Although Theravada Buddhism and Roman Catholicism agree on the moral justification for palliative sedation, they differ on the premises underlying the justification. While Catholicism justifies palliative sedation on the ground of the Principle of Double Effect, Buddhism does so on the basis of the Third Noble Truth. Despite their theological differences, Buddhism and Catholicism both value the moral significance of the physician’s intent to reduce suffering and both respect the sanctity of life. This blurs the demarcation (...) line between Buddhism and Catholicism regarding the moral justification of palliative sedation. -/- . (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)

Given the wide the range of legally available options for end-of-life care in recent decades: from aggressive, even experimental, treatment to active euthanasia, our ethical analysis struggles to keep pace with technology and law. In this essay I show that the principle of double effect (PDE) remains, and will continue to be, a useful tool for ethical analysis of end-of-life care. According to PDE, an agent may ethically perform an act that s/he foresees will have a significant bad (...) effect (e.g., death) in addition to a good effect (e.g., pain relief) only if s/he does not intend the bad effect, the act is not bad for reasons other than its causing the bad effect, and there is a proportionately serious reason to act. Following a brief explanation of PDE and preliminary considerations in favor of counting death as a bad effect, I analyze several end-of-life options in terms of the principle. I begin with those that enjoy significant consensus among proponents of PDE: active euthanasia, “passive euthanasia,” and palliative care. Then I consider the less-straightforward cases of drug provision, refusing food and water, and terminal sedation, arguing that participation in such actions is justifiable via PDE only under very limited conditions. (shrink)

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.

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 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)

Pain medication is one of the responses to the mercy argument that utilitarian ethicists use for justifying active euthanasia on the grounds of prevention of cruelty and appeal to beneficence. The researcher reinforces the significance of pain medication in meeting this challenge and considers it the most preferred response among various other responses. It is because of its realism and effectiveness. In exploring the mechanism and considerations related to pain medication, the researcher briefly touches the Catholic ethical position on (...) the issue, a position that cannot be ignored in the development of contemporary bioethics. The researcher particularly deliberates on the contemporary Islamic discourse on the issue; by furthering the debate in line with the Islamic legal maxims and general guidance from the primary sources of Islamic law and ethics. The resolution on the issue is sought by synthesizing the views and legal maxims (al-Qawaid al-Fiqhiyyah) on the issue, which in conclusion provide justification for pain medication by considerably regarding pain as necessity and pressing need. However, such resolution allows pain medication to the limit and proportion that removes the pain and prohibits overdosing the patient with medication that may directly cause the death. (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 (...) class='Hi'>double-effect criteria that, when fulfilled, argues for the ethical justifiability the action in question. (shrink)

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)

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)

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)

Based on the results of empirical studies of folk moral judgment, several researchers have claimed that something like the famous Doctrine of Double Effect may be a fundamental, albeit unconscious, component of human moral psychology. Proponents of this psychological DDE hypothesis have, however, said surprisingly little about how the distinction at the heart of standard formulations of the principle—the distinction between intended and merely foreseen consequences—might be cognised when we make moral judgments about people’s actions. I first highlight (...) the problem of precisely formulating the distinction between intended and foreseen consequences and its implications for interpreting the empirical data on folk moral judgment. I then distinguish between three different approaches to this problem that have been taken by proponents of the DDE in normative ethics: so-called “closeness” accounts, accounts that employ what has come to be known as a “strict” notion of intention, and Warren Quinn’s recasting of the DDE in terms of the distinction between “direct” and “indirect agency”. I show that when taken as claims about moral psychology, these different accounts entail quite different empirical predictions about what people’s moral judgments should be in particular cases. Based on the current empirical data, I argue that a version of Quinn’s formulation of the DDE is the most empirically plausible, and that adopting such a formulation helps to diffuse much of the recent empirical criticism of the DDE hypothesis. (shrink)

