Tuesday, August 27, 2013

Abortion and Psychosis, A question

I've a friend, whom I met in hospital, who is allergic to oestrogen. Which is unfortunate because she has XX Chromosomes, as I do. Her reaction to estrogen day to day is severe depressive episodes.
We met in hospital because she'd started taking oestrogen based contraception and it had triggered a suicidal psychosis. If her fiance hadn't unexpectedly come home two hours early to find her unusually calm, she would be dead. That was around 2x her normal day-to-day levels.

This friend is now worried that she's pregnant. Oestrogen levels by the end of pregnancy are, apparently, about 1000x that of day-to-day levels. She's extremely resourceful and, during her psychoses, can be very deceptive about how bad things actually are. At anything more that 2x her normal levels of oestrogen, she will find a way to kill herself.

The Church teaches, through the principle of double effect, that she can continue and increase treatment for her mental illness during pregnancy, even to the detriment of the child. She could take some oestrogen-blocking therapy, even if it kills the child.
The child could, however, survive to or past around 20 weeks when both pain and viability-outside-the-womb become a possibility. If the child is born, at whatever stage after that, there is a high likelihood of terrible suffering for them. It is unlikely that the child will survive long after birth, if at all.

She could, of course, not continue or receive more treatment.

Meanwhile, even a week of high levels of estrogen - much more for if it's 40 weeks - and this friend is likely dead; almost certainly.

Her question to me: How is killing the embryo, foetus, child slowly, possible over 9 or 10 months, more ethical than a direct abortion? My intention in either case is to stop in estrogen and the result in either case is the thing dying?

My question to you: How should I answer?

EDIT to clarify:
 I use allergy somewhat allegorically.
She has BPD and has a psychotic-suicidal reaction to estrogen. 
My assumptions, the 'givens,' are based on my close knowledge of her and her condition.
Also, yes, she could continue with BPD therapy; the resulting death or injuries to the child are of the same likelihood.
And, she uses a utilitarian prism for her moral compass:
"Greatest good for the greatest number," while believing that "There is some suffering worse than death."


fifi said...

What would knowingly and deliberately killing her baby do to her mental state? How did she let herself become pregnant if she knew the consequences? How does she know that there aren't other hormones released that will counteract the effect of the oestrogen or in someway mitigate the problem? What if she continues the pregnancy and finds that in fact being pregnant has changed everything (such as happens with other diseases such as endometriosis) and she goes on to have a healthy child that brings joy to both her and contributes mightily to society? What if?

Anonymous said...

If I have understood the situation correctly, I would say the difference is in the intent. I would correct her question though. In the scenario where she continues treatment, the baby is not being 'killed' but is dying. So to rephrase the question it would be something like "How is continuing treatment knowing the baby will likely die more ethical than a direct abortion?" I think the best way to exemplify the difference is through an analogy.

Scenario One:

A woman and her friend are swimming in the ocean and get caught in a rip. The woman is a fair swimmer, and could get out herself, but, even though she tries, she is not strong enough to pull them both from the rip. So the woman swims back to shore and manages to survive but her friend drowns as she could swim back.

Scenario Two:

Same people again. A woman and her friend are swimming in the ocean and get caught in a rip. The woman is a fair swimmer, and could get out herself, but she is not strong enough to pull them both from the rip. However; this time she holds her friends head under the water until her friend drowns. Then she swims back.

The end result is the same, but one way was clearly moral and the other not. To directly kill someone, than to do your best to help them, even if you know there death is inevitable is wrong. I would in fact say not that one is more immoral than the other. But that one is moral, the other is not.

Kelly said...

Fifi, you make some (unfair) assumptions. "Let herself get pregnant," is presumptuous. Believe me, it's not planned.
As my comment on FB mentioned, there's nothing in pregnancy that will mitigate the psychosis induced by the oestrogen.
EverythingCatholic, as my edit and FB comment mentioned, the ultilitarian prism inhibits the acceptance of the 'intention' aregument.

Tom Coffey said...

Dismantle the prism?

Kelly said...


Amy said...

Surely the 'apparently' very advanced medical profession has some way of supervising both unborn and born person here. Ie mother AND child. I refuse to believe that murder is the only solution. I am no expert but surely there must be some way of supplementing the correct combination of hormones for both mum and baby.

I have experienced first hand how quickly people will encourage an abortion in an 'undesirable' social situation. I can be quite, quite sure that someone in a better social situation would not be offered a whole host of other alternatives.'Buyer' beware.

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