Center for Liberal Education, Villanova University, 800 Lancaster Ave., Villanova, PA 19085, USA.
Theor Med Bioeth. 2011 Aug;32(4):271-83. doi: 10.1007/s11017-011-9183-z.
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.
如媒体广泛报道的那样，2009 年 11 月，亚利桑那州凤凰城圣约瑟夫医院的伦理委员会允许对一名 11 周大的胎儿进行堕胎，以挽救其母亲的生命。这名妇女患有急性肺动脉高压，医生判断这种疾病对她和她可存活的孩子都将是致命的。伦理委员会认为，在这种情况下，可以根据所谓的双重效应原则允许堕胎，但凤凰城的主教托马斯·J·奥姆斯特德不同意委员会的意见，并宣布委员会主席玛格丽特·布里德修女被“自动”绝罚，“因为委员会的行为本身”。在本文中，我以备受争议的凤凰城案例为契机，对双重效应原则进行了另一轮哲学审查。特别是，我检查了原则在其教科书表述中的第三个条件，即所讨论的恶效不能是善效的手段。我的论点简而言之是，原则的教科书表述无法经受哲学审查。然而，最终，我并不是主张我们应该完全“摒弃”这一原则。相反，我们应该在决疑论的背景下理解它，它正是从这一传统的道德推理中产生的。
