The Act of the Principle of Double Effect

[Atreyu]

The Principle of Double Effect describes when it is morally permissible (or possibly morally necessary) to perform a certain act that has two effects; one of which is evil. This applies in cases such as ectopic pregnancies and killing someone in self-defence (or defence of another). One of the criteria that must be fulfilled for such an act to be morally OK, is that the act itself must not be morally evil. It must be morally good, or morally neutral.

For me, this is a real sticking point. How can we say that removal of the fallopian tube is morally neutral, but removal of a foetus is not? This might seem obvious to some people, but I’m struggling to see it. In the case of killing someone in self-defence or defence of another, how can we say that this is a morally neutral “act”? Or are we saying that the act is shooting someone, and the evil effect is that the person dies? So shooting someone is morally neutral?

Help please! Pax vobiscum.

 

[Pug]

The act of removing a fallopian tube in the abstract is okay. It would need to be done to a woman with certain cancers, for instance, just as it is okay to remove an appendix or other such thing for health of the person. Thus the act of removing a fallopian tube can be done. It is not intrinsically evil.

But what if there is a child living in the fallopian tube who is too small to live anywhere else? Then the principle of double effect might come into play. The idea would be to remove the fallopian tube as in the other cases, because it is diseased, but the child as a side effect will be moved with the tube. To accept a side effect of that magnitutde, there must be just cause. Even otherwise good actions can become bad if there is no pressing reason to do them and they have bad side effects. But in the case of a tubal pregnancy, it is possible for there to be pressing reason to act.

The intent cannot be to directly kill the child in this action.

Also, note that moving the baby might not be wrong in itself either. Say the child is in the tube and will die there unless moved to the uterus, and say they do develop a way to move the child like that. Then it might not prove wrong to move the child from the tube to the uterus. But I haven’t really thought about that. Just a passing idea.

 

[Atreyu]

The act of removing a fallopian tube in the abstract is okay. It would need to be done to a woman with certain cancers, for instance, just as it is okay to remove an appendix or other such thing for health of the person. Thus the act of removing a fallopian tube can be done. It is not intrinsically evil.

But what if there is a child living in the fallopian tube who is too small to live anywhere else? Then the principle of double effect might come into play. The idea would be to remove the fallopian tube as in the other cases, because it is diseased, but the child as a side effect will be moved with the tube. To accept a side effect of that magnitutde, there must be just cause. Even otherwise good actions can become bad if there is no pressing reason to do them and they have bad side effects. But in the case of a tubal pregnancy, it is possible for there to be pressing reason to act.

The intent cannot be to directly kill the child in this action.

Also, note that moving the baby might not be wrong in itself either. Say the child is in the tube and will die there unless moved to the uterus, and say they do develop a way to move the child like that. Then it might not prove wrong to move the child from the tube to the uterus. But I haven’t really thought about that. Just a passing idea.

Yeah I think I’m OK with that. But what about killing someone in self-defence? I feel like I’m so close to getting it, but I just don’t yet!!

 

[Pug]

Yeah I think I’m OK with that. But what about killing someone in self-defence? I feel like I’m so close to getting it, but I just don’t yet!!

Ah, well I was deliberately avoiding the self-defence topic because it troubles me. Say you are a man in possession of a gun and someone stronger than you is trying to kill you in a field. You are within your rights to stop him from killing you. Your intent is to stop him, not to kill him. So you use the gun to that effect. If it is not needed to aim for anything but his knee and you aim for the heart, this is wrong. If it is needed to aim elsewhere, then you may do so. Probably the average man will need to aim for something he can hit. The death of the aggressor is accepted as a likely side-effect.

Note that the man can choose not to defend himself with strong force, assuming he has no pressing duty calling him to live, and hope the aggressor lives to later repent.

Using this method of double effect troubles me. I have difficultly envisioning shooting someone in the head without intending severe bodily harm as a real part of my plan. I can easily see how death itself need not be intended, however.

There exist other means of dealing with this, not using double effect, by calling it direct killing that is justified because your aggressor was not innocent. If I recall, some classical moralists use this approach.