Under the standard formulation of the Doctrine of Double Effect, an act is permissible only if it is the result of an intention to do good and not the result of an intention to do bad. Many find that this absurdly ties the act’s permissibility to the agent’s character and not to features of the act itself. In light of such criticism, some philosophers have reformulated the doctrine so that it holds that an act is permissible given that it (...) results from an intention to do good by some agent. I argue that this appeal to possible intentions to do good fails. There is no modal or moral reason to privilege intentions to do good over those to do bad, and without privileging them, this version of the Doctrine of Double Effect leads to contradiction. In many scenarios, if a possible intention to do good is considered to be sufficient for permissibility, then in that same scenario a possible intention to do bad should be sufficient for impermissibility. However, one and the same act can have both possible intentions to do good and possible intentions to do bad. Thus, the principle leads to the contradictory ruling that one and the same act is both permissible and impermissible. (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)

At the present time there is a boom in the use of pharmacological cognitive enhancers (PCEs) particularly within an academic and labor context. Numerous objections to the use of this medicines arise in the context of Neuroethics, being one of the most important, the principle of justice. Among the most prevalent arguments put forward it is noted the disturbance of distributive justice and competitive fairness. -/- Succinctly it is established that hypothetical PCEs without adverse effects could promote the social (...) fragmentation by favoring economically dominant classes. However, it has been experimentally observed that PCEs present benefits ruled by the inverted U phenomenon, where cognitive benefits given by these medicines are not dose-dependent and have dependence on the baseline performance. Producing bigger benefits in individuals that initially had a worst performance. In this way the use of PCEs, assuming a context of open-access, could contribute to social equity and distributive justice. (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 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)

Joshua Stuchlik’s /Intention and Wrongdoing/ provides a rigorous, comprehensive defense of the coherence of double-effect reasoning and its importance to moral philosophy. The book is essential reading for anyone doing research into double-effect reasoning or adjacent topics in philosophy and theology. It is accessible enough to be read by graduate students or advanced undergraduates, and will also be beneficial to specialists in the area. It ought to set the agenda for future research on these topics.

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.

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)

Mümkün varlıkları aracı kılmadan Vâcibü’l-Vücûd’un varlığını ispatlama çabalarının bir sonucu olan sıddıkîn burhanı ilk defa Müslüman filozoflar tarafından dillendirildi. İbn Sînâ (ö. 428/1037) da Fârâbî’nin etkisiyle yeni bir burhan açıkladı ve buna sıddıkîn adını verdi. Molla Sadrâ (ö. 1050/1641) varlığın asaleti ilkesini mutasavvıflardan, teşkîk ilkesini de Sühreverdî’den iktibas ederek yeni bir sıddıkîn burhanı dillendirdi. Bu burhanın, varlığın asaleti, basîtliği/yalınlığı, teşkîkî ve ma’lûlün illete ihtiyacı olmak üzere bazı öncülleri vardır. O, bu öncülleri açıkladıktan sonra teselsüle ihtiyaç duymadan Vâcibü’l-Vücûd’un varlığını ispatlar. Onun (...) burhanı diğer sıddıkîn burhanlarına nispetle bazı üstün özelliklere sahiptir. Öncelikle bu burhan varlığın asaleti ilkesi üzerine bina edildiğinden dayanağı varlık kavramı değil, varlığın nesnel hakikatidir. İkincisi bu burhan Vâcibü’l-Vücûd’un zâtını ispatlamakla birlikte Vâcibü’l-Vücûd’un birliğini ve kemâlî sıfatlarını ispatlar. Üçüncüsü bu burhana göre mümkün varlıklar hiçbir aracı olmadan Vâcibü’l-Vücûd’a bağımlı olduklarından burhanın açıklanmasında teselsül ve kısır döngüden yararlanma ihtiyacı yoktur. Molla Sadrâ’nın teselsül ve kısır döngüden de yararlanarak Vâcibü’l-Vücûd’un varlığını ispatladığı burhanlar da vardır. Molla Sadrâ bu burhanıyla hem Vâcibü’l-Vücûd’un varlığını ve hem de onun kemâlî sıfatlarını ispatladığını iddia eder. Bu çalışmada bu iddia incelecek ve ispat-ı vacip meselesinde Molla Sadrâ’nın ne gibi yenilikler getirdiği ele alınacaktır. ABSTRACT A result of the attempts to prove the existence of The Necessary Existence without the mediation of possible beings, proof of the truthful was first expressed by Muslim philosophers called it sıddıkin. Mullā Ṣadrā’s “proof” that he explains has certain premises such as the fundamental of existence, indivisibility of the existence, existential gradation, effect’s need for cause. After explanining these premises, Mullā Ṣadrā then proves the Necessary Existence without needing succession. Mullā Ṣadrā’s proof of the truthful has certain superior features tan the proofs of truthful expressed before him. First of all, as this proof is built upon the principle of the fundamental of existence, its foundation is the external truth of existence, not the concept of existence itself. Secondly, this proof proves the unity and perfection attributes of The Necessary Existence as well as proving the existence of the Necessary Existence. Thirdly, according to this proof, as all possible existences are dependent on The Necessary Existence without any mediation, there is no need to benefit from succession and vicious circle in explaining the proof. However, Mullā Ṣadrā proves the Necessary Existence by benefitting from succession and vicious circle in other proofs. Mullā Ṣadrā asserts that this proof demonstrates the presence of The Necessary Existence and its perfection attributions. This study examines this assertion and addresses what kind of innovations was brought by Mullā Ṣadrā in terms of proving The Necessary Existence. (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)

