Confidence ratings have often been integrated into reasoning and intelligence tasks as a means for assessing meta-reasoning processes. Although it is often assumed that eliciting these judgements throughout reasoning tasks has no effect on the underlying performance outcomes, this is yet to be established empirically. The current study examines whether eliciting CR from participants during a fluid-reasoning task influences their performance and how this effect is moderated by their initial self-confidence in their own reasoning abilities. In a first (...) experiment, we found that participants performing CR during Raven's Progressive Matrices significantly outperformed a control group who did not provide ratings. Additionally, a second experiment demonstrated that CR only facilitated performance in participants who have a high level of initial self-confidence in their reasoning ability, whereas they were detrimental to participants low in self-confidence. (shrink)

Metaethical subjectivism, the idea that the truth or falsity of moral statements is contingent upon the attitudes or conventions of observers, is often regarded as a lurid philosophical doctrine which generates much psychological resistance to its acceptance. In this accessible book, Richard Double, presents a vigorous defense of metaethical subjectivism, arguing that the acceptance of this doctrine need have no deleterious effects upon theorizing either in normative ethics or in moral practice. Proceeding from a 'worldview' methodology Double criticizes (...) the rival doctrine of metaethical objectivism for lacking both 'completeness' and 'soundness', argues that a defense of metaethical subjectivism requires no special semantic analysis of moral language and defends the plausibility of metaethical subjectivism as explaining key intractable disagreements in moral philosophy. Double concludes by suggesting that the acceptance of metaethical subjectivism is better for constructing theories of normative ethics and moral practice than is metaethical objectivism. (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)

Emotional intelligence abilities relate to desirable outcomes such as better well-being, academic performance, and job performance. Previous research shows that coping strategies mediate the effects of ability EI on such outcomes. Across two cross-sectional studies, we show that coping strategies mediate the relationships of ability EI with both well-being and ill-being. Study 1 assessed EI with the Situational Test of Emotion Understanding and Situation Test of Emotion Management. Avoidant coping significantly mediated the relationship of both the STEU and STEM with (...) depression, anxiety, stress, and psychological well-being. EI was associated with lower avoidant coping, higher well-being and lower ill-being. Study 2 assessed EI with the Mayer–Salovey–Caruso Emotional Intelligence Test. Avoidant coping mediated the relationship between EI and ill-being, but not the relationship between EI and well-being. These effects were significant for three of the four EI branches—emotion perception, understanding, and management. We discuss possible reasons why avoidant coping may be an active ingredient by which lower EI relates to lower well-being. We also discuss a possible application of our findings—that EI training programs might benefit from including content aimed at reducing avoidant coping. (shrink)

This essay defends a version of the Doctrine of Double Effect (DDE) – the doctrine that there is normally a stronger reason against an act that has a bad state of affairs as one of its intended effects than against an otherwise similar act that has that bad state of affairs as an unintended effect. First, a precise account of this version of the DDE is given. Secondly, some suggestions are made about why we should believe the (...) DDE, and about why it is true. Finally, a solution is developed to the so-called ‘closeness problem’ that any version of the DDE must face. (shrink)

Is it possible to donate unpaired vital organs, foreseeing but not intending one's own death? We argue that this is indeed psychologically possible, and thus far agree with Charles Camosy and Joseph Vukov in their recent paper on 'double effect donation.' Where we disagree with these authors is that we see double effect donation not as a morally praiseworthy act akin to martyrdom but as a morally impermissible act that necessarily disrespects human bodily integrity. Respect for (...) bodily integrity goes beyond avoiding the aim to kill: not all side effects of deliberate bodily interventions can be outweighed by intended benefits for another even if the subject fully consents. It is not any necessary intention to kill or harm another or oneself that makes lethal donation/harvesting illicit but the more immediate intention to accept or perform surgery on an (innocent) person combined with the foresight of lethal harm and no health-related good for him or her. Double effect donation falls foul of the first condition of double effect reasoning in that the immediate act is wrong in itself. We argue further that the wider effects of such donation would be socially disastrous and corrupting of the medical profession: doctors should retain a sense of nonnegotiable respect for bodily integrity even when they intervene on willing subjects for the benefit of others. (shrink)

