Here is a very insightful and readable article about the Passion, and the modern world's impression of how Pontius Pilate was betrayed. Of course, these days we meditate not so much on Pilate, but on the Truth standing before him, but this helps anyway.
http://nationalreview.com/comment/de_souza200404080847.asp
Fr. Raymond de Souza is Catholic Chaplain of Newman Center at Queen's University, Kingston.
Thursday, April 08, 2004
Thursday, April 01, 2004
Applying Double Effect in Medicine
[Email from professor]
I thought I'd follow up a little bit on our discussion
about the doctrine of double effect (DDE) today. The
intent is a primary component of the doctrine.
Let's take the example of the mother in labour whose
life is being threatened. In scenario 1, the baby's
head is too big to be delivered, the mother will die
secondary to labour (perhaps because her blood pressure
is too high) and the options are either to continue the
delivery because the baby cannot be pulled back out
via caesarian section and the likely outcome is that the
mother will die, and perhaps the baby too OR the
baby's skull is collapse resulting in its death but the
mother is saved.
In scenario 2, the mother is having life threatening
placental hemorrhage, and needs to have an emergency
hysterectomy to save her life. In this case, the baby
may die as a result of the emergency hysterectomy
because it is still in the uterus and cannot be delivered
without the mother dying in the process.
How are these 2 situations different?
In scenario 1, the method by which the mother's life
will be saved is through the death of the baby.
Therefore according to DDE it is not justifiable since the
"intent" is to kill the baby, which will result in
saving the mother. The intended outcome of the action
(killing the baby and ending the labour) is immoral, and
even if the indirect outcome (saving the mother) is
good.
In scenario 2, the method by which the mother's life
will be saved is via hysterectomy. It is justifiable
since the "intent" is to save the mother. The intended
outcome of the action (saving the mother by stopping
the hemorrhage) is moral, while the unintended although
inextricably linked outcome (death of the baby) is
only secondary.
Of course, the intent in this circumstance is linked
to the deontological rule/commandment "thou shalt not
kill", but the issue here is that in scenario 1 killing
is the intended action, where in scenario 2 it is an
unavoidable consequence.
Personally I have difficulties with DDE once I start
thinking too much about it. It can be "wrongly" used
to either justify problematic actions or inaction
(e.g., letting the mother die in scenario 1 when the baby
will die anyways, too). It can also be twisted when we
start thinking of withdrawing treatment or
administering palliative medications at the end of life--semantic
arguments about whether you believed someone was going
to die or whether you were letting the natural course
of their disease progress.
Anyways, I hope you enjoyed class and that I clarified
some of your questions about DDE.
Cheers,
[quisutdeus responds]
The principle of double effect allows one to perform an action which has two effects, one good and the other bad, provided the following four conditions are met simultaneously: (cf. Germain Grisez)
1. the act itself must be good or at least morally neutral,
2. the agent must intend the good effect,
3. the good effect must not result from the bad effect,
4. and there must be a proportionately grave reason to justify the act (good effect outweighs bad).
I'm not sure you properly apply DDE in the first of your two scenarios, even though I agree with the conclusions. In scenario 1, the action itself (collapsing the baby's skull) is always wrong, even apart from consideration of the good effect that follows, for to kill an innocent person is intrinsically immoral. For this reason it fails to satisfy the first criterion and double effect cannot apply.
The argument from "intent" fails to distinguish the two scenarios. Intent is an act of the will in a reasoning being capable of freely choosing. In both scenarios the effect primarily intended by most surgeons is to save the life of the mother. The surgeon achieves the desired end differently in each case (she DOES something differently). In both cases the death of the baby (hysterectomy resulting in baby dying and evacuation of baby's brain resulting in baby dying) is unintended by the agent. In one case, however, when the surgeon says, "we couldn't save your baby," she means that she killed your baby. In the other case she means she did all she could, but the baby died as was foreseen. The moral distinction between the two is made in reference to the act itself.