In this article, I ask whether a principle analogous to the principle of clinical equipoise should govern the design and conduct of RCTs evaluating the effectiveness of policy interventions. I answer this question affirmatively, and introduce and defend the principle of policy equipoise. According to this principle, all arms of a policy RCT must be, at minimum, in a state of equipoise with the best proven policy that is also morally and practically attainable and sustainable. For (...) all arms of a policy RCT, policy experts must either reasonably disagree about whether the trial arms are more effective than this policy, or know that they are. (shrink)

According to the Thomistic tradition, the Principle of Totality (TPoT) articulates a secondary principle of natural law which guides the exercise of human ownership or dominium over creation. In its general signification, TPoT is a principle of distributive justice determining the right ordering of wholes to their parts. In the medical field it is traditionally understood as entailing an absolute prohibition of bodily mutilation as irrational and immoral, and an imperfect obligation to use the parts of one’s (...) body for the perfection of the bodily whole. TPoT is thus a key element of the system of principles within which an individual exercises her right to life: it helps specify the nature, scope and limits of those actions by which an agent permissibly acts in order to preserve her life. While the Thomistic tradition and the Catholic Church have drawn clear conclusions from the principle regarding, e.g., direct sterilization and non-therapeutic experimentation on human subjects, less attention has been given to the implications of TPoT for non-therapeutic procedures that may positively impact biological functioning or supra-biological goals–that is, for human “enhancement.” We will explore the degree to which TPoT non-univocally guides our use of both artifacts and bodies. We will argue that a careful analysis of these distinct kinds of totalities suggests that the application of TPoT to artifacts and bodies is strongly isomorphic, which is what tempts advocates of the Principle of Autonomy to invalidly infer the absolute dominium of the individual over her body. The inference is invalid because this isomorphism also includes a principle of intrinsic value whose function is to resist the instrumentalization of both artifacts and bodies in some contexts; we are not even related to artifacts as advocates of absolute autonomy believe we are, let alone to our bodies. Rather, the limits of human dominium are determined by the nature and finalities, inherent or acquired, of the objects in question, and it will be argued that articulating these limits raises important, understudied, and fascinating questions about the permissibility of various kinds of human enhancement. (shrink)

Canonical defenders of the principle of sufficient reason (PSR), such as Leibniz and Spinoza, are metaphysical foundationalists of one stripe or another. This is curious since the PSR—which says that everything has a ground, cause, or explanation—in effect, denies fundamental entities. In this paper, I explore the apparent inconsistency between metaphysical foundationalism and approaches to metaphysical system building that are driven by a commitment to the PSR. I do so by analyzing how Indian Buddhist philosophers arrive at foundationalist (...) and anti-foundationalist positions motivated by implicit commitments to different versions of the PSR. I begin by introducing the Buddhist principle of dependent origination (pratītyasamutpāda) as a proto-PSR that is restricted to causal explanation. Next, I show how Vasubandhu’s Sautrāntika Abhidharma metaphysics is shaped by a qualified commitment to both causal and metaphysical grounding versions of the PSR. I then reveal how Nāgārjuna’s Madhyamaka metaphysics is driven by an unrestricted and exceptionless commitment to causal and metaphysical grounding versions of the PSR. Finally, I consider how Nāgārjuna’s account may put him in a unique position to respond to a common contemporary objection to the PSR from necessitarianism. I conclude by addressing a competing interpretation on which Nāgārjuna is best understood as an anti-rationalist rather than an uber-rationalist, as I characterize him. (shrink)

