruram generationis. |
Hence [Pope] Innocent XI condemned the proposition: “it is licit to procure abortion before animation of the fetus, in order that the pregnant woman may not be caught and killed or disgraced.” | Hinc Innoc. XI. damnavit hanc propositionem: licet procurare abortum ante animationem foetus, ne puella deprehensa gravida occidatur, aut infametur. |
And this is confirmed in St. Basil’s Letter to Amphilocus: | Confirmari potest ex S. Basil. ep. ad Amphil. |
“She who deliberately destroys [her] fetus incurs the penalty for murder. The subtle question whether the fetus is formed or unformed is irrelevant.” |
Quae de industria foetum corripit, caedis poenas luat. Formati autem, vel informis subtilitas non attenditur. |
From the Councils of Eliberit. Ancy. Mainz & Worms. And from c.5. on homicide: |
Ex Conc. Eliberit. Ancy. Moguntino, & Wormat. & ex c. 5. de homic. |
If a anyone by way of satisfying lust, or out of premeditated hatred for mankind, should do anything to a woman, or give her a potion in order to make her sterile or incapable of conceiving or bearing children, they shall be regarded as a murderer. |
Si aliquis causa explendae libidinis , vel odii meditatione, homini, aut mulieri aliqujd fecerit, vel ad potandum dederit, ut non possit generare, aut concipere, vel nasci soboles, ut homicida teneatur. |
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23.(Q.4). Whether it is permissible to give a mother who is mortally ill medicine to expel a fetus? |
23. Quaest. 4. Num liceat matri in morbo extremo constitutae sumere remedium ad foetum expellendum? |
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First of all, it is certain that it is not permissible for a mother who is not in danger of death to take medicine that results in the expulsion even of an inanimate fetus, since directly obstructing the life of a human being is a grave sin, and an even worse [sin] if the fetus is animate. |
R. 1. certum est non licere matri extra mortis periculum, sumere pharmacum, quo.foetus expellatur , etiamsi sit inanimis, quia vitam hominis directe impedire, peccatum est grave; gravius autem erit, si foetus animatus sit. |
Second, it is certain that it is not permissible for a mother even in danger of death to take an oral remedy that directly causes the expulsion of an ensouled fetus, since this would be directly causing the child's death. |
Certum est 2. non licere Matri etiam cum mortis periculo, sumere potionem ad expellendum directe foetum, anima praditum cum hoc esset directe procurare filii mortem. |
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THE question, rather, is whether it is permissible for a mother to take a medicine absolutely necessary to save her life when it entails the danger of expelling her fetus. |
Quaestio autem est, an liceat matri', sumere remedium ad vitae suae conservationem omnino necessarium cum periculo expulsionis foetus? |
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The question, rather, is whether it is permissible for a mother to take a medicine absolutely necessary to save her life when it involves danger of expulsion of the fetus. | Quaestio autem est, an liceat matri', sumere remedium ad vitae suae conservationem omnino necessarium cum periculo expulsionis foetus? |
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RESPONSE: IF the fetus is inanimate, the mother may certainly insure her life, even though this has the effect, unintended by her, of expelling the fetus: and the mother is not responsible for this since she is only using her natural right to preserve her life. |
R. si fetus sit inanimis, certe licet matri, vitam suam procurare, licet inde praeter mentem suam sequatur foetus expulsio; quae matri non tribuitur , cum ea solum utatur jure sibi a natura dato vitae suae conservandae. |
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IF the fetus is animate, it is generally held that a mother may take a medicine whose direct purpose is to save her life when nothing else will serve; but it is different in the case of medicines that of themselves are intended to kill the fetus: these are never permissible |
Quod si foetus sit animatus, communis sententia docet, posse a Matre remedia adhiberi, quae directe tendant ad servandam ejus vitam, quae aliter servari non posset; secus autem de iis remediis, qua e per se tendunt ad occisionem foetus; haec enim nunquam licent. |
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(Alphonsus Maria de Ligorio, Theologia Moralis (Bassano 1831), vol. 1, pp. 247-248); cf. Timothy Lincoln Bouscaren, When Mother or Baby Must Die (originally published in 1933; reprint: Tradibooks 2008 ISBN 978-2-917813-01-0), p. 61.
