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An abortion ban in the Dominican Republic is being unnecessarily questioned in the wake of a pregnant teenager with leukemia needing chemotherapy. According to a CNN story, “Some Dominican opposition law makers say there should be a new debate over the ban on abortion in the Caribbean country. The Dominican Republic outlawed all abortions in 2010. Article 37 of the Constitution approved that year doesn’t leave any room for interpretation or exceptions.”

But no exception for abortion is needed to address the situation of the woman’s life being in danger, for her medical condition can be addressed without directly killing the child.

This is a sentiment echoed by one of the authors of the controversial Article 37, Pelegrin Castillo, who said, “What we have clearly said is that in this case doctors are authorized by the constitution to treat the patient. They don’t have to worry about anything. They have the mandate of protecting both lives.”

Indeed, in a crisis like this, one must be guided by concern for both lives, not elevating one over the other.  Tragically, the teenager’s own mother (and the pre-born child’s grandmother) doesn’t agree when she says, “My daughter’s life is first.” Actually, both her daughter and her granddaughter’s (or grandson’s) lives should, together, be first. What should motivate anyone in this situation is the following: “How can we respect the dignity of both human lives?”

And the good news is there is a way to do that. Just because directly and intentionally killing the pre-born child (i.e., abortion) is not morally permissible, doesn’t mean nothing is permissible.  By applying The Principle of Double Effect, one can see there is a way to help the mother without directly killing (aborting) the child and without breaking Dominican law:

1. The action in itself must be good or indifferent:  By virtue of having a pathological condition (cancer), if saving her life depends on the administration of chemotherapy, it is a good action to administer that.

2. The good effect cannot be obtained through the bad effect (because then the end
would justify the means): The good effect of the teenager (hopefully) not dying from cancer is not achieved by means of killing the pre-born child, but rather by means of administering chemotherapy (a drug designed to target an existing pathological condition).

3. There must be a proportion between the good and bad effects brought about (e.g. life against life): If, as an effect of treating the pathological condition, the pre-born child is harmed or dies, that bad effect would be in proportion to the good effect of the mother not being killed by cancer.

4. The intention of the subject must be directed towards the good effect, and merely tolerate the bad effect: Indeed, those administering chemotherapy should in no way intend the (possible) bad effect of the pre-born child being harmed or dying, but rather only intend the good effect of eliminating the cancer.

Some say there is a fifth requirement: That there does not exist another possibility or avenue.  Certainly the medical professionals must consider whether it’s possible to delay the start of chemotherapy. But whether they can delay, or whether the cancer is so severe that immediate administration of chemotherapy is required, the above principles provide an ethical framework to guide their decision-making process.  When moving forward guided by these principles, one shows concern for both lives, and may even be able to save all (as can be seen here.)

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