This book, like the practice of medicine itself, is about the value of life. Health care is one of the clearest and most visible expressions of a society's ...

In this major new book, the internationally renowned thinker Jonathan Bennett offers a deeper understanding of what is going on in our own moral thoughts about human behavior. The Act Itself presents a conceptual analysis of descriptions of behavior on which we base our moral judgements, and shows that this analysis can be used as a means toward getting more control of our thoughts and thus of our lives.

The paper outlines and explores a possible strategy for defending both the action/omission distinction (AOD) and the principle of double effect (PDE). The strategy is to argue that there are degrees of actionhood, and that we are in general less responsible for what has a lower degree of actionhood, because of that lower degree. Moreover, what we omit generally has a lower degree of actionhood than what we actively do, and what we do under known-but-not-intended descriptions generally has a lower (...) degree of actionhood than what we do under known-and-intended descriptions. Therefore, we are in general less responsible for what we omit than for what we do—which is just what AOD says. And we are in general less responsible for what we do under known-but-not-intended descriptions than for what we do under known-and-intended descriptions—which is just what PDE says. (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)

As medical technology advances and severely injured or ill people can be kept alive and functioning long beyond what was previously medically possible, the debate surrounding the ethics of end-of-life care and quality-of-life issues has grown more urgent. In this lucid and vigorous book, Craig Paterson discusses assisted suicide and euthanasia from a fully fledged but non-dogmatic secular natural law perspective. He rehabilitates and revitalises the natural law approach to moral reasoning by developing a pluralistic account of just why we (...) are required by practical rationality to respect and not violate key demands generated by the primary goods of persons, especially human life. Important issues that shape the moral quality of an action are explained and analysed: intention/foresight; action/omission; action/consequences; killing/letting die; innocence/non-innocence; person/non-person. Paterson defends the central normative proposition that ’it is always a serious moral wrong to intentionally kill an innocent human person, whether self or another, notwithstanding any further appeal to consequences or motive’. (shrink)

This classic work examines the issues surrounding military theory, war crimes, and the spoils of war from the Athenian attack on Melos to the My Lai massacre.

Is the science of moral cognition usefully modelled on aspects of Universal Grammar? Are human beings born with an innate 'moral grammar' that causes them to analyse human action in terms of its moral structure, with just as little awareness as they analyse human speech in terms of its grammatical structure? Questions like these have been at the forefront of moral psychology ever since John Mikhail revived them in his influential work on the linguistic analogy and its implications for jurisprudence (...) and moral theory. In this seminal book, Mikhail offers a careful and sustained analysis of the moral grammar hypothesis, showing how some of John Rawls' original ideas about the linguistic analogy, together with famous thought experiments like the trolley problem, can be used to improve our understanding of moral and legal judgement. (shrink)

For thirty years, Peter Singer's Practical Ethics has been the classic introduction to applied ethics. For this third edition, the author has revised and updated all the chapters and added a new chapter addressing climate change, one of the most important ethical challenges of our generation. Some of the questions discussed in this book concern our daily lives. Is it ethical to buy luxuries when others do not have enough to eat? Should we buy meat from intensively reared animals? Am (...) I doing something wrong if my carbon footprint is above the global average? Other questions confront us as concerned citizens: equality and discrimination on the grounds of race or sex; abortion, the use of embryos for research and euthanasia; political violence and terrorism; and the preservation of our planet's environment. This book's lucid style and provocative arguments make it an ideal text for university courses and for anyone willing to think about how she or he ought to live. (shrink)

Applied Ethics focuses the central concepts of traditional morality from the companion book Moral Theory - rights, justice, the good, virtue, and the fundamental value of human life - on a number of pressing contemporary problems, including abortion, euthanasia, animals, capital punishment, and war.