A couple of things follow from the four criteria that we may grapple with personally.
The first is that sometimes we will have to allow an innocent mother to die because we are morally unable to kill the innocent baby trapped in her birth canal. While this is extremely tragic (as well as exceedingly rare) there are profoundly positive cultural implications to be obtained by affirming life not only in principle (thou shalt not kill - dignity of personhood, etc.) but also in act.
Second, the principle of double effect can work the other way in scenario 1, where the (consenting) mother can be operated on to save the baby, with the high probability that she will die during surgery. The case of Gianna Bretta Molla, an Italian pediatrian, is similar. She refused surgery to remove a large ovarian cyst during her pregnancy because it would result in the death of her child. She died shortly after giving birth in 1962.
Third, the intent itself is enough to vitiate a morally neutral or even good act. In the second scenario, for instance, if the surgeon performing the hysterectomy intends to kill the baby to save the mother, the surgeon IS morally guilty of killing the baby.
I enjoyed your comments. Let me know what you think of these.
I thought I'd follow up a little bit on our discussion
about the doctrine of double effect (DDE) today. The
intent is a primary component of the doctrine.
Let's take the example of the mother in labour whose
life is being threatened. In scenario 1, the baby's
head is too big to be delivered, the mother will die
secondary to labour (perhaps because her blood pressure
is too high) and the options are either to continue the
delivery because the baby cannot be pulled back out
via caesarian section and the likely outcome is that the
mother will die, and perhaps the baby too OR the
baby's skull is collapse resulting in its death but the
mother is saved.
In scenario 2, the mother is having life threatening
placental hemorrhage, and needs to have an emergency
hysterectomy to save her life. In this case, the baby
may die as a result of the emergency hysterectomy
because it is still in the uterus and cannot be delivered
without the mother dying in the process.
How are these 2 situations different?
In scenario 1, the method by which the mother's life
will be saved is through the death of the baby.
Therefore according to DDE it is not justifiable since the
"intent" is to kill the baby, which will result in
saving the mother. The intended outcome of the action
(killing the baby and ending the labour) is immoral, and
even if the indirect outcome (saving the mother) is
good.
In scenario 2, the method by which the mother's life
will be saved is via hysterectomy. It is justifiable
since the "intent" is to save the mother. The intended
outcome of the action (saving the mother by stopping
the hemorrhage) is moral, while the unintended although
inextricably linked outcome (death of the baby) is
only secondary.
Of course, the intent in this circumstance is linked
to the deontological rule/commandment "thou shalt not
kill", but the issue here is that in scenario 1 killing
is the intended action, where in scenario 2 it is an
unavoidable consequence.
Personally I have difficulties with DDE once I start
thinking too much about it. It can be "wrongly" used
to either justify problematic actions or inaction
(e.g., letting the mother die in scenario 1 when the baby
will die anyways, too). It can also be twisted when we
start thinking of withdrawing treatment or
administering palliative medications at the end of life--semantic
arguments about whether you believed someone was going
to die or whether you were letting the natural course
of their disease progress.
Anyways, I hope you enjoyed class and that I clarified
some of your questions about DDE.
Cheers,
[quisutdeus responds]
The principle of double effect allows one to perform an action which has two effects, one good and the other bad, provided the following four conditions are met simultaneously: (cf. Germain Grisez)
1. the act itself must be good or at least morally neutral,
2. the agent must intend the good effect,
3. the good effect must not result from the bad effect,
4. and there must be a proportionately grave reason to justify the act (good effect outweighs bad).
I'm not sure you properly apply DDE in the first of your two scenarios, even though I agree with the conclusions. In scenario 1, the action itself (collapsing the baby's skull) is always wrong, even apart from consideration of the good effect that follows, for to kill an innocent person is intrinsically immoral. For this reason it fails to satisfy the first criterion and double effect cannot apply.
