Part of a series on

Thomas Aquinas

Thomism[show]

Works[show]

People[show]

Related topics[show]

 Catholicism portal
 Philosophy portal

 v
 t
 e

Part of a series of articles on

Abortion
and the Catholic Church
 show

Official opposition

show

Philosophy and theology

show

History

show

Activism

show

Dissidence

show

See also

Catholicism portal

 v
 t
 e

The principle of double effect is also known and determine as a rule of double effect;
the doctrine of double effect, often abbreviated as DDE or PDE, double-effect reasoning; or
simply double effect—is a set of ethical criteria which Christian philosophers, and some others,
have advocated for evaluating the permissibility of acting when one's otherwise legitimate act (for
example, relieving a terminally ill patient's pain) may also cause an effect one would otherwise be
obliged to avoid (sedation and a slightly shortened life). The first known example of double-effect
reasoning is Thomas Aquinas' treatment of homicidal self-defense, in his work Summa Theologica.[1]
This set of criteria states that an action having foreseen harmful effects practically inseparable from
the right effect is justifiable if the following are true:

 the nature of the act is itself good, or at least morally neutral;

 the agent intends the good effect and does not intend the bad effect either as a means to the
good or as an end in itself;
 the good effect opposite the bad effect in circumstances sufficiently grave to justify causing the
bad effect and the agent exercises due diligence to minimize the harm.[2]
 Contents

 1Intentional harm versus side effects

 2Examples
o 2.1Medicine
 3Criticisms
 4See also
 5References
 6External links

Intentional harm versus side effects[edit]

The principle of double effect is based on the idea that there is a morally relevant difference between
an "intended" consequence of an act and one that is foreseen by the actor but not calculated to
achieve his motive. So, for example, the principle is invoked to consider the terror bombing of non-
combatants having as its goal victory in a legitimate war morally out of bounds, while holding as
ethically in bounds an act of strategic bombing that similarly harms non-combatants with foresight as
a side effect of destroying a legitimate military target. Because advocates of double effect propose
that consequentially similar acts can be morally different, double effect is most often criticized
by consequentialists who consider the consequences of actions entirely determinative of the action's
morality.
In their use of the distinction between intent and foresight without intent, advocates of double effect
make three arguments. First, that intent differs from foresight, even in cases in which one foresees
an effect as inevitable. Second, that one can apply the distinction to specific sets of cases found in
military ethics (terror bombing/strategic bombing), medical ethics (craniotomy/hysterectomy), and
social ethics (euthanasia). Third, that the distinction has moral relevance, importance, or
significance.
The doctrine consists of four conditions that must be satisfied before an act is morally permissible:

1. The nature-of-the-act condition. The action, apart from the foreseen evil, must be either
morally good or indifferent.
2. The means-end condition. The bad effect must not be the means by which one achieves the
good effect. Good ends do not justify evil means.[3]
3. The right-intention condition. The intention must be the achieving of only the good effect, with
the bad effect being only an unintended side effect. All reasonable measures to avoid or
mitigate the bad effect must be taken.
4. The proportionality condition. There must be a proportionately grave reason for permitting
the evil effect.

Examples[edit]
Medicine[edit]
The principle of double effect is frequently cited in cases of pregnancy and abortion. A doctor who
believes abortion is always morally wrong may still remove the uterus or fallopian tubes of a
pregnant woman, knowing the procedure will cause the death of the embryo or fetus, in cases in
which the woman is certain to die without the procedure (examples cited include
aggressive uterine cancer and ectopic pregnancy). In these cases, the intended effect is to save the
woman's life, not to terminate the pregnancy, and the effect of not performing the procedure would
result in the greater evil of the death of both the mother and the fetus.[4][5][6]
In cases of terminally ill patients who would hasten their deaths because of unbearable pain, or
whose caregivers would do so for them (euthanasia, medical aid in dying, etc.), a principle of "double
effect death" could be applied to justify the deliberate administration of a pain-killer in potentially
unsafe doses—not in an attempt to end life but to relieve the pain suffered as it is considered
harmful to the patient. The U.S. Supreme Court has voiced support for this principle in its
deliberations over the constitutionality of medical aid in dying.[7]

Criticisms[edit]
Consequentialists, in particular, reject the notion that two acts can differ in their moral permissibility if
both have exactly the same consequences, or expected consequences. John Stuart Mill, a
nineteenth-century advocate of the utilitarian version of consequentialism, argues that it is a mistake
to confuse the standards for right action with a consideration of our motives to perform a right action:
"He who saves a fellow creature from drowning does what is morally right, whether his motive be
duty, or the hope of being paid for his trouble; he who betrays the friend that trusts him, is guilty of a
crime, even if his object be to serve another friend to whom he is under greater obligations."
According to Mill, scrutiny of motives will show that almost all good behavior proceeds from
questionable intentions. Therefore, Mill argues, our moral analysis should ignore matters of
motivation, and so we should reject DDE, which appeals to a distinction between intended
and unintended consequences.[8] Mill further claims that scrutiny of motives will reveal a man's
character, but utilitarianism does not judge character, only the rightness or wrongness of actions.