_Ethics: The Fundamentals_ explores core ideas and arguments in moral theory by introducing students to different philosophical approaches to ethics, including virtue ethics, Kantian ethics, divine command theory, and feminist ethics. The first volume in the new Fundamentals of Philosophy series. Presents lively, real-world examples and thoughtful discussion of key moral philosophers and their ideas. Constitutes an excellent resource for readers coming to the subject of ethics for the first time.

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)

John Mackie's stimulating book is a complete and clear treatise on moral theory. His writings on normative ethics-the moral principles he recommends-offer a fresh approach on a much neglected subject, and the work as a whole is undoubtedly a major contribution to modern philosophy.The author deals first with the status of ethics, arguing that there are not objective values, that morality cannot be discovered but must be made. He examines next the content of ethics, seeing morality as a functional device, (...) basically the same at all times but changing significantly in response to changes in the human condition. He sketches a practical moral system, criticizing but also borrowing from both utilitarian and absolutist views. Thirdly, the frontiers of ethics, areas of contact with psychology, metaphysics, theology, law and politcs, are explored.Throughout, his aim is to discuss a wide range of questions that are both philosophical and practical, working within a distinctive version of subjectivism-an "error" theory of the apparent objectivity of values. John Mackie has drawn on the contributions of such classic thinkers as Plato, Aristotle, Hobbes, Hume, Kant and Sidgwick, and on more recent discussions, to produce a thought-provoking account that will inspire both the general reader and the student of philosophy. (shrink)

Over the course of its first seven editions, Principles of Biomedical Ethics has proved to be, globally, the most widely used, authored work in biomedical ethics. It is unique in being a book in bioethics used in numerous disciplines for purposes of instruction in bioethics. Its framework of moral principles is authoritative for many professional associations and biomedical institutions-for instruction in both clinical ethics and research ethics. It has been widely used in several disciplines for purposes of teaching in the (...) classroom, during conferences, etc. (shrink)

The illusory appeal of double effect -- The significance of intent -- Means and ends -- Blame.

In this paper, I argue that the doctrine of double effect is disposed toward abuse. I try to identify two distinct sources of abuse of double effect: the conditions associated with standard formulations of double effect and the difficulty of fully understanding one’s own intentions in action. Both of these sources of abuse are exacerbated in complex circumstances, where double effect is most often employed. I raise this concern about abuse not as a criticism of double effect but rather as (...) a problem that defenders should observe and try to prevent. I go on to suggest certain methods for avoiding the abuse of double effect such as hesitating to use it, applying it only with other agents, and selectively and carefully propagating it. (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)

1. The traditional position and the pressures for change. The Western legal tradition -- The Christian ethical hinterland -- The exceptional value of human life -- The justification of taking human life -- Suicide -- Christian ethics, assisted suicide, and voluntary euthanasia -- The cultural pressures for change -- 2. The value of human life -- 3. The morality of acts of killing -- 4. Slippery slopes.

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)

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)

Humanitarian interventions aim at saving human lives, but they also take human lives. The death of innocent people is an unintended but foreseen consequence of military actions. Can this be morally justified? Those who argue from a deontological perspective and give an affirmative answer to this question, point to the Principle of Double Effect (PDE). Others, also arguing from a deontological perspective, nevertheless reject the PDE and give a negative answer to the above question. In this paper I argue that (...) an adequate interpretation of the PDE brings these two positions closer together. A deontological (rather than the prevalent consequentialist) interpretation of the reference to proportionality within the PDE should bring even the proponents of the PDE to an approximately pacifist position. (shrink)

A major challenge to the Doctrine of Double Effect is the concern that an agent’s intention can be identified in such a fine-grained way as to eliminate an intention to harm from a putative example of an intended harm, and yet, the resulting case appears to be a case of impermissibility. This is the so-called “closeness problem.” Many people believe that one can address the closeness problem by adopting Warren Quinn’s version of the DDE, call it DDE*, which distinguishes between (...) harmful direct agency and harmful indirect agency. In this paper, I first argue that Quinn’s DDE* is just as vulnerable to the closeness problem as the DDE is. Second, some might think that what we should therefore do is give up on intentions altogether and move towards some kind of non-state-of-mind, victim-based deontology. I shall argue against this move and explain why intentions are indispensable to an adequate nonconsequentialist theory. Finally, I shall propose a new way of answering the closeness problem. (shrink)

