The Doctrine of Double Effect

Absolutist systems of ethics have come in for harsh criticism on a number of fronts. The Principle of Double Effect was formulated by Catholic ethicists to overcome such objections. In this essay, Leslie Allan addresses four of the most prominent problems faced by an absolutist ethic and evaluates the extent to which the Principle of Double Effect is successful in avoiding or mitigating these criticisms.

I analyse the relationship between the Doctrine of Double Effect and the Trolley Problem: the former offers a solution for the latter only on the premise that killing the one in Bystander at the Switch is permissible. Here I offer both empirical and theoretical arguments against the permissibility of killing the one: firstly, I present data from my own empirical studies according to which the intuition that killing the one is permissible is neither widespread nor stable; secondly, I defend a (...) normative principle according to which killing the one in Bystander at the Switch is not permissible. In conclusion, there just is no trolley problem. (shrink)

I offer eight arguments against the Doctrine of Double Effect, a normative principle according to which in pursuing the good it is sometimes morally permissible to bring about some evil as a side-effect or merely foreseen consequence: the same evil would not be morally justified as an intended means or end.

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)

In moral dilemmas performing an action often leads to both a good primary and a bad secondary effect. In such cases, how do people judge whether the bad secondary effect was brought about intentionally, and how do they assess the moral value of the act leading to the secondary effect? Various theories have been proposed that either focus on the causal role or on the moral valence of the secondary effect as the primary determinants of intentionality and morality assessments. We (...) present experiments which show that these theories have neglected a further important factor, the primary effect. A new theory is proposed that is based on the key assumption that people’s judgments of intentionality and morality depend on the strength of assumed reasons the agent has for the primary and secondary effects. (shrink)

In recent years, a number of authors – such as Kershnar and Kelly, Steinhoff, and Scanlon – have criticized the doctrine of double effect (DDE) as incoherent, lacking an underlying rationale, or leading to counterintuitive conclusions. These critiques, however, rest on a failure to understand the DDE’s broader theoretical context and presuppositions. This paper aims to clarify and advance the debate regarding the DDE by, first, outlining a contemporary version of the broader normative theory (i.e. the Aristotelian-Thomistic natural law tradition) (...) within which the DDE finds its proper context, and explaining the rationale for the DDE within this context; second, clarifying the DDE’s proportionality condition to avoid common misinterpretations; and, third, showing how the DDE, when properly formulated and understood within the appropriate theoretical context, can withstand the recent criticisms that have been raised against it. (shrink)

Consider three cases: -/- Turn: A trolley is about to kill five innocent strangers. You can turn the trolley onto me, saving the five and killing me. -/- Hurl: A trolley is about to kill five innocent strangers. You can hurl me at the trolley, saving the five and paralyzing me. -/- TurnHurl: A trolley is about to kill five innocent strangers. You can turn the trolley onto me, saving the five and killing me. You can instead hurl me at (...) the trolley, saving the five and paralyzing me. -/- Most find the following four claims intuitively plausible: -/- (1) It is permissible to turn the trolley onto me in Turn. (2) It is impermissible to hurl me at the trolley in Hurl. (3) It is impermissible to turn the trolley onto me in TurnHurl. (4) It is permissible to hurl me at the trolley in TurnHurl. -/- But how does turning go from permissible to impermissible, and hurling from impermissible to permissible, when both alternatives are available? I argue that such “secondary permissibility” claims are explained by contrastive consent. Even if I do not consent to being harmed, it is likely I’ll consent to being hurled at the trolley rather than being turned onto. (shrink)

In 1989, Thomas Donaldson requested the California courts to allow physicians to hasten his death. Donaldson had been diagnosed with brain cancer, and he desired to die in order to cryonically preserve his brain, so as to stop its further deterioration. This case elicits an important question: is this a case of euthanasia? In this article, we examine the traditional criteria of death, and contrast it with the information-theoretic criterion. If this criterion is accepted, we posit that Donaldson’s case would (...) have been cryocide, but not euthanasia. We then examine if cryocide is an ethically feasible alternative to euthanasia. To do so, we rely on the ethical doctrine of double effect. (shrink)

