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.

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)

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 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)

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)

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)

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)

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)

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)

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.

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)

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)

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)

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)

In this article Judith Jarvis Thomson's Good Samaritan Argument in defense of abortion in the case of rape is defended from two objections: the Kill vs. Let Die Objection, and the Intend to Kill vs. Merely Foresee Death Objection. The article concludes that these defenses do not defend Thomson from further objections from Peter Singer and David Oderberg.

A traditional idea is that moral judgment involves more than calculating the consequences of actions; it also requires an assessment of the agent's intentions, the act's nature, and whether the agent uses another person as a means to her ends. I survey experimental developments suggesting that ordinary people often tacitly reason in terms of such deontological rules. It's now unclear whether we should posit a traditional form of the doctrine of double effect. However, further research suggests that a range of (...) non-consequentialist factors influence moral judgment, including intentions, commissions, personal harm, and agent-centered commitments. Many, if not all, such factors appear to affect how involved the agent is in bringing about an outcome. (shrink)

Agent-centered constraints on harming hold that some harmful upshots of our conduct cannot be justified by its generating equal or somewhat greater benefits. In this paper I argue that all plausible theories of agent-centered constraints on harming are undermined by the likelihood that our actions will have butterfly effects, or cause cascades of changes that make the world dramatically different than it would have been. Theories that impose constraints against only intended harming or proximally caused harm have unacceptable implications for (...) choices between more and less harmful ways of securing greater goods. This leaves as plausible only theories that impose constraints against causing some unintended distal harms. But, I argue, given the distal harms our actions are likely to cause through their butterfly effects, these theories entail that any way of sustaining our lives is overwhelmingly likely to involve unjustified killing, and that we are therefore morally required either to allow ourselves to waste away or kill ourselves. (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 article focuses on the ethical implications of so-called ‘collateral damage’. It develops a moral typology of collateral harm to innocents, which occurs as a side effect of military or quasi-military action. Distinguishing between accidental and incidental collateral damage, it introduces four categories of such damage: negligent, oblivious, knowing and reckless collateral damage. Objecting mainstream versions of the doctrine of double effect, the article argues that in order for any collateral damage to be morally permissible, violent agents must comply with (...) high standards of care. In order for incidental harm to be permissible, an agent must take pains to avoid such harm even at higher cost to him- or herself. It is argued that accidentally but negligently caused collateral damage may be just as difficult to excuse as incidental harm. Only if high precautionary standards of care are met, can unintended harm to innocents – incidental or accidental – be permissible. In practice, such a strong commitment to avoiding harm to civilians may well lead us to question more generally and rethink more radically how violent conflicts ought to be fought, how military violence ought to be used and whether there are better ways of achieving those aims that we think are legitimate than those we are currently using. (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 Bomber and Strategic Bomber which dominates this debate is underdetermined in three crucial respects: (1) the non-psychological worlds of Terror Bomber and Strategic Bomber; (2) the psychologies of Terror Bomber and Strategic Bomber; and (3) the structure of the thought-experiment, especially in relation to its similarity with the Trolley Problem. (1) If the two (...) worlds are not identical, then it may be these differences between the two worlds and not the Doctrine of Double Effect to explain the moral difference; (2a) 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; (2b) 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. Finally, (3) the Strategic Bomber scenario could also be constructed so as to be structurally equivalent to the Fat Man scenario in the Trolley Problem: but then the Doctrine of Double Effect would give different answers to two symmetrical cases. (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 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)

Judith Jarvis Thomson has recently proposed a new argument for the thesis that killing the one in the Trolley Problem is not permissible. Her argument relies on the introduction of a new scenario, in which the bystander may also sacrifice herself to save the five. Thomson argues that those not willing to sacrifice themselves if they could may not kill the one to save the five. Bryce Huebner and Marc Hauser have recently put Thomson's argument to empirical test by asking (...) people what they should do in the new trilemma case, in which they may also sacrifice themselves. They found that the majority judge that they should either kill the one or sacrifice themselves; Huebner and Hauser argue that those numbers speak against Thomson's argument. But Thomson's argument was about the dialectical effect of the new trilemma on the traditional dilemma, rather than about the trilemma itself. Here I present the results of a study in which I asked subjects first what they should do in the trilemma and then what they should do in the traditional Trolley Problem. I found that, if asked first about the trilemma, subjects then have the intuition that killing the one in the traditional Bystander at the Switch is not permissible?exactly what Thomson's argument had predicted. (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)

