Principle of Double Effect

Prepared by: Raida M. Ibrahim, RN

Scenario 1
It's a lovely day out, and you decide to go for a walk along the trolley tracks that crisscross your town. As you walk, you hear a trolley behind you, and you step away from the tracks. But as the trolley gets closer, you hear the sounds of panic -- the five people on board are shouting for help. The trolley's brakes have gone out, and it's gathering speed. You find that you just happen to be standing next to a side track that veers into a sand pit, potentially providing safety for the trolley's five passengers. All you have to do is pull a hand lever to switch the tracks, and you'll save the five people. Sounds easy, right? But there's a problem. Along this offshoot of track leading to the sandpit stands a man who is totally unaware of the trolley's problem and the action you're considering. There's no time to warn him. So by pulling the lever and guiding the trolley to safety, you'll save the five passengers. But you'll kill the man. What do you do?

Scenario 2
Consider another, similar dilemma. You're walking along the track again, you notice the trolley is out of control, although this time there is no auxiliary track. But there is a man within arm's reach, between you and the track. He's large enough to stop the runaway trolley. You can save the five people on the trolley by pushing him onto the tracks, stopping the out-of-control vehicle, but you'll kill the man by using him to stop the trolley. Again, what do you do?

What is the principle of double effect?

An action that is good in itself that has two effects--an intended and otherwise not reasonably attainable good effect, and an unintended yet foreseen evil effect--is licit, provided there is a due proportion between the intended good and the permitted evil. When there is a clash between the two universal norms of "do good" and "avoid evil," the question arises as to whether the obligation to avoid evil requires one to abstain from a good action in order to prevent a foreseen but merely permitted concomitant evil effect.

Criteria to be considered:
The action to be performed must be good in itself, or at least indifferent. The evil effect must not be directly intended for itself but only permitted to happen as an accidental by-product of the act performed. The good intended must not be obtained by means of the evil effects. There must be a reasonably grave reason for permitting the evil effect.

Examples:
The terror bomber aims to bring about civilian deaths in order to weaken the resolve of the enemy: when his bombs kill civilians this is a consequence that he intends. The strategic bomber aims at military targets while foreseeing that bombing such targets will cause civilian deaths. When his bombs kill civilians this is a foreseen but unintended consequence of his actions. Even if it is equally certain that the two bombers will cause the same number of civilian deaths, terror bombing is impermissible while strategic bombing is permissible.

Examples:
A doctor who intends to hasten the death of a terminally ill patient by injecting a large dose of morphine would act impermissibly because he intends to bring about the patient's death. However, a doctor who intended to relieve the patients pain with that same dose and merely foresaw the hastening of the patients death would act permissibly.

Examples:
A doctor who believed that abortion was wrong, even in order to save the mothers life, might nevertheless consistently believe that it would be permissible to perform a hysterectomy on a pregnant woman with cancer. In carrying out the hysterectomy, the doctor would aim to save the womans life while merely foreseeing the death of the fetus. Performing an abortion, by contrast, would involve intending to kill the fetus as a means to saving the mother

Examples:
To kill a person whom you know to be plotting to kill you would be impermissible because it would be a case of intentional killing; however, to strike in self-defense against an aggressor is permissible, even if one foresees that the blow by which one defends oneself will be fatal.

Examples:
Sacrificing ones own life in order to save the lives of others can be distinguished from suicide by characterizing the agents intention: a soldier who throws himself on a live grenade intends to shield others from its blast and merely foresees his own death; by contrast, a person who commits suicide intends to bring his or her own life to an end.