The doctrine of double effect has a firm, respected position within Roman Catholic medical ethics. In addition, public debate often incorporates this doctrine when determining the acceptability of certain actions. This essay examines and assesses the application of this doctrine to end-of-life decisions. National Catholic Bioethics Quarterly 11.1 (Spring 2011): 99–119.

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)

Many philosophers think that if you're morally responsible for a state of affairs, you must be a cause of it. Ingmar Persson argues that this strand of common sense morality is asymmetrical, in that it features the act-omission doctrine, according to which there are stronger reasons against performing some harmful actions than in favour of performing any beneficial actions. He analyses the act-omission doctrine as consisting in a theory of negative rights, according to which there are rights not to have (...) one's life, body, and property interfered with, and a conception of responsibility as being based on causality. This conception of responsibility is also found to be involved in the doctrine of double effect. The outcome of Persson's critical examination of these ideas is that reasons of rights are replaced by reasons of beneficence, and we are made responsible for what is under the influence of our practical reasons. The argument gives rise to a symmetrical, consequentialist morality which is more demanding but less authoritative than common sense morality, because reasons of beneficence are weaker than reasons of rights. It is also argued that there are no non-naturalist external practical reasons, and all practical reasons are desire-dependent: so practical reasons cannot be universally binding. The question is whether such a morality possesses enough authority to command our compliance. This seems necessary in order for us to cope with the greatest moral problems of our time, such as aid to developing countries and anthropogenic climate change. (shrink)

The doctrine of double effect continues to be an important tool in bioethical casuistry. Its role within the Catholic moral tradition continues, and there is considerable interest in it by contemporary moral philosophers. But problems of justification and correct application remain. I argue that if the traditional Catholic conviction that there are exceptionless norms prohibiting inflicting some kinds of harms on people is correct, then double effect is justified and necessary. The objection that double effect is superfluous is a rejection (...) of that normative conviction, not a refutation of double effect itself. This justification suggests the correct way of applying double effect to controversial cases. But versions of double effect which dispense with the absolutism of the Catholic tradition lack justification and fall to the objection that double effect is an unnecessary complication. Keywords: double effect, intention, side effect CiteULike Connotea Del.icio.us What's this? (shrink)

Against the domination of moral deliberation by rights-talk In Defence of War asserts that belligerency can be morally justified, even while it is tragic and morally flawed. Recovering the early Christian tradition of just war thinking, Nigel Biggar argues in favour of aggressive war in punishment of grave injustice.

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)

There are different formulations of the doctrine of double effect (DDE), and sometimes philosophers propose “revisions” or alternatives, like the means principle, for instance. To demonstrate that such principles are needed in the first place, one would have to compare cases in which all else is equal and show that the difference in intuitions, if any, can only be explained by the one remaining difference and thus by the principle in question. This is not the methodology defenders of the DDE (...) and of related principles use, however. I will discuss how they actually proceed, focusing on their preferred four pairs of examples. While these examples might have rhetorical force, they are nevertheless philosophically and methodologically useless (since they do not keep all else equal). As a corrective, I shall offer examples that do keep all else equal. These examples undermine the DDE and related principles. I then argue that while the Loop case and the “closeness” problem in the context of Jonathan Bennett’s Sophisticated Bomber example might once have been an embarrassment of sorts for defenders of the DDE, meanwhile their discussion serves as a convenient distraction from the many clear examples disproving the DDE and related principles. I conclude that there is simply no sufficient intuitive support for the DDE or related principles. Instead of looking for their “rationales,” they should be abandoned. (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)

