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)

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)

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)

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)

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)

The standard version of the doctrine of double effect, a significant doctrine in applied ethics particularly medical ethics, not only fails to capture some morally significant components of Aquinas’ view, but it does not resort to proper complementary features in order to accommodate the doctrine to our moral intuitions. We attempt to offer a new formulation of the doctrine incorporating the main components of Aquinas’ view and also to extend the view using some complementary features. We (...) will examine the strength of the formulation applying it into some ethically controversial situations, mainly in medical ethics. (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)

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)

Manuel Velasquez and F. Neil Brady apply the doctrine of double effect to business ethics and conclude that the doctrine allows a pharmaceutical company to sell a drug with potentially fatal side effects only if it also has the good effect of saving lives. This forbidsthe sale of many common products, such as automobiles and alcohol. My account preserves the virtues of the doctrine of double effectwithout making it too restrictive. I apply the doctrine to (...) a pharmaceutical company’s decision to market a drug with dangerous side effects and argue that free markets often offer the best way to compare the good and bad effects of business decisions. I conclude that the doctrine does allow a business to sell a potentially fatal product that does not save lives, provided that it warns consumers about the danger. (shrink)

The use of terminal sedation to control theintense discomfort of dying patients appearsboth to be an established practice inpalliative care and to run counter to the moraland legal norm that forbids health careprofessionals from intentionally killingpatients. This raises the worry that therequirements of established palliative care areincompatible with moral and legal opposition toeuthanasia. This paper explains how thedoctrine of double effect can be relied on todistinguish terminal sedation from euthanasia. The doctrine of double effect is rooted (...) inCatholic moral casuistry, but its applicationin law and morality need not depend on theparticular framework in which it was developed. The paper further explains how the moral weightof the distinction between intended harms andmerely foreseen harms in the doctrine of doubleeffect can be justified by appeal to alimitation on the human capacity to pursue good. (shrink)

After the terrorist attacks of September 11, 2001, most legacy airlines filed for bankruptcy protection as a way to cut costs drastically, with the exception of American Airlines. This article applies the Principle of Double-Effect to the act of filing for Chapter 11 bankruptcy protection for reasons of management strategy, in particular, cost-cutting. It argues that the Principle can be a useful tool for discerning the ethicality of the action, and demonstrates the usefulness by proposing three double- (...) class='Hi'>effect criteria that, when fulfilled, argues for the ethical justifiability the action in question. (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)

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)

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)

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)

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)

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)

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)

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)

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)

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.

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)

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)

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)

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 U.S. Supreme Court's majority opinion in Vacco v. Quill assumes that the principle of double effect explains the permissibility of hastening death in the context of ordinary palliative care and in extraordinary cases in which painkilling drugs have failed to relieve especially intractable suffering and terminal sedation has been adopted as a last resort. The traditional doctrine of double effect, understood as providing a prohibition on instrumental harming as opposed to incidental harming or harming asa (...) side effect, must be distinguished from other ways in which the claim that a result is notintended might be offered as part of ajustification for it. Although double effectmight appropriately be invoked as a constrainton ordinary palliative care, it is not clearthat it can be coherently extended to justifysuch practices as terminal sedation. A betterapproach would reconsider double effect'straditional prohibition on hastening death as ameans to relieve suffering in the context ofacute palliative care. (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)

ABSTRACTBusiness actors often act in ways that may harm other parties. While the law aims to restrict harmful behavior and to provide remedies, legal systems do not anticipate all contingencies and legal regulations are not always well-enforced. This article argues that the logic of double effect, which has been developed and deployed in other areas of practical ethics, can be useful in helping business actors decide whether or not to pursue potentially harmful activities in commonplace business activity. (...) The article illustrates how LDE helps to explain the exploitative nature of payday lending, the distinction between permissible and impermissible forms of market competition, and the potential wrong of imposing risk of harm on others. The article also addresses foundational debates about LDE itself. We offer the article as an illustration of the sort of “midlevel” theorizing that can address directly the needs of practitioners. (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 has a firm, respected position within Roman Catholic medical ethics. Neil M. Gorsuch, a judge on the U.S. Court of Appeals for the Tenth Circuit, believes that this doctrine also enjoys a central place within U.S. law. This essay examines and assesses Gorsuch’s thesis. National Catholic Bioethics Quarterly 11.1 (Spring 2011): 31–40.

