Are There Rare Cases When an Abortion Is Justified?

By Dr. Patrick Johnston, D.O.

Dir., Assn. of Pro-Life Physicians

The Sixth Commandment states, “You shall not murder.”

It’s a commandment that even mass murderers keep most of the time. They just make an exception every now and then. The devil doesn’t want to overthrow God’s law – he just wants you to make an exception. Our exceptions to God’s commandments, however, are indeed a challenge to God’s authority and an assault against His Word-law. If you make an exception to the commandment “Thou shalt not murder” then in that instance, you have violated it. All sophistry aside, there are no exceptions to the divine ordinance against intentionally killing innocent people, and to fancy exceptions is to usurp God’s rule and set up a counterfeit moral standard after Lucifer’s example.

A Pro-Life Rebellion is Afoot

There is a pro-life rebellion afoot that is distinguishing itself from the mainstream pro-life movement and is indicting it for complicity in the Abortion Holocaust. Personhood Amendments are a perfect example; through amending state constitutions to define person to include unborn children, states are trying to end all abortion without exception within their borders. As of May 2013, over 1.3 million people have signed a Personhood petition in state ballot initiatives, and thrice states have brought their Personhood Amendment to the ballot box on an Election Day. Many Personhood leaders do not believe that the goal of their Amendment is to overturn Roe v. Wade; on the contrary, they believe Roe v. Wade is unlawful, invalid, and ultimately inconsequential to theirSeven Weeks Alive duty to protect every child within their lawful jurisdiction. Predictably, one of the greatest threats to these attempts to protect every child statewide by love and by law are “pro-life” groups and “pro-life” leaders who favor exceptions or who believe states have a duty to submit to lawless and unconstitutional judicial tyranny. Regardless, these signature-gathering personhood warriors are akin to the “slavery abolitionists” of the civil war era, standing on principle and on God’s Word, and exposing all wet-finger-raising compromisers as accomplices in the Abortion Holocaust.

Another example of this pro-life shift from pragmatism to principle is found in a movement of Hippocratic physicians that began in 2004 in Muskingum County, Ohio. In that county, fifteen physicians from a dozen different specialties have publicly stated that they are convinced that life begins at fertilization, and have committed not to do abortions nor refer for abortions. Billboards have erupted that claim, over the backdrop of a ten-week old human fetus, “Does your doctor kill babies?” Physicians are joining this group – the Association of Pro-Life Physicians – from all over the country, longing to be distinguished from colleagues that are, unfortunately, willing to kill their patients. The most controversial element of this crusade to draw a line in the sand over the issue of abortion is that doctors who are “pro-life with exceptions” are being left on the side with the unabashed abortionists. Whether you kill thirty people a day for a living, or whether you are simply an accomplice in one murder of one child conceived through rape or incest, you are a murderer. God’s Word makes it plain: “He that keepeth the whole law, and offends in one point, is guilty of all.” (James 2:10) Indeed, our exceptions define our principles and reveal our heart.

It makes perfect sense for politicians to make pragmatic exceptions to the pro-life ethic, especially if they are running against an openly pro-choice opponent. When George W. Bush, John McCain, and Mitt Romney ran for President, they publicly justified abortion in some cases, and had funded Planned Parenthood in previous positions of leadership, with no promise to cease doing so. In spite of this, they gained the endorsement of National Right to Life and almost every pro-life organization in the country. Pro-lifers feared the pro-choice rhetoric of the Democrat more than they feared the Republican’s exceptions to the Sixth Commandment. The Republican candidate could count on the endorsement of pro-lifers because, at worst, he was “the lesser of two evils,” and he was more likely to win some moderates by justifying abortion in some cases. If a politician is willing to sacrifice God’s law on the altar of pragmatism and expedience, however, he may gain more votes – but at what cost? When we abandon God’s law for a counterfeit standard of right and wrong, do we lose the favor of the only Voter that counts for eternity? When we support such candidates, how do we not bring bloodguilt on ourselves?

What about the Health of the Mother?

What about Rape and Incest?

What about a Severely Handicapped Fetus?

We should never abandon our principles in our response to these difficult, heart-wrenching scenarios. These exceptions can and should be answered without shame or hesitation from the unshakeable foundation of these two indisputable premises:

  1. Human life begins at fertilization, and
  2. It is always wrong to intentionally kill an innocent human being.

Scientific fact can prove the first premise conclusively. Nothing after fertilization makes you any more human or any more alive than the moment before. The Scripture says that Rebecca’s twins “struggled together within her.” Mary was “great with child.” Job spoke of “a man child was conceived.” Exodus 21 prescribed the death penalty for killing an unborn child through negligent carelessness. A fair trial and conviction for a capital crime was necessary before a person could be killed.