According to the classical Doctrine of Double Effect, there is a morally significant difference between intending harm and merely foreseeing harm. Versions of DDE have been defended in a variety of creative ways, but there is one difficulty, the so-called “closeness problem”, that continues to bedevil all of them. The problem is that an agent's intention can always be identified in such a fine-grained way as to eliminate an intention to harm from almost any situation, including those that have been (...) taken to be paradigmatic instances in which DDE applies to intended harm. In this paper, we consider and reject a number of recent attempts to solve the closeness problem. We argue that the failure of these proposals strongly suggests that the closeness problem is intractable, and that the distinction between intending harm and merely foreseeing harm is not morally significant. Further, we argue that there may be a deeper reason why such attempts must fail: the rationale that makes the best fit with DDE, namely, an imperative not to aim at evil, is itself irredeemably flawed. While we believe that these observations should lead us to abandon further attempts to solve the closeness problem for DDE, we also conclude by showing how a related principle that is supported by a distinct rationale and avoids facing the closeness problem altogether nevertheless shares with DDE its most important features, including an intuitive explanation of a number of cases and a commitment to the relevance of intentions. (shrink)

The Rule of Double Effect (RDE) holds that it may be permissible to harm an individual while acting for the sake of a proportionate good, given that the harm is not an intended means to the good but merely a foreseen side-effect. Although frequently used in medical ethical reasoning, the rule has been repeatedly questioned in the past few decades. However, Daniel Sulmasy, a proponent who has done a lot of work lately defending the RDE, has recently presented a reformulated (...) and more detailed version of the rule. Thanks to its greater precision, this reinvented RDE avoids several problems thought to plague the traditional RDE. Although an improvement compared with the traditional version, we argue that Sulmasy's reinvented RDE will not stand closer scrutiny. Not only has the range of proper applicability narrowed significantly, but, more importantly, Sulmasy fails to establish that there is a morally relevant distinction between intended and foreseen effects. In particular, he fails to establish that there is any distinction that can account for the alleged moral difference between sedation therapy and euthanasia. (shrink)

One's conception of the conditions and applicability of the principle of double effect derive from one's broader convictions about moral methodology. Developed in a Catholic context which presumed the existence of moral absolutes, the principle of double effect was originally a conceptual tool to aid priests in being skilled confessors. In recent decades, as the practice of moral theology has become less connected with its earlier ecclesial and sacramental context, the principle of double effect has fallen into an epistemological crisis. (...) Contemporary moral theological discussion of the principle of double effect usually operates in one of the following four contexts: interpretation of Aquinas; in relation to manualist casuistry; as understood within proportionalist methodology; as defended within the new natural law methodology. The essay argues that juridically-oriented methodologies do not adequately sustain the principle of double effect. To be sustained, it must be viewed as a theological achievement based upon the meaning of our redemption in Christ and the concomitant possibilities regarding our actions in pursuit of our true good and true end. (shrink)