I argue that the Doctrine of Double Effect is accepted because of unreliable processes of belief-formation, making it unacceptably likely to be mistaken. We accept the doctrine because we more vividly imagine intended consequences of our actions than merely foreseen ones, making our aversions to the intended harms more violent, and making us judge that producing the intended harms is morally worse. This explanation fits psychological evidence from Schnall and others, and recent neuroscientific research from Greene, Klein, Kahane, and Schaich (...) Borg. It explains Mikhail and Hauser’s “universal moral grammar” and an interesting phenomenon about Double Effect cases noted by Bennett. When unequally vivid representations determine our decisions, we typically misjudge the merits of our options and make mistakes. So if Double Effect is a product of unequal vividness, it is likely to be mistaken. This argument, I claim, fits Berker’s specifications for good empirically grounded arguments in ethics. (shrink)

Philosophers debate over the truth of the Doctrine of Doing and Allowing, the thesis that there is a morally significant difference between doing harm and merely allowing harm to happen. Deontologists tend to accept this doctrine, whereas consequentialists tend to reject it. A robust defence of this doctrine would require a conceptual distinction between doing and allowing that both matches our ordinary use of the concepts in a wide range of cases and enables a justification for the alleged moral difference. (...) In this article, I argue not only that a robust defence of this doctrine is available, but also that it is available within a consequentialist framework. (shrink)

Utilitarianism is the strand of moral philosophy that holds that judgment of whether an act is morally right or wrong, hence whether it ought to be done or not, is primarily based upon the foreseen consequences of the act in question. It has a bad reputation in military ethics because it would supposedly make military expedience override all other concerns. Given that the utilitarian credo of the greatest happiness for the greatest number is in fact agent-neutral, meaning that the consequences (...) to everyone should weigh equally, this critique of utilitarianism is not entirely fair. By focusing on some anomalies in both the principle of double effect and in our tendency to give priority to the interests of those who are near and dear to us, this article argues that there is something to be said for a military ethic that attaches less weight to intentions, and more to the consequences. (shrink)

There are two kinds of view in the literature concerning the relevance of intention to permissibility. While subjectivism assumes that an agent acts permissibly if he or she believes that the conduct is necessary for a moral purpose, for objectivism the de facto presence of an objective reason to justify one’s deeds is what matters. Recently, Scanlon and Hanser defend a moderate version of objectivism and subjectivism, respectively. Although I have a degree of sympathy toward both views, I will argue (...) that the truth lies somewhere in between. The view that I suggest in this paper hopefully occupies a space between subjectivism and objectivism and can accommodate the intuitions that neither of those views cannot account for. (shrink)

Philosophers from Hart to Lewis, Johnston and Bennett have expressed various degrees of reservation concerning the doctrine of double effect. A common concern is that, with regard to many activities that double effect is traditionally thought to prohibit, what might at first look to be a directly intended bad effect is really, on closer examination, a directly intended neutral effect that is closely connected to a foreseen bad effect. This essay examines the extent to which the commonsense concept of intention (...) supports a reasonably consistent and coherent application of double effect. Two important conclusions are these: (1) a number of traditionally proscribed activities involve a kind of “targeting” of innocents that can be taken to exhibit a direct intention to harm them; (2) a direct intention to harm need not involve a desire to harm in any ordinary sense of the latter expression. (shrink)

Frances Kamm’s Intricate Ethics1 lives up to its title. It presents the methods and contents of Kamm’s nonconsequentialist ethical theory with discussion of some alternatives, both substantive and methodological. The main focus is on the distinctions that non- consequentialist ethical theory draws between different ways of bringing about states of affairs. This is presented in Kamm’s char- acteristic style. Readers should expect highly complex, subtle arguments as Kamm draws out fine-grained distinctions from intuitive responses to cases. Those who find their (...) intuitions less than firm at such a level of detail may find Intricate Ethics frustrat- ing at times. Nonetheless, it is a highly significant work. It dis- cusses issues at the heart of nonconsequentialist ethical theory with prodigious insight and clarity of thought. Even those whose intuitions prevent them from following Kamm to her conclusions will find the discussion along the way richly rewarding. (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)

An extended discussion with Frances Kamm about deontology and the methodology of ethical theorizing. (An extended and revised version appears in Alex Voorhoeve, Conversations on Ethics, OUP 2009).).