T. A. Cavanaugh defends double-effect reasoning, also known as the principle of double effect. DER plays a role in anti-consequentialist ethics, in hard cases in which one cannot realize a good without also causing a foreseen, but not intended, bad effect. 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, and moral theology. It will also interest (...) legal and public policy scholars. (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)

As media reports have made widely known, in November 2009, the ethics committee of St. Joseph’s Hospital in Phoenix, Arizona, permitted the abortion of an eleven-week-old fetus in order to save the life of its mother. This woman was suffering from acute pulmonary hypertension, which her doctors judged would prove fatal for both her and her previable child. The ethics committee believed abortion to be permitted in this case under the so-called principle of double effect, but Thomas J. (...) Olmsted, the bishop of Phoenix, disagreed with the committee and pronounced its chair, Sister Margaret McBride, excommunicated latae sententiae, “by the very commission of the act.” In this article, I take the much discussed Phoenix case as an occasion to subject the principle of double effect to another round of philosophical scrutiny. In particular, I examine the third condition of the principle in its textbook formulation, namely, that the evil effect in question may not be the means to the good effect. My argument, in brief, is that the textbook formulation of the principle does not withstand philosophical scrutiny. Nevertheless, in the end, I do not claim that we should then “do away” with the principle altogether. Instead, we do well to understand it within the context of casuistry, the tradition of moral reasoning from which it issued. (shrink)

The dead donor rule (DDR) prohibits retrieval protocols that would be lethal to the donor. Some argue that compliance with it can be maintained by satisfying the requirements of double‐effect reasoning (DER). If successful, one could support organ donation without reference to the definition of death while being faithful to an ethic that prohibits intentionally killing innocent human life. On the contrary, I argue that DER cannot make lethal organ donation compatible with the DDR, because there are plausible (...) ways it fails DER's requirements. A key takeaway is that the theories of intention and proportionality assumed in DER matter for its plausibility as a constraint on practical reasoning. (shrink)

The relevance of double effect for end-of-life decision-making has been challenged recently by a number of scholars. The principal reason is that opioids such as morphine do not usually hasten death when administered to relieve pain at the end of life; therefore, no secondary “double” effect is brought about. In my article, I argue against this view, showing how the doctrine of double effect is relevant to the administration of opioids at the end of (...) life. I contend that the prevailing view suffers from a misunderstanding of the nature of double effect, which includes application to risking a grave harm. (shrink)

This article treats recent bioethical discussions of double effect reasoning (DER), offering a summary account of DER and construing it as rooted in a sensible view of what is central to someone's identity as a moral agent. It then treats objections raised in recent years by Judith Thomson, Alison McIntyre, and Frances Kamm against familiar ways of applying DER to certain controversies within medical ethics, especially, that over physician-assisted suicide. After detailing, interpreting, and attempting to rebut the challenges (...) from these philosophers, who are especially interesting because their criticisms of DER come from allies in DER's struggle against consequentialist reasoning, the essay engages DER's contribution to a recent dispute over treatment of patients in what is called ‘persistent vegetative state.' Near its end, the paper sketches several possible points of entry to DER and sources of justification for it. The essay concludes by indicating a connection between these paths and its opening idea of moral identity. (shrink)

American criminal law is committed to some version of the doctrine of double effect. In this paper, I defend a new variant of the agent-centered rationale for a version of DDE that is of particular relevance to the criminal law. In particular, I argue for a non-absolute version of DDE that concerns the relative culpability of intending a bad or wrongful state of affairs as opposed to bringing it about merely knowingly. My aim is to identify a particular (...) feature of the former in virtue of which it is pro tanto more culpable than the latter. Providing an agent-centered argument of this kind for a culpability version of DDE, I argue, is an especially attractive route to take for those who are interested in vindicating the way the criminal law actually encodes DDE. (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)