There are some interesting similarities between Aristotle’s ‘mixed actions’ in Book III of the Nicomachean Ethics and the actions often thought to be justifiable with the Doctrine of Double Effect. Here I analyse these similarities by comparing Aristotle’s examples of mixed actions with standard cases from the literature on double effect such as, amongst others, strategic bombing, the trolley problem, and craniotomy. I find that, despite some common features such as the dilemmatic structure and the (...) inevitability of a bad effect, Aristotle’s mixed actions do not count as cases justifiable through application of the Doctrine of Double Effect because they fail to meet the crucial necessary condition of the Doctrine according to which the bad effect can only be a merely foreseen side-effect and not an intended means. (shrink)

I argue that the moral distinction in double effect cases rests on a difference not in intention as traditionally stated in the Doctrine of Double Effect (DDE), but in desire. The traditional DDE has difficulty ensuring that an agent intends the bad effect just in those cases where what he does is morally objectionable. I show firstly that the mental state of a rational agent who is certain that a side-effect will occur satisfies Bratman's (...) criteria for intending that effect. I then clarify the nature of the moral distinction in double effect cases and how it can be used to evaluate the moral blameworthiness of agents rather than the moral status of acts. The agent's blameworthiness is reduced not by his lack of intention but by his desire not to bring about the side-effect, and the 'counterfactual test' can be used to determine whether he desires the effect in acting. In my version, the DDE has its rationale in virtue ethics; it is not liable to abuse as the traditional version is; and it makes more plausible distinctions when applied to standard examples. (shrink)

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

This paper examines the doctrine of double effect as it is typically applied. The difficulty of distinguishing between what we intend and what we foresee is highlighted. In particular, Warren Quinn's articulation of that distinction is examined and criticised. It is then proposed that the only credible way that we can be said to foresee that a harm will result and mean something other than that we intend it to result, is if we are not certain that that (...) harm will result. The ramifications of this are explored. The paper concludes with a moral evaluation of a variety of cases that have harmful outcomes. It is recommended both that we abandon the doctrine of double effect and that we cease to describe cases with harmful outcomes in a dishonest way. (shrink)

Few moral theorists would disagree that the fundamental principle of morality – perhaps of practical rationality itself – is “ Do good and avoid evil. ” Yet along with such an uncontroversial principle comes a major question: Can you fulfi l both halves satisfactorily across your life as a moral agent? We all have opportunities to perform acts that do good with no accompanying evil, but these are not as common as we might think. We can avoid evil by doing (...) nothing, but doing nothing implies doing no good either. Clearly the fundamental principle does not require that you go about your life doing good on any and every possible occasion any more than that you sit on your hands and abstain from action out of fear of doing evil. The principle tells us to avoid evil, not to refrain from ever causing it. And the simple fact is that the complexities of life make it inevitable that, much of the time when we go about doing good, we will also be doing evil. Further, they are such that sometimes we can avoid evil only at the cost of not performing a good act which reasonable people would regard as at least permissible, if not sometimes obligatory. So how, as rational, morally responsible agents, are we to satisfy the fundamental principle in an adequate, harmonious fashion, given life ’ s exigencies? This is where the so - called ‘ doctrine of double effect ’ comes into play. Some call it a doctrine, infl uenced by the fact that Catholic ethicists and moral theologians have, since the Middle Ages, codifi ed and ratifi ed it as something akin to a doctrine of Catholic moral philosophy. Others call it the ‘ principle of double effect, ’ though it breaks down into a set of principles unifi ed by a common idea. Yet other writers see it simply as a kind of reasoning about certain types of hard case in ethics. Whatever the preferred nomenclature, the DDE, as I will call it here, is – for all its critics and the diffi culties it faces – a keystone of sound moral thinking, without which the fundamental principle would remain nothing but a high ideal with little consistent applicability. So consider a simple example.. (shrink)

Abstract: This essay consists of some clarifying remarks on the doctrine of double effect (DDE). After providing a contemporary formulation of the doctrine we put special emphasis on the distinction between those aspects of an action plan that are intended and those that are merely foreseen (the I/F distinction). Making use of this distinction is often made difficult in practice because salient aspects of the action plan exhibit a felt “closeness” to one another that is difficult if not (...) impossible to articulate with the precision we might like. The essay goes on to examine an especially adroit criticism of DDE best articulated by J.J. Thomson. We conclude with a brand new double effect case (new to the philosophical literature anyway) taken from medicine and Roman Catholic pastoral ministry. (shrink)