NOTES to Ligouri, Moral Theology, tr. 4, c. 1, no. 370-375.
[a] Azor, part. 1, lib. 5, cap. 6, qu. 7, v. His praenotatis, distinctionem adhibet: «Cuicumque monacho Carthusiensi, inquit, licet carnibus abstinere, etiam cum probabili vitae discrimine, quotiescumque id fecerit ob alicujus virtutis officium tuendum... Si vero nullum sit hujusmodi virtutis opus, mihi videtur Carthusiensem monachum astringi, ita ut jure ipso naturali compellatur ad vescendum carnibus, imminenti certo et evidenti, aut etiam probabili vitae periculo. Ut si solus sit in deserta solitudine, nec quid aliud ad edendum habeat praeter carnes, et fame laboret ac pereat, debet tunc carnes edere ne intereat».
[b] Joan. Medina, tr. 4, cod. de Jejunio, qu. 13, ad 4, omnino negat posse Carthusianum a carnibus abstinere, «si... accideret ut... nihil aliud quam carnem ad manducandum haberet, aut in talem incideret aegritudinem a qua sine carnis usu, ex peritorum medicorum judicio, liberari non posset».
[c] Vasquez, in 1<“» 2ac, disp. 162, cap. 4, distinctione utitur; et in casu aegritudinis, negat Carthusianum posse carnibus vesci; in casu vero quo deessent alii cibi praeter carnes, affirmat eumdem debere carnes comedere. Cujus sententiae adhaerent Granado, in jam 2ae, controv. 7, tr. 3, disp. 8, n. 27; et Salmant., tr. 11, cap. 2, n. 135, et seqq., qui tamen ut satis probabilem agnoscunt sententiam, dicentem posse in casu aegritudinis carnes comedere.
[a] Azor, part. 1, lib. 5, cap. 6, qu. 7, v. His praenotatis, distinctionem adhibet: «Cuicumque monacho Carthusiensi, inquit, licet carnibus abstinere, etiam cum probabili vitae discrimine, quotiescumque id fecerit ob alicujus virtutis officium tuendum... Si vero nullum sit hujusmodi virtutis opus, mihi videtur Carthusiensem monachum astringi, ita ut jure ipso naturali compellatur ad vescendum carnibus, imminenti certo et evidenti, aut etiam probabili vitae periculo. Ut si solus sit in deserta solitudine, nec quid aliud ad edendum habeat praeter carnes, et fame laboret ac pereat, debet tunc carnes edere ne intereat».
[b] Joan. Medina, tr. 4, cod. de Jejunio, qu. 13, ad 4, omnino negat posse Carthusianum a carnibus abstinere, «si... accideret ut... nihil aliud quam carnem ad manducandum haberet, aut in talem incideret aegritudinem a qua sine carnis usu, ex peritorum medicorum judicio, liberari non posset».
[c] Vasquez, in 1<“» 2ac, disp. 162, cap. 4, distinctione utitur; et in casu aegritudinis, negat Carthusianum posse carnibus vesci; in casu vero quo deessent alii cibi praeter carnes, affirmat eumdem debere carnes comedere. Cujus sententiae adhaerent Granado, in jam 2ae, controv. 7, tr. 3, disp. 8, n. 27; et Salmant., tr. 11, cap. 2, n. 135, et seqq., qui tamen ut satis probabilem agnoscunt sententiam, dicentem posse in casu aegritudinis carnes comedere.
[d] Sanchez, dicit solum quod infra Busenbaum ei tribuit, et distinguit necessitatem ab intrinseco a necessitate ab extrinseco. Quod autem medicus aut alius possit aegroto inscio carnes praebere, id Diana tribuit Vasquezio, qui revera sic tenet, loc. cit., cap. 5, i. f.