This paper develops a question-sensitive theory of intention. We show that this theory explains some puzzling closure properties of intention. In particular, it can be used to explain why one is rationally required to intend the means to one’s ends, even though one is not rationally required to intend all the foreseen consequences of one’s intended actions. It also explains why rational intention is not always closed under logical implication, and why one can only intend outcomes that one believes to (...) be under one’s control. (shrink)

In this paper I will use sex by deception as a case study for highlighting some of the most tricky concepts around sexuality and moral psychology, including rape, consensual sex, sexual rights, sexual autonomy, sexual individuality, and disrespectful sex. I begin with a discussion of morally wrong sex as rooted in the breach of five sexual liberty rights that are derived from our fundamental human liberty rights: sexual self-possession, sexual autonomy, sexual individuality, sexual dignity and sexual privacy. I then argue (...) (against the standard interpretation) that experimental findings in moral psychology show that the principle of respect for persons—a principle that grounds our human liberty rights—drives our intuitive moral judgments. In light of this discussion, I examine a puzzle about sex by deception—a puzzle which at first may seem to compel us to define 'rape' strictly in terms of force rather than sexual autonomy. I proceed by presenting an argument against the view that, as a rule, sex by deception undermines consent—a position held by prominent thinkers such as Philippe Patry (2001), Onora O’Neill (2003), Rubenfeld (2012), Tom Dougherty (2013a, 2013b), Joyce M. Short (2013), and Danielle Bromwich and Joseph Millum (2013, 2018). As we will see, sex following deception to increase your chances does not always constitute rape. Lying about your age, education, job, family background, marital status, or interest in a relationship, for example, does not make your sex partner incapable of consenting, which is to say that sex by deception need not be rape. I even go so far as to say that sex with another person that is facilitated by withholding information about having a venereal disease shouldn't be classified as rape. Although sex by deception doesn't compromise consent, it nonetheless violates the principle of respect for persons, not by vitiating sexual autonomy and compromising consent, but by failing to respect other sexual rights, such as our rights to sexual dignity, individuality, and privacy. (shrink)

Sometimes one can prevent harm only by contravening rights. If the harm one can prevent is great enough, compared to the stringency of the opposing rights, then one has a lesser-evil justification to contravene the rights. Non-consequentialist orthodoxy holds that, most of the time, lesser-evil justifications add to agents’ permissible options without taking any away. Helen Frowe rejects this view. She claims that, almost always, agents must act on their lesser-evil justifications. Our primary task is to refute Frowe’s flagship argument. (...) Secondarily, it is to sketch a positive case for nonconsequentialist orthodoxy. (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 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)

In this book chapter I argue that contrary to what is said by Paul Guyer in Kant (Routledge, 2006) Kant's moral philosophy prohibits the bystander from throwing the switch to divert the runaway trolley to a side track with an innocent person on it in order to save more people who are in the path of the trolley in the "Trolley Problem" case made famous by Judith Jarvis Thomson (1976; 1985). Furthermore, Thomson herself (2008) came to agree that it would (...) be wrong to throw the switch, just as it is wrong to push the person off the bridge to stop the trolley (1976; 1985). In changing her mind about this case, Thomson came to agree with Kant as well as with Philippa Foot (1967) who argued in her original paper that a negative duty not to harm one healthy patient outweighed a positive duty to give aid to five other patients by transplanting the healthy person's organs. (shrink)

I present the strict definition of intended effects and pose two questions for its critics: Apart from rationalizing moral intuitions about the craniotomy and other controversial cases, why classify an effect as intended if it does not explain the action? What definition of intended effects can people use to guide their actions? These questions show that broad definitions of intended effects have no basis in action theory and are too vague to guide people’s actions. I suggest that broad definitions seem (...) plausible because people confuse what someone intends and what someone is responsible for causing. (shrink)

BackgroundPalliative sedation and analgesia are employed in patients with refractory and intractable symptoms at the end of life to reduce their suffering by lowering their level of consciousness. The doctrine of double effect, a philosophical principle that justifies doing a “good action” with a potentially “bad effect,” is frequently employed to provide an ethical justification for this practice. Main textWe argue that palliative sedation and analgesia do not fulfill the conditions required to apply the doctrine of double effect, and therefore (...) its use in this domain is inappropriate. Furthermore, we argue that the frequent application of the doctrine of double effect to palliative sedation and analgesia reflects physicians’ discomfort with the complex moral, intentional, and causal aspects of end-of-life care. ConclusionsWe are concerned that this misapplication of the doctrine of double effect can consequently impair physicians’ ethical reasoning and relationships with patients at the end of life. (shrink)

