Are There Rare Cases When an Abortion Is Justified?

The devil doesn't want to overthrow God's law - he just wants you to make an exception now and then. Our exceptions to God's commandments, however, are indeed a challenge to God's authority and an assault against His Word-law. If the commandment "Thou shalt not murder" has an exception, then in that instance, "Thou shalt murder." All sophistry aside, there are no exceptions to the divine ordinance against intentionally killing innocent people, and to fancy exceptions is to usurp God's rule and set up a counterfeit moral standard after Lucifer's example.

There is a pro-life rebellion afoot that is distinguishing itself from the mainstream pro-life movement and is indicting it for complicity in the Abortion Holocaust. For example, a movement of Hippocratic physicians has begun in Muskingum County, Ohio, where fifteen physicians have publicly stated that they are convinced that life begins at fertilization, and have publicly committed not to commit abortions nor refer for the same. Billboards have erupted that claim, over the backdrop of a ten-week old human fetus, "Does your doctor kill babies? www.ProLifePhysicians.org." The most controversial element of this crusade to draw a line in the sand over the issue of abortion is that the line is being drawn so that doctors who are "pro-life with exceptions" are being left on the side of the line in the sand with the unabashed abortionists. Whether you kill thirty people a day for a living, or whether you are simply an accomplice in one murder of a handicapped child, or a child conceived through rape or incest, you are a murderer. God's Word makes it plain: "He that keepeth the whole law, and offends in one point, is guilty of all." (James 2:10) Indeed, our exceptions define our principles and reveal our heart.

It makes perfect sense for politicians to make exceptions to the pro-life ethic, especially if they are running against an openly pro-choice opponent. When George W. Bush ran for President, he publicly justified abortion in cases of rape and incest. In spite of this, he gained the endorsement of National Right to Life, and almost every pro-life organization in the country. Pro-lifers feared the pro-choice rhetoric of John Kerry more than they feared Bush's exceptions to the Sixth Commandment. George Bush could count on the endorsement of pro-lifers because, at worst, he was "the lesser of two evils," and he was sure to win some "moderates" by justifying abortion in some cases. If a politician is willing to sacrifice God's law on the altar of pragmatism and expedience, he certainly might gain more votes. But at what cost? When we abandon God's law for a counterfeit standard of right and wrong, do we lose the favor of the only Voter that counts for eternity?

What About the Health of the Mother? What About Rape and Incest? What About a Severely Handicapped Fetus?

We should never abandon our principles in our response to these difficult, heart-wrenching scenarios. These exceptions can and should be answered without shame or hesitation from the unshakeable foundation of these two indisputable premises: 1. Human life begins at fertilization, and 2. It is always wrong to intentionally kill an innocent human being.

Both scientific fact and Scripture can prove the first premise conclusively, and Scripture can prove the second premise as well.

It is always wrong - without exception - to fatally discriminate against human lives on the basis of their age, place of residence, stage of development, health status, or circumstances of conception. It is always wrong to kill one innocent human being to alleviate the suffering of another human being. It is just as evil to kill a pre-born baby conceived through rape or incest as it would be to kill a toddler who was conceived by rape or incest. Children should not be executed for the crimes of their fathers. One act of violence against an innocent person is not remedied, but rather, compounded by another act of violence against another innocent person.

A murderer of one person is not any less a murderer if he allows thousands to live, nor even if he saves thousands from dying! We should never be swayed from the unshakable foundation of God's law by emotional appeals that admittedly swell our eyes with tears. Truth, compassion, and the fear of God should prevent us from this fatal compromise.

What About the Life of the Mother?

This is the exception that most commonly seduces the sincere pro-lifer. The scenario in which this exception is most frequently packaged is an ectopic pregnancy, which is when the embryo attaches somewhere inside the mother's body in a place other than the inner lining of the uterus. It is argued that in an ectopic pregnancy, an abortion must be performed in order to save the mother's life.

What is rarely realized is that there are several cases in the medical literature where abdominal ectopic pregnancies have survived! There are no cases of ectopic pregnancies in a fallopian tube surviving, but several large studies have confirmed that expectant management may allow spontaneous regression of the tubal ectopic pregnancy the vast majority of the time. So an abortion of an ectopic pregnancy is not necessary to save the mother's life after all.