3 Part. 5, tr. 3, resol. 136.
4 Tr. 11, de Legib., cap. 2, num. 136.
5 Part. 5, tr. 4, resol. 32. - Victoria, loc. cit., num. 9. - Lorca, in 1est 2st, de Legib., disp. 23, ad 4 exempl.
5 Part. 5, tr. 4, resol. 32. - Victoria, loc. cit., num. 9. - Lorca, in 1est 2st, de Legib., disp. 23, ad 4 exempl.
1 De Just. et Jure, disp. 10, n. 35.
2 Tr. 6, exam. 7, cap. 7, nnm. 119. [al. n. 66, v. Quonammodo).
1 De Just. et Jure, disp. 10, n. 35.
2 Tr. 6, exam. 7, cap. 7, nnm. 119. [al. n. 66, v. Quonammodo).
3 Consil., Iib. 5, cap. 1, dub. 34, num. 5 et seqq.
3 Consil., Iib. 5, cap. 1, dub. 34, num. 5 et seqq.
4 Tr. 11, cap. 2, n. 135.
4 Tr. 11, cap. 2, n. 135.
5 Lib. 3, tr. 3, part. 3, cap. 1, num. 6. - Cajetan., in 2”» 2”. qu. 147, art. 1.
5 Lib. 3, tr. 3, part. 3, cap. 1, num. 6. - Cajetan., in 2”» 2”. qu. 147, art. 1.
6 Disp. 2, de Restit. in part., qn. ult., sect. 1, punct. 5, num. 9.
7 Tr. 29, num. 78.
8 De Just. et Jure, disp. 10, n. 32, 35 et 36.
6 Disp. 2, de Restit. in part., qn. ult., sect. 1, punct. 5, num. 9.
7 Tr. 29, num. 78.
8 De Just. et Jure, disp. 10, n. 32, 35 et 36.
9 De Just. et Jore, disp. 10, n. 32.
10 De 5º Praec., art. 1, concl. 2, y.Qu.3.
11 Tr. 18, cap. 2, n. 30. - Granado, in 2”» 2”, controv. 3, tr. 6, disp. 2, num. 12 - Sayr., Clav., lib. 7, cap. 9, n. 33. — Lugo, loc. cit., n. 29, 32, 35 et 36. - Bonac., disp. 2, de Restit. in part., qu. ult., sect. 1, punct. 5, n. 6. Trull., lib. 5, cap*. 3, dub. 3, n. 1.
[a] [371] Villalobos, part. 2, tr. 12, dijff. 8, n. 1, modo aliquantulum diverso casum ponit, et negat peccatum esse, abstinentiis uti majoribus, quam quae solent fieri, quia vitam non abbreviant; si tamen adeo immoderatae torent, a mortali non excusarentur.
9 De Just. et Jore, disp. 10, n. 32.
10 De 5º Praec., art. 1, concl. 2, y.Qu.3.
11 Tr. 18, cap. 2, n. 30. - Granado, in 2”» 2”, controv. 3, tr. 6, disp. 2, num. 12 - Sayr., Clav., lib. 7, cap. 9, n. 33. — Lugo, loc. cit., n. 29, 32, 35 et 36. - Bonac., disp. 2, de Restit. in part., qu. ult., sect. 1, punct. 5, n. 6. Trull., lib. 5, cap*. 3, dub. 3, n. 1.
[a] [371] Villalobos, part. 2, tr. 12, dijff. 8, n. 1, modo aliquantulum diverso casum ponit, et negat peccatum esse, abstinentiis uti majoribus, quam quae solent fieri, quia vitam non abbreviant; si tamen adeo immoderatae torent, a mortali non excusarentur.