The argument from "intent" fails to distinguish the two scenarios. Intent is an act of the will in a reasoning being capable of freely choosing. In both scenarios the effect primarily intended by most surgeons is to save the life of the mother. The surgeon achieves the desired end differently in each case (she DOES something differently). In both cases the death of the baby (hysterectomy resulting in baby dying and evacuation of baby's brain resulting in baby dying) is unintended by the agent. In one case, however, when the surgeon says, "we couldn't save your baby," she means that she killed your baby. In the other case she means she did all she could, but the baby died as was foreseen. The moral distinction between the two is made in reference to the act itself.
A couple of things follow from the four criteria that we may grapple with personally.
The first is that sometimes we will have to allow an innocent mother to die because we are morally unable to kill the innocent baby trapped in her birth canal. While this is extremely tragic (as well as exceedingly rare) there are profoundly positive cultural implications to be obtained by affirming life not only in principle (thou shalt not kill - dignity of personhood, etc.) but also in act.
Second, the principle of double effect can work the other way in scenario 1, where the (consenting) mother can be operated on to save the baby, with the high probability that she will die during surgery. The case of Gianna Bretta Molla, an Italian pediatrian, is similar. She refused surgery to remove a large ovarian cyst during her pregnancy because it would result in the death of her child. She died shortly after giving birth in 1962.
Third, the intent itself is enough to vitiate a morally neutral or even good act. In the second scenario, for instance, if the surgeon performing the hysterectomy intends to kill the baby to save the mother, the surgeon IS morally guilty of killing the baby.
I enjoyed your comments. Let me know what you think of these.
Wednesday, March 31, 2004
The Bioethics of Killing & Letting Die
There has never been a shortage of poor philosophers at the disposal of big business. The case of hospital bioethicists is no exception. And as a sure sign that they are poor philosophers, they are almost never financially wanting.
Bioethicists are a select group of co-affirming free thinkers who are hired, at good price, by the healthcare industry (hospitals, pharmaceutical companies, government departments) in order to sell hard policies. Bioethicists are proficient at manufacturing “ethical” arguments for previously unethical practices that promise to save their employers lots of money.
“Anyone familiar with medical research knows that ethics committees are indispensable – they have the important job of wringing their hands and furrowing their brows before writing the permission slips to cross lines that heretofore were thought impermissible to cross.” more
One current battlefield is the area of withholding and withdrawing treatment at the end of life. Physicians in intensive care units face death and dying on a daily basis. They are regularly an intimate part of the life and death decisions that face dying patients and their families. It is often the physician who counsels the patient and family, and inevitably the physician who implements the decision that has been reached.
Bioethicists, out to save their employers money, are trying to convince doctors not to save their patients. It is happening in hospitals everywhere in the “developed” nations, and it is becoming less and less subtle. Under the guise of “Futile Care Theory,” hospitals are putting in place procedural protocols which allow them to refuse treatment to sick patients, whether they want it or not, if the patient is deemed incurable or terminal. Treatment doesn’t just refer to new and expensive therapies; it extends to life-sustaining food, water and basic hygiene.
On the basis of “futile care theory,” Leslie Burke, age 44, is suing his hospital in the UK for the right to remain alive. Doctors there have refused (in advance) to provide him food or water when is condition deteriorates to the point of needing a feeding tube.
The parents of David Glass were shocked to find the same attitude from their doctors at St. Mary’s Hospital in Portsmouth. In 1998, at age 12, David suffered respiratory failure. Not only did doctors refuse to treat his life, but they sought to administer a “palliative” agent to David in order to hasten his death. They reasoned that David’s profound developmental and physical disabilities made his life not worth living, and therefore not worth saving.
And healthcare boards across North America are quietly implementing similar policies. Physicians, the final common pathway in the withholding and withdrawing that will bring lives to their end, are either unaware or don’t care. But those who don’t care have to be taught to overcome their intuitive instinct that killing is wrong. Enter the bioethicists. Some killing is okay. Some letting die is okay too. In fact, anything is okay given the right motivation, intention, circumstances and societal context.