According to the principle of double effect, there is a strict moral constraint against bringing about serious harm to the innocent intentionally, but it is permissible in a wider range of circumstances to act in a way that brings about harm as a foreseen but non-intended side effect. This idea plays an important role in just war theory and international law, and in the twentieth century Elizabeth Anscombe and Philippa Foot invoked it as a way of resisting consequentialism. However, many (...) moral philosophers now regard the principle with hostility or suspicion. Challenging the philosophical orthodoxy, Joshua Stuchlik defends the principle of double effect, situating it within a moral framework of human solidarity and responding to philosophical objections to it. His study uncovers links between ethics, philosophy of action, and moral psychology, and will be of interest to anyone seeking to understand the moral relevance of intention. (shrink)

Cooperation in wrongdoing is an everyday matter for all of us, though we need to discern when such cooperation is morally excluded as constituting formal cooperation, as opposed to material (unintended) cooperation whether justified or otherwise. In this paper, I offer examples of formal cooperation such as referral of patients for certain procedures where the cooperating doctor intends an intrinsically wrongful plan of action on the part of the patient and a medical colleague. I also consider a case of formal (...) cooperation where the cooperator intends a choice on the part of another person that is not intrinsically wrong, but wrong in the circumstances because the person believes it will cause serious uncompensated harm. (shrink)

Human society of the modern world, which is greatly affected by technological and economic advancements, has to address moral problems with a new urgency. In many instances, the decision does not bring only positive effects. Such cases can be found in applied ethics: bio-medical ethics, business ethics, and legal ethics, but also in other areas of human activity, too, most recently, in debates, concerning the use of autonomous vehicles or autonomous machines in general. This paper aims to describe and explain (...) the principle of ‘double effect’, when solving complicated and, from the perspective of morality, profoundly dilemmatic situations. The principle of double effect was gradually developed as a means of seeking the right moral decisions. It has a firm and respected position within Catholic medical ethics, but also in secular legislation. The paper presents current thought experiments, which clarify moral decision-making in dilemmatic situations. What seems to be a shortcoming here, is that ethical thought experiments are far too abstract. On the one hand, they refine our knowledge, but on the other hand, they are very partial. The evolution of medical imaging methods, has enabled us to take a closer look at the relationship between the deontological and utilitarian approaches to making moral judgments, but it does not relieve us of our responsibility for the decisions that we have made. The positive side of the principle of double effect, is that it protects us from the slippery slope of utilitarian consequentialism, where the admission of a lesser evil, is only a step away from committing evil in the name of the greater good. (shrink)

If people have stringent moral rights, then the doctrine of double effect is false or unimportant, at least when it comes to making acts permissible or wrong. There are strong and weak versions of the doctrine of double effect. The strong version asserts that an act is morally right if and only if the agent does not intentionally infringe a moral norm and the act brings about a desirable result (perhaps the best state of affairs available to the agent or (...) a promotion of the common good). The weak version asserts that, other things being equal, it is deontically worse to intentionally infringe a norm than to foreseeably do so. A person’s intention or mere foresight might still be relevant to his or her blameworthiness or virtue, but this is a separate issue. (shrink)

El autor recobra las fuentes originales del llamado Dilema del Tranvía pues considera que existe confusión sobre quién es el autor original. Sostiene que no es Phillipa Foot como suele citarse comúnmente, ni siquiera Judith Thomson, sino que sus raíces son más lejanas y se encuentran en dos juristas alemanes: Hans Welzel y, aún antes, Karl Engisch. Propone que la solución al dilema está dada desde el Derecho positivo y no en especulaciones consecuencialistas. ABSTRACT The author recovers the original sources (...) of the so-called Trolley Dilemma because he considers that there is confusion about who the original author is. He argues that it is not Phillipa Foot as it is commonly cited, not even Judith Thomson, but that its roots are more distant and are found in two German jurists: Hans Welzel and, even earlier, Karl Engisch. Proposes that the solution to the dilemma is given from the positive law and not in consequentialist speculations. (shrink)

Lethal organ donation is a hypothetical procedure in which vital organs are removed from living donors, resulting in their death. An important objection to lethal organ donation is that it would infringe the prohibition on doctors intentionally causing the death of patients. I present a series of arguments intended to undermine this objection. In a case of lethal organ donation, the donor’s death is merely foreseen, and not intended.

