Objections to the principle of double effect usually concern its first and second conditions (that the act not be evil in itself, and that the evil effect may not be intended). The difficulties often arise from a rejection of the idea that acts have a moral nature independent of context, and a tendency to interpret intention as purely psychological. This article argues that the “act itself” should be understood as the act-type and suggests that examples of (...) evil act-types are not hard to find. It argues that the notion of intention is involved in both conditions, but in different ways. It proposes that these different ways can be interestingly illuminated by Anscombe’s distinction between acting intentionally and acting with an intention. (shrink)

In Catholic moral theology, the principle of double effect has been an effective normative tool for centuries, and it can be used to determine the ethicality of actions that contain both good and evil consequences. The principle of double effect is especially useful in end-of-life care, because many end-of-life treatment options inherently have both good and evil conse­quences. The principle of double effect can be used to make both practical and moral (...) distinctions between the acts of euthanasia, physician-assisted suicide, palliative sedation, and the withholding and withdrawal of life-sustaining treatment, which can be classified as either unjustified acts of killing or jus­tifiable acts of allowing to die. (shrink)

Many medical interventions have both negative and positive effects. When health care professionals cannot achieve a particular desired good result without bringing about some bad effects also they often rely on double-effect reasoning to justify their decisions. The principle of double effect is therefore an important guide for ethical decision-making in medicine. At the same time, however, it is a very controversial tool for resolving complex ethical problems that has been criticized by many authors. For (...) these reasons, I examine in this paper whether the principle of double effect can serve as a basis for ethical decisions in medicine. The conclusion reached in this article is that even though this principle has desirable effects on clinical conduct, it is only an unreliable guide and physicians and nurses cannot feel secure in continuing to use this principle for ethical guidance. (shrink)

In “The Contralife Argument and the Principle of Double Effect” (NCBQ, Spring 2011), Lawrence Masek tries to use the principle of double effect to show that natural family planning (NFP) is morally justified. This essay presents a summary explanation of the principle of double effect. It demonstrates that Masek wrongly applies the principle of double effect to NFP. It presents the teaching of the 1968 papal encyclical Humanae vitae (...) with regard to NFP, and contends that to apply the principle of double effect to the case of NFP is not only incorrect but also contrary to teaching of Humanae vitae. Because Masek implies that NFP involves the (justified) permission of evil, his article also counteracts the efforts of the Catholic Church to promote the practice of NFP. National Catholic Bioethics Quarterly 11.4 (Winter 2011): 661–667. (shrink)

The paper explores the relationship between the Principle of Double Effect and Just War Theory, with emphasis on their relationship in the philosophy of Thomas Aquinas. Both PDE and JWT are of Medieval origin, and are classical exponents of medieval moral philosophy. The main connection between them is, however, that they can both be viewed as theories about permissible violence and harm, that is theories about when it is morally permissible to harm and possibly kill another human (...) being. The final point of the paper is that PDE is an important element within JWT, or rather that when just war theorists manage to justify a certain types of violence they do so by extensive use of PDE. This only applies to one part of JWT, jus in bello, which concerns the actual morality of fighting, not the right to war itself. If these assumptions can be reasonably fleshed out, and if it is possible to show that PDE is of crucial importance to certain elements of jus in bello, such as methods for justifying civilian casualties, that would entail that our own moral examinations of warfare differ precisely because we either accept or don’t accept PDE as a viable and reasonable principle in normative ethics. (shrink)

The principle of double effect is often used in bioethics as a tool to evaluate significant cases in obstetrics and gynecology. In this article the author, a Catholic priest, presents and interprets St. Thomas Aquinas’s delineation of the principle and discusses several classical applications, namely, to hysterectomy during pregnancy, ectopic pregnancy, and craniotomy. He explains the medical anatomy and physiology of the conjoined Maltese twins, Jodie and Mary, and then examines the arguments of four moralists on (...) their separation. He concludes by arguing that the principle morally justified the surgical separation of Jodie and Mary. National Catholic Bioethics Quarterly 9.1 : 85–96. (shrink)

