T. A. Cavanaugh defends double-effect reasoning (DER), also known as the principle of double effect. DER plays a role in anti-consequentialist ethics (such as deontology), in hard cases in which one cannot realize a good without also causing a foreseen, but not intended, bad effect (for example, killing non-combatants when bombing a military target). This study is the first book-length account of the history and issues surrounding this controversial approach to hard cases. It will be indispensable in theoretical ethics, applied (...) ethics (especially medical and military), and moral theology. It will also interest legal and public policy scholars. (shrink)

T. A. Cavanaugh's Hippocrates' Oath and Asclepius' Snake: The Birth of the Medical Profession articulates the Oath as establishing the medical profession's unique internal medical ethic - in its most basic and least controvertible form, this ethic mandates that physicians help and not harm the sick. Relying on Greek myth, drama, and medical experience (e.g., homeopathy), the book shows how this medical ethic arose from reflection on the most vexing medical-ethical problem -- injury caused by a physician -- and argues (...) that deliberate iatrogenic harm, especially the harm of a doctor choosing to kill (physician assisted suicide, euthanasia, abortion, and involvement in capital punishment), amounts to an abandonment of medicine as an exclusively therapeutic profession. The book argues that medicine as a profession necessarily involves stating before others what one stands for: the good one seeks and the bad one seeks to avoid on behalf of the sick, and rejects the view that medicine is purely a technique lacking its own unique internal ethic. It concludes noting that medical promising (as found in the White Coat Ceremony through which U. S. medical students matriculate) implicates medical autonomy which in turn merits respect, including honoring professional conscientious objections. (shrink)

This paper argues that the current stock of anti-personnel cluster bombs are temporally indiscriminate, and, therefore, unjust weapons. The paper introduces and explains the idea of temporal indiscriminateness. It argues that to honor non-combatant immunity—in addition to not targeting civilians—one must adequately target combatants. Due to their high dud rate, cluster submunitions fail to target combatants with sufficient temporal accuracy, and, thereby, result in avoidable serious harm to non-combatants. The paper concludes that non-combatant immunity and the principle of discrimination require (...) a moratorium on the use of current cluster munitions. (shrink)

In “Modern Moral Philosophy” Anscombe argues that the distinction between intention of an end or means and foresight of a consequentially comparable outcome proves crucial in act-evaluation. The deontologist J. J. Thomson disagrees. She asserts that Anscombe mistakes the distinction’s moral import; it bears on agent-evaluation, not act-evaluation. I map out the contours of this dispute. I show that it implicates other disagreements, some to be expected and others not to be expected. Amongst the expected, one finds the ethicists’ accounts (...) of action and understanding of how agent-assessment relates to act-assessment. Amongst the unexpected, one finds the moralists’ views about the possibility of self-imposed moral dilemmas and allied positions concerning temporal aspects of “ought implies can.” Anscombe’s employment of the distinction in act-evaluation withstands close scrutiny; Thomson’s denial of it does not. (shrink)

In “Modern Moral Philosophy” Anscombe argues that the distinction between intention of an end or means and foresight of a consequentially comparable outcome proves crucial in act-evaluation. The deontologist J. J. Thomson disagrees. She asserts that Anscombe mistakes the distinction’s moral import; it bears on agent-evaluation, not act-evaluation. I map out the contours of this dispute. I show that it implicates other disagreements, some to be expected and others not to be expected. Amongst the expected, one finds the ethicists’ accounts (...) of action and understanding of how agent-assessment relates to act-assessment. Amongst the unexpected, one finds the moralists’ views about the possibility of self-imposed moral dilemmas and allied positions concerning temporal aspects of “ought implies can.” Anscombe’s employment of the distinction in act-evaluation withstands close scrutiny; Thomson’s denial of it does not. (shrink)

In this essay I articulate Aristotle’s account of the voluntary with a view to weighing in on a contemporary ethical debate concerning the moral relevance of the intended / foreseen distinction. Natural lawyers employ this distinction to contrast consequentially comparable acts with different intentional structures. They propose, for example, that consequentially comparable acts of terror and tactical bombing morally differ, based on their diverse structures of intention. Opponents of double-effect reasoning hold that one best captures the widely acknowledged intuitive appeal (...) of the distinction by contrasting agents, not acts. These thinkers hold that the terror bomber differs from the tactical bomber while terror bombing does not differ ethically from tactical bombing. Aristotle’s accounts of the voluntary and the deliberately decided upon provide grounds for the ethical relevance of the intended / foreseen distinction as applied to both acts and agents. (shrink)

