Principle of Double

Effect
Bautista, Cajiles, Camaing, Camila, Chua
Introduction

The doctrine (or principle) of double effect is often

invoked to explain the permissibility of an action that
causes a serious harm, such as the death of a human
being, as a side effect of promoting some good end.
THERE ARE TWO EFFECTS THAT EMANATE, NAMELY:

1. THE GOOD OR BENEFICIAL EFFECT

2. THE BAD OR HARMFUL EFFECT
Accordingly, this principle must ultimately be to “form a
good conscience when an act is foreseen to have both
beneficial (good) and harmful (evil) effects.”
 4 Conditions in the use of the Principle of
Double Effect

1. The act itself must be morally good or at least indifferent.

Criteria that must be considered to determine and act to be morally good by Ashley and
O’Rourke (2002):

a. An act must be directed towards the union with God and friendship with fellow men
b. Choosing an effective means to achieve the goal
c. To have an honest intention and all other circumstances must contribute to the good
moral object
 4 Conditions in the use of the Principle of
Double Effect

2. Intention is to achieve directly the beneficial effect and even if

there is a resulting harmful effect.
-good effect must be “primus in intentione” (first in intention) and evil effect is
never intended.

- all medical and surgical procedures normally seek what is good for the patient
 4 Conditions in the use of the Principle of
Double Effect

3. Effects must be equal to or greater that the harmful effects

-PRINCIPLE OF PROPORTIONALITY

- “we should not do evil that good

GOOD
may come” - St.Paul BAD
 4 Conditions in the use of the Principle of
Double Effect

4. Beneficial effect must happen first or at least at the same time as

the harmful effect

- Necessary requirement that must be recognized under the

element of the order of time.
 ANY MEDICAL OR SURGICAL PROCEDURE
MUST POSSES ALL THE FOUR CRITERIA
ENUMERATED. Any lack of single one of them
makes the procedure ethically questionable
and consequently illegitimate. It’s all or
nothing
 CASE A
“TWO CLOSE FOR COMFORT”

MARIA AND ROSA ARE TWINS AND ARE MONTHS OLD. BUT THEIR CONDITION IS UNUSUAL. THEY WERE JOINED TOGETHER AT BIRTH, AND IT
WAS MARIA’S HEART AND LUNGS THAT WERE KEEPING BOTH GIRLS ALIVE. IT WAS CERTAIN THAT REMOVING ROSA WOULD CAUSE ROSA’S
DEATH. “WERE THEY LEFT JOINED, THE DOCTORS SAID, “THERE WAS AN 80%EXPECTAION THAT BOTH GIRLS WOULD DIE WITHIN SIX
MONTHS.”

THE PARENTS OF THE TWINS HAD OPPOSED THE OPERATION IN AN UNSUCCESFUL LEGAL ACTION THAT CITED RELIGIOUS OBJECTIONS. THEY
FURTHER INTIMATED THAT THEIR RELIGIOUS FAITH , BOTH BEING CATHOLICS, COMPELLED THEM TO LET NATURE TAKE ITS COURSE, WITH
NO MEDICAL INTERVENTIONS, EVEN THOUGH IT COULD RESULT IN THE DEATHS OF BOTH THEIR DAUGHTERS. THEY SAID “WE COULD NOT
BEGIN TO CONTEMPLATE THAT ONE OF OUR CHILDREN SHOULD DIE TO ENABLE THE OTHER ONE TO SURVIVE. THAT IS NOT GOD’S WILL.”
INCIDENTALLY, THE CASE OF MARIA OF MARIA AND ROSA WAS ELEVATED TO THE COURT OF LAW AND THEREAFTER, THE COURT TURN
DOWN THE PARENT’S APPEAL AND DECIDED TO SEPARATE THE BABY NOTWITHSANDING THE CONSEQUENCES.
1. WHAT ARE THE ETHICAL ISSUES THAT CAN BE RAISED IN THE
CASE?EXPLAIN EACH