This paper looks at the Catholic justification of medical interventions in ectopic pregnancies. The paper first shows that the way how Double Effect Reasoning is often applied to ectopic pregnancies is not consistent with the way Aquinas introduces this mode of reasoning. The paper then shows certain problems in common defences of the use of salpingectomies. The paper then re-evaluates the medical interventions used in the management of ectopic pregnancies, with both a focus on the aim of the (...) treatment and the timing of the treatment. (shrink)

This essay defends a version of the Doctrine of Double Effect (DDE) – the doctrine that there is normally a stronger reason against an act that has a bad state of affairs as one of its intended effects than against an otherwise similar act that has that bad state of affairs as an unintended effect. First, a precise account of this version of the DDE is given. Secondly, some suggestions are made about why we should believe the (...) DDE, and about why it is true. Finally, a solution is developed to the so-called ‘closeness problem’ that any version of the DDE must face. (shrink)

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)

Many philosophers display relaxed scepticism about the Doctrine of Doing and Allowing and the Doctrine of Double Effect, suspecting, without great alarm, that one or both of these Doctrines is indefensible. This relaxed scepticism is misplaced. Anyone who aims to endorse a theory of right action with Nonconsequentialist implications should accept both the DDA and the DDE. First, even to state a Nonconsequentialist theory requires drawing a distinction between respecting and promoting values. This cannot be done without accepting (...) some deontological distinction. Second, if someone is going to accept any deontological distinction she should accept either the DDE or the DDA or some replacement. Finally, anyone who accepts either the DDE or the DDA should accept both doctrines or a replacement of each. Unless both Doctrines can be defended or given a defensible replacement, any Nonconsequentialist is in trouble. (shrink)

The Doctrine of Double Effect [DDE] states roughly that it is harder to justify causing or allowing harm as a means to an end than it is to justify conduct that results in harm as a side effect. This chapter argues that a theory of deontological constraints on harming needs something like the DDE in order to avoid the charge that it reflects a narcissistic obsession with the cleanliness of our own hands. Unfortunately, the DDE is often (...) interpreted as maintaining that we must avoid acting with certain intentions, which, this chapter contends, embodies an equally narcissistic obsession with the purity of our own hearts. The chapter argues that the DDE is better interpreted as a denial of the Machiavellian idea that beneficial ends justify harmful means. On this view, the objective fact that our conduct will secure benefits for some individuals at the expense of other individuals weakens the extent to which those benefits count as reasons to engage in that conduct. The chapter argues that this version of the DDE provides a plausible, non-narcissistic foundation for deontological constraints. (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)

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)

Is it possible to donate unpaired vital organs, foreseeing but not intending one’s own death? We argue that this is indeed psychologically possible, and thus far agree with Charles Camosy and Joseph Vukov in their recent paper on “double effect donation.” Where we disagree with these authors is that we see double-effect donation not as a morally praiseworthy act akin to mar- tyrdom but as a morally impermissible act that necessarily disrespects human bodily integrity. Respect for (...) bodily integrity goes beyond avoiding the aim to kill; not all side effects of deliberate bodily interventions can be outweighed by intended benefits for another even if the subject fully consents. It is not any necessary intention to kill or harm another or oneself that makes lethal donation/harvesting illicit but the more immediate intention to accept or perform surgery on an (innocent) person combined with the foresight of lethal harm and no health-related good for him or her. Double-effect donation falls foul of the first condition of double-effect reasoning in that the immediate act is wrong in itself. We argue further that the wider effects of such don- ation would be socially disastrous and corrupting of the medical profession: doctors should retain a sense of nonnegotiable respect for bodily integrity even when they intervene on willing subjects for the benefit of others. (shrink)

