In this paper, we consider three arguments for the irrelevance of the doctrine of double effect in end-of-life decision making. The third argument is our own and, to that extent, we seek to defend it. The first argument is that end-of-life decisions do not in fact shorten lives and that therefore there is no need for the doctrine in justification of these decisions. We reject this argument; some end-of-life decisions clearly shorten lives. The second is that the doctrine of double (...) effect is not recognized in UK law (and similar jurisdictions); therefore, clinicians cannot use it as the basis for justification of their decisions. Against this we suggest that while the doctrine might have dubious legal grounds, it could be of relevance in some ways, e.g. in marking the boundary between acceptable and unacceptable practice in relation to the clinician's duty to relieve pain and suffering. The third is that the doctrine is irrelevant because it requires there to be a bad effect that needs justification. This is not the case in end-of-life care for patients diagnosed as dying. Here, bringing about a satisfactory dying process for a patient is a good effect, not a bad one. What matters is that patients die without pain and suffering. This marks a crucial departure from the double-effect doctrine; if the patient's death is not a bad effect then the doctrine is clearly irrelevant. A diagnosis of dying allows clinicians to focus on good dying and not to worry about whether their intervention affects the time of death. For a patient diagnosed as dying, time of death is rarely important. In our conclusion we suggest that acceptance of our argument might be problematic for opponents of physician-assisted death. We suggest one way in which these opponents might argue for a distinction between such practice and palliative care; this relies on the double-effect doctrine's distinction between foresight and intention. (shrink)

I will begin by stating three theses which I present in this paper. The first is that it is not profitable for us at present to do moral philosophy; that should be laid aside at any rate until we have an adequate philosophy of psychology, in which we are conspicuously lacking. The second is that the concepts of obligation, and duty — moral obligation and moral duty, that is to say — and of what is morally right and wrong, and (...) of the moral sense of "ought," ought.. (shrink)

In this lecture I shall offer to make clear, deeply grounded, objective sense of a certain contrast: I call it the contrast between positive and negative instrumentality, and it shows up in ordinary speech in remarks about what happens because a person did do such and such, as against what happens because he did not. The line between positive and negative instrumentality lies fairly close to some others which are drawn by more ordinary bits of English. For instance, the difference (...) between positive and negative instrumentality in someone’s dying is cousin to the difference between killing a person and letting him die. The latter distinction has the advantage of being already encoded in plain. (shrink)

In replying to my article ‘An Error about the Doctrine of Double Effect’, Kaufman claims that the permission given by the four-condition Doctrine for certain mixed actions is merely complementary to an absolute prohibition—which he claims is the DDE's primary function. I point out again that in many cases this makes an appeal to the DDE's fourth condition not merely redundant but incoherent. Furthermore, his claim that I am a utilitarian maximizer, frustrated by a doctrine prohibiting intentional harms, however great (...) the net overall benefit, is based on a misrepresentation. I did not object to a candidate for justification under the DDE being rejected before reaching the fourth condition, only to its being accepted. (shrink)

This paper claims as erroneous the current widespread representation of the Doctrine of Double Effect (DDE) as primarily condemning as intrinsically bad actions involving intentional harm. The DDE's Four Conditions are in fact used solely for justifying certain intrinsically good actions with both intended good and unintended bad effects. Though contemporary writers assign a minor justificatory role to the DDE this is incompatible with their attribution to it of a primary prohibitive role. Not only is the conduct cited by these (...) writers as justifiable under the DDE so morally innocuous as to require no justification, but any attempt to justify it by appeal to the DDE leads to incoherence. We finally suggest reasons for this misinterpretation in current concerns with the structure of deontological moral theories. (shrink)

The use of terminal sedation to control theintense discomfort of dying patients appearsboth to be an established practice inpalliative care and to run counter to the moraland legal norm that forbids health careprofessionals from intentionally killingpatients. This raises the worry that therequirements of established palliative care areincompatible with moral and legal opposition toeuthanasia. This paper explains how thedoctrine of double effect can be relied on todistinguish terminal sedation from euthanasia. The doctrine of double effect is rooted inCatholic moral casuistry, but (...) its applicationin law and morality need not depend on theparticular framework in which it was developed. The paper further explains how the moral weightof the distinction between intended harms andmerely foreseen harms in the doctrine of doubleeffect can be justified by appeal to alimitation on the human capacity to pursue good. (shrink)

The doctrine of double effect continues to be an important tool in bioethical casuistry. Its role within the Catholic moral tradition continues, and there is considerable interest in it by contemporary moral philosophers. But problems of justification and correct application remain. I argue that if the traditional Catholic conviction that there are exceptionless norms prohibiting inflicting some kinds of harms on people is correct, then double effect is justified and necessary. The objection that double effect is superfluous is a rejection (...) of that normative conviction, not a refutation of double effect itself. This justification suggests the correct way of applying double effect to controversial cases. But versions of double effect which dispense with the absolutism of the Catholic tradition lack justification and fall to the objection that double effect is an unnecessary complication. Keywords: double effect, intention, side effect CiteULike Connotea Del.icio.us What's this? (shrink)

