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utsfl:classroom:seminars:pba303h [2016/09/30 10:03] – balleyneutsfl:classroom:seminars:pba303h [2023/11/08 21:59] (current) – mmccann
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 ====== PBA303H: Double-Effect Reasoning ====== ====== PBA303H: Double-Effect Reasoning ======
 Prerequisite: [[PBA203Y]] Prerequisite: [[PBA203Y]]
 +
 +FIXME double-effect reasoning is not a magic "principle", not pixie dust that you can throw over a situation to get a moral answer. It's a method of reasoning about the moral object to navigate these situations.
  
   * Simple example: a mother cleaning her child's wound with alcohol that causes her child to scream out in pain((From SAT3952H with Fr. Kevin Belgrave))   * Simple example: a mother cleaning her child's wound with alcohol that causes her child to scream out in pain((From SAT3952H with Fr. Kevin Belgrave))
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             * That doctor could not say the moral object of that case is simply to cure cancer             * That doctor could not say the moral object of that case is simply to cure cancer
     * The removal of cancer was the direct action, and the removal of the pre-viable child was the indirect/nondirect action (even if you're the physically direct cause of the evil effect)     * The removal of cancer was the direct action, and the removal of the pre-viable child was the indirect/nondirect action (even if you're the physically direct cause of the evil effect)
-  * FIXME Ectopic pregnancy+  * FIXME Ectopic pregnancy, Fr. Kevin Belgrave says double-effect reasoning breaks down and you just need to use your brain to focus on the moral object? 
 + 
 +===== The Principle of Cooperation ===== 
 +This is just an application of double-effect reasoning. 
 + 
 +  * __Principle Moral Agent:__ The person doing the evil is the  
 +  * __Cooperator:__ The other person 
 +  * __Formal cooperation:__ when you, the cooperator, assent to the evil being done by the principle moral agent 
 +    * Could be done at the level of moral object (where your aim is shared), or at the level of intention (where what you're doing isn't necessarily related but you agree with what they're doing) 
 +      * e.g. boyfriend who counsels and pays for the abortion, even though he doesn't have an abortion 
 +      * e.g. boyfriend says I don't agree, I think it's wrong, we shouldn't do this, but I'll drive you there (there's no other purpose that could be reasonable for driving to the abortion clinic) -- complicit formal cooperation //or// immediate material cooperation, you //say// you don't want to cooperate but what you're doing serves //no other purpose// 
 +  * __Material cooperation__ 
 +    * __Immediate material cooperation:__ you can't do it, there's no other purpose whatsoever for your action but the evil 
 +    * __Mediate material cooperation:__ you don't intend or agree or assent to it, the act that your doing may even have its own independent goodness 
 +      * //May// be licit, question is: how do you figure it out? 
 +      * basically, when it meets the condition of double-effect reasoning 
 +  * Examples 
 +    * Librarian: access to all kinds of good books, but also some evil books 
 +      * How close are we to the evil if someone checks out a book on IVF? Very far, e.g. David Boonin 
 +  * Categories FIX from Sept 30 SAT3952H lecture, or rather guide 
 +    - How grave is the evil act of the principle agent? 
 +    - How close is your action to the evil? 
 +    - What reasons do you have for cooperating? 
 +  * Preventing scandal and promoting a positive witness: these considerations alone could make an action immoral 
 + 
 +===== Conscientious Objection ===== 
 +When you can't cooperate based on the application of double-effect reasoning. 
 + 
 +  * Terms: Conscientious objections, conscious-based objections, conscious-based exemptions((Not just "what I won't do", but at its heart, a positive contribution to the good of society, in saying that we as a society are //better// when we act in this way -- not just an objection)) 
 +  * One of the dangers is that we just think of this as some kind of "personal preference" 
 +    * Julian Sevalescu (sp?): A doctor's conscience has no place in medical care, if doctors aren't wiling to provide legally available medical procedures, they shouldn't be doctors 
 +    * Queen's University guy: The very idea that we should countenance conscientious objection in any profession is objectionable. No one forces anyone to enter any profession. It's like someone becoming a taxi driver and then objecting that cars produce pollution. No one forced you to become a taxi driver. 
