The Santorum baby and the question of abortion

GOP Presidential candidate Rick Santorum and his wife Karen lost a child in 1996 . . .

Fr. Tad Pacholczyk

Inducing labor early during a pregnancy is dangerous, but it’s permissible under certain circumstances. Once the unborn child has reached viability, labor may be induced for a proportionate reason. Such early induction must be carefully considered with respect to each patient in an attempt to maximize clinical outcomes for both mother and child.

Early induction of labor after viability may be indicated, for example, in some cases of fetal hemolytic disease (where incompatibility between maternal and fetal blood causes the destruction of fetal red blood cells), assuming a significant risk to fetal health if the pregnancy were to continue.

Even prior to viability, in certain severe cases, the principle of Double Effect may allow for early induction of labor, with the death of the unborn child as a consequence. In such circumstances, the early induction of labor could not be construed as the equivalent of a direct abortion, but would constitute an indirect loss of life.

Some have claimed that presidential candidate Rick Santorum would have chosen an abortion, through an early induction of labor, when his wife Karen faced a difficult pregnancy back in 1996. According to media reports, Karen was fighting an infection that arose after she had undergone intrauterine surgery to correct a serious genetic defect in their unborn child.

Following the appearance of the infection, antibiotics were given to target the pathology. The family discussed inducing labor, which would have relied on a drug called pitocin. This would have been done to clear out the source of the infection, surmised to be infected membranes, from her body. According to Rick, “Karen said, ‘We’re not inducing labor, that’s an abortion. No way. That isn’t going to happen. I don’t care what happens.’”

What ended up happening was that she went into labor spontaneously, without being induced. When she realized it, she requested that an agent be given to block the labor so she could continue the pregnancy, since the child was too young to survive outside the womb, but her physicians refused, citing malpractice concerns. Children born prior to 21-23 weeks of gestation are not considered viable, and their child was only in the 19th or 20th week of pregnancy. Gabriel Michael Santorum was born shortly afterwards and lived for about two hours.

Karen’s claim that inducing labor would be the moral equivalent of abortion, it should be noted, is not quite correct. In circumstances where an intrauterine infection arises prior to viability, the decision to induce labor does not necessarily constitute an instance of a direct abortion, because in the absence of a suitable alternative or remedy for the infection, and with death looming for both mother and child, the physician who induces labor is seeking to clear and remove the source of the infection by acting pharmacologically on the mother’s body, not the child’s, through inducing the uterus to contract.

One is not attacking the body of the child, as in a direct abortion where the child’s body is dismembered with suction or surgical instruments. One is instead delivering the membranes, and thus, also the child early, with the foreseen, but unintended consequence that the child will probably die subsequently due to prematurity. When no other alternatives are available, this represents a valid application of the principle of Double Effect and would be morally permissible.

The Ethical and Religious Directives for Catholic Health Care Services of the U.S. Conference of Catholic Bishops phrases it this way: “Operations, treatments and medications that have as their direct purpose the cure of 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” (#47).

When interviewed about the matter, Rick reportedly stated: “The baby was going to die no matter what, and if she hadn’t already gone into labor, it would have been the equivalent of murder not to put her into labor. We did everything medically possible to save both.”

While it is clear the Santorums did indeed do everything they could to save both, Rick’s conclusion that not putting Karen into labor would be the “equivalent of murder” is not precisely correct either. To decide not to induce labor, when such labor would be anticipated to save her from the infection, could be a form of negligence, but it would not be murder if there were no evil intent.

Clearly the Santorums were not involved in any form of a direct abortion. Unless one were to stipulate that the antibiotic was responsible for causing Karen’s labor to begin, which seems doubtful, then they were not involved in any indirect taking of life either, since the labor arose spontaneously as Karen’s body reacted to the presence of the infection itself.

However, insofar as the loss of the child’s life ended up resulting from the original corrective surgical intervention (and co-occurring infection), one could conclude that the Santorums were involved in the indirect and unintended loss of the life of their child because they chose to try the surgery. Because the defect of the child was extremely serious, nevertheless, there appeared to be a proportionate and justifiable reason for choosing that particular high-risk surgery in an attempt to benefit both child and mother.

Rev. Tadeusz Pacholczyk, Ph.D., earned his doctorate in neuroscience from Yale and did post-doctoral work at Harvard. He is a priest of the diocese of Fall River, Mass., and serves as the director of education at the National Catholic Bioethics Center in Philadelphia.