T. A. Cavanaugh defends double-effect reasoning (DER), also known as the principle of double effect. DER plays a role in anti-consequentialist ethics (such as deontology), in hard cases in which one cannot realize a good without also causing a foreseen, but not intended, bad effect (for example, killing non-combatants when bombing a military target). This study is the first book-length account of the history and issues surrounding this controversial approach to hard cases. It will be indispensable in theoretical ethics, applied (...) ethics (especially medical and military), and moral theology. It will also interest legal and public policy scholars. (shrink)

I argue that the moral distinction in double effect cases rests on a difference not in intention as traditionally stated in the Doctrine of Double Effect (DDE), but in desire. The traditional DDE has difficulty ensuring that an agent intends the bad effect just in those cases where what he does is morally objectionable. I show firstly that the mental state of a rational agent who is certain that a side-effect will occur satisfies Bratman's criteria for intending that effect. I (...) then clarify the nature of the moral distinction in double effect cases and how it can be used to evaluate the moral blameworthiness of agents rather than the moral status of acts. The agent's blameworthiness is reduced not by his lack of intention but by his desire not to bring about the side-effect, and the 'counterfactual test' can be used to determine whether he desires the effect in acting. In my version, the DDE has its rationale in virtue ethics; it is not liable to abuse as the traditional version is; and it makes more plausible distinctions when applied to standard examples. (shrink)

The paper outlines and explores a possible strategy for defending both the action/omission distinction (AOD) and the principle of double effect (PDE). The strategy is to argue that there are degrees of actionhood, and that we are in general less responsible for what has a lower degree of actionhood, because of that lower degree. Moreover, what we omit generally has a lower degree of actionhood than what we actively do, and what we do under known-but-not-intended descriptions generally has a lower (...) degree of actionhood than what we do under known-and-intended descriptions. Therefore, we are in general less responsible for what we omit than for what we do—which is just what AOD says. And we are in general less responsible for what we do under known-but-not-intended descriptions than for what we do under known-and-intended descriptions—which is just what PDE says. (shrink)

[T. M. Scanlon] It is clearly impermissible to kill one person (or refrain from giving him treatment that he needs in order to survive) because his organs can be used to save five others who are in need of transplants. It has seemed to many that the explanation for this lies in the fact that in such cases we would be intending the death of the person whom we killed, or failed to save. What makes these actions impermissible, however, is (...) not the agent's intention but rather the fact that the benefit envisaged does not justify an exception to the prohibition against killing or the requirement to give aid. The difference between this explanation and one appealing to intention is easily overlooked if one fails to distinguish between the prospective use of a moral principle to guide action and its retrospective use to appraise the way an agent governed him or herself. Even if this explanation is accepted, however, it remains an open question whether and how an agent's intention may be relevant to the permissibility of actions in other cases. \\\ [Jonathan Dancy] My first four sections concentrate on the second section of Professor Scanlon's contribution (hereafter IP), where he lays out his conception of moral principles and of the role they play in theory and practice. I will raise questions on the following issues: 1. Scanlon's initial introduction of the notion of a principle. 2. His rejection of the standard view that principles are concerned with the forbidding, permitting and requiring of actions. 3. His rejection of pro tanto conceptions of principles in favour of a conception of them as conclusive. 4. The resulting account of what it is for a principle to face and survive exceptions. Scanlon's discussion of these matters here both appeals to and is in some respects more detailed than the relevant section of his recent What We Owe to Each Other (hereafter WWO). The topic is interesting both for the role played by principles in Scanlon's present discussion of intention and permissibility, and more generally because of his account of wrongness: an act is wrong iff it is ruled out by principles that nobody could reasonably reject. The remainder of my contribution is concerned with the ostensible focus of IP, namely the relevance (if any) of agent-intentions to the permissibility of what is done. (shrink)

Recently, a new problem has arisen for an Anscombean conception of intentional action. The claim is that the Anscombean’s emphasis on the formally causal character of practical knowledge precludes distinguishing between an aim and a merely foreseen side effect. I propose a solution to this problem: the difference between aim and side effect should be understood in terms of the familiar Anscombean distinction between acting intentionally and the intention with which one acts. I also argue that this solution has advantages (...) over an alternative that has already been endorsed in the literature: it is a better fit for the Anscombean theory, and it naturally accommodates intuitions about the moral significance of aiming vs. merely foreseeing. (shrink)

This paper has two aims. First, I explore the scope and limitations of the doctrine of double effect (DOE) by focusing specifically on the notion of "effect classification." Turning my attention to some hard cases, I argue that the DOE has to be supplemented by additional principles that specify how effects are to be discriminated from one another and how the various aspects of the relevant actions are to be classified as intended or simply foreseen. Secondly, I draw some general (...) lessons from this specific investigation of the ODE bearing on the way in which moral principles of this sort can be seen to function helpfully in moral reflection. (shrink)