 +    * June 2016 10 point thing: Health care workers primary duty is to their patients, not to their personal conscience or personal moral values 
 +  * Also the chaos argument: if we allow people to object to anything for any reason there will be chaos! 
 +  * Important to understand 
 +    - //Not// a protection of personal preferences or opinions, but talking about a situation that touches the very moral integrity of a person 
 +    - It's not simply the integrity of the person that's at stake, as important as that is, but issues where conscience objection plays in concern fundamental and objectively grave matters not only for the individual but for the common good and integrity of the society 
 +  * Referrals: "I don't kill people, but I know someone who does." 
 + 
 +===== Vital Conflicts ===== 
 +Situations in a pregnancy where the life or health of the mother or child is in question, and there's no clear answer that doesn't involve harm. 
 + 
 +FIXME Thomas Murphy Goodwin, medicalizing abortion decisions (400-level) 
 + 
 +Examples: 
 +  * cancer, e.g. uterine cancer 
 +  * premature rupture of membrane (amniotic sac), risk of life threatening infection 
 +  * placental eruption (detaches from the uterus) 
 +  * preeclamcia, severe blood pressure that threatens both lives 
 +  * pre-existing conditions 
 +    * peripartum cardiomyopathy: if your heart already has trouble pumping blood, you've got to pump more blood pregnancy, so you're in trouble 
 +    * pulminary aerterial hypertension 
 +    * ectopic pregnancy 
 + 
 +In same cases, the risk can be so extreme that it is impossible to save the life of the child, no matter what you do. And the only thing you can do brings you to an action that seems very similar to an abortion. 
 + 
 +FIXME extreme cases are referred to as extreme vital conflicts (and Ronheimer's article is only about extreme vital conflicts, not about vital conflicts more generally) 
 + 
 +The deliberate and direct killing of a human being is always wrong. Direct abortion, willed as an ends or a means, is always a serious moral evil. Double-effect reasoning does not seem precise enough. 
 + 
 +Before viability, you have to have an extreme vital conflict before you can apply double-effect reasoning. We're talking about inducing labour here, not doing a surgical removal of the child (D&C). 
 + 
 +After viability, you just need a proportionate reason that inducing labour is in the best interest of the child and the mother. 
 + 
 +==== Uterine Cancer ==== 
 +Rare because young people rarely get cancer, and pregnant people are usually young. And rare because chemotherapy has advanced to the point where the child can tolerate chemotherapy just fine. If a child can endure a therapeutic program of chemotherapy, then you're just in a vital conflict, not an extreme vital conflict. 
 + 
 +The first step is always: what can we do to save both? 
 + 
 +If you have moral certainty that (a) there is no longer anything medical technology can offer, (b) the child is not viable, and (c) you cannot wait to viability otherwise both will die, then and only then does double-effect reasoning offer a way forward. 
 + 
 +==== Ectopic Pregnancy ==== 
 +FIXME laptop notes
  
 +FIXME 
 +Q from a fellow pro-lifer, regarding a video that talks about how purposefully removing the baby too early (e.g. abortion pill) is still a form of killing the baby because you are purposefully putting the baby in a lethal environment.
 +PL: "But this is exactly what we do when the mother's life is in danger - and early delivery - with every hope that the child will live, even though they often won't.
 +And we do not consider this killing; rather it shows respect for life. How do we reconcile this comment with this post?"
 +Maria: "in a life-threatening scenario like that, the child is no longer safe when inside the mother, either; so yes, you are moving her to an unsafe
 +environment, but I don't think that is making her 'worse off', given that she was already in an unsafe environment. Consider two different scenarios: on a night with a crazy snowstorm, a mom and her infant are safely inside a warm house. She purposely puts the baby outside, and the baby freezes to death. I think we would all agree that that is a very immoral action and was a form of killing the baby. Now imagine the same scenario–mom and baby are in the house, crazy snowstorm outside, but then the house catches fire. The mother runs outside of the burning building with her baby, but the roads are so bad that the paramedics and
 +firefighters don't get there for ages. By that time, the baby has died of
 +exposure. In that second scenario, was she responsible for the baby's death? No; she and the baby left an imminently lethal environment, and then there just wasn't enough help in time to preserve the baby's life."