I will introduce six constraints that should guide the formulation and use of DE. One goal in listing them is to engage in dialectical fair play by ruling out criticisms of the doctrine that are directed at misformulations of DE or that result from misapplications of it. Each of these constraints should be acceptable to any proponent of DE. Yet when these constraints on the application of DE are respected, it becomes clear that many of the examples provided as illustrations (...) of DE actually illustrate other, more interesting uses of the contrast between intention and foresight. (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)

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 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)

Frances Kamm sets out to draw and make plausible distinctions that would show how and why it is, in some circumstances, permissible to kill some to save many more, but is not so in others. To do so she draws on a famous, and famously artificial, example of Judith Thomson, which illustrates the fact that people intutitively reject some instances of such killings but not others. The irrationality, implausibility and in many cases the self-defeating nature of such distinctions I had (...) attempted to expose in my 'The Survival Lottery' over 25 years ago. I still think these distinctions irrational and implausible and I will try, in this response, to show why this remains the case and why doctrines of additional effects, to however many powers they are taken, remain unhelpful in ethics. (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 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)

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 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)

Most people believe that there are limits to the sacrifices that morality can demand. Although it would often be meritorious, we are not, in fact, morally required to do all that we can to promote overall good. What's more, most people also believe that certain types of acts are simply forbidden, morally off limits, even when necessary for promoting the overall good. In this provocative analysis Kagan maintains that despite the intuitive appeal of these views, they cannot be adequately defended. (...) In criticizing arguments for limited moral requirements as well as those for unconditionally prohibited acts, Kagan offers a sustained attack on two of the most basic features of ordinary common sense morality. (shrink)

Proponents of double‐effect reasoning — relying in part on a distinction between intention and foresight — assert that it is worse intentionally to cause harm than to cause harm with foresight but without intention. They hold, for example, that terror bombing is worse than tactical bombing in so far as terror bombing is the intentional harming of non‐combatants while tactical bombing is not. In articulating the ethical relevance of the intended/foreseen distinction, advocates of double effect employ the Kantian end‐not‐means principle. (...) Jonathan Bennett has recently argued that this principle cannot ground the ethical relevance of the intended/foreseen distinction. He holds that the principle demands that one benefit others while double effect deals with acts that do not benefit others. Thus, he maintains, the intended/foreseen distinction does not have ethical import and double effect is not tenable. I argue for a reading of the end‐not‐means principle that grounds the ethical relevance of both the intended/foreseen distinction and double effect. (shrink)

The validity of the double effect doctrine is examined in euthanasia and abortion. In these two situations killing is a method of treatment. It is argued that the doctrine cannot apply to the care of the dying. Firstly, doctors are obliged to harm patients in order to do good to them. Secondly, patients should make their own value judgments about being mutilated or killed. Thirdly, there is little intuitive moral difference between direct and indirect killing. Nor can the doctrine apply (...) to abortion. Doctors kill fetuses as a means of treating the mother. They also kill them as an inevitable side effect of other treatment. Drawing a moral distinction between the direct and the indirect killing gives counterintuitive results. It is suggested that pragmatic rules, not ethics, govern practices around euthanasia and cause it to be more restricted than abortion. (shrink)

This combination textbook and anthology provides coverage of the fundamental topics in current medical ethics adn familiarizes the reader with the basic moreal and social issues confronting the medical profession today.

According to the "sanctity-of-life" view, all human lives are equally valuable and inviolable, and it would be wrong to base life-and-death medical decisions on the quality of the patient's life. Examining the ideas and assumptions behind the sanctity-of-life view, Kuhse argues against the traditional view that allowing someone to die is morally different from killing, and shows that quality-of-life judgments are ubiquitous. Refuting the sanctity-of-life view, she provides a sketch of a quality-of-life ethics based on the belief that there is (...) a profound difference between merely being alive and life being in the patient's interest. (shrink)

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