Philosophers from Hart to Lewis, Johnston and Bennett have expressed various degrees of reservation concerning the doctrine of double effect. A common concern is that, with regard to many activities that double effect is traditionally thought to prohibit, what might at first look to be a directly intended bad effect is really, on closer examination, a directly intended neutral effect that is closely connected to a foreseen bad effect. This essay examines the extent to which the commonsense concept of intention (...) supports a reasonably consistent and coherent application of double effect. Two important conclusions are these: (1) a number of traditionally proscribed activities involve a kind of “targeting” of innocents that can be taken to exhibit a direct intention to harm them; (2) a direct intention to harm need not involve a desire to harm in any ordinary sense of the latter expression. (shrink)

The purpose of this note is to tidy up some matters concerning ascriptions of intention and the employment of the doctrine of double effect (henceforth DDE). I first argue that Jonathan Bennett’s efforts to show that DDE is a foolish doctrine are unsatisfactory. I then consider a puzzle of Mark Johnston’s that seems to pose a problem for the defender of DDE. I turn to possible solutions to the puzzle, criticize one, and then offer the one I find most appealing. (...) I then show how my proposal for employing DDE enables it to make some distinctions between courses of conduct without issuing foolish pronouncements about moral permissibility. (shrink)

Judith Jarvis Thomson has recently proposed a new argument for the thesis that killing the one in the Trolley Problem is not permissible. Her argument relies on the introduction of a new scenario in which the bystander may also sacrifice herself to save the five. Thomson argues that those not willing to sacrifice themselves if they could may not kill the one to save the five. Bryce Huebner and Marc Hauser have recently put Thomson’s argument to the empirical test by (...) asking people what they should do in the new trilemma case in which they may also sacrifice themselves. They found that the majority judge that they should either kill the one or sacrifice themselves; Huebner and Hauser argue that those numbers speak against Thomson’s argument. But Thomson’s argument was about the dialectical effect of the new trilemma on the traditional dilemma, rather than about the trilemma itself. Here I present the results of a study in which I asked subjects first what they should do in the trilemma and then what they should do in the traditional Trolley Problem. I found that, if asked first about the trilemma, subjects then have the intuition that killing the one in the traditional Bystander at the Switch is not permissible – exactly what Thomson’s argument had predicted. (shrink)

I defend the argument that if embryo loss in stem cell research is morally problematic, then embryo loss in in vivo conception is similarly morally problematic. According to a recent challenge to this argument, we can distinguish between in vivo embryo loss and the in vitro embryo loss of stem cell research by appealing to the Doctrine of Double Effect. I argue that this challenge fails to show that in vivo embryo loss is a mere unintended side-effect while in vitro (...) embryo loss is an intended means and that, even if we refine the challenge by appealing to Michael Bratman’s three roles of intention, the distinction is still unwarranted. (shrink)

I argue against the Doctrine of Double Effect’s explanation of the moral difference between terror bombing and strategic bombing. I show that the standard thought-experiment of Terror Bomber and Strategic Bomber which dominates this debate is underdetermined in three crucial respects: (1) the non-psychological worlds of Terror Bomber and Strategic Bomber; (2) the psychologies of Terror Bomber and Strategic Bomber; and (3) the structure of the thought-experiment, especially in relation to its similarity with the Trolley Problem. (1) If the two (...) worlds are not identical, then it may be these differences between the two worlds and not the Doctrine of Double Effect to explain the moral difference; (2a) if Terror Bomber and Strategic Bomber have the same causal beliefs, then why does Terror Bomber set out to kill the children? It may then be this unwarranted and immoral choice and not the Doctrine of Double Effect that explains the moral difference; (2b) if the two have different causal beliefs, then we can’t rule out the counterfactual that, had Strategic Bomber had the same beliefs as Terror Bomber, she would have also acted as Terror Bomber did. Finally, (3) the Strategic Bomber scenario could also be constructed so as to be structurally equivalent to the Fat Man scenario in the Trolley Problem: but then the Doctrine of Double Effect would give different answers to two symmetrical cases. (shrink)

Joseph Boyle raises important questions about the place of the double-effect exception in absolutist moral theories. His own absolutist theory (held by many, but not all, Catholic moralists), which derives from the principles that fundamental human goods may not be intentionally violated, cannot dispense with such exceptions, although he rightly rejects some widely held views about what they are. By contrast, Kantian absolutist theory, which derives from the principle that lawful freedom must not be violated, has a corollary – that (...) it is a duty, where possible, to coerce those who try to violate lawful freedom – which makes superfluous many of the double-effect exceptions Boyle allows. Other implications of the two theories are contrasted. Inter alia , it is argued that, in Boyle's theory, that a violation of a fundamental human good can be viewed as a cost proportionate to a benefit obtained, cannot yield a double-effect exception to the prohibition of intentionally violating that good, because paying a cost cannot be unintentional. Keywords: cost-benefit analysis, double effect, intention, side effect CiteULike Connotea Del.icio.us What's this? (shrink)