Many people presume that you can permissibly support the good features of a symbol, person, activity, or work of art while simultaneously denouncing its bad features. This chapter refines and assesses this commonsense (but undertheorized) moral justification for supporting problematic people, projects, and political symbols, and proposes an analogue of the Doctrine of Double Effect called the Doctrine of Double Endorsement (DDN). DDN proposes that when certain conditions are met, it is morally permissible to directly endorse some object in virtue (...) of its positive properties while standing against its negative properties, even though it would be morally impermissible to directly endorse those negative properties themselves. These conditions include separability (the good and bad features must not be inextricably linked), proportionality (the positive value of the good features must be significantly greater than the negative value of the bad features), and constrained choice (there must not be other things that the agent could endorse instead that share the same positive features but are not saddled with the negative ones). The chapter applies these constraints to a number of practical issues, including (among others) voting for morally troubling candidates, supporting Confederate monuments, and consuming sexist art. (shrink)

It is commonly believed that the Doctrine of Double Effect is identical with, or presupposes, the Intention Principle according to which an act can be impermissible if done with a wrongful intention. A main line of objections to the DDE, then, stems from the worry that the Intention Principle implausibly interiorizes the wrongness of an action. I will argue, first, that the DDE does not presuppose the Intention Principle, and, second, that intuitions brought against the Intention Principle do not warrant (...) us to reject the DDE. Therefore, a main line of objections to the DDE is misguided. (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)

Is the “act itself” of separating a pregnant woman and her previable child neither good nor bad morally, considered in the abstract? Recently, Maureen Condic and Donna Harrison have argued that such separation is justified to protect the mother’s life and that it does not constitute an abortion as the aim is not to kill the child. In our article on maternal–fetal conflicts, we agree there need be no such aim to kill (supplementing aims such as to remove). However, we (...) argue that to understand “abortion” as performed only where the death of the child is intended is to define the term too narrowly. Respect for the mother, the fetus, and the bond between them goes well beyond avoiding any such aim. We distinguish between legitimate maternal treatments simply aimed at treating or removing a damaged part of the woman and illegitimate treatments that focus harmfully on the fetal body and its presence within the mother’s body. In obstetrics as elsewhere, not all side effects for one subject of intervention can be outweighed by intended benefits for another. Certain side effects of certain intended interventions are morally conclusive. (shrink)

Many believe that intended harms are more difficult to justify than are harms that result as a foreseen side effect of one's conduct. We describe cases of harming in which the harm is not intended, yet the harmful act nevertheless runs afoul of the intuitive moral constraint that governs intended harms. We note that these cases provide new and improved counterexamples to the so-called Simple View, according to which intentionally phi-ing requires intending to phi. We then give a new theory (...) of the moral relevance of intention. This theory yields the traditional constraint on intending harm as a special case, along with several stronger demands. (shrink)

The principle of double effect has a long history, from scholastic disputations about self-defense and scandal to current debates about terrorism, torture, euthanasia, and abortion. Despite being widely debated, the principle remains poorly understood. In Intention, Character, and Double Effect, Lawrence Masek combines theoretical and applied questions into a systematic defense of the principle that does not depend on appeals to authority or intuitions about cases. Masek argues that actions can be wrong because they corrupt the agent's character and that (...) one must consider the agent's perspective to determine which effects the agent intends. This defense of the principle clears up common confusions and overcomes critics' objections, including confusions about trolley and transplant cases and objections from neuroscience and moral psychology. This book will interest scholars and students in different fields of study, including moral philosophy, action theory, moral theology, and moral psychology. Its discussion of contemporary ethical issues and sparse use of technical jargon make it suitable for undergraduate and graduate courses in applied ethics. The appendix summarizes the main cases that have been used to illustrate or to criticize the principle of double effect. (shrink)

What is the difference between an intended consequence and a foreseen unavoidable consequence? The answer, I argue, turns on the exercise of knowhow knowledge in the process that led to the consequence. I argue for this using a theory according to which acting intentionally is acting as a reason. I show how this gives us a more promising explanation of the difference than the dominant explanations, according to which acting intentionally is acting for a reason.

