More from Karen Stohr

Thanks again to Karen Stohr for her contributions (here and here).  Here is another:

I must say, I have always found the terms of this particular debate [ecgtopic pregnancy] quite troubling.  As a Catholic philosopher (and mother) who subscribes to the basic tenets of double effect, I am very skeptical of attempts to apply it definitively in such situations.  If anyone is going to insist that a woman suffering from an ectopic pregnancy must undergo the removal of her fallopian tube, on the grounds that nothing else is a morally licit option, one had better have a *very* good justification for that view.  After all, her health, hopes, and dreams may rest on it (what if it is her only remaining fallopian tube?).   And the justification for the view depends on philosophical concepts that are undeniably murky.

In order to use double effect in a philosophically responsible way, one must have reasonably defensible views about intention and related issues in action theory.   The distinction between 'direct' and 'indirect' killing  requires, among other things, an account of what it is to intend something (including whether actions can be intentional only under descriptions and if so, which descriptions of one's actions one must accept) and an theory of action individuation (including how we can distinguish actions from their consequences).   Many discussions of double effect just slide past these issues.  I have not seen a comprehensive and persuasive action theory that supports May's contention that while salpingectomy does not count as intentional killing, salpingostomy and methotrexate do.  It's not that there couldn't be such a theory, but I do not see it in the articles Professor Myers cites, nor have I seen it elsewhere.

On the other hand, the line on intention taken by Grisez, Finnis, and Boyle in the article I mention[ed] in the email to Rob [here] undermines the distinction as May draws it.   And in her seminal book, /Intention, /the great Catholic philosopher Elizabeth Anscombe argues for a theory of intention that also cannot support the salpingectomy/salpingostomy distinction.   The accounts of these four thinkers are far from decisive, but their combined philosophical skill and sophistication ought to carry considerable weight, and hence, give pause to anyone who wants to insist that women suffering from ectopic pregnancy choose evil if they choose salpingostomy or methotrextate.