Bernard G. Prusak

Double effect, all over again: the case of Sister Margaret McBride.

As media reports have made widely known, in November 2009, the ethics committee of St. Joseph’s Hospital in Phoenix, Arizona, permitted the abortion of an eleven-week-old fetus in order to save the life of its mother. This woman was suffering from acute pulmonary hypertension, which her doctors judged would prove fatal for both her and her previable child. The ethics committee believed abortion to be permitted in this case under the so-called principle of double effect, but Thomas J. Olmsted, the bishop of Phoenix, disagreed with the committee and pronounced its chair, Sister Margaret McBride, excommunicated latae sententiae, “by the very commission of the act.” In this article, I take the much discussed Phoenix case as an occasion to subject the principle of double effect to another round of philosophical scrutiny. In particular, I examine the third condition of the principle in its textbook formulation, namely, that the evil effect in question may not be the means to the good effect. My argument, in brief, is that the textbook formulation of the principle does not withstand philosophical scrutiny. Nevertheless, in the end, I do not claim that we should then “do away” with the principle altogether. Instead, we do well to understand it within the context of casuistry, the tradition of moral reasoning from which it issued.

What Are Parents For?: Reproductive Ethics After the Nonidentity Problem

Bioethicists often use the “nonidentity problem”—the idea that a child born with a disability would actually be a different child if she were born without the disability—to defend parents’ rights to have whatever children they want. After all, a child is not harmed by being brought into the world with a disability; without the disability, she would not be brought into the world at all. But what happens if we turn the moral question around and ask, not about the benefits and harms to the child, but just about parental obligations? Will that lead to a different view of reproductive decisions?

Cloning And Corporeality

Hans Jonas?s paper has, to date, withstood the test of time: it is regularly cited in contemporary discussions of cloning to produce children, and, even when it is not, some semblance of the critique it develops often is. To be sure Jonas?s critique has provoked criticism. This chapter retrieves whatever wisdom is to be found in Jonas?s earlier reflections. Jonas pleads for the recognition of what he calls a ?right to ignorance? as ?a condition for the possibility of authentic action?. Precisely, ?the ethical command?, he writes, is ?to respect the right of each human life to find its own way and be a surprise to it?. In the bioethics literature, this right is often assimilated to what Joel Feinberg has called ?the child?s right to an open future?. The chapter considers several objections to this critique of cloning, a critique that is not quite Jonas?s, but derived from his. Keywords: bioethics; cloning; Hans Jonas; human life; Joel Feinberg