James Sterba uses the Pauline Principle to argue that the occurrence of significant, horrendous evils is logically incompatible with the existence of a good God. The Pauline Principle states that (as a rule) one must never do evil so that good may come from it, and according to Sterba, this principle implies that God may not permit significant evils even if that permission would be necessary to secure other, greater goods. By contrast, I argue that the occurrence (...) of significant evils is logically compatible with the existence of a good God because victims of significant evils may themselves reasonably consent to their suffering. In particular, I argue that they may be able to accept their suffering if it turns out that there was no way for God to secure relevant greater goods (or prevent other, greater evils) except by way of allowing their suffering, and God also provides them with other compensating, heavenly comforts. After using this consent-based argument to address Sterba’s logical problem from evil, I briefly consider how this argument may also help address a related evidential problem from evil, which suggests that while it is possible that victims of significant evils would consent to their suffering, it is unlikely that they would do so. While I do not provide a definitive solution to this evidential problem of evil, I highlight one important example of a trade-off that God may need to make that would—along with the provision of compensating, heavenly comforts—potentially persuade victims of significant evils to consent to their suffering. Specifically, I argue that there may be a necessary trade-off that God needs to make between permitting significant evils (on the one hand) and protecting a certain, morally significant form of free will (on the other hand). (shrink)

1: Placebo effect sometimes plausibly has powerful effects. 2: Buddhism philosophy holds that every living animal is sentient, and has a consciousness and killing them is bad for the killer and freeing them is good somehow. Consciousness may involve some aspects of quantum mechanism as Roger Penrose’s Orch OR' theory of consciousness pointed out. -/- 3: Although previous studies show that there is no “demonstrable effects of distant intercessory prayer. Anecdotal cases of a special kind of Buddhist activity of (...) freeing captive animals in huge amount seem to have powerful therapeutic effects on severe and terminal patients. We want test it experimentally. 4: The cunning point that exceeds previous stuies is, it’s reasonable to consider there may be collective and superpositional effects of this activity due to the likely quantum mechanism of consciousness, and it may play as a sort of magnifying glass that shows a discernible placebo effect. -/- 5:We recruit a considerable number of patients that are terminally ill and the doctors said they can not help them anymore and have double-blind experiments of the above idea.The statistics may show some anomalous distribution. Ethical concerns shall take into consideration. (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)

As the Zika virus pandemic continues to bring worry and fear to health officials and medical scientists, Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) have recommended that residents of the Zika-infected countries, e.g., Brazil, and those who have traveled to the area should delay having babies which may involve artificial contraceptive, particularly condom. This preventive policy, however, is seemingly at odds with the Roman Catholic Church’s position on the contraceptive. As least since the promulgation (...) of Paul VI’s 1968 encyclical, Humanae Vitae, the Church has explicitly condemned artificial birth control as intrinsic evil. However, the current pontiff, Pope Francis, during his recent visit to Latin America, remarked that the use of artificial contraception may not be in contradiction to the teaching of Humanae Vitae while drawing a parallel between the current Zika Crisis and the 1960’s Belgian Congo Nun Controversy. The pope mentioned that the traditional ethical principle of the lesser of two evils may be the doctrine that justified the exceptions. The authors of this paper attempt to expand the theological rationale of the pope’s suggestion. In so doing, the authors rely on casuistical reasoning as an analytic tool that compares the Belgian Congo Nun case and the given Zika case, and suggest that the former is highly similar to, if not the same as, the latter in terms of normative moral feature. That is, in both cases the use of artificial contraception is theologically justified in reference to the criteria that the doctrine of the lesser of two evils requires. The authors wish that the paper would provide a solid theological-ethical ground based on which condom-use as the most immediate and effective preventive measure can be recommended in numerous Catholic hospitals as well as among Catholic communities in the world, particularly the most Zika-affected and largest Catholic community in the world, Brazil – 123 million present Brazilian citizens are reported to be Roman Catholic. (shrink)

