A Stronger Doctrine of Double Effect

Many believe that intended harms are more difficult to justify than are harms that result as a foreseen side effect of one's conduct. We describe cases of harming in which the harm is not intended, yet the harmful act nevertheless runs afoul of the intuitive moral constraint that governs intended harms. We note that these cases provide new and improved counterexamples to the so-called Simple View, according to which intentionally phi-ing requires intending to phi. We then give a new theory of the moral relevance of intention. This theory yields the traditional constraint on intending harm as a special case, along with several stronger demands.     

Intention and Responsibility in Double Effect Cases

I argue that the moral distinction in double effect cases rests on a difference not in intention as traditionally stated in the Doctrine of Double Effect (DDE), but in desire. The traditional DDE has difficulty ensuring that an agent intends the bad effect just in those cases where what he does is morally objectionable. I show firstly that the mental state of a rational agent who is certain that a side-effect will occur satisfies Bratman's criteria for intending that effect. I then clarify the nature of the moral distinction in double effect cases and how it can be used to evaluate the moral blameworthiness of agents rather than the moral status of acts. The agent's blameworthiness is reduced not by his lack of intention but by his desire not to bring about the side-effect, and the 'counterfactual test' can be used to determine whether he desires the effect in acting. In my version, the DDE has its rationale in virtue ethics; it is not liable to abuse as the traditional version is; and it makes more plausible distinctions when applied to standard examples.     

The Double Life of Double Effect

The U.S. Supreme Court's majorityopinion in Vacco v. Quill assumes thatthe principle of double effect explains thepermissibility of hastening death in thecontext of ordinary palliative care and inextraordinary cases in which painkilling drugshave failed to relieve especially intractablesuffering and terminal sedation has beenadopted as a last resort. The traditionaldoctrine of double effect, understood asproviding a prohibition on instrumental harmingas opposed to incidental harming or harming asa side effect, must be distinguished from otherways in which the claim that a result is notintended might be offered as part of ajustification for it. Although double effectmight appropriately be invoked as a constrainton ordinary palliative care, it is not clearthat it can be coherently extended to justifysuch practices as terminal sedation. A betterapproach would reconsider double effect'straditional prohibition on hastening death as ameans to relieve suffering in the context ofacute palliative care.     

浅谈临终医疗的双重效应原则

双重效应原则常用于临终患者的治疗中,应用药物为患者解除痛苦,但可能导致患者严重不良反应甚至死亡,这在伦理上是可以接受的。但目前仍存在着较大争议,特别是如何认定医师的主观意图。     

Affirmative Action and the Doctrine of Double Effect

ABSTRACT  This article attempts to show that affirmative action can be supported by the doctrine of double effect which recognises distinctions between desired and unintended effects such that the responsibility for acts falls on the side of the former rather than the latter. With this doctrine it may also be seen why affirmative action programmes cannot be simply equated with numerical quota systems, nor can they be called discriminatory, at least not under the definition of discrimination utilised.     

牟宗三"实践的智慧学"探求诠论

对哲学作为“实践的智慧学”的探求是牟宗三后期哲学思考的核心。这一探索,开启了牟宗三中国哲学与康德哲学双向诠释的基本视域,也拓出了道德形而上学体系建构的理论地平。“实践的智慧学”诠释具有独特的理论内涵,也隐含了牟氏道德形上学自我批判与超越的思想线索。     

Intending and Causing

In much of the contemporary discussion of end of life cases, active killing is forbidden doctors, whereas the passive bringing about of death is, e.g., a rather common occurrence in our hospitals. In the former sorts of cases, doctors are held to be causes of death; in the latter sorts of cases, they are held not to be. If they did not cause a death, even though they did passively bring it about, we cannot use casual responsibility for a death in order to raise possible questions about moral responsibility for that death. I here look at part of this insistence that doctors are not a part cause of death and call it into question.     

The Identification of the Triune God: Robert W. Jenson's Approach to the Doctrine of the Trinity

Abstract : Robert W. Jenson's programmatic approach to the doctrine of the Trinity consists of his aim to identify the triune God in an anti‐religious and anti‐nihilistic way. Jenson has in a unique manner carried out this identification, i.e., ontologically, contextually, and narratively; and then defined the limits of his trinitarian doctrine in accordance with this approach. The fundamental prerequisite of Jenson's approach is his “negative” natural theology, including his existential analysis of living in time.     

