Talk:Principle of double effect

Previous discussions:

• Archive01: Str1977 12:39, 14 September 2005 (UTC)
  • Note: The above archive mostly consists of writing by User:Famekeeper. —Lowellian (reply) 06:53, 5 October 2005 (UTC)

"may also cause an effect one would otherwise be obliged to avoid (sedation and a slightly shortened life)"

Why is sedation something one is otherwise obliged to avoid?

Criticism #2

Not a valid criticism. Torture is an 'intrinsic evil,' an inherently bad moral object and therefore the Principle of Double Effect does not even apply. Wikipedia is a joke. —Preceding unsigned comment added by 24.147.25.37 (talk) 18:21, 21 May 2011 (UTC)

Title of article

Should be referred to as "Principle" not "Doctrine". User:194.80.106.135

Agreed, and I have moved the page accordingly. Google returns more hits for "principle of double effect" than "doctrine of double effect". —Lowellian (reply) 07:01, 5 October 2005 (UTC)

It should be referred to as the "Doctrine of Double Effect" as that is the term most used in philosophical circles today. It is the term employed by the popular textbook "Ethics in Practice" and the term used by Peter Singer in "Practical Ethics"

Doing Ethics also refers to it as the Doctrine of Double Effect Eggbertx (talk) 20:34, 18 October 2010 (UTC)

controversial statements on war

"Whether the Principle applies to the bombing of Hiroshima and Nagasaki is a highly controversial question, whereas the sometimes massive conventional bombing of european cities was usually justify by the principle."

Apart from the obvious spelling mistakes, I don't see where the bombing of European cities were justified by the principle. On the contrary, most history books claim they were of the other type cited in the article, that of purposefully doing wrong to demoralise the enemy. The same was said for the atomic bombs (which, in destruction, were not so much greater than the bombing of Tokyo, for example, or the German cities.) I suggest to rewrite or remove this paragraph. Hoemaco 05:08, 11 September 2007 (UTC)

• Rewritten. Someone might say "sometimes justified", but it probably applies to both, and this is one of those things that really should be attributed in any case.

some evil must be done to bring about an enormous good?

"Although he is reluctant to give up the bomb's location, his interrogators can exploit his attachment to his family by torturing them before his eyes, in order to extract the information which would save millions of lives."

Imagine a five years old boy screaming while being skinned alive in front of his father. I fail to convince myself that saving other people, even millions, is "enormous good" enough to justify it.

Well, yes, but in that case justification would come from the fact that skinning five-year-olds alive is jolly fun! —Preceding unsigned comment added by 83.132.65.97 (talk) 04:01, 4 February 2010 (UTC)

• I'm not sure that example would fall under double effect anyway - perhaps it should be removed.

While torturing a child to extract information from a terrorist father does NOT meet the conditions of the DDE, I think the idea is show that the DDE is too restrictive by presenting an example which "clearly shows" that one may do evil in order to achieve a greater good. If this was the intent, then perhaps some rewording may make this clearer. Then again, DDE implicitly assumes that we already agree that doing evil to achieve good is wrong. Utilitarians who believe that one may murder to harvest organs for many obviously have no need for DDE. 64.42.233.58 21:00, 17 January 2007 (UTC)

I don't know how this example can be salvaged. —Preceding unsigned comment added by 192.75.48.150 (talk) 18:12, 11 December 2007 (UTC)

I would like to add that this page has defined very poorly Double-Effect. I studied Thomism and specialized in Aquinas' philosophy at the University of Western Ontario. It is in regard to the third point about conditions on double effect. You state that the two results must be proportionate. This is false, and let me quote Aquinas to prove it

"And yet, though proceeding from a good intention, an act may be rendered unlawful, if it be out of proportion to the end." [Summa Theologica II, II, question 64, article 7]

In other words, proportionality is between the object/act and the intended-result, not between the two ends. If you were to measure proportionality between the two ends you would be rendering the object neutral and therefore be ascribing to a consequentionalistic or utilitarian philosophy. Any more questions e-mail me at cpietra@uwo.ca

Utilitarianism and examples

The article suffers from a serious consistency problem. It says that utilitarians reject DDE and gives torture examples as examples of what is prohibited if the DDE is true. But this doesn't fit the DDE as it is stated at the top of the article. The DDE as given states (I paraphrase for clarity): "IF these four conditions are met, THEN the action is permissible." It does not state that the four conditions MUST be met for an action to be permissible. In fact, a utilitarian can say that the DDE is true, but just doesn't go far enough because you can delete all the conditions except for proportionality. Now as a matter of fact, just about all the ethicists who identify themselves as defenders of the DDE do so because they think it's wrong to intentionally cause basic evils like the death of an innocent person, and yet want to allow tactical bombing or manufacturing vaccines that have rare fatal side-effects. So the self-identified defenders of the DDE do think the conditions are necessary for an action with some basic evils among the consequences to be right. Bu the DDE as stated doesn't say so. So something needs to be fixed in this article. I don't have the time to do this myself.Pruss 22:39, 7 November 2007 (UTC)