In this paper, we are concerned with the morality of killing human shields. Many moral philosophers seem to believe that knowingly killing human shields necessarily involves intentionally targeting human shields. If we assume that the distinction between intention and foresight is morally significant, then this view would entail that it is generally harder to justify a military operation in which human shields are knowingly killed than a military operation in which the same number of casualties result as a merely foreseen (...) side effect. We argue, however, that only some cases of knowingly killing human shields should be regarded as intentionally targeting human shields, and thus only those cases face higher bars of justification. We shall formulate different principles that help us to distinguish between cases where a military operation involves the deliberate harming of human shields and cases where it does not. As we shall see, these principles are relevant in scenarios that are all too realistic and common, such as the bombing of legitimate military targets located amid civilian populations. (shrink)

There are different formulations of the doctrine of double effect, and sometimes philosophers propose “revisions” or alternatives, like the means principle, for instance. To demonstrate that such principles are needed in the first place, one would have to compare cases in which all else is equal and show that the difference in intuitions, if any, can only be explained by the one remaining difference and thus by the principle in question. This is not the methodology defenders of the DDE and (...) of related principles use, however. I will discuss how they actually proceed, focusing on their preferred four pairs of examples. While these examples might have rhetorical force, they are nevertheless philosophically and methodologically useless. As a corrective, I shall offer examples that do keep all else equal. These examples undermine the DDE and related principles. I then argue that while the Loop case and the “closeness” problem in the context of Jonathan Bennett’s Sophisticated Bomber example might once have been an embarrassment of sorts for defenders of the DDE, meanwhile their discussion serves as a convenient distraction from the many clear examples disproving the DDE and related principles. I conclude that the methodological mistakes found in defenses of the DDE – the biased framing, the rigged examples, the empirically unwarranted claims about how widely shared certain intuitions are, and the avoidance of the strongest counter-examples – can only be explained by systematic bias. There is simply no sufficient intuitive support for the DDE or related principles. Thus, instead of looking for their “rationales,” they should be abandoned. (shrink)

Arguing against the doctrine of double effect, Bennett claims that the terror bomber only intends to make his victims appear dead. An obvious reply is that he intends to make them appear dead by killing them. I argue that the alleged refutations of this reply rest on a mistaken test question to determine what an agent intends, as Bennett's own test question confirms, and that Bennett is misled by confusing metaphorical death and literal death. Moreover, Bennett's argument is half-hearted anyway, (...) and going the whole way would not only undermine the DDE but also Quinn's revision of it. (shrink)

Experimental research suggests that people draw a moral distinction between bad outcomes brought about as a means versus a side effect (or byproduct). Such findings have informed multiple psychological and philosophical debates about moral cognition, including its computational structure, its sensitivity to the famous Doctrine of Double Effect, its reliability, and its status as a universal and innate mental module akin to universal grammar. But some studies have failed to replicate the means/byproduct effect especially in the absence of other factors, (...) such as personal contact. So we aimed to determine how robust the means/byproduct effect is by conducting a meta-analysis of both published and unpublished studies (k = 101; 24,058 participants). We found that while there is an overall small difference between moral judgments of means and byproducts (standardized mean difference = 0.87, 95% CI 0.67 – 1.06; standardized mean change = 0.57, 95% CI 0.44 – 0.69; log odds ratio = 1.59, 95% CI 1.15 – 2.02), the mean effect size is primarily moderated by whether the outcome is brought about by personal contact, which typically involves the use of personal force. (shrink)

It is a commonplace that there are limits to the ways we can permissibly treat people, even in the service of good ends. For example, we may not steal someone’s wallet, even if we plan to donate the contents to famine relief, or break a promise to help a colleague move, even if we encounter someone else on the way whose need is somewhat more urgent. In other words, we should observe certain constraints against mistreating people, where a constraint is (...) a moral principle that we should not violate, even when that is the only way to prevent further, similar violations or other, greater evils. But, despite its intuitive appeal, the view that there are constraints has drawn considerable criticism, and attempts to provide a rationale for constraints have been, at best, substantially incomplete. In this paper, I develop a novel rationale for constraints that fills important gaps left by views in the literature. The account helps make sense of constraints by identifying a morally significant relation that we bear to people when, and only when, we observe certain constraints against mistreating them. Put roughly, observing these constraints is a condition for being worthy of a form of trust that I call civic trust, and being worthy of such trust is an essential part of living with others in the sort of harmony that characterizes morally permissible interaction. By focusing, in ways other accounts do not, on the role that observing constraints plays in our psychological lives, this approach not only makes the structure of constraints more intelligible, but also helps us better appreciate the force of our reason to observe constraints, and better understand the kind of moral community to which we should aspire. (shrink)

