Chapter I: Front Matter

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THE ETHICS OF MEDICAL HOMICIDE AND MUTILATION

by

AUSTIN O'MALLEY, M.D., PH.D., LL.D.

New York The Devin-Adair Company 1922

Nihil obstat Arthur J. Scanlan, S.T.D. _Censor Librorum_

Imprimatur

[see Transcriber's note below] JOHN CARDINAL FARLEY Archbishop of New York

Copyright, 1919, by The Devin-Adair Company

All Rights Reserved by The Devin-Adair Company

Third Printing

Printed in U.S.A.

CONTENTS

CHAPTER I

GENERAL PRINCIPLES CONCERNING SUICIDE AND HOMICIDE

PAGE

There is a Supreme Being who alone is master of life. The
Natural Law. The nature and determinants of morality.
Probabilism. Permissive suicide. Suicide is illicit.
Conscience. Homicide, direct and indirect. Self-defence.
Formal and material aggressors. Legalized homicide.
Bibliography 1-22

CHAPTER II

GENERAL PRINCIPLES CONCERNING MUTILATION

Mutilation. Canonical irregularity. Self-mutilation. The
double effect in morality. Direct and indirect mutilation.
The State and mutilation. The dominion of the State 23-32

CHAPTER III

WHEN DOES HUMAN LIFE BEGIN?

Ancient and modern opinions. The fetus is animated at the
moment of conception. The single cell as the primal
life-organ. Cell growth and division. Germ cells. The
development of the embryo. Fetal viability. Theories
of development. The Aristotelian and Thomistic opinions.
The formal principle. A soul exists. The primordial
cell is a sufficient organ for the soul. Metabolism
in the cell. Cell motion. Animal heat and energy.
Life in separated tissues. The soul in monsters 33-82

CHAPTER IV

WHEN DOES HUMAN LIFE END?

The heart and life. Resuscitation after apparent death. The
last sacraments in apparent death. Suspended animation.
The living fetus in the womb of a dying or dead
mother. Methods of resuscitation. Signs of death 83-91

CHAPTER V

ABORTION

Abortion and miscarriage. Causes of abortion, fetal,
maternal and paternal. Surgical operations and abortion.
The debitum in pregnancy. Premature labor. Threatened,
inevitable, and incomplete abortions. Treatment. The
use of the tampon. Precautions against abortion. Therapeutic
abortion. Methods of inducing abortion. Artificial
abortion of an inviable fetus is never licit. Decrees
of the church concerning abortion. The civil law
on abortion 92-123

CHAPTER VI

ECTOPIC GESTATION

Ectopic gestation or extrauterine pregnancy. Anatomy of the
uterus and its adnexa. Place of fecundation. The abnormal
uterus. Tubal rupture and tubal abortion. Diagnosis.
Decrees of the church on ectopic gestation. Removal
of an inviable ectopic fetus except in present
peril of life is illicit 124-132

CHAPTER VII

CESAREAN DELIVERY

Indications for cesarean delivery. Abnormal pelves.
Symphyseotomy. Varieties of cesarean delivery. Morality.
Amputation of the uterus after cesarean delivery.
Precautionary sterilization of a cesarean case is illicit 133-142

CHAPTER VIII

PLACENTA PRAEVIA AND ABRUPTIO PLACENTAE

Nature and effects of placenta praevia. Treatment. Morality
and methods of treatment. Abruptio placentae. Morality
of fetal removal 143-146

CHAPTER IX

ABDOMINAL TUMORS IN PREGNANCY

Tumors blocking parturition. Fibroids or myomata. Ovarian
tumors. Cancer. Effects and morality of operation 147-152

CHAPTER X

APPENDICITIS IN PREGNANCY

Occurrence. Time of operation. Diagnosis 153-154

CHAPTER XI

PUERPERAL INSANITY AND STERILIZATION

Causes. Varieties. Prognosis. Precautionary sterilization
of puerperal psychopaths is illicit 155-157