While some believe that the principle of double effect provides sound ethical guidance, others believe that it does not and have leveled various types of argument against it. One type of argument leveled against it proceeds by applying it to hypothetical “closeness” cases. This objection seeks to show that in such cases the principle permits what patently should not be permitted, and thus is unacceptable because it is too permissive. In this essay, I critically evaluate an (...) argument of this type developed by Alexander R. Pruss. Central to my strategy is to develop and defend a distinction between two kinds of means. I refer to them as closed-ended and open-ended means. I argue that once what is intended is understood in light of this distinction, the principle does not permit what patently should not be permitted, and thus need not be seen as being too permissive. (shrink)

While some believe that the principle of double effect provides sound ethical guidance, others believe that it does not and have leveled various types of argument against it. One type of argument leveled against it proceeds by applying it to hypothetical “closeness” cases. This objection seeks to show that in such cases the principle permits what patently should not be permitted, and thus is unacceptable because it is too permissive. In this essay, I critically evaluate an (...) argument of this type developed by Alexander R. Pruss. Central to my strategy is to develop and defend a distinction between two kinds of means. I refer to them as closed-ended and open-ended means. I argue that once what is intended is understood in light of this distinction, the principle does not permit what patently should not be permitted, and thus need not be seen as being too permissive. (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)

The Principle of Double Effect has been with us since the Middle Ages and has sanctified actions that might otherwise be viewed as morally wrong. What I wish to show in this brief perspective is that an overlooked element in the discussions of this principle raises a serious question about its applicability.

Abstract: In Vacco v. Quill, 521 U.S. 793 (1997), the Supreme Court for the first time in American case law explicitly applied the principle of double effect to reject an equal protection claim to physician-assisted suicide. Double effect, traced historically to Thomas Aquinas, proposes that under certain circumstances it is permissible unintentionally to cause foreseen evil effects that would not be permissible to cause intentionally. The court rejected the constitutional claim on the basis of a (...) distinction marked out by the principle, i.e., between directly intending the death of a terminally ill patient as opposed to merely foreseeing that death as a consequence of medical treatment. The Court held that the distinction comports with fundamental legal principles of causation and intent. Id. at 802. -/- Critics allege that the principle itself is intrinsically flawed and that, in any event, its employment in Vacco is without legal precedent. I argue in response to contemporary objections that double effect is a valid principle of ethical reflection (Part II); claims to the contrary notwithstanding, double effect analysis is a pervasive, albeit generally unacknowledged principle employed regularly in American case law (Part III); and drawing on the preceding two sections, Vacco's application of the principle of double effect is appropriate (Part IV). -/- My conclusion is that [o]peration of some form of the principle, by whatever name, is inevitable. In an imperfect world where duties and interests collide, the possibility of choices of action foreseen to have both good and evil consequences cannot be avoided. In rare circumstances, ethics and the law require that a person refrain from acting altogether. More often, however, they provide that a determination of whether an actor may pursue a good effect although knowing it will or may unintentionally cause an harmful effect requires a more complex analysis - a double effect analysis. -/- Keywords: Equal protection, double effect, intention, physician-assisted suicide, Constitutional Law, Bioethics. (shrink)

The proportionalist position on the revision of the principle of double effect is now an important feature of moral discourse in contemporary Roman Catholic theological discussion. While its claim to being rooted in the work of Saint Thomas Aquinas is defensible, its view on the universal applicability of proportionate reasoning for determining the moral rightness or wrongness of actions is not without problems in some key areas, such as the distinction between direct and indirect consequences of an (...) action. Indeed, proportionalists often argue in manners that would suggest that they have discarded this distinction outright. Such a result, it is argued, would be a grave error for Christian ethics. (shrink)

Background Because opioids can suppress respiratory drive, the principle of double effect (PDE) has been used to justify their use for terminally ill patients. Recent studies, however, suggest that the risk of respiratory depression in typical end-of-life (EOL) situations may be overstated and that heightened concern for this rare occurrence can lead to inadequate treatment of pain. The purpose of this study is to examine the role of the PDE in medical school ethics education, with specific reference (...) to its potential impact on pain management at EOL. Method After obtaining institutional review board approval, an electronic survey was sent to ethics educators at every allopathic medical school in the USA. Results One-third of ethics educators felt that opioids were ‘likely’ to cause significant respiratory depression that could hasten death. Educators' opinions of opioid effects did not influence their view of the relevance of the PDE, with approximately 70% deeming it relevant to EOL care. Only 15% of ethics educators believed that associating the PDE with opioid use might discourage clinicians from optimally treating pain, out of concern for respiratory depression. Conclusion This study demonstrates that a significant minority of ethics educators believe, contrary to current evidence, that opioids are ‘likely’ to cause significant respiratory depression that could hasten death in terminally ill patients. Yet, many of those who do not feel this is likely still rely on the PDE to justify this possibility, potentially (and unknowingly) contributing to clinical misperceptions and underutilisation of opioids at EOL. (shrink)