Whereas indirect euthanasia is a common clinical practice, active euthanasia remains forbidden in most countries. The reason for this differentiation is usually seen in the principle of double-effect (PDE). PDE states that there is a morally relevant difference between the intended consequences of an action and merely foreseen, unintended side-effects. This article discloses the fundamental assumptions presenting the basis for this application of the PDE and examines whether these assumptions are compatible with the PDE. It is shown that neither a (...) liberal nor a utilitarian point of view makes the utilization of the PDE possible. In accordance with philosophical tradition, only within the doctrine of the sanctity of life does the PDE seem to be applicable. By analysing the premises of this doctrine, and comparing them with those of the PDE, the inconsistency of this idea is demonstrated. It is suggested that the role of the PDE in the current discussion on euthanasia is largely exaggerated. (shrink)

In his book Moral Dimensions. Permissibility, Meaning, Blame , T.M. Scanlon proposes a new account of permissibility, and argues, against the doctrine of double effect (DDE), that intentions do not matter for permissibility. I argue that Scanlon's account of permissibility as based on what the agent should have known at the time of action does not sufficiently take into account Scanlon's own emphasis on permissibility as a question for the deliberating agent. A proper account of permissibility, based on the agent's (...) actual beliefs, will allow us to revise the principle Scanlon proposes for regulating the use of violence in war, and to show that, while the DDE as such might be invalid, its focus on intentions does point toward an important element which Scanlon's proposal lacks, viz. the requirement that the agent believes that her actions will have certain consequences and can be justified for that reason. (shrink)

The distinction between harm that is intended as a means or end, and harm that is merely a foreseen side-effect of one’s action, is widely cited as a significant factor in a variety of ethical contexts. Many use it, for example, to distinguish terrorist acts from certain acts of war that may have similar results as side-effects. Yet Bennett and others have argued that its application is so arbitrary that if it can be used to cast certain harmful actions in (...) a more favorable light, then it can equally be manipulated to do the same for any kind of harmful action. In response, some have tried to block such extensions of the intend/foresee distinction by rejecting its application in cases where the relation between the plainly intended means and the harm is “too close”. This move, however, has been attacked as vague and obscure, and Bennett has argued that all the plausible candidates for explicating the idea of excessive closeness ultimately fail. In this paper, I develop and defend an account of excessive closeness with the aim of rescuing the intend/foresee distinction from such charges of arbitrariness. The account is based on the distinction between merely causal and constitutive relations among states of affairs, and I show both how it escapes Bennett’s objections to other accounts and how it applies to a variety of cases. Finally, I also examine Quinn’s alternative move of shifting the focus of the intend/foresee distinction in an attempt to sidestep the issue of closeness, and argue that it is not ultimately successful. In fact, Quinn’s view has shortcomings that can be resolved only by returning to an appeal to some notion of closeness, underscoring the need for the sort of account I offer. (shrink)

One of the reasons why most of us feel puzzled about the problem of abortion is that we want, and do not want, to allow to the unborn child the rights that belong to adults and children. When we think of a baby about to be born it seems absurd to think that the next few minutes or even hours could make so radical a difference to its status; yet as we go back in the life of the fetus we (...) are more and more reluctant to say that this is a human being and must be treated as such. No doubt this is the deepest source of our dilemma, but it is not the only one. For we are also confused about the general question of what we may and may not do where the interests of human beings conflict. We have strong intuitions about certain cases; saying, for instance, that it is all right to raise the level of education in our country, though statistics allow us to predict that a rise in the suicide rate will follow, while it is not all right to kill the feeble-minded to aid cancer research. It is not easy, however, to see the principles involved, and one way of throwing light on the abortion issue will be by setting up parallels involving adults or children once born. So we will be able to isolate the “equal rights” issue and should be able to make some advance... (shrink)

The doctrine of double effect shows that for which the moral agent is responsible, by explicating the relationship between the act directly intended and the consequences of that act. I contend that this doctrine is necessary not only for natural law absolutism, but also for Donagan's Kantianism and for Quinn's revised construal of the doctrine, and even for consequentialism, as bioethical implications of the doctrine make clear. For those who do not accept this necessity, I contend that it is necessary (...) metatheoretically, in order to deal with those moral agents with irreconcilably different notions of the morally good. Keywords: cost-benefit analysis, double effect, intention, side effect CiteULike Connotea Del.icio.us What's this? (shrink)

In this essay I first provide a brief explanation of the principle of double effect (PDE) and the propositions that it entails regarding the distinction betweenintention and foresight (I/F distinction) and the distinction’s relevance to ethical evaluation. Then I address several recent critiques of PDE and the I/F distinctionby influential ethicists including Judith Jarvis Thomson, Tom Beauchamp and James Childress, and Jonathan Bennett. I argue that none of these critiques issuccessful. In the process of refuting the critiques, I also give (...) prima facie reason to believe that the I/F distinction is relevant to evaluation of agents and their actions and that PDE is a defensible ethical principle. (shrink)

