The Principle of Double Effect and Abortion

Some time ago I posted on the principle of double effect, and mentioned cases of conflict that are not evidently resolvable by the principle of double effect, at least not in its usual sense. There is also a problem applying the principle of double effect to resolve an issue or dispute, if the very point in question is whether a given effect can or should be considered as an effect, that is, as a circumstance of the action, or whether it must be considered as a defining aspect of the object.

For example, when a live baby is delivered by the induction of labor or C-section before it is mature enough to live for long outside the womb, is the death of the child an effect of the action, so that it could fall under the principle of double effect, or does the action morally need to be described as the direct killing of an innocent child?

A discussion arose recently about the case in Phoenix, where a nun at a Catholic hospital approved an abortion that was considered medically necessary to save the mother's life, and when there was (apparently) not considered to be any reasonable hope of her carrying the child until viability. The bishop of the diocese of Phoenix declared the nun who approved the abortion to have been automatically excommunicated by her action.

The diocesan's Q and A on the situation (PDF) says, "If a necessary treatment brings about the death of the child indirectly it may be allowable. A Dilation and Curettage (D&C) or Dilation and Extraction (D&E), however, would never be such a treatment since it is the direct killing of the unborn child and is, morally speaking, an abortion." This suggest that such a procedure may have been done at the hospital. I have been unable to verify the facts on this question. But suppose that the abortion was carried out by C-section, delivered a live baby, who died hours or days later because it was as yet too immature to live outside the mother's womb. Would that change the situation?

The doctrinal commission of the USCCB's statement on this case, as well as the USCCB's Ethical and Religious Directives for Catholic Health Care Services, seem to imply that it would not alter the situation morally. The ethical and religious directives say "Abortion (that is, the directly intended termination of pregnancy before viability or the directly intended   destruction of a viable fetus) is never permitted. Every procedure whose sole immediate effect is the termination of pregnancy before viability is an abortion." The doctrinal comission's comment on this is: "Direct abortion is never morally permissible. One may never directly kill an innocent human being, no matter what the reason." In other words, it considers any "directly intended termination of pregnancy before viability" to be, morally speaking, the "direct killing of an innocent human being," even when physically it is indirect, as when a live baby is delivered before viability.

The same thing seems to be taught by a statement of the Holy Office:

Dr. Titius, when called to a pregnant woman, who was very ill, observed repeatedly that the only cause of her deadly disease was her pregnancy, i. e., the presence of a fetus in her womb. Hence there was but one way open to him to save the patient from certain and imminent death, namely, to cause abortion. On this course he usually decided in similar cases, taking care, however, to avail himself of such remedies and operations which would not of themselves, or not immediately kill the fetus in the womb, but, on the contrary, would, if possible, deliver the child alive, although, not being able to live, it would die soon afterward. But after reading a rescript from the Holy See to the Archbishop of Cambrai, dated August 19, 1888, that it was unsafe to teach the lawfulness of any operation which might directly kill the fetus, even though such were necessary to save the mother, Dr. Titius began to doubt the lawfulness of the surgical operation by which he had not unfrequently caused abortion to save pregnant women who were very ill.

Therefore, in order to set his conscience at rest, Dr. T. humbly asks whether, on recurrence of the like circumstances, he may resort to the aforesaid operations.

Response:

To this urgent request the Cardinals of the Holy Roman Congregation of the General Inquisition, after advising with the theological consultors, have decided to answer: No; according to other decrees, namely, those of May 28, 1884, and of August 19, 1888…. (Response of the Holy Office to the Archbishop of Cambrai, July 24, 1895; AAS 28, 383ff., Denzinger, n. 3298)

More related statements of the Catholic Church on Abortion

In response to the argument that the death of the child that is consequent upon delivery of the child is an effect of the delivery, and thus the delivery of a child through induction of labor or C-section before viability may fall under the principle of double effect, when without such an operation both mother and child will die, the position taken by the Holy Office at that time (the CDF has been curiously silent on the question in the past forty years in its various statement on procured abortion, respect for life, etc.) and by the USCCB seems to amount to: one may not consider the principle of double effect applicable; one must consider the death of the child as an essential, determining aspect of the act of delivering the child.

