[Question:]{.underline} Is it permissible to induce early delivery in cases of fetal anencephaly?
[Answer:]{.underline} Anencephaly is a congenital deformity of an unborn fetus in which large parts of the brain and skull are missing. It is always fatal for obvious reasons. The birth can be emotionally upsetting, since the birth defect is quite ugly and obvious. The baby may be still born, or may survive for a very short period of time before dying. The condition is usually now diagnosed during the second trimester by means of ultrasound. The most frequently advised medical treatment is abortion, the justification being that the baby will not survive, and this will diminish the emotional suffering of the wait and the trauma of seeing a deformed baby. However, the fact that the child will die is irrelevant. It is clearly evident that such direct killing of the unborn is not only a mortal sin, but also merits for every Catholic the canonical censure of excommunication.
As a consequence, some Catholics devised the plan of early delivery, stating that the principle of double effect applied, and that it was not an abortion, for the death of the baby is not directly willed, but rather the relief of the mother’s anguish. This is not true, for the early delivery before viability is a direct killing of the infant. Then others came up with the opinion that premature induction could be done as soon as the fetus is considered viable, namely from 33 weeks gestation. The problem with such a position is that the fetus is likely to die not just of anencephaly, but also of the consequences of prematurity, unless extraordinary means are used, which would not normally be the case when there is such a severe defect. Clearly, then, this is not permissible. At any rate, it is of no advantage to the baby, and there is no real evidence to suggest that there is any relief of parents’ emotional distress due to such early induction. Consequently, even in such cases in which the infant is viable, there is no proportionate cause, and the principle of double effect cannot be applied to place the baby at such great risk.
Consequently, in 1996 the U.S. bishops issued a statement that treats of this question quite well, entitled, “Moral Principles Concerning Infants with Anencephaly.” It declared:” It is clear that before ‘viability’ it is never permitted to terminate the gestation of an anencephalic child as the means of avoiding psychological or physical risks to the mother. Nor is such termination permitted after ‘viability’ if early delivery endangers the child’s life due to complications of prematurity…Only if the complications of the pregnancy result in a life-threatening pathology of the mother, may the treatment of this pathology be permitted even at a risk to the child, and then only if the child’s death is not a means to treating the mother.” Origins 26. 17 (October 10, 1996), quoted in The Case against Premature Induction by Nancy Valko, the National Catholic Bioethics Center, May 2004, Vol. 29, §5. (This article treats admirably of this subject in detail).
The emotional distress referred to in this whole discussion is none other than the refusal of the mystery of the Cross. It is a consequence of original sin that sickness entered into the world, and the particularly distressing sickness of congenital deformities. If the innocence of the baby, who has not personally merited such afflictions, distresses us, yet the existence of such deformities is a necessary reminder of the universality of our inheritance of original sin, and of how much we are all in need of the Redemption, and of the mystery of the Cross. The thought of trying to escape this distress by any other way is nothing less than the running away from the Cross that is inseparable from human life in this vale of tears.
Others, however, have proposed early induction not for the comfort of the mother, but to assure the birth of a live infant, and hence a certain valid baptism. This is a grave reason, but still could not justify doing anything morally wrong, such as delivering a baby before viability, or delivering a baby after viability but not supplying the means necessary to survive. It would seem, at any rate, a false presupposition, to think that the baby would be more likely to be born alive with premature induction than with normal birth or Caesarean section at term, and so the Catholic attitude in such a case would be to pray, place all things in Divine Providence, and be ready for an emergency baptism as soon as the child is born.
Answered by Father Peter Scott, SSPX.