The classical principle of double effect offers permissibility conditions for actions foreseen to lead to evil outcomes. I shall argue that certain kinds of closeness cases, as well as general heuristic considerations about the order of explanation, lead us to replace the intensional concept of intention with the extensional concept of accomplishment in double effect.

The doctrine (or principle) of double effect is often invoked to explain the permissibility of an action that causes a serious harm, such as the death of a human being, as a side effect of promoting some good end. According to the principle of double effect, sometimes it is permissible to cause a harm as a side effect (or “double effect”) of bringing about a good result even though it would (...) not be permissible to cause such a harm as a means to bringing about the same good end. Does the principle of double effect play the important explanatory role that has been claimed for it? To consider this question, one must be careful to clarify just what the principle is supposed to explain. Three misinterpretations of the principle’s force or range of application are common. 1. To ensure that Double Effect is not misunderstood as principle issuing a blanket permission on causing any unintended harm that yields a benefit, applications must require that the agent seek to minimize the harm involved. 2. Since it is widely accepted that it is wrong to aim to produce harm to someone as an end, to rule this out is not part of double effect’s distinctive content. 3. Harms that were produced regretfully and only for the sake of producing a good end may be prohibited by double effect because they were brought about as part of the agent’s means to realizing the good end. (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)

After the terrorist attacks of September 11, 2001, most legacy airlines filed for bankruptcy protection as a way to cut costs drastically, with the exception of American Airlines. This article applies the Principle of Double-Effect to the act of filing for Chapter 11 bankruptcy protection for reasons of management strategy, in particular, cost-cutting. It argues that the Principle can be a useful tool for discerning the ethicality of the action, and demonstrates the usefulness by proposing three (...) double-effect criteria that, when fulfilled, argues for the ethical justifiability the action in question. (shrink)

The problem of closeness was posed by Philippa Foot in the article “The Problem of Abortion and the Doctrine of Double Effect”. Foot criticizes the classic version of the principle of double effect which distinguishes direct from indirect intention. On this basis, she considers it justified to cause bad effects which were foreseen but not intended. She believes that if we consider causing a bad effect to be justified then the way we do it (...) is irrelevant, while the reference to the direct/indirect distinction may lead to absurd solutions in some cases that allow us to distinguish two events in one action. These constitute, respectively, the object of direct and indirect intention and they are much too close for an application of the principle of double effect, such as when a doctor performs a craniotomy. The root of the problem of closeness is the question about the possible criterion that would allow us to determine which of the effects of an action are intended and which are merely foreseen. The starting point of the analysis of the problem of closeness in this article is the manner in which Foot outlines it in her article. In the second and more extensive part of the article, a number of contemporary attempts to solve the problem of closeness are presented, while the third section is an attempt to answer the question of why the discussion of the problem of closeness seems to remain deadlocked. (shrink)

Philosophy teachers converse with troubled students who suffer from what I dub “intelligent collegiate depression” (ICD): a lack of self‐esteem, feelings of futility and pessimism about their futures, a distrust of academic values, and a lack of conviction that their lives matter. Students express their values and their resignation with what approaches conventional wisdom for them: They must be allowed to act as they wish so long as they do not hurt anyone; otherwise it does not matter what they do (...) with their lives. I argue here that students' endorsement of this near‐nihilistic version of Mill's harm principle shows that they are committed to believing in more values than they realize. I then show how to parlay this commitment into a rejection of the worst effects of ICD—all the while holding in abeyance the question of metaethical objectivism vs. subjectivism. My approach shows that accepting a popular ICD premise logically undermines much of the unhappy ICD worldview. (shrink)