Here are some delightful selections from my professor’s bioethics notes for tomorrow’s lecture on withholding and withdrawing treatment. She is also our hospital bioethicist. We’ll face-off at 8:30am EST tomorrow.
On Moral Intuition: “Often people will intuitively believe that while it is appropriate in certain instances to withhold treatment, it is never right to withdraw treatment.”
Intuition, however, is usually a sign of what is right for the most part. If the patient refuses an IV line, I won’t put it in. If his only source of food and water is his IV line, I won’t take it out. To do so would be to starve him, and removal of the line would mean death.
On Conscience: “It is important to keep in mind that because something “feels” right or wrong is not definitive in terms of deciding morality.”
But the exception of an ignorant or malformed conscience proves the rule that conscience is generally a good guide to moral action.
On Killing and Letting Die: “Is killing always wrong? Certainly murder is always wrong… it is wrong by definition. It is defined as the wrongful killing of one human being by another. But killing non-humans (animals) is largely accepted by most societies for food, clothes, some research, etc. Killing humans is largely accepted by most societies in certain instances like self defense and war. So, there are instances where we say killing is justified… To argue that something is wrong, a priori, simply because it is killing cannot be done successfully.”
Murder is properly defined as the taking of an innocent human life, to distinguish it from killing in self defense, for instance. The reason it is wrong is because it offends against the infinite dignity of the human person, a being capable of reason and free choice.
On Life after Death: “It may be that death is nothingness and nothingness has no positive or negative value. It is nothing… it may be that not being alive is arguably better than being alive.”
Somewhere in my remote past I learned what I already had known since I first knew anything: being is better than non-being. Something is better than nothing. It is true that suffering can be so intense that it makes us want to die to make it end. But avoidance of suffering is not the same as seeking death. It is precisely in these moments that a suffering patient needs comfort, relief and support. In the darkness of suffering, a physician can snuff out the flame of hope, or affirm, respect (and treat) the dignity of both human suffering and personhood.
Bioethicists are a select group of co-affirming free thinkers who are hired, at good price, by the healthcare industry (hospitals, pharmaceutical companies, government departments) in order to sell hard policies. Bioethicists are proficient at manufacturing “ethical” arguments for previously unethical practices that promise to save their employers lots of money.
“Anyone familiar with medical research knows that ethics committees are indispensable – they have the important job of wringing their hands and furrowing their brows before writing the permission slips to cross lines that heretofore were thought impermissible to cross.” more
One current battlefield is the area of withholding and withdrawing treatment at the end of life. Physicians in intensive care units face death and dying on a daily basis. They are regularly an intimate part of the life and death decisions that face dying patients and their families. It is often the physician who counsels the patient and family, and inevitably the physician who implements the decision that has been reached.
Bioethicists, out to save their employers money, are trying to convince doctors not to save their patients. It is happening in hospitals everywhere in the “developed” nations, and it is becoming less and less subtle. Under the guise of “Futile Care Theory,” hospitals are putting in place procedural protocols which allow them to refuse treatment to sick patients, whether they want it or not, if the patient is deemed incurable or terminal. Treatment doesn’t just refer to new and expensive therapies; it extends to life-sustaining food, water and basic hygiene.
On the basis of “futile care theory,” Leslie Burke, age 44, is suing his hospital in the UK for the right to remain alive. Doctors there have refused (in advance) to provide him food or water when is condition deteriorates to the point of needing a feeding tube.
The parents of David Glass were shocked to find the same attitude from their doctors at St. Mary’s Hospital in Portsmouth. In 1998, at age 12, David suffered respiratory failure. Not only did doctors refuse to treat his life, but they sought to administer a “palliative” agent to David in order to hasten his death. They reasoned that David’s profound developmental and physical disabilities made his life not worth living, and therefore not worth saving.
