About this topic
Summary The Doctrine of Double Effect is a normative principle according to which in pursuing the good it is sometimes morally permissible to bring about some evil as a side-effect or merely foreseen consequence: the same evil would not be morally justified as an intended means or end. The Doctrine is normally thought to originate from Aquinas’s discussion of self-defence and it has today more or less legitimate application to a variety of important ethical issues: amongst the most common are collateral damages in war, palliative care, abortion, self-sacrifice, self-defence, and the so-called Trolley Problem. Following Gury and Mangan 1949, the Doctrine of Double Effect is normally formalised as comprising four conditions: 1) the action in itself from its very object must be good or at least indifferent; 2) the good effect and not the evil effect must be intended; 3) the good effect must not be produced by means of the evil effect; 4) there must be a proportionately grave reason for permitting the evil effect.
Key works Apart from Mangan 1949, a key modern source on double effect is Foot 1967. See also Boyle Jr 1980 on double effect's four conditions. For an influential critique see Bennett 1980.
Introductions McIntyre 2008 has written an introduction to the topic.
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  1. Peter Allmark, Mark Cobb, B. Jane Liddle & Angela Mary Tod (2010). Is the Doctrine of Double Effect Irrelevant in End-of-Life Decision Making? Nursing Philosophy 11 (3):170-177.
    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 (...)
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  2. Robert D. Anderson (2010). T. A. Cavanaugh, Double-Effect Reasoning: Doing Good and Avoiding Evil. [REVIEW] Journal of Value Inquiry 44 (1):113-116.
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  3. S. J. Andrew Jaspers (2008). Double-Effect Reasoning—T.A. Cavanaugh. International Philosophical Quarterly 48 (2):260-262.
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  4. G. E. M. Anscombe (1958). Modern Moral Philosophy. Philosophy 33 (124):1 - 19.
    The author presents and defends three theses: (1) "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." (2) "the second is that the concepts of obligation, And duty... And of what is morally right and wrong, And of the moral sense of 'ought', Ought to be jettisoned if this is psychologically possible...." (3) "the third thesis is that (...)
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  5. Surendra Arjoon (2007). Ethical Decision-Making: A Case for the Triple Font Theory. [REVIEW] Journal of Business Ethics 71 (4):395 - 410.
    This paper discusses the philosophical argument and the application of the Triple Font Theory (TFT) for moral evaluation of human acts and attempts to integrate the conceptual components of major moral theories into a systematic internally consistent decision-making model that is theoretically driven. The paper incorporates concepts such as formal and material cooperation and the Principle of Double Effect (PDE) into the theoretical framework. It also advances the thesis that virtue theory ought to be included in any adequate justification of (...)
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  6. M. P. Aulisio (1997). One Person's Modus Ponens: Boyle, Absolutist Catholicism, and the Doctrine of Double Effect. Christian Bioethics 3 (2):142-157.
    The doctrine of double effect (DOE) has its origins in Roman Catholic thought and has been held to have widespread applications in bioethics. Its applications range over issues of maternal-fetal conflict, organ donation and transplant, euthanasia, and resource allocation, among other controversial issues. Recently, Joseph Boyle, the foremost proponent of the DOE over the past few decades, has argued that the DOE is required by the absolutist context of the Catholic tradition, and, further, that anyone who rejects this particular context (...)
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  7. Adam D. Bailey (2011). The Intend/Foresee Distinction, Moral Absolutes, and the Side Effects of the Choice to Do Nothing. American Journal of Jurisprudence 56 (1):151-168.
    What grounds the moral significance of the intend/foresee distinction? To put the question another way, what reason do we have for believing that moral absolutes apply with respect to intended effects, but not foreseeable but unintended (bad) effects? Joseph Boyle has provided an answer that relies on the idea that persons can find themselves in situations of “moral impossibility”—situations in which every available option foreseeably will give rise to bad effects. However, Robert Anderson has put Boyle’s answer into question by (...)
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  8. Jonathan Bennett (1980). Morality and Consequences. Tanner Lectures.
    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 (...)