In this article the validity of transferring the Principle of Double Effect from the just war tradition to the domain of business is critically reviewed. If a case can be built for sufficient analogies between war and business, the principle of double effect can legitimately be transferred from war to business. If, on the other hand it can be shown that there are aspects in which business differs substantially from just war, then the transfer (...) to business of a principle developed within the context of war becomes more problematic. After exploring the nature of arguments of analogy and fallacious arguments of weak analogy some important disanalogies between war and business are highlighted. Given these disanalogies it is then contended that the just war background of the Principle of Double Effect had some bearing on both the content and manner of application of the Principle of Double Effect. Finally it is argued that these disanalogies require some revisions to the Principle of Double Effect with regard to both its content and its manner of application before it can be applied meaningfully to foreseeable negative side-effects of business. S. Afr. J. Philos. Vol.22(3) 2003: 236–246. (shrink)

Combined oral contraceptives have been demonstrated to have significant benefits for the treatment and prevention of disease. These medications also are associated with untoward health effects, and they may be directly contraceptive. Prescribers and users must compare and weigh the intended beneficial health effects against foreseeable but unintended possible adverse effects in their decisions to prescribe and use. Additionally, those who intend to abide by Catholic teachings must consider prohibitions against contraception. Ethical judgments concerning both health benefits and contraception are (...) approached in this essay through an overview of the therapeutic, prophylactic, untoward, and contraceptive effects of COC and discussion of magisterial and traditional Catholic teachings from natural law. Discerning through the principle of double effect, proportionate reason, and evidence gathered from the sciences, medical and moral conclusions are drawn that we believe to be fully compliant with good medicine and Catholic teaching. (shrink)

In an article somewhat ironically entitled “Disambiguating Clinical Intentions,” Lynn Jansen promotes an idea that should be bewildering to anyone familiar with the literature on the intention/foresight distinction. According to Jansen, “intention” has two commonsense meanings, one of which is equivalent to “foresight.” Consequently, questions about intention are “infected” with ambiguity—people cannot tell what they mean and do not know how to answer them. This hypothesis is unsupported by evidence, but Jansen states it as if it were accepted fact. In (...) this reply, we make explicit the multiple misrepresentations she has employed to make her hypothesis seem plausible. We also point out the ways in which it defies common sense. In particular, Jansen applies her thesis only to recent empirical research on the intentions of doctors, totally ignoring the widespread confusion that her assertion would imply in everyday life, in law, and indeed in religious and philosophical writings concerning the intention/foresight distinction and the Principle of Double Effect. (shrink)

In this article, responding to assertions that the principle of double effect has no place in legal analysis, I explore the overlap between double effect and negligence analysis. In both, questions of culpability arise in situations where a person acts with no intent to cause harm but where reasonable foreseeability of unintended harm exists. Under both analyses, the determination of whether such conduct is permissible involves a reasonability test that balances that foreseeable harm against the (...) good intended by the actor's conduct. In both, absent a finding that the foreseeable harm is unreasonable in light of that intended good, no liability will be imposed upon the actor. Even conceding, however, such general similarity between double effect and negligence analysis - disagreement over the proper interpretation of the reasonability criterion at play in negligence poses an additional challenge for the attempt to correlate negligence with double effect. Economic efficiency interpretations of negligence, for example, purportedly based on the Learned Hand Formula and the RESTATEMENT (SECOND) OF THE LAW OF TORTS, propose that culpability depends upon a utilitarian balancing of good effects of conduct (utility) versus its harmful foreseeable consequences (magnitude of risk of injury). Based on such an interpretation of negligence, however, contrasts between actors' states of mind, and normative differences between kinds of goods and harms, ultimately fade into the background and become irrelevant as essential conditions for properly assessing liability. This article elaborates and defends the view that double effect analysis lies at the heart of negligence theory. Part I elucidates in more detail the principle of double effect and describes its prima facie operation in negligence analysis. Part II considers and rejects the economic efficiency interpretation that has been offered as a theory of negligence, overcoming the challenge that such an interpretation presents for the effort to locate double effect analysis in the law. Part III illustrates and confirms the overlap between double effect and negligence by consideration of a series of case applications. The Article proposes that the weighing of conflicting values in double effect analysis and negligence is not achieved - as proposed by law and economics theory with respect to negligence - by imposing a consequentialist-utilitarian reduction of all value to a single concept of good and eliminating the relevance of traditional state of mind distinctions between intention and foreseeability. Instead, each mode of analysis recognizes that distinct culpability determinations flow naturally and plausibly from an appreciation of the traditional legal distinctions made between various types of goods and harms, and upon whether such goods and harms come about as result of an actor's intention or mere foreseeability. Keywords: Double effect, negligence, intention, foreseeability, choice, law and economics, utilitarianism, consequentialism, weighing of values. (shrink)