•AUTONOMY
THE PARENTS HAVE FREEDOM TO CHOOSE FOR THEIR CHILDREN SINCE THE CHILDREN COULD NEITHER CONSENT OR ASSENT TO
THEIR OWN TREATMENT. THE PARENTS WERE MORALLY AND LEGALLY QUALIFIED AS COMPETENT ADULTS TO TAKE DESCISIONS
FOR THEIR CHILDREN
•PATERNALISTIC PROTECTION
THE INTEREST OF THEIR CHILDREN WERE THEIR DEEP CONCERN.
•BENEFICENCE, NON- MALIFECENCE AND JUSTICE CANNOT BE JUSTIFIED BECAUSE THE SEPARATION IS NOT IN ROSA’S BEST
INTEREST
CAN PARENT’S DISAPPROVAL TO HAVE THE TWINS SEPARATED BE JUSTIFIED ON ETHICAL GROUNDS?
CAN RELIGIOUS BELIEF OF THE PARENTS BE A GOOD ETHICAL BASIS FOR DISALLOWING THE
PROCEDURE?

•YES BECAUSE THE PARENTS HAVE THE AUTONOMY TO CHOOSE FOR THEIR CHILDREN SINCE THEY ARE MORALLY AND LEGALLY
QUALIFIED TO MAKE DESCISIONS FOR THEIR CHILDREN
•YES IT COULD BE A GOOD ETHICAL BASIS BECAUSE THEY WANT THE BEST FOR BOTH OF THEIR CHILDREN AND LET NATURE TAKE
IT’S COURSE
3.WHAT IS THE ETHICAL JUSTIFICATION OF THE COURT TO ALLOW THE
OPARATION?

•CONSEQUENTIALISM IS THE ETHICAL JUSTIFICATION OF THE COURT TO ALLOW THE OPERATION BECAUSE IT WILL ALLOW
MARIA TO SURVIVE.
•ROSA WAS SACRIFICED FOR THE WELFARE OF MARIA.
4.IS REMOVING LITTLE ROSA A CASE OF MURDER?CAN THE PRINCIPLE OF DOUBLE EFFECT BE
USED TO JUSTIFY THE OPERATION?HOW DO YOU GUAGE THE NATURE OF GOD’S WILL IN THIS
CASE?

•NO IT’S NOT A CASE OF MURDER BECAUSE THE COURT PERMITED THE HOSPITAL TO PUSH THROUGH THE OPERATION.
•DOUBLE EFFECT CAN BE USED TO JUSTIFY THE OPERATION BECAUSE THE BENEFIT IS EQUAL TO THE HARM
•GOD’S WILL IS THE LIFE OF ROSA BEING SACRIFICED FOR MARIA TO SURVIVE AND LIVE ON AND HAVE A GOOD LIFE.
CASE B: Two close to say goodbye
Katrina, a 25 years old mother and a mother of 2 is having her third
pregnancy. During her prenatal check up her OB gyne doctor discovered a
twin pregnancy in which both of the babies are on the 19th week of gestation.
In her 21st week of pregnancy, her doctor through sn ultrasound procedure
discovered that one of the babies died in the utero. Both babies share the
same placenta. Accordingly , termination of pregnancy was indicated since the
dead baby may affect the life of the other baby and of the mother due to
some toxins emmitted by it:
1. Will the termination of pregnancy be morally justified in this situation
why? Why not? Elaborate
2. Is is ethically sound to wait for 7 weeks more to make it 28 and do the
intervention since this time, there is a medical basis to do caesarean
section?
3. Is it ethical to just proceed with pregnancy until some indications of
harmful effects are evident
1. Terminating the pregnancy gives us greater chance of saving atleast one of
them (the mother). If the pregnancy will push through, the risk of all of them dying
or the risk of having complications throughout the pregnancy may outweigh the
benefit of saving atleast one person.

2. No. the risk of them dying or having complication due to prolonged exposure to
the toxin released by the dead fetus will increase as time passes by.

3. No. We shouldn't wait for any dangerous signs before doing intervention
because this may aggravate the condition or cause any other complication that
should not even happen if we acted earlier.