The “principle of double effect” is a vital tool for moral decision making and is applicable to all areas of medical practice, including (for example) end-of-life care, transplant medicine, and cases of conscientious objection. Both our ultimate and our more immediate intentions are relevant in making and evaluating choices— though side effects must be kept proportionate and can be morally conclusive when linked with some intentions. Intentions help to form the character of doctors, and of human beings generally. (...) While hypocrisy is certainly possible in regard to this form (and other forms) of moral reasoning, double effect reasoning, sincerely practised, remains indispensable in identifying moral problems and solutions. (shrink)

Victoria’s Voluntary Assisted Dying Act 2017 (Vic) became the first state law to permit VAD in Australia under limited circumstances from June 2019. Before this, many palliative care physicians relied on the doctrine of double effect (DDE) to justify the use of pain relievers for terminally ill patients that were known to hasten death. The DDE claims that there is a morally significant difference between intending evil and merely foreseeing some bad side-effect will occur as a result (...) of one’s actions. This article argues that the legacy of the DDE is promoting inequitable access to VAD in Victoria due to the assumption that death represents an “evil” for the patient and that the intentions of physicians providing VAD cannot be trusted. The latter claim relies on two common objections to the DDE: the risk of “purifying the intentions” and the issue of “closeness” when evaluating moral acts under this theory. (shrink)

Many ethicists maintain that medical research on human subjects that presents no prospect of direct medical benefit must have a prospect of social benefit to be ethical. Payment is not the sort of benefit that justifies exposing subjects to risk. Alan Wertheimer has raised a serious challenge to this view, pointing out that in industry, social value is not considered necessary to make dangerous jobs ethical. This article argues that Wertheimer was correct to think that the ethics of hazard pay (...) should be the same in medical research and in business. Nevertheless, a qualified social benefit requirement should apply in both fields. For a study or a job with significant net physical risk to be ethical, it must have social value beyond the satisfaction of ordinary preferences, including the preference for money. The requirement derives from a non-absolutist version of the doctrine of double effect. If a risky study or a dangerous job has no distinctive social value, and hazard pay is subjects' or workers’ only reason to undergo risks, the very fact that they undergo risk is intended as a means to a financial end. Inviting people to enrol in such a study or to take such a job wrongfully treats people as mere means. By contrast, if a study or a job has social value, people can participate with a primary end other than money, even if they accept compensation. Researchers or employers do not intend but merely foresee risks to subjects or workers. (shrink)

Double Effect Donation claims it is permissible for a person meeting brain death criteria to donate vital organs, even though such a person may be alive. The reason this act is permissible is that it does not aim at one’s own death but rather at saving the lives of others, and because saving the lives of others constitutes a proportionately serious reason for engaging in a behavior in which one foresees one’s death as the outcome. Double (...) class='Hi'>Effect Donation, we argue, opens a novel position in debates surrounding brain death and organ donation, and does so without compromising the sacredness and fundamental equality of human life. (shrink)

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 the rule each require their own ethical justification. A variety of moral theories are relevant to making judgements in a pluralistic society. Much of the rich moral conversation germane to the rule has been reflected in arguments about physician-asssisted suicide and voluntary active euthanasia, but the rule itself has limited relevance to these debates, and requires its own moral justifications when applied to other practices that might hasten death. (shrink)

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)

In the Trolley Case (Figure 1), as devised by Philippa Foot and modified by Judith Jarvis Thomson, a runaway trolley (i.e. tram) is headed down a main track and will hit and kill five unless you divert it onto a side track, where it will hit and kill one.

