The Morality of Medical Treatment While Pregnant

Is it moral for a pregnant woman to receive medical treatment such as chemotherapy, knowing it may endanger the life of her unborn baby?

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If a pregnant woman is diagnosed with cancer, can she take chemotherapy knowing that it might hurt her unborn child? This is a difficult question to answer. First, a disclaimer: I'm not intending to give medical advice. I'm not a doctor. Every person's situation is unique, and your situation will alter the kind of decision you have to make. I am not answering this question with regards to any specific situation, but just answering it broadly.

Having said that, based on what I've read in medical studies, it seems that chemotherapy is most harmful during embryogenesis - the first 10 weeks of human development. This is roughly around the first trimester. So, it seems as though during the second and third trimesters that chemotherapy doesn't have a negative effect on the unborn child. I’m not saying it doesn't have any effect, but based on what we can see, it doesn't appear to be that second or third trimester development is impacted greatly by chemotherapy.

So, with regard to the question: Could a woman take chemotherapy if she has cancer while she's pregnant? I would say yes. During the second and third trimesters, it appears to be morally permissible to do so.

What about the first trimester? I would say that it would also be permissible for a woman to take chemotherapy during the first trimester, but based on a slightly different rationale. If a woman has cancer during her first trimester, then the child is so underdeveloped there's no way that we can remove the child and put them in an incubator or a neonatal intensive care unit because he or she is just not developed enough. So, if the woman doesn't take chemotherapy to save her life, then the child is going to die no matter what. Obviously without the mother alive and healthy, the unborn child cannot survive.

By taking chemotherapy, you might risk harming the unborn child. This is where we would apply the Law of Double Effect where you intend a particular outcome by your action, but that action also has a second undesirable effect. The double effect in this case being that chemotherapy, although it might save the life of the mother, might hurt the child.

This is similar to a situation in which a woman is facing an ectopic pregnancy. The child is growing in a place like her fallopian tube where it's not supposed to grow. If you do nothing, the child will die, and perhaps also the mother will die. However, if you act to save the life of the mother, the child might die, but at least you save the life of the mother. 

In other words, it's better that one should live than two should die. I think a similar kind of thing is going on in the case of a woman who is pregnant with cancer needing to take chemotherapy. If she does nothing, she will die, but that would also result in the death of her unborn child. 

Therefore, I would say it would be morally permissible for her to take chemotherapy in order to save her own life in the hopes that the child would also be able to tolerate it and survive. Then, perhaps both could live. Even if a child dies, at least one person survives rather than two should die.

Those are the principles that I'm operating on when I think about this question. Is it morally permissible for a woman to take chemotherapy when she's pregnant? I would say yes in the first, second, and third trimesters but with slightly different rationales justifying each of them.

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Alan Shlemon

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