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Case:
Lila-a pregnant woman is found with uterine cancer. If her uterus can be removed completely
before the cancer metastasizes, her life can be saved but it will kill the foetus which is six and
half months. If she waits for another five weeks her chances of living will drop down but
baby would have seventy five percent chance of surviving.
Neither utilitarianism nor deontological theory will be of much help here. Utilitarian cannot
deal this case if overall expected utility is equal. Since, this poses a dilemma to choose one
life over the other deontological theory is not well equipped to resolve this sort of dilemma.
Natural law theory2, which is an off shoot of virtue ethics, embodies a little of both tact i.e.,
utilitarianism and deontological theory. It aims at certain goods, but not in the way utilitarian
does. It provides principle that holds universally and at the same time considers particular
situation.3
2
It has its root in Aristotle and Stoic. If you read carefully the first paragraph of Nichomachean Ethics of
Chapter I then you can see the connection. “Every art, every applied science….aims at good”. (NE, I). But this
theory was fully developed by medieval philosopher cum theologian Thomas Aquinas.
3
But sometimes things malfunction. In that case natural law theory will maintain that things are good by
nature when they function properly. Bad or evil is nothing but the malfunction of the thing which itself is good.
For instance, eye is good as it imparts vision when functions properly. Blindness is considered as bad eye
ceases its function.
Natural law theory
Traditionally natural law theory maintains that everything has natural function that aims at
some desirable goal or end. For instance, our heart circulates blood, sun feeds energy to our
earth’s ecosystem, mind is equipped to gain us knowledge, and deep need for human
companionship creates society. Each function reflects the fundamental design or structure of
the world.
Natural law theory bases its moral principle on the given natural values viz., life, health,
procreation, knowledge, use of reason and social interaction. These values are also called
foundational good. According to this theory, we should promote these natural values towards
which nature aims. This creates a moral obligation on our part to support these natural values.
Living organisms have instinct to preserve life, so life has a natural value. Therefore, we
ought to cooperate with nature to maintain this good. Procreation is a natural value. Anything
opposes procreation (sterilization, contraception etc) is morally wrong. Anything that
supports social interaction i.e., trust, respect for others, promises and friendship must be
valued. Natural law theory places important value to reason as it views the cosmic or natural
order as rational. For this reason, it holds that natural order and its law can be discovered and
understood through reason.
Aquinas placed his natural law ethics upon the religious foundation. According to him, the
rationality and natural order explained as a work of a rational and good God. As a creator he
assigns function to each and everything and ordered things to co-exist in harmony.
According to natural law theory there are six foundational goods viz., life, health,
procreation, knowledge, use of reason and social interaction. Anything done against those
foundational good constitutes morally wrong. Natural law theory derives two additional
principles viz., principle of forfeiture and double effect by applying its fundamental principle
i.e., we should maintain and promote these natural goods.
Doctrine of double effect: There are some cases which produces both good and bad
consequences. How does natural law theory deal with that? Which natural value to be
supported at the cost of another natural value? To deal with such kind of situation, natural
law theory has developed the doctrine of double effect.
Doctor removes the uterus and saves the life of the mother. This is the good consequence. By
removing the uterus, doctor kills foetus. This is bad consequence. However, natural law
theory does not follow the principle: end justifies the means. Doctrine of double effect allows
certain acts for the sake of good even if it has also some bad effect. For instance, in trolley
car case, turning the steering to avoid the death of 5 persons will result in the death of a
person.
This doctrine states that when the act leads to both good and bad effect, it is permissible to
perform the action only if all four of the following conditions are satisfied:
(1) Moral Principle condition: The act cannot itself be of a kind that violates moral
principle, for that would make the act wrong. For instance, purposefully one cannot
kill to save another (e.g., Dudley and Stephen case). Violating moral principle is
always wrong, since it is always against natural value.
(2) Means-end condition: The bad effect cannot itself be a means for achieving a good
end.
(3) Right intention condition: One must intend only good effect and not the bad effect.
Even if bad effect is foreseen and expected, it must not be intended. For instance,
doctor should not intend to kill the foetus as killing the innocent is always wrong. Yet,
if the doctor intends to remove the uterus while foreseeing that this will kill the foetus
that satisfies this condition.
(4) Proportionality condition: The good effect must be at least as great as the bad effect.
For instance, if the good effect is that one life is saved and the bad effect is one life is
lost, then good and bad effect are equal. Hence, this condition is satisfied.
A clear distinction must be made between the act itself, the intention and two effects.
Condition 1 applies to the act; condition 3 to the intention, and condition 2 and 4 to the
effects. Condition 3 is quite difficult as an act can produce two independent effects. For
instance, John steals the bread from the bakery shop to feed his friend who is hungry. Here
the act of John has two independent effects viz., baker suffers the loss and his friend is fed.
Feeding his friend does not require that the baker to suffer loss. His friend still can be fed if
the bystander reimburses to the baker. None of the effects are dependent on the initial
condition i.e., John’s stealing the bread. On the other hand, there are certain cases where one
effect is achieved through another effect which is dependent on the other. For instance, a
person is seeking media attention for a reform in the country. He plots death of twenty
people at bus stand by blowing up a bomb. Here good effect depends upon the bad effect. In
another instance, one person is pulled into an already full life boat (good effect by saving a
life). After sometime the boat is hit by a slight storm and sinks due to overload. Here bad
effect depends upon the good effect.
Means-end condition cannot be applied without determining how the effects are related to
each other.
All the four conditions are satisfied in the above case. So, natural theory will not blame the
act of removing the foetus to save the life of the woman.
1. Application of moral principle condition: The act being contemplated violates the
moral principle which prohibits torturing/killing an innocent person.
2. Application of means-end condition: Torture/death of a child was means to achieve
the end i.e., information from the terrorist.
3. Application of intention condition: Intends both good and bad consequences. First
of all the person intends the torture of innocent child. Doctrine of double effect states
that bad consequences may be foreseen but not intended. Only good consequences
must be intended.
4. Application of proportionality condition: The good effect is greater than bad effect.
The above case failed to fulfil all the criteria except 4. So, natural law theory will blame the
act of torturing the innocent child of the terrorist to get the information from him.