Yes, I would agree with that. There are certainly many modern deconstructions of the DDE that betray the actual teaching of Thomas Aquinas, such as its use to justify neoconservative agendas of (supposedly) just wars in Iraq and so forth. ADM (talk) 08:33, 18 July 2009 (UTC)

Merging and expanding

I will take up the task of merging the two articles, deleting the temporary one and expanding this one as best as I can. Anyone interested in helping me out with this task will be very welcome. --- Kripkenstein 11:27, 10 February 2006 (UTC)

Citations needed

Citations are needed for (especially) two items. One, the article states: "Double Effect depends on the following principles" and lists three such principles. Where do these come from? Second, in the section "Catholic view", the article lists four requirements for an action to be justified by the doctrine. Perhaps this comes from the Summa Theologica? or the Catholic Encyclopedia? or the New Catholic Encycolpedia? It certainly sounds like the Roman Catholic view, but the article needs to cite the source.

The above wasn't me, but I removed the following "The principle of double effect is becoming a defence used by doctors who have acted negligently or illegally in caring for ill or dying patients." because it's a sweeping statement and no citation is given anyway...--212.56.109.125 11:55, 31 May 2006 (UTC)

I'm removing the statement "Double Effect depends on the following principles" and the three listed principle; I couldn't find any source that supports it. However, I have inserted the four requirements necessary for the justification of double effect. -- 12:00, 28 Oct 2006

Do we need a citation concerning Hiroshima and Nagasaki bombings? Has anyone actually suggested in a published source that the principles of double effect apply to Hiroshima and Nagasaki? The support for Hiroshima bombing seems to take the "ends justifies the means" approach which is distinct from double effect 68.147.171.228 06:16, 8 March 2007 (UTC)

The entire article suffers from lack of citations - each example should be cited somewhere, or the point of having examples is lost.Not even Mr. Lister's Koromon survived intact. 07:33, 21 November 2008 (UTC)

Biased content

The last two paragraphs of the "Applications" section are written by an absolutist, who seems to feel that, given current medical knowledge, bad effects can always be avoided. The author refers to (but does not cite) “Thirty years of palliative care experience and research” showing that “it is invariably possible to manage pain or distress with titrated doses of drugs, without hastening death.” This is simply untrue. Current literature suggests that the risk of bad effects, such as dependence and hastening of death, can be reduced but not eliminated entirely (see Fallon M, Hanks G, Cherny N. Principles of control of cancer pain British Medical Journal 2006 Apr 29;332(7548):1022-4 for review). Literature also suggests that pain is often undertreated to avoid adverse effects, constituting a "reverse double effect": allowing pain (intentional bad effect) while avoiding adverse effects. A similar argument follows for the final paragraph. Although neutropenia is an undesirable side effect which warrants careful monitoring and treatment, withholding or reducing chemotherapy to avoid this effect consitutes malpractice, since it allows a primary bad effect (non-treatment of cancer). Both paragraphs should be removed.

I concur --67.114.173.106 19:41, 2 March 2007 (UTC)

I am sympatetic with Claude fight for better information for palliative care.

I disagree with carry on a *discussion* on a palliative care article.I very very very disagree with spreading this discussion in many Wikipedia article. Albert0

Oh well, for fear of being more absolutist (I should wish...) I need to point out that the article by Fallon et al has been misrepresented. In this article the authors write:

• 'Tolerance to opioids is rarely seen in cancer patients.'
• 'Psychological dependence or addiction is not a problem...'

As for hastening death, the authors acknowledge that opioids have that potential, but perhaps I could point you to the section on Opioids which now contains multiple references to the experiences that opioids do not hasten death when used safely.
Perhaps my absolutism on opioids was the reason for removing the second paragraph about neutropaenia, but doing so missed the point. The issue is that many consider it acceptable to link double effect with opioids despite considerable evidence that this does not happen when they are used safely. And yet death due to neutropaenia is never considered as double effect. The point was that death from an opioid should be investigated and analysed in the same way as death from neutropaenia.
I have attempted to correct my absolutism in the changes I made. I promise to try and be less absolute (I think...)
--Claud Regnard 23:53, 4 February 2007 (UTC)

The final sentence of the penultimate paragraph is still biased: "The intent of a palliative care physician is relief without harm, while the second is relief at any cost and suggests either negligence or malice." The intent of "the second" type of physician need not be negligence or malice; if this physician is working under priciples very different from the author's (i.e. if the physician supported assisted suicide in certain cases), she would believe herself to be doing good. A sizeable population of third-party observers would agree.