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  9. J. Berkman (1997). How Important is the Doctrine of Double Effect for Moral Theology? Contextualizing the Controversy. Christian Bioethics 3 (2):89-114.
    One's conception of the conditions and applicability of the principle of double effect derive from one's broader convictions about moral methodology. Developed in a Catholic context which presumed the existence of moral absolutes, the principle of double effect was originally a conceptual tool to aid priests in being skilled confessors. In recent decades, as the practice of moral theology has become less connected with its earlier ecclesial and sacramental context, the principle of double effect has fallen into an epistemological crisis. (...)
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  10. Camillo C. Bica (1997). Collateral Violence and the Doctrine of Double Effect. Public Affairs Quarterly 11 (1):87-92.
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  11. J. A. Billings (2011). Double Effect: A Useful Rule That Alone Cannot Justify Hastening Death. Journal of Medical Ethics 37 (7):437-440.
    The rule of double effect is regularly invoked in ethical discussions about palliative sedation, terminal extubation and other clinical acts that may be viewed as hastening death for imminently dying patients. Unfortunately, the literature tends to employ this useful principle in a fashion suggesting that it offers the final word on the moral acceptability of such medical procedures. In fact, the rule cannot be applied appropriately without invoking moral theories that are not explicit in the rule itself. Four tenets of (...)
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  12. T. J. Bole (1991). The Theoretical Tenability of the Doctrine of Double Effect. Journal of Medicine and Philosophy 16 (5):467-473.
    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 (...)
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  13. Thornas Bole (1991). The Doctrine of Double Effect. Southwest Philosophy Review 7 (1):91-103.
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  14. Sophie Botros (2001). An Error About the Doctrine of Double Effect: A Response to Kaufman's Reply to Botros. Philosophy 76 (2):304-311.
    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 (...)
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  15. Sophie Botros (1999). An Error About the Doctrine of Double Effect. Philosophy 74 (1):71-83.
    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 (...)
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  16. Joseph M. Boyle Jr (1980). Toward Understanding the Principle of Double Effect. Ethics 90 (4):527-538.
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  17. J. Boyle (1997). Intentions, Christian Morality, and Bioethics: Puzzles of Double Effect. Christian Bioethics 3 (2):87-88.
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  18. Joseph Boyle (2012). Just War and Double Effect. Philosophy in the Contemporary World 19 (2):61-71.
    Just war doctrine includes a stringent prohibition against killing and otherwise harming 'innocents', those of one's enemy population who are not engaged in the act of making war. This category includes most enemy civilians. The prohibition cannot reasonably prohibit all possible harms to these innocents. The doctrine of double effect is a way of limiting the prohibition to acts of intentionally harming innocents. This paper explores the application of double effect reasoning in this context, with a view towards determining whether (...)
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  19. Joseph Boyle (2004). Medical Ethics and Double Effect: The Case of Terminal Sedation. Theoretical Medicine and Bioethics 25 (1):51-60.
    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 (...)
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  20. Joseph Boyle (1991). Further Thoughts on Double Effect: Some Preliminary Responses. Journal of Medicine and Philosophy 16 (5):565-570.
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  21. Joseph Boyle (1991). Who is Entitled to Double Effect? Journal of Medicine and Philosophy 16 (5):475-494.
    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 (...)
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  22. Ray Campbell (2012). Double Effect Reasoning and Cooperation. Bioethics Research Notes 24 (1):1.
    Campbell, Ray This paper is an abbreviated version of a paper given at the National Colloquium for Catholic Bioethicists, Melbourne, 2012. That paper in turn was an abbreviated version of part of my doctoral thesis, The Human Act and Moral Responsibility, John Paul II Institute for Marriage and Family, Melbourne, 2011. The larger works give more of the context for this discussion and more examples.
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  23. Laura Capitaine, Katrien Devolder & Guido Pennings (2013). Lifespan Extension and the Doctrine of Double Effect. Theoretical Medicine and Bioethics 34 (3):207-226.
