in a case that attracted international attention in 2009, when brazilian archbishop jose cardoso sobrinho said that an abortion performed on a nine-year-old girl pregnant with twins, reportedly fathered by her stepfather, had resulted in excommunication for the mother who arranged for the abortion and the doctors who carried it out, fisichella defended the doctors in a statement addressed to the girl: "there are others who deserve excommunication and our forgiveness, not those who permitted you to live and who will help you to regain hope and faith." he wrote: "her life was in serious danger because of the pregnancy in progress. how to act in these cases? an arduous decision for the physician and for the moral law itself. the conscience of the physician finds itself alone when forced to decide the best thing to do. a choice like that of having to save a life, knowing that one puts a second at serious risk, never comes easily." "l'osservatore romano" published fisichella's essay critical of sobrinho on its front page. several members of the academy wrote a letter protesting fisichella's intervention in the case. in july, "l'osservatore romano" published a document issued by the congregation for the doctrine of the faith called "clarification on procured abortion", which declared that church teaching on abortion had not changed and will not change.