1 NOTE ON THE DOCTRINE OF DOUBLE EFFECT AND THE DOCTRINE OF ACTS AND OMISSIONS For Philosophy 13 Fall, 2008 1. THE DOCTRINE OF DOUBLE EFFECT The Doctrine of Double Effect (DDE) holds that in some contexts it is morally permissible to bring about as a foreseen but unintended consequence a bad effect that it would be morally wrong to bring about as a strictly intended consequence. The distinction between merely foreseen but unintended versus foreseen and intended consequences can be illustrated with the example of PUNISHING THE INNOCENT. Suppose we know that when we punish convicted criminals, innocent people guilty of no crime are also made to suffer. If we put the guilty offender behind bars, members of the offender's family will be deprived of his love, companionship, financial support, and so on. These consequences can be serious. Perhaps in some cases we ought to forego punishing some guilty person because of the harm that punishing him would visit on innocent persons. Nonetheless such consequences, though foreseen, are unintended. When we punish the guilty we aim at the punishment of the guilty person's family members neither as a means to our ends nor as an end. We might say that punishing the innocent is not part of our plan. The harm that comes to the innocent is a merely foreseen but unintended consequence of what we do. In contrast, suppose that for some reason the guilty offender is beyond our reach and cannot be punished directly. But his family ties are so close that if we deliberately punished his family members and publicized this fact, the guilty person would suffer just as much as if we put him in prison or gave some equivalent direct punishment. But in this variant case punishing the innocent would be not a merely foreseen but an intended consequence of our action. We aim at punishing the innocent as a means to our goal of punishing the guilty offender. Many people would judge that even if the overall consequences turned out to be the same whether we punished the guilty and caused harm to the innocent as an unintended byproduct or punished the innocent and caused harm to the guilty through punishing the innocent, the two acts are not morally on a par. The structure of the agent's intentions makes a difference to moral assessment. This is the intuition that lies behind the DDE. In contrast, according to consequentialist moral theory, the distinction between intended and merely foreseen consequences does not matter for moral assessment except insofar as the distinction happens to distinguish factors that are consequential for the production of better outcomes. In and of itself, the distinction is unimportant for consequentialist assessment. FORMULATION. The DDE applies when the following conditions hold: 1. The agent chooses an act as a means to achieving a morally permissible goal. 2. Besides the intended good effect of the act, there is another (double) effect. The agent foresees that the act she proposes to do will cause harm. 3. The agent does not intend the bad effect that is foreseen. That is to say, she aims at the bad effect neither as a means to her ends nor as an end. 4. There is due proportion between the good effect the agent's proposed act would achieve and its foreseen unintended consequences. The good that is to be achieved sufficiently outweighs the unintended bad. (In some types of case, due proportion might be satisfied even though the good to be achieved is less than, but not unduly les than, the unintended bad.) The DDE holds that when these conditions hold, in some contexts it may be permissible to bring about harm as a foreseen but unintended consequence of what one does whereas it would be forbidden to bring about that same amount of harm in otherwise similar circumstances as an intended consequence. EXAMPLES OF APPLICATION. Consider three pairs of examples (from Warren Quinn essay) . A. TERROR BOMBER AND STRATEGIC BOMBER. The terror bomber deliberately drops bombs on civilians during wartime, in order to terrorize the enemy population and cause the enemy leaders to sue for peace. The strategic bomber does not aim deliberately at civilian2 deaths, but in order to secure an important military objective she is willing to drop bombs on a military target in the knowledge that some civilians nearby will be killed. Suppose that the cases are parallel in other respects--the number of civilian deaths brought about and the importance of the military objective one's act will gain are the same. But one case involves deaths brought about as foreseen but unintended whereas the other case involves deaths brought about as strictly intended. GUINEA PIG AND DIRECTION OF RESOURCES. Suppose that a new disease endangers many lives. Doctors have available a limited supply of medicine to cope with the disease. In GUINEA PIG, some patients stricken with the disease are deliberately allowed to languish and die without medicine. The doctors observe the progress of the disease and are thus enabled to help future patients more effectively. In a similar case, DIRECTION OF RESOURCES, imagine that doctors ration the available medicine, giving it to those who will most benefit from it. Some would-be patients do not receive medicine and they die. Suppose that the numbers of lives saved and lost are the same in the two cases. The difference is that in GUINEA PIG, the deaths the doctors allow to happen are intended, whereas in DIRECTION OF RESOURCES, the deaths brought about by the doctors' choice of policy are foreseen but not intended. REMOVAL OF CANCEROUS UTERUS AND CRANIOTOMY. Compare two medical ethics cases. Both involve abortion as interpreted by Roman Catholic moralists deploying the DDE. In CANCEROUS UTERUS, a woman who is pregnant develops cancer of the uterus. The procedure that would be recommended for the woman's medical condition, if one sets aside the fact that she is pregnant, is the removal of the uterus. If the doctors operate to remove the uterus to save the mother's life, the death of the fetus is a merely foreseen but not intended consequence of their action. In contrast, sometimes in childbirth the child becomes wedged in the birth canal, and to save the mother's life, the head of the child must be crushed and the child's body removed from the birth canal. In this CRANIOTOMY example, according to the Catholic moralists, the death of the fetus is intended as a means to saving the