 

[Ham1]

As you probably know, there are three components to an act. There is object, intention and circumstance. Obviously, in the double effect principle the object must be good or indifferent. In a case like self defense, it is tough because one wants to say that killing is the object which would appear to be evil. The fact is that killing is not the object. There are what St. Thomas calls principal conditions (usually mistranslated as circumstances which makes this even more confusing) which specify the object to one moral species or another. It seems there are certain objects that require principal conditions in order to determine their morality according to right reason. “Killing” is one of those objects. In short, we need more information as to what principle conditions exist.

If we add “in an act of justifiable self-defense” the object of killing becomes a separate and distinct object and morally good. If, on the other hand, we add the principal condition of “an innocent human being” the object of killing again becomes an act of murder and becomes intrinsically evil. Another example would be the object “sexual intercourse.” In order to evaluate the object “sexual intercourse”, we must have more information, namely, is the act “marital” or “non-marital”. Obviously, that specifically designates the object as either good or intrinsically evil.

Admittedly, this is a razor thin distinction within moral theology. But it is important to understand that what are sometimes mistakenly termed circumstances (St. Thomas uses conditio particularis) sometimes fundamentally change the object to a particular moral species and should really be called principle conditions (conditio principalis).

I know this is kind of condensed and some of it may be unclear. If it is, please let me know and I will try to explain it more fully.

 

[manualman]

The wikipedia article on double effect seems quite good to me. Worth reading.

Ectopic Pregnancy: It may help you to know that double effect does NOT justify use of abortifacient chemicals to kill the baby and clear the tube. Only surgical removal of the tube section is morally allowed. It is allowed because it presumes that we would, if we could, relocate the baby to the womb. The act is the removal of the damaged tube, the death of the child is an undesired side effect. Hopefully, medical tech will someday advance to where relocation can be acheived.

Self-defense: If you are attacked and decide the person intends to kill you, you are allowed to use force to defend your life against the unjust agressor. This is the positive action taken. The foreseeable side effect is the potential death of the assailant. The goal of defense does not REQUIRE the killing of the assailant (a bad wound will do), but is often a side effect. Now if see it coming and rage overtakes you and you purposely kill out of anger and vengeance, rather than what you feel is necessary to defend yourself, then that is quite another matter - even if the agressor really did intend you harm. This is why I need to stop watching Bronson movies…

 

[Atreyu]

As you probably know, there are three components to an act. There is object, intention and circumstance. Obviously, in the double effect principle the object must be good or indifferent. In a case like self defense, it is tough because one wants to say that killing is the object which would appear to be evil. The fact is that killing is not the object. There are what St. Thomas calls principal conditions (usually mistranslated as circumstances which makes this even more confusing) which specify the object to one moral species or another. It seems there are certain objects that require principal conditions in order to determine their morality according to right reason. “Killing” is one of those objects. In short, we need more information as to what principle conditions exist.

If we add “in an act of justifiable self-defense” the object of killing becomes a separate and distinct object and morally good. If, on the other hand, we add the principal condition of “an innocent human being” the object of killing again becomes an act of murder and becomes intrinsically evil. Another example would be the object “sexual intercourse.” In order to evaluate the object “sexual intercourse”, we must have more information, namely, is the act “marital” or “non-marital”. Obviously, that specifically designates the object as either good or intrinsically evil.

Admittedly, this is a razor thin distinction within moral theology. But it is important to understand that what are sometimes mistakenly termed circumstances (St. Thomas uses conditio particularis) sometimes fundamentally change the object to a particular moral species and should really be called principle conditions (conditio principalis).

I know this is kind of condensed and some of it may be unclear. If it is, please let me know and I will try to explain it more fully.

Wow great post Ham, thanks for that. With a name like that, you’re not an amateur are you? Amateur radio?

 

[mosher]

Self defense is not a matter that involves the principle of double effect. This is the reason why people are having a hard time with making it fit. Rather, killing another is not an intrinsically evil act but is morally neutral in and of itself when taken in a vacuum. We have to consider all of the four causes to determine if it is evil or good. There are cases in which killing another is actually a practice of virtue such as in just war and self-defense.

