Indirect abortion is the name given by Catholic theologians to an abortion procedure which has a therapeutic medical effect, presumably to save the life of a pregnant woman. Scholars with the National Catholic Review[1] and AmericanCatholic.org[2] make a distinction between "direct abortions" that is, abortion which is either an end or a means, and "indirect abortions", where the loss of the fetus is then considered to be a "secondary effect."
For example, if a woman is suffering an ectopic pregnancy (a fetus is developing in her fallopian tube, not the womb), a doctor may remove the fallopian tube as therapeutic treatment to prevent the woman's death. The fetus will not survive long after this, but the intention of the procedure and its action is to preserve the woman’s life. It is not a direct abortion.
While the positions in the previous two paragraphs appear in tension with one another, the relevant distinction may be between cases where the woman's life may be "in jeopardy", and cases where the woman would almost certainly die without the procedure that would incidentally destroy the fetus. However, this does not mean Catholics feel a direct abortion, even when intended to save the life of a woman, is ever acceptable.[3][4]
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This view is also held in the 1968 encyclical Humanae Vitae, which says that "the Church does not consider at all illicit the use of those therapeutic means necessary to cure bodily diseases, even if a foreseeable impediment to procreation should result there from—provided such impediment is not directly intended for any motive whatsoever". Paul VI quotes Pius XII in a 1953 address to the Italian Association of Urology.
According to Archbishop Jose Antonio Eguren in Peru, indirect abortion is not the same as a therapeutic abortion. Mgr Eguren asserts that indirect abortion is an extraordinary moral case which has nothing to do ‘therapeutic abortion’ ; in Catholic doctrine, therapeutic abortion simply does not exist, since abortion is never a cure for anything.[5]
According to Mgr Elio Sgreccia, President of the Pontifical Academy for Life, a great number of indications for such abortions have lost their raison d'être. He further asserts that the progressive extension of these indications beyond the scope of medicine has often been driven by political reasons, part of which are related to the eugenics movement.[6]
Tuberculosis, cardiopathies, vascular diseases, diseases of the hematopoietic system (some forms of anemia), kidney diseases, hepatic and pancreatic diseases, gastro-intestinal diseases, pregnancy-related chorea, myasthenia gravis, tumors, all these diseases are claimed to be motives for indications.
However, a thorough study of each one of them shows that the medical basis of these motives is very limited, and that in the cases where, in the absence of a therapeutic alternative, there remains a real risk for the life or health of the woman, these cases are in a strong and progressive downward trend.[7]
Pope Benedict XVI later gave a controversial speech in Angola where he appeared to blur the distinction between indirect abortion and direct abortion. He condemned all forms of abortion, even those considered to be therapeutic. This raised the eyebrows of the Vatican communications department, which reiterated the distinction between direct and indirect abortion, and commented that the allocution merely re-stated the Church's opposition to some sections of the gender-oriented Maputo Protocol.[8][9]