This article examines a fundamental question of justice in global health. Is it ethically preferable to provide a larger number of people with cheaper treatments that are less effective (or more toxic), or to restrict treatments to a smaller group to provide a more expensive but more effective or less toxic alternative? We argue that choosing to provide less effective or more toxic interventions to a larger number of people is favored by the principles of utility, equality, and priority for (...) those worst-off. Advocates are mistaken to demand that medical care provided in low-income and middle-income countries should be the same as in high-income countries. (shrink)

The research has three objectives: 1) to study the concept of Heisenberg’s uncertainty principle, 2) to study the concept of reality and knowledge in Buddhist philosophy, and 3) to analyze the concept of Heisenberg’s uncertainty principle in Buddhist philosophical perspective. This is documentary research. In this research, it was found that Heisenberg's uncertainty principle refers to the experiment of thought while studying physical reality on smaller particles than atoms where at the present no theory of (...) Physics can clearly explain such properties. In this respect, the mentioned principle is utilized to predict the pairs of a certain attribute of physics, position, and momentum, for instance. The accuracy of position, however, cannot be precisely yielded in advance by such a principle. In other words, it is impossible to measure the position and momentum of a quantum particle at the same time. In the study of the ultimate reality on the matter in the Buddhist philosophy, it showed that corporeality in nature is conditioned by cause and effect and thereby falling under the three common characteristics: 1) impermanence, 2) state of suffering, and 3) state of non-substantiality. In the study of Heisenberg’s uncertainty principle in the Buddhist philosophical perspective, this research was found that the processes in acquiring certain knowledge of Heisenberg and Buddhist philosophy are by one another in the sense that such knowledge is methodologically acquired through experience, rationality, and intuition because both see the Reality in the same manners, that is, the physical reality is viewed by Heisenberg as the thing that goes under changing state of wave-particle all the times, and the matter is seen by Buddhist philosophy as the impermanence and change depending upon its factors involved and thereby is not-self. However, in the different aspect, on the one hand, Buddhist philosophy utilizes the knowledge on the matter to develop the morality and ethics by which the cessation of suffering could be respectively made, but on the other hand, Heisenberg somehow applies the certain knowledge on physical objects into quantum technology to accommodate the physical comfortability in living life. Suggestions in the application of knowledge gained from this research into benefit were that while Buddhist philosophy can make use of Heisenberg’s uncertainty principle to provide certain help at the time of explanation of three common characteristics being done through the scientific method, science also can utilize knowledge gained from Buddhist philosophy to expand the framework of scientific knowledge which is aimed at studying only the physical objects to be able to study the mental objects through the integration of three epistemological methods as well. (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)

PETER KNAUER'S CONCEPTION OF MORAL CHOICE ON THE ANTHROPOLOGICAL CREAITVENESS IN MODERN MORAL THEOLOGY Summary The author undertakes a critical analysis of the ethical views of Peter Knauer who is one of the most influential theological moralist today. The author tends to show the consequences of Knauer's theory which consequences are destructive for morality. The first part of the paper presents Knauer's standpoint in view of the conception of moral choice and shows three crucial points of his system. They are (...) the following: the definition of moral good (lightness) in its relation to physical good; the reinterpretation of the principle of double effect which reinterpretation reduces that principle to its "Ideological explanation"; and, finally, the conception of the so-called non-counterproductivity which decides whether an activity is right. That non-counterproductivity is comprehended as an all-embracing correspondence between the goals which the subject has chosen and means which the subject has taken in order to accomplish the goals. In the second critical part one finds some questions related to the immanent critique of the discussed theory and some consequences of Knauer's claims. If one applies his assumptions strictly, it turns out that in his model of morality there is no place for such an activity of man which, at the same time, would be both rational and free, i.e., sensu stricto moral. In view of Knauer's system the criteria of moral evaluation, which criteria he proposed, do not hold sense. Thus morality and ethics lose their essential normative character. Consequently, the system under scrutiny leads to an antipersonalistic vision of both an individual and society, and in terms of eternity it seems to dismiss the possibility of recognizing the existence of Absolute. The theory rejects values for the sake of which it was construed. Translated by Jan Kłos. (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)