The question of eptopic pregnancies is a little difficult because certain moral principles must be in effect at all times. We must never directly intend the death of an innocent. We must never to evil to bring about a good. The proper usage of the Principle of Double Effect respects all of the foundational principles of Ethics. Thus, in the case where it is an either ow situation such as an eptopic pregnancy it is still necessary to not intend the death of the child but rather the life of the mother and the life of the child must be treated as equal. There is as of yet no easy answer to this and it is currently under debate among bio-ethicists on what is the proper course of action and if in some way the death of the child in that case as with other specific medical cases could be treated under self-defense. However, there is no real consensus among the experts. I just pray that medical science can perfect the method of “forcing” the child through the tube so that it can implant without grave danger to the mother. Currently a mother that uses this option is taking a serious risk of her own mortality.

 

[Ron_Conte]

Self defense is not a matter that involves the principle of double effect.

The classic example of the principle of double effect is given by St. Thomas in the Summa Theologica in reference to killing in self-defense:

newadvent.org/summa/3064.htm#7

This is usually cited as the first explict theological explanation of that principle.

ectopic pregnancy

1. The disease is the growth of the fetus in the wrong location, hence the term ‘ectopic’.
2. Removal of the fetus from that location directly treats that disease.
3. (given the current state of medical science) the fetus cannot be saved by transplantation to the proper location, the womb.
4. the fetus cannot survive if it remains in its ectopic location (usually the fallopian tube)
5. The act of removing an ectopic fetus is not intrinsically evil because the fetus cannot live in that location and its growth in that location is a disease which threatens the life of the mother, who can be saved.

The principle of double effect applies here.
There are two effects, the unintended and unavoidable death of the fetus, and the treatment of a disease to save the life of the mother. Since the former cannot be saved and the latter can be saved, the treatment of the disease by the removal of the ectopic fetus is moral.

Ron Conte

 

[Pug]

1. The act of removing an ectopic fetus is not intrinsically evil because the fetus cannot live in that location and its growth in that location is a disease which threatens the life of the mother

A baby can survive in the abdominal cavity to viability. The chances are of some small size no doubt, but it has happened. Also, you appear to be discussing the direct removal of the baby in your post. As I discussed above, the removal of the tube with the baby in it is usually accepted under double effect. The removal of the baby himself, leaving the tube intact, does not enjoy the same level of favor. Usually it is deemed wrong by Catholic moralists.

There is no Vatican ruling on this topic, afaik. There are some guidelines from the USCCB, but they are not as clear as I’d like. (see #45-48).

 

[BlestOne]

My sister had a fallopian tube removed as part of a surgery to remove a 1 pound mass in her abdomen when she was 6 months pregnant. This was to save the life of the baby not my sister. The mass was preventing her uterus from being able to expand properly during pregnancy and was also cutting off the nutrients and blood to the uterus. The fallopian tube was in the middle of the mass and could not be saved when removing this cantalope sized mass. She certainly did what was right to preserve the life of her child.

The removal of the fallopian tube was secondary to the mass removal… very much like removing an etopic fetus is when removing a fallopian tube. If the tube ruptures there are all kinds of problems that it can create, including death, so removal of the distended fallopian tube is considered critical to saving the life of the mother. The fetus cannot survive 9 months in the fallopian tube and then be born…it just isn’t possible. So the choice is not mother or baby it is mother or neither…

 

[Ron_Conte]

A baby can survive in the abdominal cavity to viability. The chances are of some small size no doubt, but it has happened. Also, you appear to be discussing the direct removal of the baby in your post. As I discussed above, the removal of the tube with the baby in it is usually accepted under double effect. The removal of the baby himself, leaving the tube intact, does not enjoy the same level of favor. Usually it is deemed wrong by Catholic moralists.

There is no Vatican ruling on this topic, afaik. There are some guidelines from the USCCB, but they are not as clear as I’d like. (see #45-48).

You are stating the majority opinion of theologians (removal of tube and fetus, not fetus alone). The Church has no official teaching on this question.

My opinion is that the tube is not diseased. If the tube is diseased, what is the cause of that disease? It can only be the fetus. A more accurate evaluation of this situation is that the disease is the growth of the fetus in the wrong location (hence the term ectopic). Therefore, removal of the fetus itself is moral (given the conditions stated in my other post).