And healthcare boards across North America are quietly implementing similar policies. Physicians, the final common pathway in the withholding and withdrawing that will bring lives to their end, are either unaware or don’t care. But those who don’t care have to be taught to overcome their intuitive instinct that killing is wrong. Enter the bioethicists. Some killing is okay. Some letting die is okay too. In fact, anything is okay given the right motivation, intention, circumstances and societal context.
Here are some delightful selections from my professor’s bioethics notes for tomorrow’s lecture on withholding and withdrawing treatment. She is also our hospital bioethicist. We’ll face-off at 8:30am EST tomorrow.
On Moral Intuition: “Often people will intuitively believe that while it is appropriate in certain instances to withhold treatment, it is never right to withdraw treatment.”
Intuition, however, is usually a sign of what is right for the most part. If the patient refuses an IV line, I won’t put it in. If his only source of food and water is his IV line, I won’t take it out. To do so would be to starve him, and removal of the line would mean death.
On Conscience: “It is important to keep in mind that because something “feels” right or wrong is not definitive in terms of deciding morality.”
But the exception of an ignorant or malformed conscience proves the rule that conscience is generally a good guide to moral action.
On Killing and Letting Die: “Is killing always wrong? Certainly murder is always wrong… it is wrong by definition. It is defined as the wrongful killing of one human being by another. But killing non-humans (animals) is largely accepted by most societies for food, clothes, some research, etc. Killing humans is largely accepted by most societies in certain instances like self defense and war. So, there are instances where we say killing is justified… To argue that something is wrong, a priori, simply because it is killing cannot be done successfully.”
Murder is properly defined as the taking of an innocent human life, to distinguish it from killing in self defense, for instance. The reason it is wrong is because it offends against the infinite dignity of the human person, a being capable of reason and free choice.
On Life after Death: “It may be that death is nothingness and nothingness has no positive or negative value. It is nothing… it may be that not being alive is arguably better than being alive.”
Somewhere in my remote past I learned what I already had known since I first knew anything: being is better than non-being. Something is better than nothing. It is true that suffering can be so intense that it makes us want to die to make it end. But avoidance of suffering is not the same as seeking death. It is precisely in these moments that a suffering patient needs comfort, relief and support. In the darkness of suffering, a physician can snuff out the flame of hope, or affirm, respect (and treat) the dignity of both human suffering and personhood.
Thursday, March 25, 2004
Hate Crime Comes to Canada
OTTAWA, March 25, 2004 (LifeSiteNews.com) –
LifeSiteNews.com has learned that homosexual hate crime bill
C-250 was passed without amendment in the Senate
Committee this morning. The dangerous legislation which
threatens to shut down free speech on the issue of
homosexuality has been sent back to the Senate with a final
vote which could occur as early as Friday but more
likely Monday.
Bill C-250 is pending its final approval by Canada's "free-thinking" senators. Although it has received little or no coverage by the similarly "free-thinking" media, it represents a grave and imminent danger to Canadian's freedom of speech and religion.
Introduced by homosexual activist MP Svend Robinson, and passing through Parliament by a narrow
and to some, a questionable margin, Bill C-250 introduces the term "sexual orientation" into the current Hate Crimes criminal code.
Arguments for and against to follow...
LifeSiteNews.com has learned that homosexual hate crime bill
C-250 was passed without amendment in the Senate
Committee this morning. The dangerous legislation which
threatens to shut down free speech on the issue of
homosexuality has been sent back to the Senate with a final
vote which could occur as early as Friday but more
likely Monday.
Bill C-250 is pending its final approval by Canada's "free-thinking" senators. Although it has received little or no coverage by the similarly "free-thinking" media, it represents a grave and imminent danger to Canadian's freedom of speech and religion.
Introduced by homosexual activist MP Svend Robinson, and passing through Parliament by a narrow
and to some, a questionable margin, Bill C-250 introduces the term "sexual orientation" into the current Hate Crimes criminal code.
Arguments for and against to follow...
