Statement of the NCBC on Salpingectomy to Reduce Cancer Risk (Updated)

In the Spring issue of The National Catholic Bioethics Quarterly (volume 16, number 1), there is a controversial article titled “Opportunistic Salpingectomy to Reduce the Risk of Ovarian Cancer.” The Center publishes scholarly articles, even those with which it may disagree, in order to foster debate, as long as the articles are not contrary to Catholic teaching. The Ethicists of the Center would like to take this opportunity to offer the following statement:

“Because it appears that some ovarian cancers may be caused by cancerous cells from the fallopian tubes, the authors of the article propose that it would be morally licit to perform a bilateral salpingectomy (the removal of the fallopian tubes) opportunistically (at the time of another procedure such as a cesarean section) for women at average risk of ovarian cancer. Specifically, the authors argue this would be justified by the principle of double effect for women of childbearing potential: that the act itself is good because it is done to prevent cancer even while it is foreseen that there would a bad effect, the loss of the great good of the woman’s fertility.

“The Ethicists of The National Catholic Bioethics Center do not believe that such a surgery would be morally justifiable if the woman of childbearing potential has only an average risk of ovarian cancer. We believe it could represent a mutilating intervention directed against a properly functioning reproductive system and would raise concerns about whether, in fact, there might be a contraceptive intention motivating the request for the procedure. Such a moral danger was acknowledged by the authors of the article themselves.

“Given the radical and irreversible loss of fertility resulting from this intervention, we believe that it is necessary, generally speaking, that there be evidence of heightened risk (not just average risk) of cancer for the individual woman who is considering this procedure. This heightened risk could be ascertained, for example, through direct diagnosis, genetic testing, or family history risk-assessment (e.g., blood relatives diagnosed with the same kind of cancer), or other means. Similar indications of heightened cancer risk for a particular woman would likewise be required for other preventive interventions, such as prophylactic mastectomy or prophylactic oophorectomy. At this point we do not believe the arguments as developed in the article provide adequate guidance for the establishment of hospital policy allowing for bilateral salpingectomy for women of childbearing potential with an average risk of ovarian cancer.”

—The Ethicists of The National Catholic Bioethics Center

(This is an update of the original June 2016 statement.)