The moral importance of the ‘intention–foresight’ distinction has long been a matter of philosophical controversy, particularly in the context of end-of-life care. Previous empirical research in Australia has suggested that general physicians and surgeons may use analgesic or sedative infusions with ambiguous intentions, their actions sometimes approximating ‘slow euthanasia’. In this paper, we report findings from a qualitative study of 18 Australian palliative care medical specialists, using in-depth interviews to address the use of sedation at the end of life. The (...) majority of subjects were agnostic or atheistic. In contrast to their colleagues in acute medical practice, these Australian palliative care specialists were almost unanimously committed to distinguishing their actions from euthanasia. This commitment appeared to arise principally from the need to maintain a clear professional role, and not obviously from an ideological opposition to euthanasia. While some respondents acknowledged that there are difficult cases that require considered reflection upon one's intention, and where there may be some ‘mental gymnastics,’ the nearly unanimous view was that it is important, even in these difficult cases, to cultivate an intention that focuses exclusively on the relief of symptoms. We present four narratives of ‘terminal’ sedation – cases where sedation was administered in significant doses just before death, and may well have hastened death. Considerable ambiguities of intention were evident in some instances, but the discussion around these clearly exceptional cases illustrates the importance of intention to palliative care specialists in maintaining their professional roles. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:CHARITY LOST: TBE SECtJLA'.RIZATfON OF THE PRINCIPLE OF DOUBLE EFFECT IN THE JUST-WAR TRADITION TIMOTHY M. RENICK Georgia State University Atlanta, Georgia 0 N AUGUST 12, 1945, the city of Hiroshima still smoldered, and President Harry Truman addressed the American people : We have used [the atomic bomb] against those who have attacked us without warning at Pearl Harbor, against those who have starved and beaten and executed American (...) prisoners of war, against those who have abandoned all pretense of obeying international laws of warfare. We have used it in order to shorten the agony of war.1 Truman and his military advisers had made a calculation. Japan was preparing for a last-ditch defense of the Japanese Islands. The prospect was ominous, to say the least. The United States had suffered eighty thousand casualties in the taking of the smaller and less protected Okinawa just two months earlier; 120,000 Japanese soldiers had been killed (and only ten-thousand taken prisoner). Strategists estimated that losses, both military and civilian, from a full scale battle for Japan itself would exceed one million. Surely the tens of thousands killed by exploding a bomb over Hiroshima was the lesser evil. Surely this was a proportionate act : fifty thousand lives traded for a million. As Winston Churchill wrote in support of Truman's decision: "To avert a vast, indefinite butchery... at the cost of a few explosions seemed, after all our toils and perils, a miracle of deliverance." 2 1 Michael Walzer, lust and Unjust Wars (New York: Basic Books, 1979), p.164. 2 Ibid., pp. 266-267. 441 442 TIMOTHY M. RENICK From an ethical perspective, however, the act was anything but a deliverance. I am not alone in this assessment. Advocates of the just-war tradition including Elizabeth Anscombe, Paul Ramsey, George Kennan, John Langan, and Michael Walzer have condemned the bombing of Hiroshima by means of a shared just-war argument.8 The argument goes as follows, and it is a good one. In times of war, many actions are likely to have both good and evil effects. One destroys an enemy's munitions factory (good effect) but kills an innocent child in the process (evil effect). The jus in bello of the just-war tradition, however, stipulates that an action which has a " double effect " is permissible if and only if: ( 1) it is discriminate (i.e., the actor aims only at the good effect and does not intend the evil effect, nor is the evil effect a means to the end, however good); and (2) it is proportionate (i.e., the good created by the act outweighs the bad).4 Now, the argument continues, Truman's decision to bomb Hiroshima failed the first criterion. It was not a discriminate act because the evil effect (the killing of tens of thousands of Japanese civilians) was not unintended. In fact, the evil was the very means to the good end. Although Truman himself claimed to have selected Hiroshima as a target because it was "a war s See, for example, G. E. M. Anscombe, "Mr. Truman's Decision," in Ethics, Religion and Politics (Minneapolis, Minn.: University of Minnesota, 1981); M. Walzer "Supreme Emergency," in Just and Unjust Wars; and John Langan, "The American Hierarchy and Nuclear Weapons," Theological Studies 43 (1982) : 447-467. ' I utilize here a helpful shorthand version of the principle of double effect introduced by Paul Ramsey in War and the Christian Conscience (Durham, North Carolina: Duke, 1961). More frequently, the principle is rendered by means of four criteria: It is permissible to perform an act likely to have evil consequences if and only if (I) the act is good in itself or at least indifferent; (2) the direct effect is morally justified; (3) the actor aims only at the acceptable effect and does not intend the evil effect, nor is the evil effect a means to the end, however good ; and (4) there is in the good effect a proportionately grave reason for permitting the evil effect. The shortened version of the theory captures all components essential to my discussion and enhances clarity. I thus will make use of it throughout this essay. CHARITY AND... (shrink)