Objectives—To assess whether UK and US health care professionals share the views of medical ethicists about medical futility, withdrawing/withholding treatment, ordinary/extraordinary interventions, and the doctrine of double effectDesign, subjects and setting–A 138-item attitudinal questionnaire completed by 469 UK nurses studying the Open University course on “Death and Dying” was compared with a similar questionnaire administered to 759 US nurses and 687 US doctors taking the Hastings Center course on “Decisions near the End of Life”.Results–Practitioners accept the relevance of concepts (...) widely disparaged by bioethicists: double effect, medical futility, and the distinctions between heroic/ordinary interventions and withholding/ withdrawing treatment. Within the UK nurses' group a “rationalist” axis of respondents who describe themselves as having “no religion” are closer to the bioethics consensus on withholding and withdrawing treatment.Conclusions—Professionals' beliefs differ substantially from the recommendations of their professional bodies and from majority opinion in bioethics. Bioethicists should be cautious about assuming that their opinions will be readily accepted by practitioners. (shrink)

Flannery’s volume looks in two directions. On the one hand, as Flannery announces in the book’s introduction, the chapters in the volume were intended to shed light on three specific ‘background’ issues in contemporary ethics and the interpretation of Thomas Aquinas, namely, Aquinas’ notion of ethical theory (as articulated especially in Summa Theologica 1-2.6-21), the ramifications of physical actions on moral evaluation in contemporary ethics (for instance, whether the fact that an abortion consists specifically in the crushing of a fetus’ (...) skull rather than some other form of terminating the fetus has moral relevance), and the understanding of Aquinas’ ‘principle of double effect’ (Summa Theologica 2-2.64.7). On the other hand, the eight chapters (and two appendices) are all devoted to the exegesis of passages in Aristotle’s corpus (primarily the ethical treatises, but with substantial discussions of passages from the Prior Analytics, the Physics, and the Metaphysics insofar as they shed light on passages in the eth-ical corpus). Although the exegetical chapters are motivated by contemporary and Thomistic background issues, the exegesis appears entirely grounded in Aristotle’s (rather than Aristotelian) texts. (shrink)

The research has three objectives: 1) to study the concept of Heisenberg’s uncertainty principle, 2) to study the concept of reality and knowledge in Buddhist philosophy, and 3) to analyze the concept of Heisenberg’s uncertainty principle in Buddhist philosophical perspective. This is documentary research. In this research, it was found that Heisenberg's uncertainty principle refers to the experiment of thought while studying physical reality on smaller particles than atoms where at the present no theory of (...) Physics can clearly explain such properties. In this respect, the mentioned principle is utilized to predict the pairs of a certain attribute of physics, position, and momentum, for instance. The accuracy of position, however, cannot be precisely yielded in advance by such a principle. In other words, it is impossible to measure the position and momentum of a quantum particle at the same time. In the study of the ultimate reality on the matter in the Buddhist philosophy, it showed that corporeality in nature is conditioned by cause and effect and thereby falling under the three common characteristics: 1) impermanence, 2) state of suffering, and 3) state of non-substantiality. In the study of Heisenberg’s uncertainty principle in the Buddhist philosophical perspective, this research was found that the processes in acquiring certain knowledge of Heisenberg and Buddhist philosophy are by one another in the sense that such knowledge is methodologically acquired through experience, rationality, and intuition because both see the Reality in the same manners, that is, the physical reality is viewed by Heisenberg as the thing that goes under changing state of wave-particle all the times, and the matter is seen by Buddhist philosophy as the impermanence and change depending upon its factors involved and thereby is not-self. However, in the different aspect, on the one hand, Buddhist philosophy utilizes the knowledge on the matter to develop the morality and ethics by which the cessation of suffering could be respectively made, but on the other hand, Heisenberg somehow applies the certain knowledge on physical objects into quantum technology to accommodate the physical comfortability in living life. Suggestions in the application of knowledge gained from this research into benefit were that while Buddhist philosophy can make use of Heisenberg’s uncertainty principle to provide certain help at the time of explanation of three common characteristics being done through the scientific method, science also can utilize knowledge gained from Buddhist philosophy to expand the framework of scientific knowledge which is aimed at studying only the physical objects to be able to study the mental objects through the integration of three epistemological methods as well. (shrink)

