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)

This paper is part of a larger project. My overall aim is to argue that the evolution of familiar forms of termination of life sustaining treatment, constituting so called passive euthanasia,1 has severaly undercut the logic of every form of reasoning that has traditionally been used to oppose active euthanasia and assistance in suicide. Basically, there are two such forms of traditional opposition, each represented in a range of different versions. There is the inevitable argument concerning social utilities — that (...) permitting euthanasia and assisted suicide will have bad social consequences. But more fundamentally, the idea persists that killing is intrinsically worse than letting‐die in some sense that justifies the current practice of prohibiting the first while allowing the latter. In this paper, I first consider this latter claim. My ultimate strategy, as I have said, is to show that the nature of certain things we have all come to approve regarding termination of treatment makes it next to impossible to convincingly explain, in either of these ways, what is wrong with certain forms of assistance in suicide and euthanasia. In the second part of this paper I take another step in this direction by discussing, in a preliminary way, a special case of the argument from social risks. (shrink)

The intentional punishment of the innocent is ordinarily claimed to be a special problem for utilitarian theories of punishment. The unintentional punishment of the innocent is a problem for any theory of punishment which holds that the guilty should be punished. This paper examines the criteria that are relevant to a determination of the appropriate probability of punishment mistakes for a society, and argues that this is the kind of moral problem for which utilitarian judgments, as opposed to considerations of (...) justice, are most appropriate. To illustrate some of the trade-offs involved, the paper employs some hypothetical data. (shrink)

This paper examines the absolutist grounds for denying an agent's responsibility for what he allows to happen in 'keeping his hands clean' in acute circumstances. In defending an agent's non-prevention of what is, viewed impersonally, the greater harm in such cases, absolutists typically insist on a difference in responsibility between what an agent brings about as opposed to what he allows. This alleged difference is taken to be central to the absolutist justification of non-intervention in acute cases: the agent's obligation (...) not to do harm is held to be more stringent than his obligation to prevent (comparable) harm, since as agents we are principally responsible for what we ourselves do. The paper's central point is that this representation of the absolutist response to acute cases- as grounded in a difference in responsibility for what we do as opposed to what we allow- involves a misleading theoretical inversion. I argue that the absolutist justification of non-intervention in acute cases must depend on a direct defence of the nature and the stringency of the moral norm with which the agent's non-intervention complies. The nature and stringency of this norm are basic to attribution of agent responsibility in acute cases, and not the other way around. (shrink)

A puzzle has been presented in the recent past in Northern Ireland: what is the correct description of the person who dies as a result of a hungerstrike? For many the simple answer is that such a person commits suicide, in that his is surely a case of . Where then is the puzzle? It is that a number of people do not see such deaths as suicides. I am not here referring to political propagandists or paramilitaries, for whom the (...) correct description of such deaths is or (to quote advertisements in the Belfast nationalist press at the time of Bobby Sands' death). I am rather thinking of some theologians who, despite being opposed to the hunger-strike and indeed publicly condemning the whole campaign, refused to describe what the hunger-strikers did as suicide. (shrink)

A number of practices at the end of life can causally contribute to diminished consciousness in dying patients. Despite overlapping meanings and a confusing plethora of names in the published literature, this article distinguishes three types of clinically and ethically distinct practices: double-effect sedation, parsimonious direct sedation, and sedation to unconsciousness and death. After exploring the concept of suffering, the value of consciousness, the philosophy of therapy, the ethical importance of intention, and the rule of double effect, these three practices (...) are defined clearly and evaluated ethically. It is concluded that, if one is opposed to euthanasia and assisted suicide, double-effect sedation can frequently be ethically justified, that parsimonious direct sedation can be ethically justified only in extremely rare circumstances in which symptoms have already completely consumed the patient’s consciousness, and that sedation to unconsciousness and death is never justifiable. The special case of sedation for existential suffering is also considered and rejected. (shrink)

One of the most important questions in the debate over the morality of euthanasia and assisted suicide is whether an important distinction between killing patients and allowing them to die exists. The U.S. Supreme Court, in rejecting challenges to the constitutionality of laws prohibiting physician-assisted suicide, explicitly invoked this distinction, but did not explicate or defend it. The Second Circuit of the U.S. Court of Appeals had previously asserted, also without argument, that no meaningful distinction exists between killing and allowing (...) to die. That court had reasoned that if this were so, it would be discriminatory to allow persons on life support to end their lives by removing such treatment, while those who are not connected to life support would be denied similar access to death. (shrink)