In this article, responding to assertions that the principle of double effect has no place in legal analysis, I explore the overlap between double effect and negligence analysis. In both, questions of culpability arise in situations where a person acts with no intent to cause harm but where reasonable foreseeability of unintended harm exists. Under both analyses, the determination of whether such conduct is permissible involves a reasonability test that balances that foreseeable harm against the good intended by the actor's (...) conduct. In both, absent a finding that the foreseeable harm is unreasonable in light of that intended good, no liability will be imposed upon the actor. Even conceding, however, such general similarity between double effect and negligence analysis - disagreement over the proper interpretation of the reasonability criterion at play in negligence poses an additional challenge for the attempt to correlate negligence with double effect. Economic efficiency interpretations of negligence, for example, purportedly based on the Learned Hand Formula and the RESTATEMENT (SECOND) OF THE LAW OF TORTS, propose that culpability depends upon a utilitarian balancing of good effects of conduct (utility) versus its harmful foreseeable consequences (magnitude of risk of injury). Based on such an interpretation of negligence, however, contrasts between actors' states of mind, and normative differences between kinds of goods and harms, ultimately fade into the background and become irrelevant as essential conditions for properly assessing liability. This article elaborates and defends the view that double effect analysis lies at the heart of negligence theory. Part I elucidates in more detail the principle of double effect and describes its prima facie operation in negligence analysis. Part II considers and rejects the economic efficiency interpretation that has been offered as a theory of negligence, overcoming the challenge that such an interpretation presents for the effort to locate double effect analysis in the law. Part III illustrates and confirms the overlap between double effect and negligence by consideration of a series of case applications. The Article proposes that the weighing of conflicting values in double effect analysis and negligence is not achieved - as proposed by law and economics theory with respect to negligence - by imposing a consequentialist-utilitarian reduction of all value to a single concept of good and eliminating the relevance of traditional state of mind distinctions between intention and foreseeability. Instead, each mode of analysis recognizes that distinct culpability determinations flow naturally and plausibly from an appreciation of the traditional legal distinctions made between various types of goods and harms, and upon whether such goods and harms come about as result of an actor's intention or mere foreseeability. Keywords: Double effect, negligence, intention, foreseeability, choice, law and economics, utilitarianism, consequentialism, weighing of values. (shrink)

Abstract: In Vacco v. Quill, 521 U.S. 793 (1997), the Supreme Court for the first time in American case law explicitly applied the principle of double effect to reject an equal protection claim to physician-assisted suicide. Double effect, traced historically to Thomas Aquinas, proposes that under certain circumstances it is permissible unintentionally to cause foreseen evil effects that would not be permissible to cause intentionally. The court rejected the constitutional claim on the basis of a distinction marked out by the (...) principle, i.e., between directly intending the death of a terminally ill patient as opposed to merely foreseeing that death as a consequence of medical treatment. The Court held that the distinction comports with fundamental legal principles of causation and intent. Id. at 802. -/- Critics allege that the principle itself is intrinsically flawed and that, in any event, its employment in Vacco is without legal precedent. I argue in response to contemporary objections that double effect is a valid principle of ethical reflection (Part II); claims to the contrary notwithstanding, double effect analysis is a pervasive, albeit generally unacknowledged principle employed regularly in American case law (Part III); and drawing on the preceding two sections, Vacco's application of the principle of double effect is appropriate (Part IV). -/- My conclusion is that [o]peration of some form of the principle, by whatever name, is inevitable. In an imperfect world where duties and interests collide, the possibility of choices of action foreseen to have both good and evil consequences cannot be avoided. In rare circumstances, ethics and the law require that a person refrain from acting altogether. More often, however, they provide that a determination of whether an actor may pursue a good effect although knowing it will or may unintentionally cause an harmful effect requires a more complex analysis - a double effect analysis. -/- Keywords: Equal protection, double effect, intention, physician-assisted suicide, Constitutional Law, Bioethics. (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)

One of the reasons why most of us feel puzzled about the problem of abortion is that we want, and do not want, to allow to the unborn child the rights that belong to adults and children. When we think of a baby about to be born it seems absurd to think that the next few minutes or even hours could make so radical a difference to its status; yet as we go back in the life of the fetus we (...) are more and more reluctant to say that this is a human being and must be treated as such. No doubt this is the deepest source of our dilemma, but it is not the only one. For we are also confused about the general question of what we may and may not do where the interests of human beings conflict. We have strong intuitions about certain cases; saying, for instance, that it is all right to raise the level of education in our country, though statistics allow us to predict that a rise in the suicide rate will follow, while it is not all right to kill the feeble-minded to aid cancer research. It is not easy, however, to see the principles involved, and one way of throwing light on the abortion issue will be by setting up parallels involving adults or children once born. So we will be able to isolate the “equal rights” issue and should be able to make some advance... (shrink)

The principle of the double effect is one of the most practical in the study of moral theology. As a principle it is important not so much in purely theoretical matters as in the application of theory to practical cases. It is especially necessary in the subject matter of scandal, material cooperation, illicit pleasure and of injury done to oneself or to another. Although it is a fundamental principle, it is far from a simple one; and moralists readily admit its (...) complexity. Moreover, it is not an inflexible rule or mathematical formula, but rather an efficient guide to prudent moral judgment in solving the more difficult cases. (shrink)