If a lunatic is just about to fire three cartridges at me, I may know the chances are only two in three, or even only one in three, that he will hit me fatally, nevertheless I may licitly kill him to stop the firing and save my life. The mother in Case II. is in exactly similar danger of life.
The objection that the danger to my life from the action of the lunatic exists _hic et nunc_ and that the danger to the mother's life does not threaten _hic et nunc_, is not of any weight. She is in actual danger _hic et nunc_, even while the surgeon is in the room examining her. Moreover, the matter of time here is accidental. If you give a man a poison that may kill him in ten hours, or one that may kill him in ten days, the action is essentially the same.
I am of the opinion that if this second case were proposed to moral theologians many of them would decide that the surgeon should explain the case fully to the patient or her family, and if immediate operation were insisted upon he should withdraw from the case. Nevertheless, as far as I can see, he has sound probabilism on the side that operation is justifiable.
But, it may be objected, in Case I. the surgeon ligated the uterine and ovarian arteries to stop an actual hemorrhage, and he permitted the death of the foetus; in Case II. there is no hemorrhage yet, there may possibly be none at all. I answer { 33} that in Case II. if he operates he ties the two arteries to forestall an imminent hemorrhage which might begin within the next hour if it were not securely shut off, and to forestall sepsis by leisurely and proper precautions, and exactly as in the first case he permits the death of the foetus, he indirectly kills an unjust aggressor. If the lunatic is aiming at me I do not have to wait until he begins firing to licitly shoot at him. The sooner I shoot, _servato moderamine inculpatae tutelae_, the more prudent my action.
To put it in another form--in Case II. the surgeon is standing before a dam (the stretched Fallopian tube) that is threatening to break at any moment and cause death to a woman below it, because there is a lunatic (the foetus) behind it tearing away the masonry. If the surgeon shunts off the water just above the dam (the ligation of the arteries), he will suddenly let the lunatic who is tearing away the masonry fall down to the rocks at the bottom of the dam and be killed. May he let the lunatic fall? Certainly he may. But perhaps the lunatic will not succeed in tearing away the masonry. He is well provided with tools to do so; the chances are even two in three that he will succeed. Is he or the woman to be given the benefit of the doubt? The woman, by all means; she has a doubt worth in juridic value at the least twice as much as that which the lunatic has.