Common morality endorses some form of an exceptionless prohibition against killing innocents. Natural lawyers employ double-effect reasoning to address hard cases involving deaths of the innocent. Current deontologists criticize DER-proponents as conflating act-with agent-evaluations. Scanlon develops this critique extensively. I respond to his criticism. He maintains that the DER-advocate tells a badly-motivated agent to refrain from an obligatory act. Thus, he asserts, the natural lawyer who employs DER errs. Instead, Scanlon proposes, one ought to assess the act as permissible while (...) blaming the agent. I argue that DER does not succumb to this critique. Moreover, Scanlon’s particular criticism nicely shows the reasonableness of the approach the DER-thinker takes, namely, that defective agents produce defective acts. Thus, employing DER does not lead to a confusion of act-with agent-evaluations. Rather, it results in coherent assessments of both. (shrink)

Common morality endorses some form of an exceptionless prohibition against killing innocents. Natural lawyers employ double-effect reasoning to address hard cases involving deaths of the innocent. Current deontologists criticize DER-proponents as conflating act-with agent-evaluations. Scanlon develops this critique extensively. I respond to his criticism. He maintains that the DER-advocate tells a badly-motivated agent to refrain from an obligatory act. Thus, he asserts, the natural lawyer who employs DER errs. Instead, Scanlon proposes, one ought to assess the act as permissible while (...) blaming the agent. I argue that DER does not succumb to this critique. Moreover, Scanlon’s particular criticism nicely shows the reasonableness of the approach the DER-thinker takes, namely, that defective agents produce defective acts. Thus, employing DER does not lead to a confusion of act-with agent-evaluations. Rather, it results in coherent assessments of both. (shrink)

If viable, DER justifies certain individual acts that—by definition—have two effects. Presumably, it would in some fashion justify policies concerning the very same acts. By contrast, acts that sometimes have a good effect and sometimes have a bad effect do not have the requisite two effects such that DER can justify them immediately. Yet, a policy concerning numerous such acts would have the requisite good and bad effects. For while any one such act would lack the relevant two effects, a (...) series of such acts and a policy governing such a series would have them. This paper addresses DER’s justification of policies that apply to such acts. It shows that there are certain acts which DER mediately justifies by justifying policies concerning them. Thus, it recommends the larger topic of DER’s bearing on policy. (shrink)

Common morality endorses some form of an exceptionless prohibition against killing innocents. Natural lawyers employ double-effect reasoning to address hard cases involving deaths of the innocent. Current deontologists criticize DER-proponents as conflating act-with agent-evaluations. Scanlon develops this critique extensively. I respond to his criticism. He maintains that the DER-advocate tells a badly-motivated agent to refrain from an obligatory act. Thus, he asserts, the natural lawyer who employs DER errs. Instead, Scanlon proposes, one ought to assess the act as permissible while (...) blaming the agent. I argue that DER does not succumb to this critique. Moreover, Scanlon’s particular criticism nicely shows the reasonableness of the approach the DER-thinker takes, namely, that defective agents produce defective acts. Thus, employing DER does not lead to a confusion of act-with agent-evaluations. Rather, it results in coherent assessments of both. (shrink)

This is a condensed description of the contents and overarching argument found in Hippocrates’ Oath and Asclepius’ Snake: The Birth of the Medical Profession. In that work, I maintain that the basic medical ethical problem concerns iatrogenic harm. I focus particularly on what I refer to as ‘role-conflation’. This most egregious form of iatrogenic harm occurs when a physician deliberately adopts the role of wounder. A contemporary practice such as physician-assisted suicide exemplifies a doctor’s deliberate wounding. I argue that the (...) author of the Hippocratic Oath – aware of the chronic risk of role-conflation – responds to this threat by having the oath-taker specifically forswear signal acts that wound the sick, such as giving a deadly drug even if asked, giving an abortifacient, sexual predation, and gossiping. I argue that by means of the Oath, Hippocrates founds medicine as a profession, a practice intimately involving promising. (shrink)

In what follows, I reply to critical appraisals of my book entitled Hippocrates’ Oath and Asclepius’ Snake: The Birth of the Medical Profession. Professors Tollefsen, McPherson, and Potts separately offer these thoughtful critiques. Professor Tollefsen approaches the work from the standpoint of the physician-patient relationship. Professors McPherson and Potts both address it in terms of virtues. Potts treats the theme of virtue generally while McPherson focuses on the virtue of piety. Since virtues attend relationships, in what follows, I discuss, first, (...) the physician-patient relationship ; second, virtue generally ; and third, and finally, the virtue of piety specifically. (shrink)

Suzanne Uniacke has written an adventurous and philosophically elegant work in which she justifies the intentional use of necessary and proportionate lethal force in private homicidal self-defense. Her contribution will interest those engaged in discussions concerning the ethics of homicide.