These exceptions, when evaluated, are really just smoke and mirrors – distractions from the true point of contention. If I held an infant in my arms and informed a crowd of pro-choice leaders that the child was conceived through rape, was handicapped, and the mother was extremely depressed that this child was still living, do you think any of them would propose that the infant should be killed? This proves that the circumstances surrounding conception are irrelevant, and making such excuses for abortion are insincere attempts to distract from the true point of contention in the debate: when does life begin?

It is always wrong – without exception – to fatally discriminate against human lives on the basis of their age, place of residence, stage of development, health status, or circumstances of conception. It is always wrong to kill one innocent human being to alleviate the suffering of another human being. It is just as evil to kill a pre-born baby conceived through rape or incest as it would be to kill a toddler who was conceived by rape or incest. Children should not be executed for the crimes of their fathers. One act of violence or sexual assault against an innocent person is not remedied, but rather, compounded by another act of violence against another innocent person.

A murderer of one person is no less a murderer if he allows thousands to live, nor even if he saves thousands from dying! We should never be swayed from the unshakable foundation of God’s law by emotional appeals that admittedly swell our eyes with tears. Truth, compassion, and the fear of God should prevent us from this fatal compromise.

What about the Life of the Mother?

This is the exception that most commonly seduces the sincere pro-lifer. Answers in Genesis (AiG) is a large Christian ministry that is well known for their Creation Museum in the Cincinnati area; they’ve earned the respect of genuine Christians all over the world for their defense of the biblical six-day creation, but on February 26, 2013, the Bible took a back seat in their pragmatic justification of child-killing. In their Answers magazine, Dr. Tommy Mitchell, a physician and speaker for AiG, wrote an article entitled, “Is Abortion Ever Justifiable?” In this article, Dr. Mitchell justifies the killing of babies in some circumstances. If a mother has aggressive leukemia and requires immediate chemotherapy “that is virtually certain to kill the unborn child,” and if postponing chemotherapy is too risky for the mother, then, Dr. Mitchell argues, the doctor is justified in advising “immediate abortion.”

Is this justification even compatible with the scientific facts? The chemotherapy necessary to save the life of the leukemia patient in Dr. Mitchell’s hypothetical scenario would be just as effective whether the patient were pregnant or not. Dr. Mitchell expressed concern that the low platelet count common with some chemotherapeutic agents would be too risky if the woman underwent delivery, but would a surgical abortion mitigate that risk at all? Where is the evidence that killing that baby is necessary to save the life of his or her mother?

As reported in The Lancet medical journal in August 2012, the German Breast Group followed 413 pregnant cancer patients receiving chemotherapy, and found little to no evidence of negative health effects on their infants.1 Delay of cancer treatment did “not significantly affect disease free survival” in this study, and chemotherapy was found to be relatively safe after the first trimester.

When you examine the actual fetal health risks of maternal chemotherapy, it looks like killing babies isn’t good healthcare after all.

Most physicians recommend an abortion before they will prescribe chemotherapy, however, it is not to save the mother’s life, but to protect themselves from litigation. I have witnessed physicians withhold life-saving care from a pregnant mother unless she gets an abortion, not because the abortion was necessary to save the mother’s life, but because their care or the medicine they planned to prescribe could have hurt or handicapped the baby and they feared a lawsuit.

Drs. Tommy Mitchell and Elizabeth Mitchell also brought up HELLP Syndrome and chorioamnionitis as justifications for abortion. Dr. Elizabeth Mitchell even said that she would be willing to do an abortion in such a scenario.2 The medical literature declares that in chorioamnionitis and HELLP Syndrome, “facilitating delivery” may be necessary to save the life of the mother. Can you facilitate delivery and not dismember the baby? Of course. Granted, the premature delivery may inadvertently result in the death of the child, but the physician should do everything in his power to save the mother and the baby. If the mother’s life is truly threatened, then the premature delivery may be the best way to save the baby, not just mother, because if the mother dies so does the baby. If through our careful treatment of the mother’s illness the unborn baby inadvertently dies or is injured, this is tragic, but, if it is unintentional, it is not unethical and is consistent with both the Hippocratic Oath and the law of God. The intentional killing of an unborn baby by an abortion, however, is a grievous violation of God’s law.

