Thomas Aquinas’ Principles of Double Effect and Totality

Thomas Aquinas followed the philosophy of Aristotle. So, he believed that the universe is
organized so that each thing in it has a purpose or goal. Reason helps humans discover and
achieve their goals. Actions which are in accordance with our natural goals are good and those
that interfere with these goals are bad. So, for example, since we are capable of reasoning we
should develop our intellect and since all living things are inclined to preserve their own lives,
committing suicide goes against nature and is wrong.

Aquinas’ beliefs also include a theological framework. His beliefs support the Roman Catholic
Church’s positions on abortion and contraception. One can see this by looking at two of
Aquinas’ most well-known principles.

The Principle of Totality:​ An individual may not dispose of his organs or destroy their capacity to
function, except to the extent that this is necessary for the general well-being of the whole body.
Destroying an organ or interfering with its capacity to function prevents the organ from achieving
its natural purpose.

The Principle of Double Effect:​ Aquinas recognized that there are times when the action you
think you ought to do will have good and bad effects. In effect, you have an ethical dilemma or
conflict.

Under these circumstances, it is permissible to perform an action causing bad effects if you
meet these four conditions:
1. The action itself is morally neutral or morally good.
2. The bad effect is not the means by which the good effect is achieved.
3. The motive must be the achievement of the good effect only.
4. The good effect is at least equivalent in importance to the bad effect.

Of course, these criteria require a means by which you determine whether something is morally
good, neutral, or bad. Aquinas used the combination of his Roman Catholic faith and Aristotle’s
teachings. Someone else might use the same method, but with a different ethical foundation
and come up with different answers.
 The Doctrine of Double Effect
Sometimes doing the right thing involves a morally bad consequence. For instance, if someone
is about to murder your family, and the only thing you can do to stop him is to yourself kill that
person, it certainly seems that the right thing to do is to kill the murderer. And yet there is the
morally bad consequence of killing someone at play here.

It’d be great for moral philosophers if we could adopt simple moral rules that apply in every
situation, like “thou shalt not kill”. But situations like the above make it clear that the world is
seldom so kind to those of us who would plumb the depths of ethical reality. So, if you’re looking
to create a coherent moral system, you’d better be able to explain why it is that you are justified
in killing a murderer who is intent on killing you and your family. Under what circumstances is
killing okay?

Perhaps if we view the killing in this situation as a regrettable consequence of doing the right
thing… That is, perhaps the moral action of saving your family — even if it results in the killing of
someone — is the ​real action that you are undertaking. And perhaps the killing of the murderer
is a tangential, unavoidable, bad moral consequence. In this analysis, we might be able to work
things out to the effect that you are not a killer — you are a family-saver whose actions led
(regrettably) to an unintended killing.
Aquinas

Aquinas​, back in the 13th century, was thinking of a similar situation, and came up with four
conditions that he thought must be met for acting morally with a tangential bad moral
consequence:
1. The Nature-of-the-Act Condition​. The action itself cannot be morally wrong.
2. The Means-End Condition​. The bad effect must not lead directly to the good
effect.
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. The bad effect
may be foreseen, but not desired.
4. The Proportionality Condition​. The good effect must be at least as morally good
as the bad effect is morally bad.
If Aquinas’ analysis is on the money, then you can save your family with a clear moral
conscience, despite the fact that you wound up killing someone in order to do it.

Unfortunately, in the case of killing the murderer, we hit a pretty significant problem right off the
bat with condition one. The action itself here seems to be one of killing. Isn’t this almost
definitionally morally wrong? To get himself out of this fix, Aquinas argues that the actual action
undertaken here is ​saving one’s family, and that the killing is the bad but unintended side effect:
“Accordingly, the act of self-defense may have two effects: one, the saving of one’s life; the
other, the slaying of the aggressor.” I’m not sure I buy that, but let’s step through the other
conditions…

Actually, condition two seems problematic as well. Indeed, the saving of your family’s lives
seems to be a direct consequence of you killing the murderer. But Aquinas would argue that
actually the bad effect of killing the murderer somehow comes later in the chain of cause-effect
than the good effect of saving your family. Honestly, this seems like complete bullshit to me, but
let’s keep riding this train to the station and see where we end up.