Opponents of euthanasia sometimes argue that it is incompatible with the purpose of medicine, since physicians have an unconditional duty never to intentionally cause death. But it is not clear how such a duty could ever actually be unconditional, if due consideration is given to the moral weight of countervailing duties equally fundamental to medicine. Whether physicians' moral duties are understood as correlative with patients' moral rights or construed noncorrelatively, a doctor's obligation to abstain from intentional killing cannot be more (...) than a defeasible duty. (shrink)

If killing another human being is morally wrong on at least some occasions, what precisely makes it wrong on those occasions? I have framed the question thus to indicate that I shall not be considering the view that killing another human being is always and everywhere morally wrong. I take it as read that there are at least some morally justifiable killings. Once it is clear what is wrong with killing on some occasions it should become possible to explain why (...) it is not wrong on others. My immediate concern is with the killing of another human being, and with applying my answer to cases of voluntary and non-voluntary euthanasia, but light will be shed on whether and, if so, why it is wrong to kill oneself, to kill unborn human beings, and to kill non-human animals especially those whose life has most in common with the life of human beings. (shrink)

A puzzle has been presented in the recent past in Northern Ireland: what is the correct description of the person who dies as a result of a hungerstrike? For many the simple answer is that such a person commits suicide, in that his is surely a case of ‘self-inflicted death’. Where then is the puzzle? It is that a number of people do not see such deaths as suicides. I am not here referring to political propagandists or paramilitaries, for whom (...) the correct description of such deaths is ‘murder by Mrs Thatcher’ or ‘killed by British intransigence’. I am rather thinking of some theologians who, despite being opposed to the hunger-strike and indeed publicly condemning the whole campaign, refused to describe what the hunger-strikers did as suicide. (shrink)

In this article I attempt to show conclusively that the apparent intrinsic difference between causing collateral damage and directly attacking innocents is an illusion. I show how eleven morally irrelevant alterations can transform an apparently permissible case of harming as a side-effect into an apparently impermissible case of harming as a means. The alterations are as obviously irrelevant as the victims’ skin colour, and consistently treating them as relevant would have unacceptable implications for choices between more and less harmful ways (...) of securing greater goods. This shows not only how the principles philosophers have proposed for distinguishing between these cases cannot withstand scrutiny, but how we can be sure that there are no relevant differences yet to be discovered. I conclude by considering reasons to think that there are deontological constraints against harming, but that they apply just as forcefully against collateral harms as they do against intended harms. (shrink)

This paper is about the idea of a moral distinction between doing harm and allowing harm to occurr. It discusses, and developes a general argument against, the version of the distinction often described as counterfactual, which I characterize in terms of making a moral difference between different ways of causing harm (in contrast to, e.g., the version famously discussed by Jonathan Bennett). The gist of the argument is that all variants of this version of the doing-allowing idea would have to (...) make factors out of the agent's control into wrong-making characteristics and that, therefore, this version violates a plausible extension of the principle that 'ought' implies 'can'. (shrink)

Philosophers traditionally have been concerned both to explain intentional behavior and to evaluate it from a moral point of view. Some have maintained that whether actions (and their consequences) properly count as intended sometimes hinges on moral considerations - specifically, considerations of moral responsibility. The same claim has been made about an action's properly counting as having been done intentionally. These contentions will be made more precise in subsequent sections, where influential proponents are identified. Our aim in this paper is (...) to show that familiar defenses of these more precise claims are unpersuasive and that the claims do not merit acceptance. Our concern, more broadly, is to illuminate the place occupied by intention and intentional action in a conceptual scheme suited both to explanatory needs in the philosophy of mind to evaluative needs in moral philosophy. (shrink)

This report explores the relationship between philosophy and medicine in the U.K. We note that medical training involves very little formal instruction in philosophy and ethics, and that, with few exceptions, philosophers in the U.K. do not contribute to the instruction of physicians or the philosophy of medicine. However, reviewing the problems arising out of recent developments within scientific medicine we find a pressing need for future philosophical analysis in the following areas: psychiatry, organ transplantation, abortion, euthanasia, experiments on living (...) subjects, consent, confidentiality, the relationship between medicine and political authority, and the provisions for social justice in medicine. (shrink)