There has been much debate regarding the 'double-effect' of sedatives and analgesics administered at the end-of-life, and the possibility that health professionals using these drugs are performing 'slow euthanasia.' On the one hand analgesics and sedatives can do much to relieve suffering in the terminally ill. On the other hand, they can hasten death. According to a standard view, the administration of analgesics and sedatives amounts to euthanasia when the drugs are given with an intention to hasten death. In (...) this paper we report a small qualitative study based on interviews with 8 Australian general physicians regarding their understanding of intention in the context of questions about voluntary euthanasia, assisted suicide and particularly the use of analgesic and sedative infusions (including the possibility of voluntary or non-voluntary 'slow euthanasia'). We found a striking ambiguity and uncertainty regarding intentions amongst doctors interviewed. Some were explicit in describing a 'grey' area between palliation and euthanasia, or a continuum between the two. Not one of the respondents was consistent in distinguishing between a foreseen death and an intended death. A major theme was that 'slow euthanasia' may be more psychologically acceptable to doctors than active voluntary euthanasia by bolus injection, partly because the former would usually only result in a small loss of 'time' for patients already very close to death, but also because of the desirable ambiguities surrounding causation and intention when an infusion of analgesics and sedatives is used. The empirical and philosophical implications of these findings are discussed. (shrink)

One important foundation of Buddhist ethics is a commitment to nonviolence. My aim in this paper is to work out the implications of this commitment with regard to the treatment of offenders. Given that punishment involves the intentional infliction of harm, I argue that the practice of punishment is incompatible with the principle of nonviolence. The core moral teaching of the Buddha is to conquer evil with goodness, and it is reconciliation, rather than punishment, that conforms to this (...) teaching. I argue that a commitment to nonviolence requires not only that we refrain from inflicting intentional harm, but that we refrain from inflicting unnecessary harm, and that this has important implications concerning the practice of incapacitation. I analyze the concept of harm and argue that the Buddhist understanding of this notion leads to the conclusion that none of the standard justifications for punishment are compatible with the principle of nonviolence, properly understood. (shrink)

Chinese Chan or Zen Buddhism is renowned for its improvisational, atypical, and perplexing use of words. In particular, the tradition’s encounter dialogues, which took place between Chan masters and their interlocutors, abound in puzzling, astonishing, and paradoxical ways of speaking. In this chapter, we are concerned with Chan’s use of paradoxical language. In philosophical parlance, a linguistic paradox comprises the confluence of opposite or incongruent concepts in a way that runs counter to our common sense and ordinary rational thinking. One (...) naturally wonders about Chan masters’ rationales for their use of paradox. There are also concerns about whether the use violates the logical principle of noncontradiction to the effect that nothing can be both P and not-P all over in the same way at the same time. Chan became a viable Chinese Buddhist tradition during the Tang dynasty (618−907) and continued to develop for several centuries. The tradition had produced a huge literature; consequently, our investigation of its use of paradox cannot but be limited and selective. In the second section, I first sketch key ideas of Chan that are pertinent to our investigation and then examine the use of paradox in the sermons associated with certain Tang masters of the southern Chan. In the third section, I analyze the presence of paradoxical language in post-Tang encounter dialogues. The fourth section concludes. (shrink)

This study examines from an ethical framework the circumstances of workers who are engaged in non-professional services that are offered through corporations that are organized to serve high volume of costumers. Drawing on the relevant ethical teachings of the Catholic social tradition (CST), it explores some practices, strategies, and policies that could address the problems experienced by many service providers in the United States today. CST refers to a wide variety of documents of the magisterium of the Catholic (...) Church which respond to the changing social and economic challenges of the modern world. The study argues that the primacy of the person, love and subsidiarity, sense of community, and respect for worker’s rights and unionism in CST are not only moral principles that uphold intrinsic human goods, they are likewise instrumental to operational effectivity because they promote job satisfaction, smooth interpersonal relationship, and long-term commitment with the company. They enable service providers to work efficiently, deliver exceptional service, and act as conduit between the customers and the business establishment, rather than simply being caught between their conflicting demands. (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)