    Recent developments in biogerontology—the study of the biology of ageing—suggest that it may eventually be possible to intervene in the human ageing process. This, in turn, offers the prospect of significantly postponing the onset of age-related diseases. The biogerontological project, however, has met with strong resistance, especially by deontologists. They consider the act of intervening in the ageing process impermissible on the grounds that it would (most probably) bring about an extended maximum lifespan—a state of affairs that they deem intrinsically (...)
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  24. T. Cavanaugh (1997). Double Effect and the Ethical Significance of Distinct Volitional States. Christian Bioethics 3 (2):131-141.
    Much of Roman Catholic discussion concerning bioethical controversies, such as the surgical removal of a life-threatening cancerous uterus when the fetus is not viable, has focused on the employment of double-effect reasoning. While double-effect reasoning has been the subject of much debate, this paper argues first, that there is a distinction between the intended and the foreseen; second, that this distinction applies to the contrasted cases in such a way as to categorize foreseen but not intended consequences; and third, that (...)
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  25. T. A. Cavanaugh (2006). Double-Effect Reasoning: Doing Good and Avoiding Evil. Oxford University Press.
    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 (...)
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  26. Thomas Cavanaugh (1999). Double Effect and the End-Not-Means Principle: A Response to Bennett. Journal of Applied Philosophy 16 (2):181–185.
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  27. Thomas A. Cavanaugh (forthcoming). Aquinas's Account of Double Effect. The Thomist.
    Double-effect reasoning (DER) is attributed to Aquinas "tout court". Aquinas's account, however, differs from contemporary DER insofar as Thomas considers the ethical status of "risking" an assailant's life while contemporary accounts focus on actions causing harm inevitably. Since one cannot claim to risk the inevitable, and since there is a significant difference between risking harm and causing harm inevitably. Thomas's account does not extend to cases of inevitable harm. Thus, the received understanding of Aquinas's account is flawed and leads to (...)
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  28. Thomas A. Cavanaugh (1997). Act Evaluation, Willing and Double Effect. Proceedings of the American Catholic Philosophical Association 71:243-253.
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  29. David K. Chan (2000). Intention and Responsibility in Double Effect Cases. Ethical Theory and Moral Practice 3 (4):405-434.
    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 (...)
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  30. Timothy Chappell (2002). Two Distinctions That Do Make a Difference: The Action/Omission Distinction and the Principle of Double Effect. Philosophy 77 (2):211-233.
    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 (...)
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  31. Ronald S. Cohen & William D. Rhine (2008). Response to “Deception and the Principle of Double Effect” by Amnon Goldworth (CQ Vol. 17, No. 4). Cambridge Quarterly of Healthcare Ethics 18 (01):101-.
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  32. William Cooney (1989). Affirmative Action and the Doctrine of Double Effect. Journal of Applied Philosophy 6 (2):201-204.
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  33. Jonathan Dancy (2000). Intention and Permissibility, II. Aristotelian Society Supplementary Volume 74 (1):319–338.
    [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 (...)
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  34. Stephen Davey (2013). How to Respond to the Problem of Deviant Formal Causation. Philosophia 41 (3):703-717.
    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 (...)
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  35. Neil Delaney (2007). Review of T. A. Cavanaugh, Double-Effect Reasoning: Doing Good and Avoiding Evil. [REVIEW] Notre Dame Philosophical Reviews 2007 (10).
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  36. Neil Delaney (2001). To Double Business Bound. American Catholic Philosophical Quarterly 75 (4):561-583.
    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 (...)
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  37. Neil Francis Delaney (2008). Two Cheers for “Closeness”: Terror, Targeting and Double Effect. Philosophical Studies 137 (3):335 - 367.
    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 (...)
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  38. Neil Francis Delaney (2007). A Note on Intention and the Doctrine of Double Effect. Philosophical Studies 134 (2):103 - 110.
    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. (...)
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  39. Philip E. Pe Devine (1974). The Principle of Double Effect. American Journal of Jurisprudence 19 (1):44.
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  40. K. Devolder (2013). Embryo Deaths in Reproduction and Embryo Research: A Reply to Murphy's Double Effect Argument. Journal of Medical Ethics 39 (8):533-536.