12 Loc. cit., num. 26.
12 Loc. cit., num. 26.
13 In 1am 2ae disp. 162, cap. 4, num. 25 et 26.
13 In 1am 2ae disp. 162, cap. 4, num. 25 et 26.
14 Lib. 3, tr. 3, part. 3, cap. 1, n. 4, i. f. — Lugo, loc. cit.. n. 21. Sotus, de Just. et Jure, lib. 5, qu. 2, art. 1, concl. 3. Bafien, in 2’“ 2”, qu. 65, art. 1. - Bonac., loc. dt., punct. 6, num. 2. - “
14 Lib. 3, tr. 3, part. 3, cap. 1, n. 4, i. f. — Lugo, loc. cit.. n. 21. Sotus, de Just. et Jure, lib. 5, qu. 2, art. 1, concl. 3. Bafien, in 2’“ 2”, qu. 65, art. 1. - Bonac., loc. dt., punct. 6, num. 2. - “
[a] 372 - Ipse Busenbaum (non vero auctores citati) addidit istam limitationem: nisi bono communi sit necessaria.
15 Loc. cit., num. 50.
16 Loc. cit„ concl. 2, v. Quartus casus. — Silvius, in 2»~ 2”, qu. 65, artic 1, concl. 2.
[b] Henno non citatur a Continuat. Tournely contra hanc sententiam, quam ipse Henno cum eodem Cont. Tournely tuetur; sed, disp. 5, qu. 3, art. 1, v. Sed teneturne, negat ceteros, qui scilicet curam personae mutilandae non habent, posse eam ad mutilationem ejusmodi cogere.
15 Loc. cit., num. 50.
16 Loc. cit„ concl. 2, v. Quartus casus. — Silvius, in 2»~ 2”, qu. 65, artic 1, concl. 2.
[b] Henno non citatur a Continuat. Tournely contra hanc sententiam, quam ipse Henno cum eodem Cont. Tournely tuetur; sed, disp. 5, qu. 3, art. 1, v. Sed teneturne, negat ceteros, qui scilicet curam personae mutilandae non habent, posse eam ad mutilationem ejusmodi cogere.
1 Lib. 2, cap. 9, num. 96.
2 Consil., lib. 5, cap. 1, dub. 33.
[c] Sanchez, loc. cit., id clare innuit, scribens n. 8, licitum esse viris perfectis medicinam respuere «in aliquibus morbis et doloribus gravibus, non ajfferentibus periculum mortis».
3 Tr. 1, exam. 7, cap. 1, n. 56 (edit. Lugd., s. d.)
[d] Turrianus, Sum.,part. 1, cap.263, dub. 5, concl. 11, non solum negat ad id teneri virginem, quando illi gravissimum foret; sed absolute negat teneri manum medici subire,« propter honestatem servandam, quae est majoris momenti quam salus corporalis». — Et ita etiam Sanchez, Consil., lib. 1, cap. 4, dub. 13.
1 Lib. 2, cap. 9, num. 96.
2 Consil., lib. 5, cap. 1, dub. 33.
[c] Sanchez, loc. cit., id clare innuit, scribens n. 8, licitum esse viris perfectis medicinam respuere «in aliquibus morbis et doloribus gravibus, non ajfferentibus periculum mortis».
3 Tr. 1, exam. 7, cap. 1, n. 56 (edit. Lugd., s. d.)
[d] Turrianus, Sum.,part. 1, cap.263, dub. 5, concl. 11, non solum negat ad id teneri virginem, quando illi gravissimum foret; sed absolute negat teneri manum medici subire,« propter honestatem servandam, quae est majoris momenti quam salus corporalis». — Et ita etiam Sanchez, Consil., lib. 1, cap. 4, dub. 13.
4 Tr. 13, cap. 2, num. 28. Less., lib. 4, cap. 3, dub. 8, n. 60. Diana, part. 5, tr. 3, resol.138. — Diana, loc. cit., resol. 138, i. f.