In this article I am concerned with whether it could be morally significant to distinguish between doing something 'in order to bring about an effect' as opposed to 'doing something because we will bring about an effect'. For example, the Doctrine of Double Effect (DDE) tells us that we should not act in order to bring about evil, but even if this is true is it perhaps permissible to act only because an evil will thus occur? I discuss these questions (...) in connection with a version of the so-called Trolley Problem known as the Loop Case. I also consider how these questions may bear on whether a rational agent must aim at an event which he believes is causally necessary to achieve an end he pursues. (shrink)

The difficulty of distinguishing between the intended and the merely foreseen consequences of actions seems to many to be the most serious problem for the doctrine of double effect. It has led some to reject the doctrine altogether, and has left some of its defenders recasting it in entirely different terms. I argue that these responses are unnecessary. Using Bratman’s conception of intention, I distinguish the intended consequences of an action from the merely foreseen in a way that can be (...) used to support the doctrine of double effect. (shrink)

According to the doctrine of double effect(DDE), there is a morally significantdifference between harm that is intended andharm that is merely foreseen and not intended.It is not difficult to explain why it is bad tointend harm as an end (you have a ``badattitude'' toward that harm) but it is hard toexplain why it is bad to intend harm as a meansto some good end. If you intend harm as a meansto some good end, you need not have a ``badattitude'' toward (...) it. I distinguish two ways inwhich you can treat something that is yourchosen means to your ends. You can pursue yourends directly, and treat X as a mere means thatyou pursue for the sake of your end. Or you canpursue your ends indirectly, and treat X as a``plan-relative end'' that you pursue for its ownsake. I argue that much of the time we pursueour ends indirectly, and treat our means asplan-relative ends. There are significantanalogies between intending harm as an end, andintending harm as a plan-relative end. So,under certain circumstances, it is morallyworse to intend harm as a means or an end thanto foresee bringing about the same amount of harm. (shrink)

This paper examines the doctrine of double effect as it is typically applied. The difficulty of distinguishing between what we intend and what we foresee is highlighted. In particular, Warren Quinn's articulation of that distinction is examined and criticised. It is then proposed that the only credible way that we can be said to foresee that a harm will result and mean something other than that we intend it to result, is if we are not certain that that harm will (...) result. The ramifications of this are explored. The paper concludes with a moral evaluation of a variety of cases that have harmful outcomes. It is recommended both that we abandon the doctrine of double effect and that we cease to describe cases with harmful outcomes in a dishonest way. (shrink)

If one accepts a version of absolutism that excludes the intentional killing of any innocent human person from conception to natural death, ectopic pregnancy poses vexing difficulties. Given that the embryonic life almost certainly will die anyway, how can one retain ones moral principle and yet adequately respond to a situation that gravely threatens the life of the mother and her future fertility? The four options of treatment most often discussed in the literature are non-intervention, salpingectomy (removal of tube with (...) embryo), salpingostomy (removal of embryo alone), and use of methotrexate (MXT). In this essay, I review these four options and introduce a fifth (the milking technique). In order to assess these options in terms of the absolutism mentioned, it will also be necessary to discuss various accounts of the intention/foresight distinction. I conclude that salpingectomy, salpingostomy, and the milking technique are compatible with absolutist presuppositions, but not the use of methotrexate. (shrink)

In this article, I shall present three arguments for thc pcrmissibility 0f physician-assisted suicide (PAS), and then examine several objections 0f 21 "K21nti2m" and non-Kantian nature against them. These are really 0bjcctions against certain types of suicide. I shall focus 0n active PAS (eg., when 21 patient takes 21 lethal drug given by E1 physician, in which case both thc physician and patient are active). I shall assume the patient is 21 competent, responsible, rational agent, who gives his being in (...) physical discomfort (pain, nausea, ctc.) as thc reason for intending his death. I am assuming, therefore, thc pain while 21 sourcc of suffering docs not undermine his rational agency in 21 way that threatens responsibility for choice.] Current legal proposals for permitting PAS focus 0n procedures.. (shrink)

In this article I am concerned with whether it could be morally significant to distinguish between doing something 'in order to bring about an effect' as opposed to 'doing something because we will bring about an effect'. For example, the Doctrine of Double Effect (DDE) tells us that we should not act in order to bring about evil, but even if this is true is it perhaps permissible to act only because an evil will thus occur? I discuss these questions (...) in connection with a version of the so-called Trolley Problem known as the Loop Case. I also consider how these questions may bear on whether a rational agent must aim at an event which he believes is causally necessary to achieve an end he pursues. (shrink)

