Intention and Double Effect

Several critiques of the New Natural Law theory of action are to be found in a special issue of the National Catholic Bioethics Quarterly dedicated to criticizing the NNL theory as a whole.  This essay addresses three of the articles in that issue. Those essays, by Steven A. Long, Matthew O’Brien, and Fr. Kevin Flannery, SJ, as well as a more recent essay by Edward Furton (in Ethics and Medics), eventually converge on a variation of the “closeness” criticism that I will address in the second part of the paper.  In the first part, I address three further issues, raised, respectively, by Flannery, Long, and O’Brien.

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 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.

The goal of this chapter is to examine the account of 'mixed' or 'necessitated' actions in NE 3.1, to see whether Aristotle's discussion there provides an analogue or anticipation of the so-called 'doctrine of double effect' (DE). This project will, I hope, prove illuminating as regards both mixed actions and DE.

RESUMEN: En este trabajo el autor intenta mostrar la relevancia que le corresponde al principio del doble efecto en el razonamiento práctico general y especialmente en el razonamiento jurídico. Para ello procede del siguiente modo. Primero, estudia la naturaleza del principio como regla para la deliberación moral. Segundo, y con el propósito de ilustrar acerca de las principales situaciones a las que el principio se ha aplicado, ofrece una exposición de su desarrollo histórico. Tercero, presenta los argumentos para justificar la necesidad de acoger el principio del doble efecto, probando que este constituye la única forma no consecuencialista de atribuir responsabilidad por lo efectos de los actos humanos. En cuarto lugar, examina el significado de los requisitos del principio e indica la forma en que ellos deben ser comprendidos. Finalmente, señala algunos ejemplos de diversos ámbitos del Derecho en los que el principio puede ser una útil herramienta para el razonamiento judicial y legislativo.

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.

Resumen: Este trabajo estudia la distinción entre "aborto directo" y "aborto indirecto". El propósito del autor es clarificar el sentido de esta distinción y mostrar que existen argumentos filosóficos sólidos para justificar su relevancia moral. Para lograr este objetivo expone, en primer lugar, el principal argumento esgrimido por quienes consideran el aborto (directo) como un acto intrínsecamente injusto; en segundo, muestra cuál es el origen histórico de la distinción entre aborto directo y aborto indirecto; en tercero, presenta un argumento para defender la relevancia moral de esta distinción y, finalmente, explica el modo en que ella opera, usando como ejemplo el análisis de T. L. Bouscaren sobre la salpingectomía de una trompa con feto ectópico.

Abstract: People often think about justice in war in the simplest terms: some group commits an injustice; another group attempts to remedy the wrong by means of force. But in fact the pursuit of justice is never so simple. While attempting to remedy wrongs of one kind, agents of justice commit wrongs of another. Nor is this easily avoidable. Rather, justice itself seems to admit of ambiguities that frustrate even our best efforts to correct wrongs. In this essay I expose the ambiguities of justice in war by analyzing real-world and literary examples. In so doing, I reveal some ethical issues that the just war tradition has not, to date, adequately addressed. To conclude, I explain why recognition of the ambiguities of justice in war is both morally and strategically advantageous.

Defenders of categorically exceptionless rights sometimes rely on a principle of double effect to maintain their position. But critics of a principle of double effect charge that it admits sophistical solutions to many moral dilemmas. I try to meet this criticism (1) by offering a more precisely formulated principle of double effect than its critics usually consider and (2) by showing that this formulation need not lead to sophistical normative judgments. In sketching my tentative defense of a principle of double effect, I indicate the importance of a carefully worked out theory of act individuation.

Theoretical defenses of the principle of double effect (pde) due to Quinn, Nagel and Foot are claimed to face severe difficulties. But this leaves those of us who see something in the case-based support for the pde without a way of accounting for our judgments. This article proposes a novel principle it calls the mismatch principle, and argues that the mismatch principle does better than the pde at accounting for our judgments about cases and is also theoretically defensible. However, where the pde makes claims about the permissibility of actions, the mismatch principle makes claims only about the evaluation of agents; and where the pde explains the cases in terms of intending harm, the mismatch principle explains them in terms of a quite different feature of the agent's will.

Substantial medical evidence shows that about half of ovarian cancers originate in the fallopian tube. Some medical organizations and clinical articles have suggested opportunistic salpingectomy to reduce the risk of ovarian cancer in patients at average risk of developing it. This entails removing the fallopian tubes at the same time as another procedure that would occur anyway. The authors argue that the principles of totality and double effect can justify such salpingectomies, even though there is a low incidence of ovarian cancer. Since screening tools for ovarian cancer are ineffective and treatment options are poor, the good effect of reducing the risk of death from this type of ovarian cancer can be proportionate to the bad effects of the minor increase in surgical risk over the other procedure, the unintended side effect of infertility, and the removal of normally functioning tissue. The authors conclude that it is within the purview of a patient and physician to determine w...

A difficult task for politicians who want to fight injustice without doing wrong themselves is identifying where it is permissible to vote for and/or promote so-called  ‘imperfect laws’ which somewhat improve existing unjust legal situations but leave closely related injustices intact. One approach is to seek a ‘selective ban’ on some injustices which are politically preventable.  This approach is acceptable at least in principle, unlike the approach of ‘regulation’ ie permitting or instructing others to do, or prepare to do, the unjust act in specified ways.  The latter necessarily involves us in formal cooperation with evil: wrongly intending that others choose wrongly; for example, that abortion doctors deliberately prepare for abortion, albeit in ways that make an abortion less risky or less likely.  In relation to parental consent or parental notification, and to pregnancy counselling and provision of information to pregnant women, while there may be ways of requiring these without complicity in others’ wrongful choices, this is at least more difficult than is often recognised. There can also be problems of principle in seeking consensus with fellow-legislators who may positively intend and even promote the continuation of remaining injustices even as they collaborate with more consistent reformers in passing laws which mitigate injustice overall.