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)

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)

A number of common and generally noncontroversial practices in the care of patients at the end of life lead to their deaths. For example, physicians honor a patient's refusal of medical intervention even when doing so leads to the patient's death. Similarly, with a patient's or surrogate's consent, physicians administer sedatives in order to relieve pain and distress at the end of life, even when it is known that doing so will cause the patient's death. In contemporary U.S. public policy, (...) these practices are accepted as ethical and legal while physician-assisted suicide (PAS) isrejected in current U.S. law and public policy. Some think, however, that if one accepts practices that are known to lead to a patient's death, then one cannot reasonably reject a patient's request for a lethal dose of medication so that she may kill herself (PAS). (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)

This paper concerns the deficiencies of currentlyaccepted principles governing the fair use ofelectronically recorded data when applied to geneticinformation. Principles are proposed by which to dealwith the unique group-characteristics of geneticinformation.

Among the oldest extant medical ethics, the Hippocratic Oath prohibits the giving of a deadly drug, regarding this act as an egregious violation of a medical ethic that is exclusively therapeutic. Proportionate palliative sedation involves the administration of a deadly drug. Hence it seems to violate the venerable Hippocratic promise associated with the dawn of Western medicine not to give a deadly drug. Relying on distinctions commonly employed in the analysis and evaluation of human actions, this article distinguishes physician-assisted suicide (...) and euthanasia, as acts that necessarily violate the prohibition against giving a deadly drug, from proportionate palliative sedation, as an act that does not. (shrink)

In contemporary ethical discourse generally, and in discussions concerning the legalization of physician‐assisted suicide (PAS) and voluntary active euthanasia (VAE) specifically, recourse is sometimes had to the Nazi! accusation. Some disputants charge that such practices are or will become equivalent to the Nazi ‘euthanasia’ program in which over 73,000 handicapped children and adults were killed without consent. This paper reflects on the circumstances that lead to the use of this charge and offers reasons for putting the Nazi! charge aside in (...) contemporary discussions of PAS and VAE. A number of the philosophical presuppositions common to both the Nazi ‘euthanasia’ program and the currently proposed practices of PAS and VAE are examined. Noting that racist ideology and violent coercion characterized the Nazi program, the paper concludes with a cautionary consideration of the current circumstances that would specify PAS and VAE in the US. (shrink)

Itself a topic of constant comment, the Internet's implications for healthcare remain unclear even while its boundaries incessantly expand. The WorldWide Web and allied technologies such as telephony are clearly permanent fixtures of our world. These technologies have changed our ways of life and demonstrate further dynamic capacities to do so. They speak of what we shall be, but know not.

Proponents commonly justify the legalization of physician-assisted suicide (PAS) in terms of a patient's wanting to die (autonomy) and the patient's having a medically established good reason for suicide. These are the common elements of the standard justification offered for the legalization of PAS. In what follows, I argue that these two conditions exist in significant tension with one another, operating according to distinct dynamics that render the justification for PAS an unstable basis for public policy. Moreover, no natural connection (...) keeps these two criteria united. Indeedthe two elements of the justification oppose and threaten to exclude one another. Thus, the PAS justification is too labile a basis for sound public policy. (shrink)