Condition three seems really to get at the heart of the matter. ​You don’t first and foremost intend
to kill the murderer; you intend to save your family. Perhaps this is really the keystone of moral
goodness. If you don’t intend to kill the murderer, then you’re not committing murder yourself.
But if killing the murderer is something that has to happen in order for you to save your family,
then so be it.
Condition four is also conceivably well-met by our case. Saving your family, c​ eteris paribus​, is
arguably at least as morally important in the positive as killing the murderer is in the negative.

Abortion and Euthanasia

The Catholic Church has used Aquinas’ thoughts on double effect to weigh in on two weighty
moral issues of our time: abortion and euthanasia.
Many have argued that even if abortion is immoral, it is morally permissible to perform an
abortion to save the life of the mother. The Church, contrary to this, has argued that saving the
life of the mother in this sort of case would fail to meet both criteria one and two above.

But you can apply this same reasoning to the case of self-defense above. I’ll leave it to the
reader to cogitate on this further. (Hint: If saving-your-family is the true and moral act in the first
case, then why isn’t saving-the-mother the true and moral act in this case? In both cases, then,
the killing would be consequent to the saving.)

The Church meant to draw a distinction between plain abortion and, for instance, performing a
hysterectomy on a pregnant woman with uterine cancer. In the case of our cancerous woman
(so goes the Church’s logic), the result of the hysterectomy would be an abortion, but the actual
intention of the doctors is to save the woman from cancer, not to kill her fetus. This is a nifty bit
of face-saving, but, again, isn’t the real intention of the doctors in the abortion case to save the
woman’s life? And thus the abortion is secondary to the life-saving, and should be morally
acceptable.

There’s a similar Church line taken on euthanasia. A doctor killing a patient with an overdose of
morphine is (argues the Church) unacceptable, because it fails conditions one and two again.
That is, even if the desired end-result is that of mercy, getting to that end via a morally bad act
(killing) is wrong.

However, the Church allowed for doctors overdosing patients on morphine under the
circumstance where the intention is to prevent pain. That is, if the act in question is the morally
good one of pain prevention, then the unintended consequence of death is morally okay.

We’ll leave it to another day to discuss the absurdity of the presumed immorality of euthanasia,
but note again that these two situations are really not that different. No doctor (or no doctor I’ve
ever met, anyway) outright intends to kill her patients. They intend to ease suffering, and they
know that death is often the ultimate and only suffering-ender that will work in some unfortunate
circumstances.

Trolley Cases and Double Effect

​ ur primer on
Are you up to speed on philosophical trolley problems? If not, take a quick look at o
the subject​. In fact, it was the publishing of two recent books on trolley problems in philosophy
that got me thinking about double effect for this post. (Both are excellent little books, by the way,
and well worth a read: ​Would You Kill the Fat Man​, by David Edmonds, and ​The Trolley
Problem, or Would You Throw the Fat Guy Off the Bridge?​ by Thomas Cathcart.)

Some will use the doctrine of double effect to justify their intuitions about trolley cases. For
instance, in the standard case, a driver of a train with no brakes can either continue down his
track and kill five unsuspecting workers, or divert the train down a spur and kill one
unsuspecting worker. It turns out that most people believe that killing the one worker is the right
thing to do in this situation. And often people will cite utilitarian reasoning here: ‘Well, one life
isn’t as valuable as five, so it’s the right thing to kill one if you can save five.’

But if we change the circumstances of our thought experiment, the utilitarian justification loses
some weight. Say the only way to save the five workers is to push a heavy object in front of the
train. But the only object heavy enough is a fat man who happens to be above the tracks on a
bridge. Would it be the right moral thing for you to push the fat main off the bridge and let the
train run over him, saving the five lives further down the tracks? Well, it turns out that the
general moral intuition here is that it’s actually not the right thing to do. And, if this intuition is
correct, utilitarianism fails here. But the doctrine of double effect could be used to explain things!
In the first trolley case, you don’t intend to kill the one worker on the spur. And your action isn’t
really killing that worker — the action is saving the five workers by steering the train down a
different track. The killing of the one worker that results from your action is regrettable, but is not
the intended effect of the whole affair. But in the case of the fat man, you have to take direct
action against the one person in order to save the five. Your action is directly killing the fat man.
As with the above analyses, I think there’s something actually amiss here. If you put an
intermediate step in between your action and the fat man dying, that wouldn’t make it any more
or less acceptable. There has got to be another analysis that we can apply.