Ethicists of The National Catholic Bioethics Center
G. Kevin Donovan, MD, MA, Kevin FitzGerald, SJ, PhD, PhD, and Daniel Sulmasy, MD, PhD, offer a careful analysis in their article "Opportunistic Risk Reduction and Ovarian Cancer," published in Health Care Ethics USA in the Fall 2018 edition (vol. 26, no. 4). We agree with their observation that "the major ethical dilemma for Catholic health care is in category 4c: Women who are only of average population risk for ovarian cancer and are still of childbearing age for whom salpingectomy would be considered for primary prevention for ovarian cancer," as well as their conclusion eschewing a "routine practice permitting salpingectomy during other procedures, such as a cesarean section, in fertile women at a normally low or average risk of ovarian cancer".
We are therefore dismayed that the authors mischaracterize the statement of The National Catholic Bioethics Center, and consequently claim to disagree with us. We did not publish a "commentary" on the article by Gremmels et al., "Opportunistic Salpingectomy to Reduce the Risk of Ovarian Cancer" in The National Catholic Bioethics Quarterly (vol. 16, no. 1), nor did we aim to address with any detail the various populations to which the intervention might apply. Rather, our brief statement was intended to clarify that a particular conclusion of this extensive article did not reflect the position of the NCBC. The specific claim we contested involved an application of the principle of double effect, where the bad effect identified by those authors — and stated in our response — was the loss of fertility. Given this, it is evident that we were not speaking to the situation of postmenopausal women or any of the other scenarios in which opportunistic bilateral salpingectomy might be considered, but only to the scenario in which a premenopausal woman of average population risk would become sterile as a result of the procedure.
We are grateful that Donovan, FitzGerald, and Sulmasy have brought this potential for misunderstanding to light and have edited our statement for greater clarity. It can be found on our website at: https://www.ncbcenter.org/resources/news/statement-national-catholic-bioethics-center-salpingectomy-reduce-cancer-risk/.
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