If the fallopian tube is diseased in an ectopic pregnancy located in the fallopian tube, then what is diseased in an ectopic pregnancy in the abdomen? Certainly it is not the abdomen itself. No, the disease of ectopic pregnancy is the growth of the fetus in the wrong location, so removal from that wrong location treats the disease directly.

The direct act is the treatment of the disease.
The two effects are the indirect death of the fetus and the saving of the life of the mother. The latter outweighs the former because the fetus cannot be saved.

Concerning ectopic pregnancies in the womb, these account for less than 3% of cases and the chances of the growth of this ectopic pregnancy killing both mother and child is much greater than the chance of both surviving. It is immoral to risk the lives of both mother and child in favor of a very slim chance that both will survive. In such a case the fetus can be removed from the abdomen because not doing so presents a very grave and likely risk of death to both prenatal and mother.

Ron Conte

 

[Atreyu]

You are stating the majority opinion of theologians (removal of tube and fetus, not fetus alone). The Church has no official teaching on this question.

My opinion is that the tube is not diseased. If the tube is diseased, what is the cause of that disease? It can only be the fetus. A more accurate evaluation of this situation is that the disease is the growth of the fetus in the wrong location (hence the term ectopic). Therefore, removal of the fetus itself is moral (given the conditions stated in my other post).

If the fallopian tube is diseased in an ectopic pregnancy located in the fallopian tube, then what is diseased in an ectopic pregnancy in the abdomen? Certainly it is not the abdomen itself. No, the disease of ectopic pregnancy is the growth of the fetus in the wrong location, so removal from that wrong location treats the disease directly.

The direct act is the treatment of the disease.
The two effects are the indirect death of the fetus and the saving of the life of the mother. The latter outweighs the former because the fetus cannot be saved.

Concerning ectopic pregnancies in the womb, these account for less than 3% of cases and the chances of the growth of this ectopic pregnancy killing both mother and child is much greater than the chance of both surviving. It is immoral to risk the lives of both mother and child in favor of a very slim chance that both will survive. In such a case the fetus can be removed from the abdomen because not doing so presents a very grave and likely risk of death to both prenatal and mother.

Ron Conte

I feel wary being in opposition to the majority of theologians, but what you have said actually makes a lot of sense to me.

 

[Kristopher]

It should be stated, and unfortunately I do not have a specific source off the top of my head, but abortion can increase the likelihood of future ectopic pregnancies by two hundred percent, in other words a person is twice as likely to have an ectopic pregnancy after an abortion.

The percentage of three percent will change with increased distribution of Plan B, The Morning After Pill, which does life-threatening side effects, and has resulted in unplanned abortions.

 

[mosher]

Self defense is not a matter that involves the principle of double effect.

You are correct. I confused the arguments of Thomas with another position. While he does argue that any act of killing in self-defense is indirect and thus falls under the principle of double effect there is an opposing view that even allows for the direct killing of the aggressor. John de Lugo argues,“We may intend whatever is necessary for the defense of our life. Sometimes the striking of blows alone is insufficient for this purpose, but the death of the adversary is necessary. His stubbornness is such that he will mot cease from attacking you, either by himself or others, unless he dies. Therefore, you can intend his death, not merely as the striking blow [from which death may follow] but as death, because it is useful to your safety not otherwise than as death … The death of the aggressor is not merely connected with another means than is intended, but it itself, and as death, is useful and judged necessary to your defense.” (De Lugo Justitia et Jure, On Justice and Right), Disputation X, section VI, 149.) [taken from “Right and Reason” by Fr. Austin Fagothey, TAN.]

 

[porriwiggle]

It should be stated, and unfortunately I do not have a specific source off the top of my head, but abortion can increase the likelihood of future ectopic pregnancies by two hundred percent, in other words a person is twice as likely to have an ectopic pregnancy after an abortion.

This is because surgical abortion often scars the inside of the womb. If this scarring happens at the end of the fallopian tube it can close it enough so that the sperm can go up the tube, but the fertilised egg no longer has room to go down it.

The same effect can often be caused by inter-uterine contraception (the coil) and sexually transmitted diseases. All of which are encouraged by our permissive society.