This article examines the relationship between the principle of double effect and justification for separation surgeries for conjoined twins. First, the principle of double effect is examined in light of its historical context. It is argued that it can only operate under an absolutist view of good and evil that is compatible with the Bible. Given this foundation for application, scenarios for separating conjoined twins are considered against the criteria for the principle of (...) double effect. It is concluded that the principle of double effect cannot be applied to cases wherein one of the twins must be killed. However, it is noted that this does not leave decision makers without options. (shrink)

Many philosophers assume that the principle of double effect (PDE) is meant to cover trolley cases. In fact, trolley cases come from PDE’s critics, not its defenders. When philosophers stretch PDE to explain intuitions about trolley cases, they define intended effects too broadly. More importantly, trolley cases make poor illustrations of PDE because they focus attention away from the agent and onto the victim. When philosophers lose sight of the agent, some intuitions that fit PDE survive, but (...) the rational basis of these intuitions collapses. I avoid these problems by defending a minimalist, agent-based version of PDE. My version is minimalist because I do not try to turn PDE into a complete checklist that explains intuitions about every case. It is agent-based because I consider the agent’s perspective to define intentions and to make moral judgments. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Intention and Wrongdoing: A Defense of the Principle of Double Effect by Joshua StuchlikMichael J. DegnanSTUCHLIK, Joshua. Intention and Wrongdoing: A Defense of the Principle of Double Effect. Cambridge: Cambridge University Press, 2021. xvi + 220 pp. Cloth, $99.99In this book Joshua Stuchlik vigorously defends the principle of double effect (PDE), which states, "There is a strict moral constraint (...) against bringing about serious evil (harm) to an innocent person intentionally, but it is permissible in a wider range of circumstances to act in a way that brings about serious evil incidentally, as a foreseen but non-intended side effect." After defining the terms of the principle and considering an intuitive case-based defense, he supports its truth based on a standard of solidarity. Since the PDE requires the distinction between intended consequences and nonintended side effects, he explains Elizabeth Anscombe's theory of intention, which supports the distinction's moral significance. He uses her theory to treat the closeness problem, the irrelevance of intention critique, and a challenge from Joshua Greene's empirical moral psychology that purports to undermine deontological constraints on causing harm.I present Stuchlik's grounding for the PDE followed by an uncontroversial example of its application. After this I consider two important objections to the PDE that Stuchlik critiques: the closeness problem and James Rachels's argument that intentions are irrelevant to judging the moral permissibility of actions. I conclude by examining Stuchlik's treatment of these challenges.Stuchlik interprets the PDE's very strict constraint against intentional killing or seriously harming the innocent as a near absolute prohibition, for he believes innocent persons are not suitable recipients of intentional harm. He grounds this constraint on the principle of solidarity. Being in solidarity with another is possessing concern for that other's sake. The ground for this concern is a shared human nature that enables members to think of themselves as making a "we." Human nature consists in the structured potentialities for knowing and freely choosing. Evidence of these rational potentialities is the human orientation toward the transcendent values of truth and goodness. Such embodied potentialities have inviolable worth.The scenarios of the precision bomber and the terror bomber illustrate the moral significance of the intended harm versus the nonintended but foreseen harm that Stuchlik adopts from Elizabeth Anscombe's action theory. Each bombers' goal is to help his country win a just war. The precision bomber pursues that goal by targeting a munitions factory. Though he foresees that many noncombatants will be killed or seriously [End Page 367] injured from the bomb, he does not necessarily intend these harms. By contrast, the terror bomber targets a civilian center necessarily intending harm for noncombatants. The PDE rules out his conduct.Anscombe's account of intention can lead to the problem of closeness in which the content of an intention is sufficiently fine-grained that an agent need not intend harm in almost any situation. Stuchlik illustrates the problem with Alexander Pruss's zookeeper scenario.An eccentric literalistic but always truthful magnate tells Sam he will donate to famine relief saving a hundred lives if and only if Sam follows his directions to the iota. Sam is to purchase a gun, sneak at night into a zoo owned by the magnate and kill the first mammal he sees. Sam sneaks into the zoo, sees a mammal in the distance, and forms the intention to shoot it. Then he notices that the mammal is human but shoots nonetheless on utilitarian grounds.In this case applying the PDE shows that Sam is simply intending that a mammal be killed. The fact that the mammal is a human is irrelevant, according to Anscombe's action theory.Stuchlik's response clarifies the scope of intention in the PDE. As stated above, the intention's content includes seriously harming an innocent human. However, if the intention ranges only over an intention to bring about an effect, E, and it turns out that E is a serious harm for an innocent human being, then applying the principle shows that Sam's action is wrong. The intended effect of killing the mammal is, as a matter of fact, an... (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 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)