The Doctrine of Double Effect and the Principle of Do No Harm raise important theoretical and practical issues, some of which are discussed by Boyle, Donagan, and Quinn. I argue that neither principle is correct, and some revisionist, and probably nonabsolutist, analysis of constraints on action and omission is necessary. In making these points, I examine several approaches to deflection of threat cases, discuss an argument for the permissibility of voluntary euthanasia, and present arguments relevant to medical contexts which justify (...) intentionally hanning some to aid others, with and without the consent of those harmed. Keywords: consent, double effect, euthanasia, harming, organ transplantation, scarce resources, trolley problem CiteULike Connotea Del.icio.us What's this? (shrink)

This paper discusses physician-assisted suicide (PAS) and voluntary active euthanasia (VAE), supplies a short history and argues in favour of permitting both once rigid criteria have been set and the cases retro-reviewed. I suggest that among these criteria should be that VAE should only be permitted with one more necessary criterion: that VAE should only be allowed when physician assisted suicide is not a possible option. If the patient is able to ingest and absorb the medication there is no reason (...) why VAE should be permitted. A brief history of VAE and PAS is given and some of the arguments which have been given are analyzed. The Principle of the Double Effect is briefly discussed and why, in my opinion, it is not a valid principle is briefly discussed. (shrink)

The principles whereby the reason operates in ethically complicated situations has been subject to long-standing debates in Catholic Philosophy. A classic text which exemplifies this is Aquinas’s consideration of self-defensive killing. In this paper I clarify two central issues in double-effect reasoning debates surrounding this text. Both issues are connected to the seemingly simple but actually complex task of accounting for the “chosen means” of self-defense. The first issue is whether the “chosen means” are also able to be considered a (...) “proximate end,” to which the intention is directed. The second is determining whether the assailant’s death is related to the “chosen means” per se and therefore to the rest of the moral action. Resolving these issues will provide grounds for answering the broader question implicit in the situation of self-defensive killing: what is to be done when human actions would inevitably entail that some evil is instrumentally tied to realizing some good? (shrink)

Modern warfare cannot be conducted without civilians being killed. In order to reconcile this fact with the principle of discrimination in just war theory, the principle is applied through the doctrine of double effect. But this doctrine is morally inadequate because it is too permissive regarding the risk to civilians. For this reason, Michael Walzer has suggested that the doctrine be supplemented with what he calls the idea of double intention: combatants are not only to refrain from intending to harm (...) civilians; they are also to take precautions to reduce risk to civilians, even at the expense of increasing risk to themselves. The article develops the idea of double intention by addressing two questions: What does it mean to intend to reduce civilian risk, and how much should civilian risk be reduced? The results of this discussion are then used to consider a moral issue that arises in technologically asymmetric warfare, namely, the extent to which the use of precision-guided munitions, which allow more accurate targeting, can by itself bear the moral burden imposed by the principle of discrimination. (shrink)

The aim of this article is to argue, by example, for neuroethics as a new way of doing ethics. Rather than simply giving us a new subject matter—the ethical issues arising from neuroscience—to attend to, neuroethics offers us the opportunity to refine the tools we use. Ethicists often need to appeal to the intuitions provoked by consideration of cases to evaluate the permissibility of types of actions; data from the sciences of the mind give us reason to believe that some (...) of these intuitions are less reliable than others. I focus on the doctrine of double effect to illustrate my case, arguing that experimental results suggest that appeal to it might be question-begging. The doctrine of double effect is supposed to show that there is a moral difference between effects that are brought about intentionally and those that are merely foreseen; I argue that the data suggest that we regard some effects as merely foreseen only because we regard bringing them about as permissible. Appeal to the doctrine of double effect therefore cannot establish that there are such moral differences. (shrink)

Paul Ramsey has argued that the rule of double effect is morally significant because of the existence of indeterminate choices between incommensurable values. I interpret his argument as the following disjunctive syllogism. There are two sorts of principles we can appeal to in dealing with indeterminate choices: the rule of double effect and a commensurate reason principle. The second does not work, so we are left with the first. I respond, first, that this argument commits the fallacy of bifurcation and (...) second, that for all Ramsey has shown, and surprisingly, a commensurate reason principle can deal with indeterminate choices. (shrink)

Judith Jarvis Thomson’s Loop Case is particularly significant in normative ethics because it questions the validity of the intuitively plausible Doctrine of Double Effect, according to which there is a significant difference between harm that is intended and harm that is merely foreseen and not intended. Recently, Frances Kamm has argued that what she calls the Doctrine of Triple Effect (DTE), which draws a distinction between acting because-of and acting in-order-to, can account for our judgment about the Loop Case. In (...) this paper, I first argue that even if the distinction drawn by DTE can be sustained, it does not seem to apply to the Loop Case. Moreover, I question whether this distinction has any normative significance. The upshot is that I am skeptical that DTE can explain our judgment about the Loop Case. (shrink)