Moreover, if expectant management fails, the ectopic pregnancy does not spontaneously resolve, and surgery becomes necessary, the procedure to remove the ectopic pregnancy is not an abortion because the baby has already died.

A chemical abortion with a medicine called methotrexate is often recommended by physicians to patients with early tubal ectopic pregnancies, when the baby may still be alive, to decrease the chances of a surgical alternative being necessary later, but I have found this to be an unnecessary risk to human life. I offer the following true case to demonstrate this point.

One of my patients was diagnosed with a tubal ectopic pregnancy by her obstetrician, and he informed her that they were fortunate to have made the diagnosis early and that she should have a methotrexate abortion. The patient was strongly pro-life, and did not want to take the medicine, but the physician insisted. The baby was not going to survive, he argued, and a chemical abortion now could prevent the need for a surgical procedure later. The chemical abortion would lessen her chances of a life-threatening rupture of her fallopian tube and subsequent hemorrhage. The chemical abortion was also better at preserving future fertility than surgical removal of the ectopic pregnancy later. Feeling like she had no other reasonable alternative, she took the methotrexate.

However, there was a complication. Two weeks later, she still had vaginal bleeding and pelvic discomfort. A repeat ultrasound confirmed the physician's worst fears: his patient was pregnant with twins - one in the fallopian tube, and one in the uterus! He missed the uterine pregnancy in his ultrasound examination.

Expectant management would have seen spontaneous resolution of the tubal pregnancy or would have required surgical removal of the tubal pregnancy when the embryo was likely to be dead, but in both cases the uterine pregnancy would have survived. Methotrexate killed both babies, much to the dismay of this young pro-life woman.

I believe it is only ethical to remove the tubal pregnancy if spontaneous resolution does not occur after close monitoring and if the physician is 100% certain that there are no twins. At this point, the embryo in the fallopian tube is likely to be dead and an abortion is not performed, but rather, a surgical procedure to remove the dead baby. Methotrexate may still be appropriate once the physician has confirmed that there are no twins, but it is less likely to be successful at flushing the dead embryo from the fallopian tube at later stages in the ectopic pregnancy.

There are several examples that are also utilized to demonstrate that an abortion may be necessary to save the mother's life. If the mother has a severe illness that becomes life-threatening when she becomes pregnant, her physician may prescribe a therapeutic abortion to improve her chances of survival. A more specific example: if a mother has breast cancer and requires chemotherapy to survive that can kill the baby, a therapeutic abortion may be prescribed. Another example: if a mother has life-threatening seizures that can only be controlled by medicine that will kill or severely deform her unborn child, a therapeutic abortion is indicated, it is argued.

It cannot be denied that if the mother dies, her unborn baby certainly dies, and although the baby may die the mother's life can be saved. If both lives cannot simultaneously be saved, then saving the mother's life must be the primary aim. If through our careful treatment of the mother's illness the unborn baby inadvertently dies or is injured, this is tragic, but, if it is unintentional, it is not unethical and is consistent with both the Hippocratic oath and the law of God. But the intentional killing of an unborn baby by an abortion is never necessary, even in these scenarios.

Let me illustrate this point: if a rescuer is venturing into a burning vehicle to try to save its injured occupants, and is only able to save one of the two occupants, is it justifiable for him to then take out his gun and shoot the occupant he was unable to save? Of course not! Intentionally killing those you were not able to save is never justified in healthcare. We have the technology and expertise to provide quality healthcare to a pregnant woman without intentionally killing her unborn baby, regardless of the severity of her disease.

I am convinced that much of the pressure physicians place upon ailing women to get a "therapeutic abortion" is fear of malpractice suits. Several female patients have reported to me that physicians unduly pressured them into getting an abortion because they had prescribed a medicine to them that could harm their baby if they got pregnant; the contraception failed and the woman subsequently got pregnant. The motive for prescribing an abortion in such cases is not compassion, but completely selfish. The potential of a malformed or mentally retarded child does not ever justify killing the child, malpractice threats notwithstanding. It is always wrong to intentionally kill an innocent human being, even if you are going to get sued if you let them live.

In conclusion, there are no occasions in which an abortion is justified. None. Not even for the life of the mother. Scientific fact and God's Word are clear: life begins at conception, and there are no exceptions to the six commandment. We must stand true to these foundational principles through every emotional appeal and in every tragic scenario if we are to have any principles at all worth standing for.