Philosophical ethics comprises metaethics, normative ethics and applied ethics. These have characteristically received analytic treatment by twentieth-century Anglo-American philosophy. But there has been disagreement over their interrelationship to one another and the relationship of analytical ethics to substantive morality – the making of moral judgments. I contend that the expertise philosophers have in either theoretical or applied ethics does not equip them to make sounder moral judgments on the problems of bioethics than nonphilosophers. One cannot "apply" theories like Kantianism or (...) consequentialism to get solutions to practical moral problems unless one knows which theory is correct, and that is a metaethical question over which there is no consensus. On the other hand, to presume to be able to reach solutions through neutral analysis of problems is unavoidably to beg controversial theoretical issues in the process. Thus, while analytical ethics can play an important clarificatory role in bioethics, it can neither provide, nor substitute for, moral wisdom. Keywords: abortion, applied ethics, bioethics, metaethics, normative ethics CiteULike Connotea Del.icio.us What's this? (shrink)

This paper argues that a precautionary approach to scientific progress of the sort advocated by Walter Glannon with respect to life-extending therapies involves both incoherence and irresolvable paradox. This paper demonstrates the incoherence of the precautionary approach in many circumstances and argues that with respect to life-extending therapies we have at present no persuasive reasons for a moratorium on such research.

This article has two main sections. In Section I, I argue against the skeptic's position. I examine an attempt to see both prima facie objections as arising from features that killing and letting die have in common, and then argue that all such attempts are doomed to failure. In Section II, I explain how even defenders of the distinction's significance have misconstrued the difference between the two objections. In so doing I attempt to develop a better account of why killing (...) and letting die are prima facie objectionable. I also briefly explore some related matters. (shrink)

The author argues that there is no morally relevant distinction between letting and making death happen, and between withholding and withdrawing life-support. There is a discussion of possible adverse consequences in believing that there are moral distinctions. And then he shows that acknowledging the absence of such a distinction does not necessarily imply any endorsement of active euthanasia.

My interest is in two of the four conditions which must be satisfied if the doctrine of double effect is to be successfully employed. One of these involves the distinction between direct and oblique intention, And I deny that this distinction is the index of character or goodness adherents to the doctrine take it to be. Rather, I emphasize the notion of "control responsibility", In considering several cases around which discussion of the doctrine has focused. I develop this notion, In (...) the course of rejecting several attempts to render it superfluous, And then sustain it, In the face of a possible rival. Finally, I consider a second condition of the doctrine, One which turns upon the view that the order of causation between an evil and a good effect of an act is morally significant, And I suggest that this view is mistaken. (shrink)

We can distinguish two kinds of moral universalization tests for practical principles. One requires that the universal practice of the principle, i.e., universal conformity to it by all agents in a given world, satisfies some condition. The other requires that conformity to the principle by any possible agent, in any situation and at any time, satisfies some condition. We can call these universal practice and universal applicability tests respectively. The logical distinction between these tests is rarely appreciated, and many philosophers (...) systematically confuse them with each other. In practice, UP tests are more frequently used to defend deontological norms, while UA tests are used to defend consequentialist norms. Both conceptual argument and practical examples of their applications will show that UA tests are decisively superior to UP tests for grounding moral norms, casting greater doubt upon deontological theories which rely upon the latter unless they can reformulate their arguments using some version of a UA test. (shrink)

The aim of the article is to present some of the differences and similari- ties in various versions of the double effect principle. The following formulations will be analyzed: that of Thomas Aquinas and two contemporary ap- proaches, namely those of Mangan and Boyle. It will be shown that the presented modern versions vary significantly and the distinction between their intended and only predicted effects is far from clear. As a result, the different contemporary for- mulations of DDE lead to (...) contradictory conclusions, with some justifying what the others condemn. Moreover, it will be demonstrated that, unlike Aquinas, contem- porary authors mostly concentrate on unintentionality condition while neglecting the proportionality requirement. So, unlike Aquinas, they only take into account a narrow scope of cases, where the evil effect occurs with certainty, which leads to a complicated and intricate hypothetical intention test like Donagan’s. It will be shown that, besides its theoretical indistinctness, DDE lead to serious pragmatic risks. It can be quite easily misused as a kind of psychological mechanism to protect self-esteem from a sense of guilt since wrong-doing is treated as merely a predicted unintended effect. (shrink)