Dr. Elizabeth Mitchell and Dr. Tommy Mitchell countered: if the premature delivery resulted in the death of the baby, then the outcome was the same: the baby dies just as if an abortion was committed. Therefore, they argued, we should do what is best for the mother, even if that means aborting the baby. Mark Looy, who co-founded AiG with Ken Ham, concurred with the Mitchells: since the outcome was the same, then the abortion was justified.

First of all, the outcome is not necessarily the same. If a baby was delivered prematurely, the baby may survive. The dates could have been wrong, and the baby may be further along than we thought. The record of the earliest surviving baby is 18 weeks, little Kenya King born in Orlando, Florida, in 1985, as reported by the Orlando Sentinel. However, if the baby is dismembered and extracted piece by piece with forceps, as is done via a Dilation & Extraction abortion on a mid-trimester baby, what are the child’s chances of survival then? The outcomes are not always identical.

Fire.jpg Just because the baby is likely to die through a natural delivery, that does not justify an intentional killing. For example, if a rescuer is venturing into a burning vehicle to try to save its injured occupants, and is only able to save one of the two occupants, is it justifiable for him to then take out his gun and shoot the occupant he was unable to save? Of course not! Intentionally killing those you were not able to save is never justified in healthcare. We have the technology and expertise to provide quality healthcare to a pregnant woman without intentionally killing her unborn baby, regardless of the severity of her disease.

It is self-evident that killing a baby by ripping him or her out piece by piece is quite a different thing than a prematurely delivered baby (delivered to save the life of the mother and the baby) dying peacefully in the arms of his parents in spite of physician’s care. Trying to save a baby’s life and failing is not morally equivalent to trying to kill a baby! An abortion violates God’s law because it intends to kill an innocent person, whereas prematurely delivering a baby and trying to save his or her life does not intend to kill and does not violate God’s law. One is violent and cruel, the other heroic and compassionate.

Police Line jpgPennsylvania abortionist Kermit Gosnell received “Guilty” verdicts for snipping the cervical spines of babies who survived his late-term abortion procedures.

A friend of mine last year saw their preborn baby miscarry; in spite of the physician’s efforts, the baby died peacefully in her parents’ arms.

Just because the outcome is the same, that doesn’t make the acts morally equivalent.

Many Christian and pro-life groups concur that an abortion is never necessary to save the mother’s life: the American Assn. of Pro-Life Ob/Gyns, the Christian Medical Association, Personhood USA and several state affiliates, the Catholic Medical Association, American Right to Life, both Georgia and Colorado Right to Life, and the Dublin Declaration, just to name a few.

The Dublin Declaration is a statement from physicians opposing the legalization of abortion in Ireland; they state, “As experienced practitioners and researchers in obstetrics and gynecology, we affirm that direct abortion – the purposeful destruction of the unborn child – is not medically necessary to save the life of a woman. We uphold that there is a fundamental difference between abortion and necessary medical treatments that are carried out to save the life of the mother, even if such treatment results in the loss of her unborn child.”

Congressman and obstetrician Ron Paul said he never saw an abortion that was medically necessary. Former Surgeon General Everett Koop said that abortion was “not needed to save the life of the mother.” He wrote, “In my thirty-six years in pediatric surgery I have never known of one instance where the child had to be aborted to save the mother’s life.”

Even Planned Parenthood’s Dr. Alan Guttmacher acknowledged, “Today it is possible for almost any patient to be brought through pregnancy alive, unless she suffers from a fatal illness such as cancer or leukemia, and, if so, abortion would be unlikely to prolong, much less save, life.”3

With their abortion justifications, Answers in Genesis leaders have abandoned the solid rock of God’s Word for the quicksand of relative morality. They have surrendered their trump card – “Thus saith the Lord” – to the father of lies. Having sheathed the sword of the Spirit in the spiritual battle for souls and for freedom, they’ve handicapped themselves. They may have always been true to God’s Word in the past, but like a faithful husband who makes an exception on a business trip with his secretary, they’ve made one fatal exception to the Sixth Commandment forbidding murder, thus bringing bloodguilt upon themselves for all who kill their children following their lead.

What About an Ectopic Pregnancy?

Dr. Elizabeth Mitchell also mentioned an ectopic pregnancy as a justification for abortion. An ectopic pregnancy is when the embryo attaches somewhere inside the mother’s body in a place other than the inner lining of the uterus. Is an abortion in an ectopic pregnancy necessary to save the mother’s life? Not at all.