The Rule of Double Effect (RDE) holds that it may be permissible to harm an individual while acting for the sake of a proportionate good, given that the harm is not an intended means to the good but merely a foreseen side-effect. Although frequently used in medical ethical reasoning, the rule has been repeatedly questioned in the past few decades. However, Daniel Sulmasy, a proponent who has done a lot of work lately defending the RDE, has recently presented a reformulated (...) and more detailed version of the rule. Thanks to its greater precision, this reinvented RDE avoids several problems thought to plague the traditional RDE. Although an improvement compared with the traditional version, we argue that Sulmasy's reinvented RDE will not stand closer scrutiny. Not only has the range of proper applicability narrowed significantly, but, more importantly, Sulmasy fails to establish that there is a morally relevant distinction between intended and foreseen effects. In particular, he fails to establish that there is any distinction that can account for the alleged moral difference between sedation therapy and euthanasia. (shrink)

In recent work, T.M. Scanlon has unsuccessfully challenged the doctrine of double effect (DDE). First, comparing actions reflecting faulty moral deliberations and involving merely foreseen harm with actions reflecting less faulty moral deliberations involving intended harm suggests that proponents of DDE do not confuse the critical and the deliberative uses of moral principles. Second, Scanlon submits that it is odd to say to a deliberating agent that the permissibility of the actions she ponders depends on the intention with which she (...) will act. I argue that this can be explained without appeal to the claim that intentions are irrelevant to permissibility. (shrink)

Recent discussions of the doctrine of double effect have contained improved versions of the doctrine not subject to some of the difficulties of earlier versions. There is no longer one doctrine of double effect. This essay evaluates four versions of the doctrine: two formulations of the traditional Catholic doctrine, Joseph Boyle's revision of that doctrine, and Warren Quinn's version of the doctrine. I conclude that all of these versions are flawed. Keywords: double effect, intention, Joseph Boyle, medical ethics, Warren Quinn (...) CiteULike Connotea Del.icio.us What's this? (shrink)

I defend the doctrine of double effect and a so-called ‘strict’ definition of intention: A intends an effect if and only if A has it as an end or believes that it is a state of affairs in the causal sequence that will result in A's end. Following Kamm's proposed ‘doctrine of triple effect’, I distinguish an intended effect from an effect that motivates an action, and show that this distinction is morally significant. I use several contrived cases as illustrations, (...) but my position does not depend on intuitive judgements about them. Instead, it follows from the view that the moral permissibility of an action depends at least partly on how it forms the agent's character. I also respond to some objections presented by Harris, Bennett, McIntyre, Thomson and Scanlon to the doctrine of double effect. (shrink)

In a recent contribution to this journal, Patrick Tully criticizes my view that the doctrine of double effect does not prohibit a pharmaceutical company from selling a drug that has potentially fatal side-effects and that does not treat a life-threatening condition. Tully alleges my account is too permissive and makes the doctrine irrelevant to decisions about selling harmful products. In the following paper, I respond to Tully’s objections and show that he misinterprets my position and misstates some elements of the (...) doctrine of double effect. I also show how the doctrine constrains some decisions about marketing drugs with potentially fatal side-effects. (shrink)

Manuel Velasquez and F. Neil Brady apply the doctrine of double effect to business ethics and conclude that the doctrine allows a pharmaceutical company to sell a drug with potentially fatal side effects only if it also has the good effect of saving lives. This forbidsthe sale of many common products, such as automobiles and alcohol. My account preserves the virtues of the doctrine of double effectwithout making it too restrictive. I apply the doctrine to a pharmaceutical company’s decision to (...) market a drug with dangerous side effects and argue that free markets often offer the best way to compare the good and bad effects of business decisions. I conclude that the doctrine does allow a business to sell a potentially fatal product that does not save lives, provided that it warns consumers about the danger. (shrink)

The U.S. Supreme Court's majorityopinion in Vacco v. Quill assumes thatthe principle of double effect explains thepermissibility of hastening death in thecontext of ordinary palliative care and inextraordinary cases in which painkilling drugshave failed to relieve especially intractablesuffering and terminal sedation has beenadopted as a last resort. The traditionaldoctrine of double effect, understood asproviding a prohibition on instrumental harmingas opposed to incidental harming or harming asa side effect, must be distinguished from otherways in which the claim that a result is (...) notintended might be offered as part of ajustification for it. Although double effectmight appropriately be invoked as a constrainton ordinary palliative care, it is not clearthat it can be coherently extended to justifysuch practices as terminal sedation. A betterapproach would reconsider double effect'straditional prohibition on hastening death as ameans to relieve suffering in the context ofacute palliative care. (shrink)