. How does the doctrine of double effect apply to business decisions to sell products which may be harmful to consumers? Lawrence Masek believes that some authors have misapplied the doctrine to this type of decision and, as a consequence, have committed themselves to placing unwarranted constraints on businesses. Seeking to correct this mistake, Masek presents his account of how the doctrine applies here, an account which is rather permissive but which, he claims, nevertheless preserves the virtues of (...) the doctrine. It will be seen, though, that his attempt to loosen these putatively unnecessary constraints by appealing to consumer autonomy and an intuition about the morality of producing harmful products leaves the doctrine of double effect irrelevant to this type of decision. His argument that the doctrine is less restrictive in this context than others suppose leads ultimately to the conclusion that the doctrine does not constrain this kind of business decision at all. (shrink)

Recent discussions of the doctrine of double effect have contained improved versions of the doctrine not subject to some of the difficulties of earlier versions. There is no longer one doctrine of double effect. This essay evaluates four versions of the doctrine: two formulations of the traditional Catholic doctrine, Joseph Boyle's revision of that doctrine, and Warren Quinn's version of the doctrine. I conclude that all of these versions are flawed. Keywords: double effect, intention, (...) Joseph Boyle, medical ethics, Warren Quinn CiteULike Connotea Del.icio.us What's this? (shrink)

In Australian end-of-life care, practicing euthanasia or physician-assisted suicide is illegal. Despite this, death hastening practices are common across medical settings. Practices can be clandestine or overt but in many instances physicians are forced to seek protection behind ambiguous medico-legal imperatives such as the Principle of Double Effect. Moreover, the way they conceptualise and experience such practices is inconsistent. To complement the available statistical data, the purpose of this study was to understand the reasoning behind how and why (...) physicians in Australia will hasten death. (shrink)

The Rule of Double Effect has played an important role in bioethics, especially during the last fifty years. Its major application in bioethics has been in providing physicians who are opposed to euthanasia with a moral justification for using opioid analgesics in treating the pain of patients whose death might thereby be hastened. It has also prominently been applied to certain obstetric cases. The scope of application of double effect is actually much broader than medical (...) class='Hi'>ethics, extending to cover such topics as strategic bombing in warfare. This article, while general in theory, concentrates on its applications in medical ethics. (shrink)

Double-effect reasoning (DER) is attributed to Aquinas "tout court". Aquinas's account, however, differs from contemporary DER insofar as Thomas considers the ethical status of "risking" an assailant's life while contemporary accounts focus on actions causing harm inevitably. Since one cannot claim to risk the inevitable, and since there is a significant difference between risking harm and causing harm inevitably. Thomas's account does not extend to cases of inevitable harm. Thus, the received understanding of Aquinas's account is flawed and (...) leads to untenable attributions of the direction of intention to Aquinas and to misunderstandings of contemporary DER. (shrink)

In this new book Moral Dimensions, T. M. Scanlon (2008) explores the ethical significance of the intentions and motives with which people act. According to Scanlon, these intentions and motives do not have any direct bearing on the permissibility of the act. Thus, Scanlon claims that the traditional Doctrine of Double Effect (DDE) is mistaken. However, the way in which someone is motivated to act has a direct bearing on what Scanlon calls the act's "meaning". One particularly important (...) kind of "meaning" that an act can have consists in the ways in which it is appropriate for various people to blame the agent for the act. So the book ends with an extended analysis of blame and blameworthiness. (shrink)

In Catholic moral theology, the principle of double effect has been an effective normative tool for centuries, and it can be used to determine the ethicality of actions that contain both good and evil consequences. The principle of double effect is especially useful in end-of-life care, because many end-of-life treatment options inherently have both good and evil conse­quences. The principle of double effect can be used to make both practical and moral distinctions between the (...) acts of euthanasia, physician-assisted suicide, palliative sedation, and the withholding and withdrawal of life-sustaining treatment, which can be classified as either unjustified acts of killing or jus­tifiable acts of allowing to die. (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)