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William N. Nelson, Conceptions of Morality and the Doctrine of Double Effect, The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine, Volume 16, Issue 5, October 1991, Pages 545–564, https://doi.org/10.1093/jmp/16.5.545
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Abstract
Whether one should accept a principle like DDE cannot be settled independent of one's more general moral theory. In this, I take it, I agree with Professor Boyle, though I do not think he has shown that DDE has a role only in his particular form of absolutism. Still, since his theory does require DDE, an important question is what the alternatives are – whether we must choose between this absolutism and either utilitarianism or intuitionism. A form of contractualism, the requirements of which derive to a large extent from institutionally or conventionally established rights, is sketched here as an attractive alternative. It does not lead, so far as I can see, to DDE.