The Doctrine of Double Effect has been challenged by the claim that what an agent intends as a means may be limited to those effects that are precisely characterized by the descriptions under which the agent believes that they are minimally causally necessary for the production of other effects that the agent seeks to bring about. If based on so narrow a conception of an intended means, the traditional Doctrine of Double Effect becomes limitlessly permissive. In this paper I examine (...) and criticize Warren Quinn's attempt to reformulate the Doctrine in such a way that it retains its force and plausibility even if we accept the narrow conception of an intended means. Building on Quinn's insights, I conclude by offering a further version of the Doctrine that retains the virtues of Quinn's account but avoids the objections to it. I The key element in the Doctrine of Double Effect (DDE) is the claim that there is a stronger presumption against action that has harm to the innocent as an intended effect than there is against otherwise comparable action that causes the same amount of harm to the innocent as a foreseen but unintended effect. Since it is relatively uncontroversial that, except perhaps in cases involving desert, it is wrong to cause harm as an end in itself, the DDE is normally invoked to distinguish morally between harm that is intended as a means and harm that is considered a merely foreseen side-effect. (shrink)

The doctrine of double effect, together with other moral principles that appeal to the intentions of moral agents, has come under attack from many directions in recent years, as have a variety of rationales that have been given in favor of it. In this paper, our aim is to develop, defend, and provide a new theoretical rationale for a secular version of the doctrine. Following Quinn (1989), we distinguish between Harmful Direct Agency and Harmful Indirect Agency. We propose the following (...) version of the doctrine: that in cases in which harm must come to some in order to achieve a good (and is the least costly of possible harms necessary), the agent foresees the harm, and all other things are equal, a stronger case is needed to justify Harmful Direct Agency than to justify Harmful Indirect Agency. We distinguish between two Kantian rationales that might be given for the doctrine, a “dependent right” rationale, defended by Quinn, and an “independent right” rationale, which we defend. We argue that the doctrine and the “independent right” rationale for it are not vulnerable to counterexamples or counterproposals, and conclude by drawing implications for the larger debate over whether agents' intentions are in any way relevant to permissibility and obligation. (shrink)

Whether one should accept a principle like DDE cannot be settled independent of one's more general moral theory. In this, I take it, I agree with Professor Boyle, though I do not think he has shown that DDE has a role only in his particular form of absolutism. Still, since his theory does require DDE, an important question is what the alternatives are – whether we must choose between this absolutism and either utilitarianism or intuitionism. A form of contractualism, the (...) requirements of which derive to a large extent from institutionally or conventionally established rights, is sketched here as an attractive alternative. It does not lead, so far as I can see, to DDE. Keywords: authority, contractualism, rights CiteULike Connotea Del.icio.us What's this? (shrink)

Few moral theorists would disagree that the fundamental principle of morality – perhaps of practical rationality itself – is “ Do good and avoid evil. ” Yet along with such an uncontroversial principle comes a major question: Can you fulfi l both halves satisfactorily across your life as a moral agent? We all have opportunities to perform acts that do good with no accompanying evil, but these are not as common as we might think. We can avoid evil by doing (...) nothing, but doing nothing implies doing no good either. Clearly the fundamental principle does not require that you go about your life doing good on any and every possible occasion any more than that you sit on your hands and abstain from action out of fear of doing evil. The principle tells us to avoid evil, not to refrain from ever causing it. And the simple fact is that the complexities of life make it inevitable that, much of the time when we go about doing good, we will also be doing evil. Further, they are such that sometimes we can avoid evil only at the cost of not performing a good act which reasonable people would regard as at least permissible, if not sometimes obligatory. So how, as rational, morally responsible agents, are we to satisfy the fundamental principle in an adequate, harmonious fashion, given life ’ s exigencies? This is where the so - called ‘ doctrine of double effect ’ comes into play. Some call it a doctrine, infl uenced by the fact that Catholic ethicists and moral theologians have, since the Middle Ages, codifi ed and ratifi ed it as something akin to a doctrine of Catholic moral philosophy. Others call it the ‘ principle of double effect, ’ though it breaks down into a set of principles unifi ed by a common idea. Yet other writers see it simply as a kind of reasoning about certain types of hard case in ethics. Whatever the preferred nomenclature, the DDE, as I will call it here, is – for all its critics and the diffi culties it faces – a keystone of sound moral thinking, without which the fundamental principle would remain nothing but a high ideal with little consistent applicability. So consider a simple example.. (shrink)

Typically, in cases where an agent's actions produce foreseen harmful consequences, we morally discriminate in favor of scenarios in which those consequences are unintended. This intuitive distinction plays a particularly important role in our moral assessment of military strategies, especially when innocent bystanders may be involved. However, the analysis of the general principles governing such pre-theoretical inclinations must inevitably confront difficult and obstinate philosophical problems. As has often been pointed out, the criteria proposed by the traditional view on this issue, (...) the so-called Doctrine of Double Effect, are dependent upon the description of the agent's intentional profile in an intuitively inadmissible way. As a solution to the Doctrine's shortcomings, contemporary philosophers have proposed analyses in which the notion of harmful involvement plays a central role. The main thesis of this paper is that appeals to harmful involvement do not provide the desired solution. Given the pervasive role played by the assessment of an agent's intentions in our moral evaluation of the use of military force in particular situations, the philosophical puzzles raised in this paper bring to the foreground a set of correlated problems of unequivocal relevance for the discipline of military ethics. (shrink)