 McBride's supporters have argued that the abortion was licit under the terms of Directive 47 of the "Ethical and Religious Directives for Catholic Health Care Services", issued by the United States Conference of Catholic Bishops.Those who reject this argument note that Directive 47 (which refers to "operations, treatments, and medications that have as their direct purpose the cure of a proportionately serious pathological condition of a pregnant woman") applies only in the case of the death of the unborn child as an unintended consequence, according to the "principle of double effect", while the preceding Directive 45 in the same document explicitly states "Abortion (that is, the directly intended termination of pregnancy before viability or the directly intended destruction of a viable fetus) is never permitted.Every procedure whose sole immediate effect is the termination of pregnancy before viability is an abortion, which, in its moral context, includes the interval between conception and implantation of the embryo.