Ectopic Pregnancy jpgWhat is rarely realized is that there are several cases in the medical literature where abdominal ectopic pregnancies have survived! There are few cases of ectopic pregnancies in a fallopian tube surviving, but it is well documented in the medical literature that a tubal ectopic pregnancy may unattach and reattach in the uterus. There have also been successful embryo transplants where the embryo was surgically removed from the fallopian tube and implanted into the uterus. Regardless, several large studies have confirmed that expectant management may allow spontaneous regression of the tubal ectopic pregnancy the vast majority of the time.

If expectant management fails and the ectopic pregnancy does not spontaneously resolve, and surgery becomes necessary to save the life of the mother, it is likely at this point that the baby has already overgrown his or her blood supply and succumbed. Nevertheless, with the mother’s life imminently threatened by the pregnancy, a premature delivery may be necessary to save the life of the mother, but the physician should do everything possible to save the baby as well.

A chemical abortion with a medicine called methotrexate is often recommended by physicians to mothers with early tubal ectopic pregnancies to decrease the chances of hemorrhage or a surgical alternative being necessary later. I have found this to be an unnecessary risk to human life. I offer the following true case to demonstrate this point.

One of my patients was diagnosed with a tubal ectopic pregnancy by her obstetrician, and he informed her that they were fortunate to have made the diagnosis early and that she should have a methotrexate abortion. The patient was strongly pro-life, and did not want to take the medicine, but the physician insisted. The baby was not going to survive, he argued, and a chemical abortion now could prevent the need for a surgical procedure later. The chemical abortion would lessen her chances of a life-threatening rupture of her fallopian tube. The chemical abortion was also better at preserving future fertility than surgical removal of the ectopic pregnancy later. Feeling like she had no other reasonable alternative, she took the methotrexate.

However, there was a complication. Two weeks later, she still had vaginal bleeding and pelvic discomfort. A repeat ultrasound confirmed the physician’s worst fears: there was a pregnancy in the uterus! Either the patient had twins, one in the fallopian tube and one in the uterus, or the fallopian tube pregnancy unattached and reattached in the uterus.

If there were twins, expectant management would likely have seen spontaneous resolution of the tubal pregnancy or would have required surgical removal of the tubal pregnancy when the embryo was likely to be dead, but in both cases the uterine pregnancy would have survived. If the tubal pregnancy dislodged and reattached in the uterus, the baby would be alive today and the mother would not have suffered such guilt and life-threatening hemorrhaging.

In conclusion, there are no occasions in which an abortion is justified. None. Not even for the life of the mother. Scientific fact and God’s Word are clear: life begins at conception (fertilization), and there are no exceptions to the Six Commandment forbidding the intentional killing of innocent people. We must stand true to these foundational principles through every emotional appeal and in every tragic scenario if we are to have any principles at all for which to stand.


1. Treatment of breast cancer during pregnancy: an observational study. The Lancet Oncology, Volume 13, Issue 9, Pg. 887–896, September 2012.

2. “With the Compromise of Answers in Genesis, a Giant Has Fallen”. Dr. Patrick Johnston, June 18, 2013. article detailing encounter between Dr. Patrick Johnston, AiG co-founder Mark Looy & AiG staff Drs. Tommy and Elizabeth Mitchell.

3. The Case for Legalized Abortion Now, Alan Frank Guttmacher, January 1, 1967


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9 Responses

  1. Karl says:

    This is incredibly well written and I thank you for writing it and posting it here.

    I have two questions.

    Is there an easy or reliable way to find out which physicians perform abortions and which are pro-life, etc? And…

    I really love the idea of the pro-life directory. Would it make sense to extend that to pro-life clinics and hospitals and group practices, as well?

  2. Joel says:

    Thank you for the great information. I am especially interested in the section on ectopic pregnancy, especially tubal. I have only read about one case of a transplant from tube to uterus and that was in 1917. I have heard anecdotal stories of others in the 80’s and 90’s but found no info. Are you aware of any physicians that are currently willing to do embryo transplants?

    • Bonnie says:

      I am researching this topic myself. I plan to interview as many prolife doctors as I can to spread awareness of the possibility of transplantation and will report on it on my website. Feel free to email me above or friend me on FB for any updates as they occur. THX

  3. Kelly says:

    So being that there have been success stories of tubal pregnancies being surgically removed and placed into the uterus, does this mean if someone where to have the unfortant event of a tubal pregnancy occur, they can contact a local pro-life physician from this website and have help saving the baby, even if it leads to surgery?

  4. Jen says:

    Thank you for you bravery and stand for life in this culture. I was unaware about ectopic success stories until I happened upon another similar article and started researching!

  5. Maria says:

    Will you please cite the studies on ectopic pregnancy, please?

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