There are a number of cases where, collectively, groups cause harm, and yet no single individual’s contribution to the collective makes any difference to the amount of harm that is caused. For instance, though human activity is collectively causing climate change, my individual greenhouse gas emissions are neither necessary nor sufficient for any harm that results from climate change. Some (e.g., Sinnott-Armstrong) take this to indicate that there is no individual moral obligation to reduce emissions. There is a collective action (...) problem here, to which I offer a solution. My solution rests on an argument for a (sometimes) bare moral difference between intending harm and foreseeing with near certainty that harm will result as an unintended side-effect of one’s action. I conclude that we have a moral obligation to reduce our individual emissions; and, more broadly, an obligation to not participate in many other harmful group activities (e.g., factory-farming). (shrink)

What does it mean to respect life and health in an innocent fellow-human being? Separating conjoined twins where one twin will die as a result need not involve the intention to kill or harm. Arguably, however, not all side-effects are “mere” side-effects which could, in principle, be outweighed by sufficiently good intended effects. Rather, foreseen serious harm for an innocent person we non-therapeutically affect can be morally conclusive when linked to the intention to affect the person’s body or invade the (...) space it fills. In the case of infant conjoined twins, such as the Maltese twins Jodie and Mary, the twin who dies from separation has no unjust, or any, intentions as regards the twin saved. She thus has the moral immunity of any innocent person from lethal bodily invasions and other serious bodily harm. Neither the final act which killed Mary nor previous acts of cutting into Mary, including parts shared with her twin Jodie, were therefore morally permissible. (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)

It is widely believed to be permissible for a physician to discontinue any treatment upon the request of a competent patient. Many also believe it is never permissible for a physician to intentionally kill a patient. I argue that the prospect of deactivating a patient’s artificial heart presents us with a dilemma: either the first belief just mentioned is false or the second one is. Whichever horn of the dilemma we choose has significant implications for contemporary medical ethics.

The mere means principle says it is impermissible to treat someone as merely a means to someone else’s ends. I specify this principle with two conditions: a victim is used as merely a means if the victim does not want the treatment by the agent and the agent wants the presence of the victim’s body. This principle is a specification of the doctrine of double effect which is compatible with moral intuitions and with a restricted kind of libertarianism. An extension (...) of this mere means principle, where not only using but also considering someone as merely a means is immoral, can explain and unify other deontological principles: doing versus allowing, partiality in imperfect duties of beneficence, and the asymmetry of procreational duties. A loop trolley dilemma is often presented as a counterexample of the mere means principle, but I argue that this dilemma generates a moral illusion, comparable to perceptual illusions. (shrink)

In “Modern Moral Philosophy” Anscombe argues that the distinction between intention of an end or means and foresight of a consequentially comparable outcome proves crucial in act-evaluation. The deontologist J. J. Thomson disagrees. She asserts that Anscombe mistakes the distinction’s moral import; it bears on agent-evaluation, not act-evaluation. I map out the contours of this dispute. I show that it implicates other disagreements, some to be expected and others not to be expected. Amongst the expected, one finds the ethicists’ accounts (...) of action and understanding of how agent-assessment relates to act-assessment. Amongst the unexpected, one finds the moralists’ views about the possibility of self-imposed moral dilemmas and allied positions concerning temporal aspects of “ought implies can.” Anscombe’s employment of the distinction in act-evaluation withstands close scrutiny; Thomson’s denial of it does not. (shrink)

The doctrine of double effect is a moral principle that distinguishes between harm we cause as a means to an end and harm that we cause as a side-effect. As a purely descriptive matter, the DDE is well established that it describes a consistent feature of human moral judgment. There are, however, several rival theories of its psychological cause. I review these theories and consider their advantages and disadvantages. Critically, most extant psychological theories of the DDE regard it as an (...) accidental byproduct of cognitive architecture. This may provide philosophers with some reason to question its normative significance. (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 bombing and strategic bombing which dominates this debate is underdetermined with regards to the agents’ psychologies: (a) 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; (b) 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. (shrink)