Some commentators argue that conception signals the onset of human personhood and that moral responsibilities toward zygotic or embryonic persons begin at this point, not the least of which is to protect them from exposure to death. Critics of the conception threshold of personhood ask how it can be morally consistent to object to the embryo loss that occurs in fertility medicine and research but not object to the significant embryo loss that occurs through conception in vivo. Using that apparent (...) inconsistency as a starting point, they argue that if that embryo loss is tolerable as a way of conceiving children, it should be tolerable in fertility medicine and human embryonic research. Double-effect reasoning shows, by contrast, that conception in vivo is justified even if it involves the death of persons because the motives for wanting children are not inherently objectionable, because the embryo loss that occurs in unassisted conception is not the means by which successful conception occurs, and because the effect of having children is proportionate to the loss involved. A similar outcome holds true for in vitro fertilisation in fertility medicine but not for in vitro fertilisation for research involving human embryos. (shrink)

The “doctrine of double effect” has a pleasing ring to it. It is regarded by some as the cornerstone of any sound approach to end-of-life issues and by others as religious mumbo jumbo. Discussions about “the doctrine” often generate more heat than light. They are often conducted at cross-purposes and laced with footnotes from Leviticus.

This paper reconsiders whether Aquinas is rightly read as a double-effect thinker and whether it is right to understand him as concurring with Paul’s dictum that evil is not to be done that good may come. I focus on what to make of Aquinas’s position that, though the private citizen may not intend to kill a man in self-defense, those holding public authority, like soldiers, may rightly do so. On my interpretation, we cannot attribute to Aquinas the position (...) that aiming to kill in self-defense is prohibited where so aiming is the only way to stay alive. Instead, for the private citizen though not for the public authority, it is aiming to kill as an end in itself, over and above the aim of saving one’s life, that is prohibited. Accordingly, we also cannot attribute to Aquinas the third condition of the principle of double effect in its textbook formulation. (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)

Legal minds have utilized the principle of double effect as proposed by St. Thomas Aquinas for centuries to shape legal authority in cases where moral judgment and legal reasoning meet. The U.S. Supreme Court had uti­lized double-effect reasoning in the realm of self-defense cases. This article discusses more recent use of double-effect reasoning in the landmark Supreme Court case Vacco v. Quill and its companion case, Washington v. Glucksberg. Chief Justice William Rehnquist, writing for (...) the Court in Vacco, introduced double-effect reasoning to identify the distinctions between palliative care and assisted suicide in an effort to uphold the constitutionality of the ban on assisted suicide in New York. National Catholic Bioethics Quarterly 11.1 (Spring 2011): 41–48. (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)

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)

In the Trolley Case, as devised by Philippa Foot and modified by Judith Jarvis Thomson, a runaway trolley is headed down a main track and will hit and kill five unless you divert it onto a side track, where it will hit and kill one.

In the Trolley Case (Figure 1), as devised by Philippa Foot and modified by Judith Jarvis Thomson, a runaway trolley (i.e. tram) is headed down a main track and will hit and kill five unless you divert it onto a side track, where it will hit and kill one.

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 ; 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)

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 this intended/foreseen distinction has essential ethical significance. (shrink)

The ‘doctrine of double effect’ claims that it is in some sense morally less problematic to bring about a negatively evaluated state of affairs as a ‘side effect’ of one’s pursuit of another, morally unobjectionable aim than it is to bring it about in order to achieve that aim. In a first step, this chapter discusses the descriptive difference on which the claim is built. That difference is shown to derive from the attitudinal distinction between intention and (...) ‘acceptance’, a distinction that is in turn claimed to ground in a feature of the decisions that generate the attitudes in question. The resulting analysis is then plugged into two different normative principles that may each be thought to specify the intuitions behind the doctrine of double effect, but which have frequently been conflated. The first concerns the permissibility of bringing about the merely accepted state of affairs, the second its reduced attributability. It is argued that examination of the intuitions behind the two principles supports neither version of the doctrine. Rather, the intuitions are best captured in an attribution principle based on subjective probabilities and a principle of attitude evaluation, neither of which make explicit reference to the attitude of intending. (shrink)

I discuss the Principle of Double Effect (PDE) as a means of exploring aspects of the motivation of active voluntary euthanasia (a.v.e.). It is argued that the objective of a.v.e. is not death but the relief of suffering. Nor is death the means, it is a concomitant I entertain no hope of convincing the typical proponent of PDE that a.v.e. is morally acceptable. However, I point out that a central strength of the PDE is its insistence on due (...) proportionality between outcomes. When a.v.e. is appropriate, as sometimes it is, death is not out of proportion to the relief of suffering. (shrink)