The author uses the central insight of the principle of double effect—that the distinction between intended effects and foreseen side effects is morally significant—to distinguish contraception from natural family planning. After summarizing the contralife argument against contraception, the author identifies limitations of arguments presented by Pope John Paul II and by Martin Rhonheimer. To show that the contralife argument does not apply to NFP, the author argues that agents do not intend every effect that motivates their (...) actions. This argument supplements the action theory of Germain Grisez, Joseph Boyle, John Finnis, and other proponents of new natural law theory. National Catholic Bioethics Quarterly 11.1 : 83–97. (shrink)

According to the contralife argument, because both contraception and natural family planning entail at least a contralife motivation to have marital intercourse but avoid pregnancy, both should be forbidden—a conclusion rejected by the natural law tradition and Church teaching, which forbid contraception but permit NFP. This paper argues that the principle of double effect can be applied to explain why contraception is forbidden but NFP is permissible. This double-effect analysis evaluates the good effect of (...) procreation and unity against the bad effect of lustful sexual pleasure. This paper argues that contraception fails to meet the conditions of the PDE, because it intends sexual pleasure in isolation from procreation and unity and is therefore forbidden. Conversely, NFP meets the conditions of the PDE because, as with all permissible sexual intercourse, it intends sexual pleasure in conjunction with procreation and unity and is therefore itself permissible. (shrink)

Philosophers and ethicists debate this controversial moral principle illustrating its application to current moral dilemmas such as war, suicide, nuclear power, affirmative action, and morphine use for terminal cancer patients.

In some young children brought by their parents for diagnosis of acute life-threatening events investigations suggested imposed apnoea as the cause rather than spontaneous occurrence. Covert video surveillance of the cot in which the baby was monitored allowed confirmation or rebuttal of this diagnosis. That parents were not informed of the video recording was essential for diagnosis and we assert ethically justifiable as the child was the patient to whom a predominant duty of care was owed. The procedure also avoids (...) the risk of separation of child from parent on inadequate information. (shrink)

I focus on the question as to what rationale could possibly underlie the doctrine of double effect or related principles. I first briefly review the correct critiques of the claim that people who intend some evil as a means to a good must be “guided by evil,” and that this is allegedly always wrong. I then argue that Quinn’s claim that violations of the DDE express certain negative attitudes of the agent and that agents violating the DDE must (...) make an additional morally problematic presumption regarding their victims is mistaken. Tadros claims that an agent violating the means principle must force his victims to adopt his goals. I demonstrate that the difference Tadros tries to construe between an agent inflicting intended harm and an agent inflicting merely foreseen harm is non-existent. Sarch’s official rationale for the DDE also fails to distinguish harming as a means from side-effect harming, and reformulations of his rationale that suggest themselves run into severe problems. Walen’s defense of the means principle in terms of the “restricting claims principle” and Øverland’s appeal to “moral obstacles” are susceptible to counter-examples and appear to be question-begging. Recently, Walen has offered a revised formulation of his Restricting Claims Principle, claiming that it overcomes counter-examples and explains the means principle. I will argue that it contradicts the means principle and does not overcome the counter-examples. Thus I conclude that so far we are still left without a reasonable rationale for the DDE or related principles. (shrink)