Good point. However this is not the dilemma it seems as even the Dutch find morphine a poor euthanasia agent and is the drug least used of all in euthansaia in the Netherlands. Therefore, using high doses of morphine is either an negligence or malice. I have altered the text and added a reference to make this clearer. --Claud Regnard 17:43, 19 February 2007 (UTC)

Repetition

The introduction's bullet list is almost exactly the same as the list under the "roman catholic" section--will someone fix this?

You are quite right- in fact I'm not sure why there is a 'Catholic view' since this principle is not a religious edict or instruction. So, apologies to the original author of that section but I have removed it and changed the text describing the principle to a more updated version. --Claud Regnard 17:47, 19 February 2007 (UTC)

War and palliative care

The definition of double effect now includes examples from the military arena. As double effect applies to many different arenas it seems unecessary to include military examples in the definition, especially as 'War' is considered seperately. I have therefore removed military examples from the definition.

Palliative care is being misrepresented by the linkage between pain relief/terminal sedation and euthansia (two quite different clincial approaches). I realise that this has caused disbelief for one contributor earlier this year, but the link to opioids provides more references. Another previous contributor was unhappy that this section on double effect included a discussion about palliative care, but this is inevitable since palliative care is a speciality built around making decisions at the end of life. Consequently, I have altered the text to make this clearer. --Claud Regnard (talk) 21:20, 5 September 2008 (UTC)

Have there been any studies regarding "irresponsible behavior" and "unknown consequences" pertaining to double effect?

Consider the following scenario:

A man who is mentally competent to research explosives and read safety instructions fails to do so out of laziness as he plans to detonate TNT to remove a tree stump from his yard. Had he done the research, he would have known exactly how much TNT to use, but instead uses his best judgment. He uses far too much TNT and the explosion fells a nearby tree into his neighbor's house, killing one or more of its occupants.

Does any part of double effect serve to defend or condemn the man's negligence? Does negligence even get considered in double effect? Certainly other irresponsible behavior, such as driving under the influence or even failing to maintain proper hygine while preparing food for the public is accepted by the majority of the population as unethical and immoral, but according to double effect, the killing or harming of individuals in these cases are merely a side-effect of one's actions. The man with the TNT did not intend to harm anybody, nor did his lack of research directly kill his neighbor. He could have been lucky and had used just the right amount of TNT by chance, or even not enough, in which case it wouldn't have killed anybody, but wouldn't have successfully removed the stump as well. Double effect seems to only pertain to cases where people know all of the options and their consequences, which doesn't apply often in the real world.

Most people would condemn the man responsible for his neighbor's death, as would I, but it seems the principle of double effect would defend this man's actions.

To put this in perspective of an example already in this article, let's assume a strategic target is located right next to an orphanage, and by striking that target, the orphanage is also destroyed, killing the children. Had the generals done more research on the target and discovered this additional information, they would have canceled the strike, but despite their best intentions, they still managed to do just as much harm as if they had struck only the orphanage. Are the generals at fault? Perhaps the answer to this is: if time allowed them to do the extra research, then they are just as responsible for striking the orphanage in this scenario as they would if they knowingly struck the orphanage.

In the case of the trolley killing the man in a hammock, do the ethics involved change if the man was behind a fence and the observer pulling the lever did not know the man was in his hammock, but should have considered this possibility since by pulling the trolley it would be crashing into a fenced-in back yard?

Thoughts?

Randhuck (talk) 18:03, 6 July 2010 (UTC)

Attribution to Aquinas

Should DDE be attributed to Aquinas? G.E.M. Anscombe protests that it shouldn't fairly convincingly in 'Action, Intention and 'Double Effect. Aquinas's discussion of killing in self defence is not a good guide to his opinion on responsibility for the evil consequences of actions. —Preceding unsigned comment added by 86.26.16.203 (talk) 10:59, 26 November 2010 (UTC)

Medicine

The statements are overly simplified. Public health decisions are heavily based on statistics analysis, i.e., risk of taking the vaccine vs. risk of not taking the vaccine for each individual and scenario. It has nothing to do with "number of people saved vs. number of people killed". Regarding abortion, at least in Western countries, it is not a matter of public health and in the jurisdictions that allow it the decision is an individual one, taken by patients with the advise of practitioners but not enforced by any medical set of standards. Indeed, "the greater evil of the death of both the mother and the fetus" is not a medical definition. The practical consequence is that if the doctor denies the procedure, he or she cannot be prosecuted. Aldo L (talk) 13:10, 24 March 2011 (UTC)

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Who named it "double effect"?

The principle is commonly credited to Aquinas - but who named it "double effect"? Anyone know? SEP doesn't say - David Gerard (talk) 18:34, 27 May 2018 (UTC)