4 Tr. 13, cap. 2, num. 28. Less., lib. 4, cap. 3, dub. 8, n. 60. Diana, part. 5, tr. 3, resol.138. — Diana, loc. cit., resol. 138, i. f.
5 Lib. 2, cap. 9, n. 96.
5 Lib. 2, cap. 9, n. 96.
6 2a2ae, qu. 65, art.1, ad 3. — Less., lib. 2, cap. 9, n. 98.
[a] -373- Molina, tr. 3, disp. 70, n. 16, omissa quaestione de peccato, dicit irregularem esse eum qui se castraverit.
7 Tr. 29, n. 67.
6 2a2ae, qu. 65, art.1, ad 3. — Less., lib. 2, cap. 9, n. 98.
[a] -373- Molina, tr. 3, disp. 70, n. 16, omissa quaestione de peccato, dicit irregularem esse eum qui se castraverit.
7 Tr. 29, n. 67.
8 Lib. 8, tr. 3, part. 8, cap. 1, n. 2.
8 Lib. 8, tr. 3, part. 8, cap. 1, n. 2.
9 Tr. 5, cap. 3, n. 35.
10 Tr. 13, cap. 2, n. 45; et tr. 25, cap. 1, n. 121. — Lugo, de Just. et Jure, disp. 10, n. 28. — Bonac., disp. 7, de Irregular., qu. 2, punct. 2, num. 34. — Diana, part. 6, tr. 6, resol. 35; et tr. 8, resol. 36; part. 7, tr. 7, resol. 64 ; part. 9, tr. 8, resol. 45, v. f. — Villal., part. 2, tr. 12, diff 17, num. 4. — Trull., lib. 5, cap. 3, dub. 4, num. 4. — Salon, in 2am2ae, qu. 65, art. 1, controv. 2, i. f. — Pasqual., Decis. mor., decis. 498, n. 6.
[a] -374- Tamburinius, Decal., lib. 6,cap. 2, § 3, n. 4, hanc sententiam ut probabilem defendit.
11 Tr. 13, cap. 2. n. 45. — Elbel, de Homicidio, n. 29, i. f
[b] Mazzotta, tr. 4, disp. 2, qu. 3, cap. 1, § 1, Dico 4, qu. 2, absolute docet posse id fieri, nec solum probabile existimat.
[c] Elbel, de Homicidio, n. 29, non ipse probabilem appellat hanc sententiam, nisi forte in quantum oppositam probabiliorem existimat; at postquam alios retulit auctores, qui probabilem putant, subjicit:«Hanc opinionem videtur confirmare praxis saltem tolerata, praesertim in Italia, proptereaque insinuandam censui ».
[a] 375 - «Nisi (ut subdit Molina) praecessissent aliqua, unde id vehementer praesumeretur; ut si conatus fuisset antea seipsum interficere, prohibitusque fuisset, aut similia alia indicia praecessissent».
1 Tr. 3, disp. 20, n. 11.
2 Lib. 3, tr. 3, part. 3, cap. 1, n. 8.
[a] 375 - «Nisi (ut subdit Molina) praecessissent aliqua, unde id vehementer praesumeretur; ut si conatus fuisset antea seipsum interficere, prohibitusque fuisset, aut similia alia indicia praecessissent».
1 Tr. 3, disp. 20, n. 11.
2 Lib. 3, tr. 3, part. 3, cap. 1, n. 8.
3 Tr. 1, exam. 7, cap. 3, n. 109 (edit. Lugd. s. d.).
[b] Haec doctrina Escobar nequit sustineri, et contrarium omnino decretum est in bulla Detestabilem Benedicti XIV; cfr. S. Alphonsum infra n. 401.
3 Tr. 1, exam. 7, cap. 3, n. 109 (edit. Lugd. s. d.).
[b] Haec doctrina Escobar nequit sustineri, et contrarium omnino decretum est in bulla Detestabilem Benedicti XIV; cfr. S. Alphonsum infra n. 401.
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