Ecuadorian Federation of Societies of Gynecology and Obstetrics (FESGO)
April 17, 2008 – Enrique Sotomayor Hospital
Translated by Matthew Hoffman
1. The members of the Ecuadorian Federation of Societies of Gynecology and Obstetrics (FESGO) are not in agreement with any form of induced abortion; life is inviolable from the moment of conception. The elimination of an innocent human being is always unacceptable, ethically and medically speaking.
2. We are against induced abortion because it is not only an illegal act, but a criminal one, as is established in the Ecuadorian Penal Code in Chapter VI entitled “Crimes Against Life”, articles 441 through 446. Under no circumstances should abortion be decriminalized in Ecuador. To the contrary, policies and strategies must be established to strengthen moral values and defend the basic principles of universal bioethics pronounced by FESGO.
3. Science teaches that human life begins at conception. If it is also true that it is affirmed by religion, it does not for that reason cease to be a strictly scientific truth, to be transformed into a religious opinion. He who denies that human life begins with conception does not need to contend with religion, but science. To deny this certainty of biology is not to express a lack of faith, but a lack of basic knowledge of human genetics, something that is even known by the general public.
4. From the moment that the ovum is fertilized, a new life is begun that is not part of the father, nor of the mother, but rather a new human being that develops autonomously. Further, something so important is at stake that, from the point of view of moral obligation, the mere probability of the existence of a person is sufficient to justify the absolute prohibition of any intervention made for the purpose of eliminating a human embryo. Human beings must be respected and treated as a person from the instant of their conception and, for that reason, from that same moment the rights of the person must be respected, principally the inviolable right to life of every innocent human being. Human life must be respected from its conception, without exceptions.
To affirm that the woman can do with her body whatever she wishes, besides being a conceited claim, has absolutely no basis in science: the embryo is not part of the body of the mother, nor is the fetus an internal organ of her body: the DNA of the embryo is distinct from that of its parents.
5. Human life must be respected from the instant of conception, during all of the stages through which the human person passes, until its natural death, no matter what name is given to the new human person: zygote, morula, blastocyst, embryo, fetus, neonate, infant, adolescent, adult, elderly, terminally ill…all are only names for the same, unique human person in the distinct stages of development through which he is passing.
6. The inviolable ethical principle, universally valid (in time and in space), according to which “the ends do not justify the means”, is also valid in medicine, even when serious problems arise, be they surgical, economic/social, familial, or generally human ones. It is not possible to prevent so-called “unsafe abortion” by promoting “safe abortion”. Causing abortions in order to avoid abortions is as contradictory as combating death by causing death, or eliminating illness by killing those who are ill. Let us never forget that the doctor who is faced with a pregnant woman is in the presence of two patients.
7. Because doctors are also human, there are moments in medical practice in which health professionals might not know how to resolve the problems of a particular pregnancy, but we do know what not to do: to directly kill the child, making ourselves the owners and lords of life and death. Physicians are agents of life and not ambassadors of death.
8. The most effective strategy for preventing and avoiding abortion is moral and ethical education, above all among adolescents and young people, and support for women. Particularly, this instruction must be imparted in classes related to the value of life, sexuality, love, marriage, and family. It is not sufficient to give biological, physiological, and anatomical information regarding the human body, if instruction is not also given in values, in such a way that new generations adopt a responsible, orderly, and proper attitude to sexuality and procreative functions.
9. To prevent and avoid all types of abortion, with its terrible physical, psychological, and moral consequences, as well as those relating to conscience, it is essential that the pregnant woman does not feel alone, but rather that she feels supported with regard to the new life that lives within her. This support should come from the father of the child, her family, her social and work environments, religious institutions, and health professionals. Abortion is often a problem of isolation and, what is worse, of harmful influences.
10. Let us not forget that the second victim of the crime of abortion is the mother who obtains the abortion. Modern psychiatry and psychology have created the term Post-Abortion Syndrome. It is important to understand that it is easier for a woman to remove her child from her womb than from her mind and her heart.
11. Regarding abortion in cases of rape, the rapist should be punished, not the innocent child, fruit of the criminal act. If the woman who is raped obtains an abortion, in the first place, she causes irreparable damage to herself, because she is deprived of the best “psychological treatment” available to her, which is to live out her maternal instinct, caring for her child with love. It may be said that the psychological well-being of a woman who has been raped is being carried in her own womb. In the second place, if she has an abortion, not only will she not be freed from the trauma caused by the rape (it is one thing to eliminate the fruit of the rape and another to eliminate the trauma of the rape) but instead a new and more devastating trauma is created, that of having killed her own child. Adoption by a third party is a humanitarian strategy of unquestionable value.
12. Sometimes, doctors find themselves in a conflict between the life of the mother and the life of her child. In such situations the expression “therapeutic abortion” has been devised to refer to the interruption of the life of the child to save the life of the mother. However, the phrase “therapeutic abortion” as a simple expression, is unfortunate, because if we stop at the meaning of “therapeutic” it is synonymous with “cure”, which implies that the surgeon may kill the child with the purpose of saving the mother, when in fact neither the life of the mother nor that of her child can be directly ended. Doctors may never kill.
13. In such cases the doctor may act according to the principle of the “double effect”, which establishes the following. Surgical interventions from which follow two effects, one good (saving the life of the child or that of the mother) and another bad (the death of one of them) are ethical providing that the following five conditions are met:
1. That the purpose of the surgeon is to obtain a good effect (to save the life of mother or child) and is
limited to permitting or tolerating the bad (the death of one of the two).
2. That the death is not intended, whether as a goal or as a means, even if it is foreseen as an inevitable
3. That the first and immediate effect being sought by the surgeon is to save one of the two lives and the
death of one of them is tolerated with disgust or displeasure, and never desired.
4. That there exists a proportionately grave reason to act (the urgency of the operation).
5. That, under the circumstances, there exist no other effective means to save both lives.
14. In the case of a rape of a mentally disabled woman, the solution is not to kill the child, but to help the woman to continue the pregnancy to term, and once the baby has been born, he can given up for adoption. In a complementary fashion, we request that the authority in charge of adoptions facilitate them, avoiding by every means the corrupt management of adoption processes in which business and the enrichment of the parties involved take first place.
15. It is important to emphasize that the result of this workshop, given the scientific and moral quality of the Ecuadorian Federation of Societies of Gynecology and Obstetrics (FESGO) and of the content of the presentations and of these conclusions, should serve to instruct the whole country and will be a very important point of reference for every agency, including the highest levels of the executive, legislative, and judicial branches of government constituted in Ecuador.