The Principle of Double Effect has served as a guide for both statesmen and soldiers since the middle ages in determining which acts in war are morally permissible and which are not. It is used, in particular, by those who make their moral decisions on the basis of certain moral rules that concern the moral consequences of action. This Principle of Double Effect (hereafter referred to as PDE) comes into play in situations where an agent has the option of performing (...) an act with both good and bad consequences. Advocates of PDE believe that it is morally significant whether a bad consequence is intended by the agent or merely forseen as incidental to an act that is in all other respects morally acceptable.^ Of great interest to moral philosophers discussing acts of war is how this principle applies to the deaths of persons not directly involved in the prosecution of the war. Proponents of the PDE claim that while it is morally impermissible to intentionally bring about the deaths of innocent people during combat, either as a means to a military objective or as a goal in itself, it is permissible under certain circumstances for an agent to choose a course of action which may bring about the deaths of innocent people as a forseeable consequence. (shrink)

A critical survey of the main philosophical theories about events and event talk, organized in three main sections: (i) Events and Other Categories (Events vs. Objects; Events vs. Facts; Events vs. Properties; Events vs. Times); (ii) Types of Events (Activities, Accomplishments, Achievements, and States; Static and Dynamic Events; Actions and Bodily Movements; Mental and Physical Events; Negative Events); (iii) Existence, Identity, and Indeterminacy.

Morality seems important, in the sense that there are practical reasons — at least for most of us, most of the time — to be moral. A central theoretical motivation for consequentialism is that it appears clear that there are practical reasons to promote good outcomes, but mysterious why we should care about non-consequentialist moral considerations or how they could be genuine reasons to act. In this paper we argue that this theoretical motivation is mistaken, and that because many arguments (...) for consequentialism rely upon it, the mistake substantially weakens the overall case for consequentialism. We argue that there is indeed a theoretical connection between good states and reasons to act, because good states are those it is fitting to desire and there is a conceptual connection between the fittingness of a motive and reasons to perform the acts it motivates. But while some of our motives are directed at states, others are directed at acts themselves. We contend that just as the fittingness of desires for states generates reasons to promote the good, the fittingness of these act-directed motives generates reasons to do other things. Moreover, we argue that an act’s moral status consists in the fittingness of act-directed feelings of obligation to perform or avoid performing it, so the connection between fitting motives and reasons to act explains reasons to be moral whether or not morality directs us to promote the good. This, we contend, de-mystifies how there could be non-consequentialist reasons that are both moral and practical. (shrink)

The problem of act individuation is a debate about the identity conditions of human acts. The fundamental question about act individuation is: how do we distinguish between actions? Three views of act individuation have dominated the literature. First, Donald Davidson and G.E.M. Anscombe have argued that a number of different descriptions refer to a single act. Second, Alvin Goldman and Jaegwon Kim have argued that each description designates a distinct act. Finally, Irving Thalberg and Judith Jarvis Thomson have averred that (...) some acts are sequences of causally related events, which include both a primitive bodily action and some of its effects. All of these accounts have assumed that a simple invariantist account of act individuation captures how ordinary people distinguish between acts. For my dissertation, I devised an experiment to test the action theorists' assumptions. My data show that people's intuitions seem to depend on the valence of the consequences of the action under consideration. So, an invariantist account is not possible. In light of the empirical results, I argue that if we seek a folk account of act individuation, then that account should be able to explain the variability that seems to be present in people's intuitions about different cases. (shrink)

People commonly believe that any form of deception, no matter how innocuous it is and no matter whether the deceiving person intended it otherwise, is always morally wrong. In this paper, I will argue that deceiving in real-time is morally distinguishable from deceiving on-line because online actions aren’t as fine-grained as actions occurring in real-time. Our failure to detect the fine-grained characteristics of another avatar leads us to believe that that avatar intended to do a moral harm. Openly deceiving someone (...) on Facebook or Twitter is not a way to build wholesome virtual friendships but to destroy them. This paper will show how the traditional understanding of the doing / allowing distinction fails to apply in cyberspace. (shrink)

This thesis will utilise the literature on the distinction between doing harm and allowing harm to develop a novel system of moral sequencing that can be applied to general moral problems to decide if, when, and how an agent should intervene to prevent harm from occurring to another agent. Off the back of this discussion, this thesis will offer a way of determining the responsibility of certain agents for their actions within a moral sequence. These motivations will be at the (...) centre of the discussions in this thesis and will be accomplished by ultimately updating the system of moral sequencing so that it makes sense of practical cases of inner-agent change, which itself provides a justification for intervening earlier, and potentially diminishing the responsibility for agents who have experienced an inner-agent change, in a moral sequence. (shrink)

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.