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for their good advice.
Chapter 8
Toward the Essence of Nonconsequentialism
F. M. Kamm
In this article, I will try to provide an account of the nonconsequen-
tialist constraint on harming innocent, nonthreatening persons. I begin
by examining other principles that have been proposed to rule out
harm to such people. I consider objections to them and ways to revise
them. In particular, I consider the Doctrine of Double Effect and offer
as a revision of it the Doctrine of Triple Effect. I try to show how it
may explain a version of the Trolley Problem introduced by Judith
Thomson known as the Loop Case. I raise problems for the Triple Effect
Doctrine and then develop the Doctrine of Initial Justification, which,
I claim, reveals certain crucial distinctions between permissible and
impermissible harm.
1 Principles and Problems
When may we significantly harm innocent, nonthreatening people
who would not otherwise be harmed? In a case known as the Trans-
plant Case, five people can be saved from dying of organ failure if
and only if we kill one person to get his organs. (He is an innocent
nonthreat, not himself under any grave threat and not responsible
for the problems of the five.) Act consequentialists say this act is per-
missible, given that there will be no additional bad consequences. Non-
consequentialists say it is not permissible. Among the reasons they
have offered for its impermissibility is the priority of not harming
over aiding: we would harm the one if we kill him, but only not aid
the five if we did not give them the organs. Another nonconsequen-
tialist reason is the priority of not intending harm over merely fore-
seeing harm: we would intend harm to the one if we kill him, but only
foresee harm to the five if we did not aid them. Some supporters of this
intention/foresight distinction support the Doctrine of Double Effect
(DDE), according to which we may not intend evil as a means to a
greater good or as an end in itself, but it is permissible to pursue a
greater good as an end by neutral or good means even if a lesser evil
156 F. M. Kamm
is a certain, foreseen side effect (if there is no other way to achieve the
greater good).1
Problems can be raised for the moral significance of the harming/not
aiding distinction and intending/foreseeing distinction. Consider first
problems for the former: (a) In a version of the Trolley Case, a trolley
is headed toward killing five people, but a bystander can save them
(only) by redirecting the trolley. However, if redirected it will go off in
a direction where it will definitely kill one person. Typically, noncon-
sequentialists think it is permissible (though not obligatory) to divert
the trolley even though this involves harming some in order to aid
others.2
(b) In another case, five are dying of organ failure. If we let one
person who is suffering from pneumonia die by not giving him the
penicillin he needs to be cured, we can use his organs to save the five
(Penicillin Case). It seems impermissible to do this, even though it
involves letting him die rather than harming him.
Now consider problems for the moral significance of the intention/
foresight distinction: (c) Suppose a doctor is called and told that
organs innocently acquired have arrived and must be transplanted
quickly into his five patients. He drives to the hospital but on the road
finds an immovable person in his path. If he takes a different route, he
will be too late to do the transplants, and as he is the only one who can
do them, the five will die. If he runs over the person on the road, he
foresees, but does not intend, the death of the one. However, he knows
(suppose) that if he gets to the hospital, he will save the five (Car Case).
It seems impermissible for him to proceed.3
(d) Consider again the Trolley Case. Suppose it is a not very good
person who sees the trolley headed to the five. He has no interest in
saving the five per se, but he knows that it is his enemy who will be
the one person killed if he diverts the trolley. He does not want to be
accused of acting impermissibly, however, and so while he turns the
trolley in order to kill the one, he does so only because he believes that
(i.e., on condition that) a greater good will balance out the death. Hence
he would not turn the trolley unless he expected the five to be saved
(Bad Man Case). His turning the trolley is still permissible, I believe.
This raises doubt about the correctness of principles such as the DDE
if they would determine the act to be impermissible on the basis of the
bad intentions of the agent.4
(e) In the same vein, we may consider a case where someone wants
to do something on a whim but foresees that someone will die as a side
effect. However, he also foresees another side effect: a massacre of
twenty people will be stopped. He allows himself to act on the whim,
Toward the Essence of Nonconsequentialism 157
only because he believes that (i.e., on condition that) the greater good
will outbalance the lesser evil (Whim Case). He does not act with the
ultimate aim of producing that greater good (any more than in the Bad
Man Case the agent acted with that aim).5 It is permissible, I believe,
to act in the Whim Case, even though the agent does not aim at the
greater good. But the DDE says that we may produce lesser evil as a
side effect only if we are pursuing a greater good.6
(f) Finally, as an objection to the DDE it has been suggested that, in
many cases where acting is impermissible, we need not be intending
harm strictly speaking. For example, although we must intend the
removal of the organs in Transplant Case, we need not intend the death
of the person, since if he survives the removal of his organs that would
not interfere with our saving the five.
2 The Counterfactual Test and the Doctrine of Triple Effect
A great deal of contemporary nonconsequentialism has been concerned
with trying to revise moral principles employing the harming/not
aiding distinction or the intending/foreseeing distinction to meet
objections (a), (b), (c), and (f). Possibly objection (d) and almost cer-
tainly (e) are new. Let us first consider changes that might be made to
a principle involving the intention/foresight distinction so that it meets
some of the objections to it.
To deal with objection (f) (the narrowness of intention), Warren
Quinn7 suggested that we focus on the wrongness of intending the
involvement of a person without his consent in a way that we foresee will lead
to significant harm to him. This is instead of focusing on the wrongness
of intending the harm to him, as the DDE says. Let us say that Quinn s
revision results in the DDE Revised (DDE(R)). Henceforth, to mark my
acceptance of this revision without adding words, I shall use evil* to
mean  evil or involvement without consent that we foresee will lead
to evil. 8
Possibly, we can deal with objection (d) (the Bad Man Case) by
rephrasing the DDE or DDE(R) so that it requires that we not do an act [ Pobierz całość w formacie PDF ]
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