    The majority of embryos created in natural reproduction die spontaneously within a few weeks of conception. Some have argued that, therefore, if one believes the embryo is a person (in the normative sense) one should find ‘natural’ reproduction morally problematic. An extension of this argument holds that, if one accepts embryo deaths in natural reproduction, consistency requires that one also accepts embryo deaths that occur in (i) assisted reproduction via in vitro fertilisation (IVF) and (ii) embryo research. In a recent (...)
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  41. Ezio Di Nucci (forthcoming). Trolleys and Double Effect in Experimental Ethics. In Christoph Luetge, Hannes Rusch & Matthias Uhl (eds.), Experimental Ethics. Palgrave Macmillan.
    I analyse the relationship between the Doctrine of Double Effect and the Trolley Problem: the former offers a solution for the latter only on the premise that killing the one in Bystander at the Switch is permissible. Here I offer both empirical and theoretical arguments against the permissibility of killing the one: firstly, I present data from my own empirical studies according to which the intuition that killing the one is permissible is neither widespread nor stable; secondly, I defend a (...)
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  42. Ezio Di Nucci (forthcoming). Aristotle and Double Effect. Journal of Ancient Philosophy.
    There are some interesting similarities between Aristotle’s ‘mixed actions’ in Book III of the Nicomachean Ethics and the actions often thought to be justifiable with the Doctrine of Double Effect. Here I analyse these similarities by comparing Aristotle’s examples of mixed actions with standard cases from the literature on double effect such as, amongst others, strategic bombing, the trolley problem, and craniotomy. I find that, despite some common features such as the dilemmatic structure and the inevitability of a bad effect, (...)
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  43. Ezio Di Nucci (2014). Contraception and Double Effect. American Journal of Bioethics 14 (7):42-43.
  44. Ezio Di Nucci (2014). Ethics Without Intention. Bloomsbury.
    Ethics Without Intention tackles the questions raised by difficult moral dilemmas by providing a critical analysis of double effect and its most common ethical and political applications. The book discusses the philosophical distinction between intended harm and foreseen but unintended harm. This distinction, which, according to the doctrine of double effect, makes a difference to the moral justification of actions, is widely applied to some of the most controversial ethical and political questions of our time: collateral damages in wars and (...)
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  45. Ezio Di Nucci (2013). Double Effect and Terror Bombing. In T. Spitzley, M. Hoeltje & W. Spohn (eds.), GAP.8 Proceedings. GAP.
    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 (...)
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  46. Ezio Di Nucci (2013). Embryo Loss and Double Effect. Journal of Medical Ethics 39 (8):537-540.
    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 (...)
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  47. Ezio Di Nucci (2012). Self-Sacrifice and the Trolley Problem. Philosophical Psychology 26 (5):662-672.
    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 empirical test by asking (...)
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  48. Alan Donagan (1991). Moral Absolutism and the Double-Effect Exception: Reflections on Joseph Boyle's Who is Entitled to Double-Effect? Journal of Medicine and Philosophy 16 (5):495-509.
    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 (...)
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  49. Antony Duff (1982). Intention, Responsibility and Double Effect. Philosophical Quarterly 32 (126):1-16.
    I discuss a significant distinction between two different applications of the principle of double effect. It serves sometimes to distinguish the intended effects of an action from side-Effects which are "relevant" to it, As providing reasons against it, For which the agent must admit responsibility, And of which he is the intentional agent; and sometimes to distinguish intended effects from side-Effects which are "irrelevant" to the action, As to which the agent denies responsibility and intentional agency.
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  50. R. A. Duff (1976). Absolute Principles and Double Effect. Analysis 36 (2):68 - 80.
    I argue that hanink's account of the principle of double effect ("some light on double effect," "analysis", volume 35, number 5) is inadequate, and rests on the mistaken assumption that the criteria for distinguishing acts from each other, intention from foresight, acting from refraining, can be specified independently of any moral perspective. i try to indicate the way to a better understanding of these distinctions, and the essential features of the kind of absolutist morality which invokes them--its concern with "agency", (...)
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