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

The use of intention in ethics has been the subject of intense debate for many years, but no consensus has emerged over whether intention is morally relevant, or even how it should be understood. In this paper I wish to make a thorough, though by no means exhaustive, examination of the concept and the concepts around it, some to be seen as near-synonyms, and some as contrasting ideas. My interest is in the ethical use of the concept, though my own (...) analysis of it will be indebted to discussions in the philosophy of action. The most famous ethical use, which will not, however, be my direct focus here, is the ‘principle of double effect,’ which states that an agent may cause or allow something bad as long as, first, no evil is intended as an end or a means; and, second, that the foreseen bad is not out of proportion with the anticipated good. It is important to note the principle’s testimony to the plausibility of prohibitions expressed in terms of intentions, and, alongside these, a general prohibition on doing inordinate harms even without intention. (shrink)

The use of intention in ethics has been the subject of intense debate for many years, but no consensus has emerged over whether intention is morally relevant, or even how it should be understood. In this paper I wish to make a thorough, though by no means exhaustive, examination of the concept and the concepts around it, some to be seen as near-synonyms, and some as contrasting ideas. My interest is in the ethical use of the concept, though my own (...) analysis of it will be indebted to discussions in the philosophy of action. The most famous ethical use, which will not, however, be my direct focus here, is the ‘principle of double effect,’ which states that an agent may cause or allow something bad as long as, first, no evil is intended as an end or a means; and, second, that the foreseen bad is not out of proportion with the anticipated good. It is important to note the principle's testimony to the plausibility of prohibitions expressed in terms of intentions (indicated by the first condition), and, alongside these, a general prohibition on doing inordinate harms even without intention (indicated by the second condition). (shrink)

There is a puzzle about the very possibility of foreseen but unintended side effects, and solving this puzzle requires us to revise our basic picture of the structure of practical deliberation. The puzzle is that, while it seems that we can rationally foresee, but not intend, bringing about foreseen side effects, it also seems that we rationally must decide to bring about foreseen side effects and that we intend to do whatever we decide to do. I propose solving this puzzle (...) by rejecting the idea that we intend to do whatever we decide to do. My solution involves taking account of the underappreciated role that qualified intentions play in deliberation. I also argue that this solution fares better than those that instead reject the idea that we rationally must decide to bring about foreseen side effects, for these solutions are committed to rejecting the even more compelling idea that decisions rationally serve as the conclusions of practical deliberation. (shrink)

Recent empirical work appears to suggest that the moral intuitions of professional philosophers are just as vulnerable to distorting psychological factors as are those of ordinary people. This paper assesses these recent tests of the ‘expertise defense’ of philosophical intuition. I argue that the use of familiar cases and principles constitutes a methodological problem. Since these items are familiar to philosophers, but not ordinary people, the two subject groups do not confront identical cognitive tasks. Reflection on this point shows that (...) these findings do not threaten philosophical expertise—though we can draw lessons for more effective empirical tests. (shrink)

Thought: A Journal of Philosophy, EarlyView.

The difficulty of distinguishing between the intended and the merely foreseen consequences of actions seems to many to be the most serious problem for the doctrine of double effect. It has led some to reject the doctrine altogether, and has left some of its defenders recasting it in entirely different terms. I argue that these responses are unnecessary. Using Bratman’s conception of intention, I distinguish the intended consequences of an action from the merely foreseen in a way that can be (...) used to support the doctrine of double effect. (shrink)

This paper argues that practical reasoning is a mental process which leads a person from a set of existent mental states to an intention. In Section 1, I defend this view against two other proposals according to which practical reasoning either concludes in an action itself or in a normative belief. Section 2 discusses the correctness of practical reasoning and explains how the correctness of instrumental reasoning can be explained by the logical relations that hold between the contents of the (...) mental states. In Section 3, I explore the correctness of normative practical reasoning. I conclude with the sceptical view that correct practical reasoning cannot require us to intend to do what we believe we ought to do. (shrink)

The trolley problem, first described by Foot (1967) and Thomson (The Monist, 59, 204–217, 1976), is one of the most famous and influential thought experiments in deontological ethics. The general story is that a runaway trolley is threatening the lives of five people. Doing nothing will result in the death of those persons, but acting in order to save those persons would unavoidably result in the death of another, sixth person. It appears that, depending on the situation, we have different (...) moral judgments about the permissibility of action. We will review and systematize all the proposals in the literature of the past 35 years that have attempted to grasp our moral intuitions in a simple deontological principle. In particular, seventeen proposals will be classified: six algorithmic, seven psychological, and four other invalid accounts. This review and classification sheds light on some subtle differences and clarify a few issues. (shrink)

This paper deals with the core version of the Trolley Problem. In one case many people favor an act which will bring about the death of one person but save five other persons. In another case most people would refuse to “sacrifice” one person in order to save five other lives. Since the two cases seem similar in all relevant respects, we have to explain and justify the diverging verdicts. Since I don’t find current proposals of a solution convincing, I (...) propose an alternative one according to which —but not —violates two forms of equality. I also test the underlying egalitarian principle against other cases. I argue that it offers a good explanation and also a normative justification of our intuitive verdicts about the cases. (shrink)

The orthodox account of the morality of war holds that the responsibility for resorting to war rests on the state’s political authorities and the responsibility for how the war is waged rests only on the state’s army and, thus, business firms have no special obligations in wartime. The purpose of this article is to reconsider the ethical responsibilities of business firms in wartime. I defend the claim that a plausible standard of liability in war must integrate the degree of the (...) agent’s contributions to posing an unjust threat, the nature of agent's behavior, and his/her intentions. If these premises are correct, it follows that the moral obligations of civilians and business corporations are fundamentally altered by war. Taking into consideration their relative contributions to the war effort, a taxonomy of business firms is developed. (shrink)

Many believe that if the indiscriminate bombings of German cities at the beginning of World War II were necessary for preventing unlimited spread of Nazism, then the bombings were justified. For, the outcome, in which innocent Germans living in Nazi Germany are killed, was not as bad as the outcome in which the Nazis inflict ethnic cleansing and enslavement on a massive scale. Recently, however, Daniel Statman has advanced a powerful case against this type of justification. I aim in this (...) paper to develop an enriched version of consequentialism which rescues the "lesser evil elucidation" of the Exemption. (shrink)