There has been a great deal of philosophical discussion about using people, using people intentionally, using people as a means to some end, and using people merely as a means to some end. In this paper, I defend the following claim about using people: NOT ALWAYS WRONG: using people—even merely as a means—is not always morally objectionable. Having defended that claim, I suggest that the following claim is also correct: NO ONE FEATURE: when it is morally objectionable to use people, (...) this is for many different kinds of reasons—there is no one wrong-making feature that every morally objectionable using has in common. After discussing these claims, I use them to present and motivate what I call the “precaution” theory of norms against using people. I conclude by considering a few cases from the criminal law context—cases that are naturally described as using people—to assess the moral appropriateness of this kind of use in these cases, and to demonstrate how the theory applies to the real world. (shrink)

It is widely held by moral philosophers that J.J. Thomson’s “Loop Variant,” a version of the Trolley Problem first presented by her in 1985, decisively refutes the Doctrine of Double Effect as the right explanation of our moral intuitions in the various trolley-type cases.See Bruers and Brackman, “A Review and Systematization of the Trolley Problem,” Philosophia 42:2 : 251–269; T. Scanlon, Moral Dimensions: Permissibility, Meaning, Blame ; Peter Singer, “Ethics and Intuitions,” Journal of Ethics 9:314 : 331–352, p. 340; Matthew (...) Liao, “The Loop Case and Kamm’s Doctrine of Triple Effect,” Philosophical Studies 146:2 : 223–231; H. Sauer, “Morally Irrelevant Factors: What’s Left of the Dual Process Model of Moral Cognition?,” Philosophical Psychology 25:6 : 783–811, p. 797. Frances Kamm suggests the DDE can be saved from the objection, but only by radically revising it into a doctrine of “Triple Effect” (In .. (shrink)

In this paper, we defend the general thesis that intentions are relevant not only to moral permissibility and impermissibility, but also to criminal wrongdoing, as well as a specific version of the Doctrine of Double Effect that we believe can help solve some challenging puzzles in the criminal law. We begin by answering some recent arguments that marginalize or eliminate the role of intentions as components of criminal wrongdoing [e.g., Alexander and Ferzan, Chiao, Walen ]. We then turn to some (...) influential theories that articulate a direct role for intentions [e.g., Duff, Husak ]. While we endorse the commitment to such a role for intentions, we believe that extant theories have not yet been able to adequately address certain objections or solve certain puzzles, such as that some attempt convictions require criminal intent when the crime attempted, if successful, requires only foresight, and that some intended harms appear to be no more serious than non-intended ones of the same magnitude, for example. Drawing on a variety of resources, including the specific version of the Doctrine of Double Effect we have developed in recent published work, we present solutions to these puzzles, which in turn provide mutual support for our general approach to the role of intentions and for thinking that using others as means is itself a special kind of wrongdoing. (shrink)

David K. Chan provides an account of various mental entities that interact with each other to produce human action. Once we have a theory of human action, Chan states, we will be in a better position to examine how to evaluate human actions from a moral perspective. I will address only two sets of claims that I don't find convincing. The first concerns Chan's idea that we need to introduce a new category of non-intentional action (besides intentional and unintentional) to (...) account for actions that do not result from practical reasoning. The second concerns Chan's claim that the traditional Doctrine of Double Effect is not tenable, and needs to be replaced by another doctrine he introduces. (shrink)

Is there a reason to prevent deontological wrongdoing—an action that is wrong due to the violation of a decisive deontological constraint? This question is perplexing. On the one hand, the intuitive response seems to be positive, both when the question is considered in the abstract and when it is considered with regard to paradigmatic cases of deontological wrongdoing such as Bridge and Transplant. On the other hand, common theoretical accounts of deontological wrongdoing do not entail this answer, since not preventing (...) wrongdoing does not necessarily amount to doing harm or intending harm, for example. The puzzle is reinforced due to the fact that the intuitive response to other cases seems to be different, namely that there is no reason in favour of preventing deontological wrongdoing. This question is thus interesting in itself. It might also shed light on additional questions such as the “paradox of deontology” and the appropriate response to wrongful actions more generally. Yet, despite its importance, this question is typically overlooked. The paper explores this question. (shrink)