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)

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)

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)

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)

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)

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)

Suppose that one initiates a causal sequence leading to a basically evil state of affairs, but does not intend the evil effect, and the good effects of the action are proportionate to the bad. A state of affairs is a “basic evil” provided it is evil in virtue of itself and not in virtue of its connection with other states of affairs. The classic form of the Principle of Double Effect (PDE) can be taken to state that then the action (...) that initiated the causal sequence is not wrong on account of the basically evil state of affairs it produces. The action might still be wrong for some other reason, say by violating a promise, or causing some other basically evil state of affairs, or being a.. (shrink)

Case 1 (transplant) . You are a surgeon doing an appendectomy on Fred, who is otherwise healthy. You know from his file that, just by chance, his heart, lungs, bone marrow, liver and two kidneys are a perfect match for fifteen patients in your hospital who need various organs or bone marrow, of both of which there is a severe shortage of these organs; Fred, however, has refused to donate anything. If the fifteen patients do not receive the transplants today, (...) they will die. You skillfully use your scalpel to kill Fred in such a way that no one can tell it was no accident, and you use his organs to save fifteen patients. One dead, fifteen innocent people saved. (shrink)

Stable URL: http://links.jstor.org/sici?sici=0048-3915%28198923%2918%3A4%3C334%3AAIACTD%3E2.0.CO%3B2-P..

The illusory appeal of double effect -- The significance of intent -- Means and ends -- Blame.

0. According to Thomas Aquinas, acts have two kinds of effects: first, they have effects that are “within the intention” (in intentione); secondly, they have effects that are “beyond the intention” (praeter intentionem).1 In Aquinas’ view, the intended effects define the “species” to which the act belongs, whereas the effects that are beyond the intention are in a sense “accidental” to the act. For example, normally, if you kill an aggressor in self-defence, your intention is not to kill the aggressor, (...) but simply to save your own life by preventing the aggressor from continuing his attack. Hence, Aquinas claims, so long as the degree of violence that you used in defending yourself is no more than was necessary to save your own life, it will normally be permissible to kill in self-defence – although even if you are defending yourself, it is still impermissible to intend to kill the aggressor. (shrink)