Two hard cases have generated controversy regarding the application of the principle of double effect in recent years. As regards the first, the case of the conjoined twins of Malta, there has been considerable convergence: most natural law ethicists seem to agree that separation of the twins was morally permissible. By contrast, the so-called “Phoenix case,” involving an abortion at a Catholic hospital for a woman with pulmonary arterial hypertension, has become a touchstone of disagreement between defenders of (...) the so-called “new” natural law theory, and more “traditional” Thomists. I argue in this essay that, contrary to widespread opinion, the two cases were alike in the following respect: in neither need the principal agents have intended the death of anyone. (shrink)

Common morality endorses some form of an exceptionless prohibition against killing innocents. Natural lawyers employ double-effect reasoning to address hard cases involving deaths of the innocent. Current deontologists criticize DER-proponents as conflating act-with agent-evaluations. Scanlon develops this critique extensively. I respond to his criticism. He maintains that the DER-advocate tells a badly-motivated agent to refrain from an obligatory act. Thus, he asserts, the natural lawyer who employs DER errs. Instead, Scanlon proposes, one ought to assess the act as (...) permissible while blaming the agent. I argue that DER does not succumb to this critique. Moreover, Scanlon’s particular criticism nicely shows the reasonableness of the approach the DER-thinker takes, namely, that defective agents produce defective acts. Thus, employing DER does not lead to a confusion of act-with agent-evaluations. Rather, it results in coherent assessments of both. (shrink)

Common morality endorses some form of an exceptionless prohibition against killing innocents. Natural lawyers employ double-effect reasoning to address hard cases involving deaths of the innocent. Current deontologists criticize DER-proponents as conflating act-with agent-evaluations. Scanlon develops this critique extensively. I respond to his criticism. He maintains that the DER-advocate tells a badly-motivated agent to refrain from an obligatory act. Thus, he asserts, the natural lawyer who employs DER errs. Instead, Scanlon proposes, one ought to assess the act as (...) permissible while blaming the agent. I argue that DER does not succumb to this critique. Moreover, Scanlon’s particular criticism nicely shows the reasonableness of the approach the DER-thinker takes, namely, that defective agents produce defective acts. Thus, employing DER does not lead to a confusion of act-with agent-evaluations. Rather, it results in coherent assessments of both. (shrink)

By analogy to justifications offered for craniotomy by Catholic moralists (e.g., Germain Grisez and Rev. Martin Rhonheimer), a recent instance of casuistry (by the moral theologian M. Therese Lysaught) attempts to apply double-effect reasoning and, separately, the concept of a vital conflict to justify dilation and curettage in order to preserve the life of a pregnant woman. This paper examines and rejects these bases for justifying craniotomy and D&C. It concludes with a consideration of Pope John Paul II’s (...) discussion of moral martyrdom in Veritatis splendor. National Catholic Bioethics Quarterly 11.3 (Autumn 2011): 453–463. (shrink)

Common morality endorses some form of an exceptionless prohibition against killing innocents. Natural lawyers employ double-effect reasoning to address hard cases involving deaths of the innocent. Current deontologists criticize DER-proponents as conflating act-with agent-evaluations. Scanlon develops this critique extensively. I respond to his criticism. He maintains that the DER-advocate tells a badly-motivated agent to refrain from an obligatory act. Thus, he asserts, the natural lawyer who employs DER errs. Instead, Scanlon proposes, one ought to assess the act as (...) permissible while blaming the agent. I argue that DER does not succumb to this critique. Moreover, Scanlon’s particular criticism nicely shows the reasonableness of the approach the DER-thinker takes, namely, that defective agents produce defective acts. Thus, employing DER does not lead to a confusion of act-with agent-evaluations. Rather, it results in coherent assessments of both. (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 (...) class='Hi'>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)

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)