As media reports have made widely known, in November 2009, the ethics committee of St. Joseph's Hospital in Phoenix, Arizona, permitted the abortion of an eleven-week-old fetus in order to save the life of its mother. This woman was suffering from acute pulmonary hypertension, which her doctors judged would prove fatal for both her and her previable child. The ethics committee believed abortion to be permitted in this case under the so-called principle of double effect, but Thomas J. Olmsted, the bishop of Phoenix, disagreed with the committee and pronounced its chair, Sister Margaret McBride, excommunicated latae sententiae, "by the very commission of the act." In this article, I take the much discussed Phoenix case as an occasion to subject the principle of double effect to another round of philosophical scrutiny. In particular, I examine the third condition of the principle in its textbook formulation, namely, that the evil effect in question may not be the means to the good effect. My argument, in brief, is that the textbook formulation of the principle does not withstand philosophical scrutiny. Nevertheless, in the end, I do not claim that we should then "do away" with the principle altogether. Instead, we do well to understand it within the context of casuistry, the tradition of moral reasoning from which it issued.
In the new “liberal eugenics,” children could be genetically improved as long as the enhancements let children choose from among a wide range of ways to live their lives. The German political philosopher Jürgen Habermas has opened a debate with the proponents of this view. Habermas suggests that a person could not really regard her life as her own if she lived with a body that somebody else had, without asking her opinion, “enhanced” for her.
This chapter is concerned with the implications of growing religious non-affiliation for objections of conscience, which have proliferated lately in the culture wars of Western democracies. Through the eighteenth century, when the U.S. Constitution was framed, the concept of conscience was tightly bound to religion. This chapter’s leading question is: what force do claims of conscientious objection have in the context of growing religious non-affiliation? Underlying this question is a subtler one: what else might we lose when we lose religion? The chapter’s thesis is twofold. First, the public conception of conscience has changed under the pressure of both growing religious non-affiliation and growing religious pluralism. Second, the appeal to conscience is now much less powerful than it was when God figured more prominently in the picture. The buffer between citizen and state has become thinner, and the reasons to accommodate objections of conscience have become weaker.
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