Why Kamm's Principle of Secondary Permissibility Cannot Save the Doctrine of Double Effect

The DDE yields counterintuitive verdicts about certain cases: it may deem it permissible to kill a certain number of people when they are not used as means and their death is not intended, but deny that killing fewer of these people is permissible if that requires intending their death, or using them as means. To accommodate the judgement that we may kill the lesser number in such cases, supporters of the DDE may appeal to Frances Kamm's Principle of Secondary Permissibility (PSP). The principle says, roughly, that if it is permissible to kill n people when not intending their death, or using them as means, then it is permissible to kill n ? m people in a way that does involve intending their deaths, or using them as means, as ‘secondarily permissible’ (where m > 0). In this article I argue that appealing to the PSP to solve the puzzling cases of the DDE is generally misleading and that it fails in particular cases. The crux of my argument is that the PSP allows killings that go against the grain of the DDE.     

思想史视野中的DNA双螺旋发现

医学史上许多丰碑不仅仅只是技术的辉煌,而且是思想史的楼梯口,由此可以提升学科的精神高度,50年前的DNA双螺旋结构的发现就是这样一个精神“事件”。试图穿越生物学实验探究其另一面——思想实验的创新价值;重新审定了物理学对于50年来生命科学的技术和思维引领作用;分析了还原论在DNA之后的价值终结。     

Two Puzzles for Deontologists: Life-Prolonging Killings and the Moral Symmetry Between Killing and Causing a Person to be Unconscious

Some form of agent-relative constraint against the killing of innocent personsis a central principle in deontological moraltheories. In this article I make two claimsabout this constraint. First, I argue that somekillings of innocents performed incircumstances usually not taken to exculpatethe killer are not even pro tanto wrong.Second, I contend that either there is noagent-relative constraint against the killingof innocents or this constraint has a verydifferent shape from that which deontologistsnormally take it to have. My defence of theseclaims rests on two propositions. First, inkilling someone one may actually prolong thatperson's life. Roughly, life-prolongingkillings are possible, because to kill someoneis to perform an act that causes someone'sdeath and it might well be true that, had onenot performed this act, one's ``victim' wouldhave died earlier. Second, all other thingsbeing equal, killing and causing a person to beunconscious are morally equivalent. Both ofthese propositions are defended in thearticle.     

So Close,Yet So Far: Why Solutions to the Closeness Problem for the Doctrine of Double Effect Fall Short

According to the classical Doctrine of Double Effect (DDE), there is a morally significant difference between intending harm and merely foreseeing harm. Versions of DDE have been defended in a variety of creative ways, but there is one difficulty, the so‐called “closeness problem”, that continues to bedevil all of them. The problem is that an agent's intention can always be identified in such a fine‐grained way as to eliminate an intention to harm from almost any situation, including those that have been taken to be paradigmatic instances in which DDE applies to intended harm. In this paper, we consider and reject a number of recent attempts to solve the closeness problem. We argue that the failure of these proposals strongly suggests that the closeness problem is intractable, and that the distinction between intending harm and merely foreseeing harm is not morally significant. Further, we argue that there may be a deeper reason why such attempts must fail: the rationale that makes the best fit with DDE, namely, an imperative not to aim at evil, is itself irredeemably flawed. While we believe that these observations should lead us to abandon further attempts to solve the closeness problem for DDE, we also conclude by showing how a related principle that is supported by a distinct rationale and avoids facing the closeness problem altogether nevertheless shares with DDE its most important features, including an intuitive explanation of a number of cases and a commitment to the relevance of intentions.     

关于安慰剂效应的研究

安慰剂效应是指由安慰剂所引起的可观察的行为.本文讨论了安慰剂效应的确切定义,安慰剂效应的强度差异,以及临床背景、患者的人格特质、安慰剂的特征和医患关系等因素对安慰剂效应的影响.目前研究者普遍认为安慰剂效应通过期待和条件作用产生.近期的一个研究热点是疼痛和帕金森氏症背景下期待引起的安慰剂效应的神经机制.     

The Structure of the Ordinals and the Interpretation of ZF in Double Extension Set Theory

Andrzej Kisielewicz has proposed three systems of double extension set theory of which we have shown two to be inconsistent in an earlier paper. Kisielewicz presented an argument that the remaining system interprets ZF, which is defective: it actually shows that the surviving possibly consistent system of double extension set theory interprets ZF with Separation and Comprehension restricted to ₀ formulas. We show that this system does interpret ZF, using an analysis of the structure of the ordinals.