Ethics should guide the design of electronic health records (EHR), and recognized principles of bioethics can play an important role. This approach was adopted recently by a team of informaticists designing and testing a system where patients exert granular control over who views their personal health information. While this method of building ethics in from the start of the design process has significant benefits, questions remain about how useful the application of bioethics principles can be in this process, especially when (...) principles conflict. For instance, while the ethical principle of respect for autonomy supports a robust system of granular control, the principles of beneficence and non-maleficence counsel restraint due to the danger of patients being harmed by restrictions on provider access to data. Conflict between principles has long been recognized by ethicists and has even motivated attacks on approaches that state and apply principles. In this paper we show how using ethical principles can help in the design of EHRs by first, explaining how ethical principles can and should be used generally, and then by, discuss how attention to details in specific cases can show that the tension between principles is not as bad as it initially appeared. We conclude by suggesting further ways in which the application of these (and other) principles can add value to the ongoing discussion of patient involvement in their health care. This is a new approach to linking principles to informatics design that we expect will stimulate further interest. (shrink)

As a policy instrument that is deeply rooted in technology assessment, the precautionary principle examines the effects of a given object on humans and the environment. In practice the principle is rarely used to analyze the effects of our safety measures on the object itself or the way it is produced. Yet it is exactly in the effect on the blood procurement system that blood safety regulations based on the precautionary principle have to be particularly careful, as (...) the vast majority of blood products in the Global North are obtained through donations. (shrink)

Most Western Buddhists employ both utilitarian and virtue ethics, in the paradoxical unity of compassion and wisdom. On the one hand, our personal karmic clarity is most related to our cultivation of compassionate intention, but on the other hand we also need to develop penetrating insight into the most effective means to the ends. We do not believe that the person who helps others without any intention of doing so to have accrued merit, while we look upon the person who (...) causes others suffering with the best intentions a hapless fool. Similarly, in approaching the abortion decision, both the mindset of the actors and the utilitarian consequences are important. (shrink)

This article investigates the original meaning of dependent arising in the Buddha’s teaching, by focussing on the imasmi" sati formula. Modern scholars such as the Rhys Davidses, K.N. Jayatilleke and Paul Williams have interpreted it as a princi- ple of causation, comparable to a scientific conception of causation. I argue instead that this formula implies that the Buddha held that causation is nothing more than the correlation of causes and effects, and that it commits the Buddha to a Humean regularity (...) thesis about causation. I draw a distinction between the Buddhist and scientific concepts of causation, and then summarise an alternative approach made by more recent scholars such as Sue Hamilton, Noa Ronkin and Eviatar Shulman, who present dependent arising in terms of conditionality in the causal structure of subjective experience. I conclude by presenting the argument that the imasmi" sati formula does not express a principle of causation but is rather a formula for the method of discovering and presenting causation as conditionality in experience. (shrink)

When is a cause of a cause of an effect also a cause of that effect? The right answer is either Sometimes or Always . In favour of Always , transitivity is considered by some to be necessary for distinguishing causes from redundant non-causal events. Moreover transitivity may be motivated by an interest in an unselective notion of causation, untroubled by principles of invidious discrimination. And causal relations appear to add up like transitive relations, so that the obtaining of the (...) overarching relation is not independent of the obtaining of the intermediaries. On the other hand, in favour of Sometimes , often we seem not to treat events that are very spatiotemporally remote from an effect as its causes, even when connected to the effect in question by a chain of counterfactual or chance-raising dependence. Moreover cases of double prevention provide counterexamples to causal transitivity even over short chains. According to the argument of this paper, causation is non-transitive. Transitizing causation provides no viable account of causal redundancy. An unselective approach to causation may motivate resisting the distance counterexamples to transitivity, but it does not help with double prevention, and even makes it more intractable. The strongest point in favour of transitivity is the adding up of causal relations, and this is the point that extant non-transitizing analyses have not adequately addressed. I propose a necessary condition on causation that explains the adding up phenomenon. In doing so it also provides a unifying explanation of distance and double prevention counterexamples to transitivity. (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)

[Utilitarism, Nazism, and Euthanasia] The article is an answer to Prof. Munzarová who criticised my defence of physician-assisted suicide. The article points to shortcomings in the reply of prof. Munzarová which flow from the author’s underestimation of normative theory. Among these shortcomings are the ignoring of the arguments of her opponent; her calling into question the moral credit of the proponents of the competing theory (utilitarianism) rather than a critical analysis; unclear theoretical principles (a switching between paternalism and autonomy, the (...) presentation of the “principle of double-effect” as the standpoint of common sense); an unconvincing version of the “argument of the slippery slope” (ignoring the diametrical differences between the contemporary demand of some patients for assisted death and the Nazi programme of involuntary euthanasia). (shrink)