CHAPTER XII

NEPHRITIS IN PREGNANCY

Frequency. Effects. Abortion as a treatment. Varieties of
nephritis. Pyelitis. Catalepsy 158-161

CHAPTER XIII

ECLAMPSIA PARTURIENTIUM

Definition. Symptoms. Prognosis. Causes. Precautions
against eclampsia. Forced delivery. The expectant
treatment. Relative mortality and morality of the
methods. Cesarean delivery as a treatment. The expectant
treatment is apparently the best 162-169

CHAPTER XIV

HEART DISEASES IN PREGNANCY

Factors in abnormal gestation. The use of pituitrin. Weak
pains and the diseased heart. The diseased heart in
actual parturition. Operative risk in cardiopaths. Heart
block and mitral regurgitation in labor. Prognosis 170-176

CHAPTER XV

HYPEREMESIS GRAVIDARUM

Pernicious vomiting. Occurrence. Symptoms. Stages. Effects.
Causes. Therapeutic abortion in pernicious vomiting.
Treatment 177-181

CHAPTER XVI

CHOREA GRAVIDARUM AND HYSTERIA

Varieties of chorea. Differentiation. Prognosis. Hysteria.
Causes. Epidemics of hysteria. Symptoms. Prognosis 182-186

CHAPTER XVII

ACUTE YELLOW ATROPHY OF THE LIVER IN PREGNANCY

Icterus gravis. Causes. Symptoms. Prognosis 187-188

CHAPTER XVIII

INFECTIOUS DISEASES IN PREGNANCY

Effects on mother and fetus. Abortions in infectious
diseases. Placental permeability. Typhoid. Smallpox.
Pneumonia. Influenza. Scarlatina. Measles. Cholera.
Tuberculosis. Artificial abortion in tuberculosis 189-200

CHAPTER XIX

SYPHILIS IN PREGNANCY AND MARRIAGE

Prognosis. Abortion. Infection of mother and fetus. Colles'
Law. Erroneous notions on the curability of syphilis.
Once a syphilitic probably always a syphilitic. The
professional secret in syphilis. Nature of secrets. The
physician may warn an innocent person 201-211

CHAPTER XX

GONORRHOEA IN MARRIAGE

The cause of gonorrhoea. Tests of cure. Effects on a woman.
Chronicity. Prevalence. Surgical treatment in women.
Morality of the surgical treatment. Conservative surgery.
Salpingotomy. Ovariotomy. Evil effects of
ovariotomy. Internal secretion of the ovary. Results of
various operations. Pregnancy after operation. Morality
of infection. General effects of gonorrhoea. Ophthalmia
neonatorum and gonorrhoea 212-229

CHAPTER XXI

DIABETES IN PREGNANCY

Fatality of diabetes in pregnancy. Diagnosis. Sterility
of diabetics. Prognosis. Heredity in diabetes. Therapeutic
abortion in diabetes 230-231

CHAPTER XXII

CHILDBIRTH IN TWILIGHT SLEEP

Twilight sleep to avert pain in parturition. Stages of labor.
Drugs used. Scopolamine and morphine. Danger in
the use of these drugs in labor. Contradictory report
of physicians on twilight sleep. Eminent authorities opposed
to the methods. Baer's report on the evil effects.
The methods are morally illicit and useless 232-244

CHAPTER XXIII

VASECTOMY, OR STERILIZATION, BY STATE LAW

The States that have this law. Reasons for the law. Hereditary
transmission of certain diseases. The operation.
Its effects. Restoration of the function of the interrupted
vas deferens. Vasectomy and impotence. Onanism.
Vasectomy effects impotence from the moral
point of view. Other conditions in the male that effect
moral impotence. Immorality of artificial impregnation.
Vasectomy a grave mutilation. Vasectomy as ordinarily
practised is illicit. The State and vasectomy.
The limitations of the State's dominion. The State surgeon
and vasectomy. Bibliography 245-268

CHAPTER XXIV

THE ETHICS OF BIRTH CONTROL 269

Index 281