Author, Simon.
Published, April 23, 2009.
Double Effect was first expressed as a doctrine by Roman Catholic theologian and philosopher, Thomas Aquinas (see picture). Aquinas, in his enourmous work, Summa Theologica, expressed the doctrine like so; that every action has more than one effect, and that it was possible for one to intend a good consequence, but through acting to bring it about cause a negative consequence. In Just War Theory, double effect is used to reconcile the requirement that non-combatants may never be harmed, with the conduct of legitimate military operations.
A clichéd, but useful, example is that of a strategic bomber. The bomber, from nation A, has been instructed to attack a military base in nation B. His primary intention is to destroy a certain part of the base. However, unbeknownst to the bomber, there is a child-care centre in the military base, which happens to be right next to the particular section of the base he plans to bomb. As a direct result of the bombing, many children will die. Here, there are two effects happening; the effective bombing of a legitimate military target, and the deaths of many children. Both of these effects are as a result of the same action. Hence, we have a fine example of a ‘double effect’.
Part 4, which expands of DDE and Aquinas, is here.
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Interesting. In a medical ethics class I think we looked briefly at ‘double effect’ when considering the ethics of end-of-life medical treatment and euthanasia - the distinction between giving someone a lethal dose of morphine for the purpose of ending their life vs giving a lethal dose of morphine for the purpose of pain control with the other (undesired but expected )effect being their death. From what I understand, Australian law sees this distinction, even though the end point is the same…
Hi Steph. Thanks for your comment.
It is interesting. It is interesting that Australian law recognises it, also. There was a good paper I read by Warren S. Quinn (http://www.jstor.org/pss/2265475, through JSTOR) which discussed DDE regarding medicine and military. Your example is a good one, and shows how much DDE relies on the the agent’s inetntionality. There is a distinct problem with the ‘intentionality’ aspect of DDE, as I will discuss in later installments.
Do you think that DDE has a legitimate place in medicine? My analysis would suggest it doesn’t have a place in military conduct. It could be different in medicine.
Hmm. I guess one difference when looking at DDE in medicine vs military is that in medicine DDE almost always plays out in one patient’s life only - the positive effects and the negative trade-offs occur in that same patient with the expectation that ultimately the patient will be better off. Whereas in military some people (e.g. the children in the childcare centre) will only get the negative effect. Intentionality is a key part of medical ethics - whether you acted in the patient’s best interests can override other ethical principles. For example, if a patient confesses to a medical student that they are hiding a bottle of grog in their bed, but tells the student not to tell the doctor, the medical student is entitled to break confidentiality and tell the doctor because they do so in the patient’s best interest. I guess it becomes more difficult if there are multiple people involved, for example if a patient with HIV refuses to disclose their HIV status with their partner, the doctor can, and indeed must, break the principle of confidentiality and disclose their status to a register who notifies contacts in order to protect them. Is this best for the original patient? Perhaps not.