I must admit, I am quite at a loss as to the logic that could be behind the position of the Holy Office and the USCCB (Dear readers, HELP!), and wish that the CDF would make a statement on the issue, either to say that this earlier decision of the Holy Office (assuming I'm rightly interpreting it) is correct, or that it is incorrect or misunderstood or not applicable, or that the question is an open one: the silence I find distressing, particular in view of the wide gap that seems to be present between the views of Catholic doctors and the views of many bishops.

Baptism of Blood

Some time ago a question was raised about the baptism of blood, and how this is applicable to infants. Normally a martyr is someone who witnesses to Christ in the ultimate circumstance, when it means giving up his life for Christ. But infants don't know anything about Christ, and thus seemingly can't witness either to the person of Christ or to Christian truth. In what sense, then, is the shedding of their blood a baptism?

I said then that the intention of the one who kills an infant, an intention directed against Christ, is reason enough to see the infant as standing in the place of Christ, and consequently, likened unto Christ in his suffering, and thus receiving the grace of Christ. This intention against Christ is most direct in cases such as that of St. Simon of Trent, a two year old child killed out of hatred for Christ.

I also suggested that "being unjustly put to death" might, from God's point of view, count as such conformity to Christ, and thus be a way to receiving grace in the case of an infant, whose will does not place any impediment to grace.

The case of St. Coloman provides some, if only weak evidence for this. He was an Irish monk who was making a pilgrimage to Jerusalem, and in Austria detained under suspicion of being a spy. Unable to explain his purpose, since he could not speak German, he was tortured and killed. He is celebrated as a martyr, despite the fact that he was put to death by Catholics not for religious, but for quasi-military reasons. Though he found his death while making a pilgrimage, the final or decisive factor (a kind of formal cause) constituting his martyrdom seems to be being unjustly killed, or being unjustly killed despite his religious intent (rather than because of it), since (at least according to one account I've seen) he showed his cross and pointed East to indicate his intentions, but wasn't believed.

Empirical Comparison of Celibate and Married Clergy

In the article "Religious Differences Between Married and Celibate Clergy: Does Celibacy Make a Difference?" in Sociology of Religion (1998) (full text available to members of subscribing libraries or universities), Don Swenson attempts to make an empirical argument against some of the reasons advanced by the Church for clerical celibacy. While the experiment itself is poorly constructed to the point of being ludicrous, the idea is an interesting one, and I am of the opinion that this sort of empirical study could be profitably employed more within the Church (as it often is within large organizations).

Basically the idea of the study was to take a sample of married clergy and a sample of celibate clergy, measure devotion to Christ (religiosity) and the ability to devote oneself to parishioners, and see whether there is a significant statistical difference between the married and celibate clergy. Devotion to Christ was measured through responses made to questions about "thanking, talking to, loving, taking time with, worshiping, feeling close to and listening to God, reflecting on the Bible, acting on what I believe God is saying, achieving insights in prayer, sensing a divine presence, and experiencing peace" and the time spent in prayer. The ability to devote oneself to parishioners was measured by the amount of time spent in ministry.

The responses to the survey indicated that "there was no significant difference regarding MEDITATION [measuring religiosity and devotion to Christ] and PASTORAL COMMITMENT", while the priests spent more time in prayer and prayed more frequently than the married, evangelical clergy. The author argues that the "experiential religiosity" which the study aimed to measure is a better measure of devotion to Christ, and thus there was no significant difference between the two groups in terms of that devotion.

While the stated conclusion, "The results of this study are substantially consistent with the hypothesis that there are no significant differences in dimensions of religiosity and parochial commitments between celibate priests and married clergy" (emphasis added) is formally true, it is also true that the results of the study do not significantly support that hypothesis. The practical conclusion of the paper, "The implications of this study are that there is some empirical basis to argue for a change in the present law of clerical celibacy. In regards to one's devotional life and time for ministry, celibacy does not appear to matter" is therefore unwarranted. (Update: It was also pointed out in a comment that the study indicates that unmarried clergy spend more time in prayer and pray more frequently, and that this is itself in fact a reason for clergy to remain celibate, a point that the study ignored, as though prayer was of no value — or at least, that the question of prayer was basically irrelevant for the life of clergy.)

The study, in fact, has several glaring problems of which the author is apparently heedless. The two groups of clergy differed in multiple significant ways other than being celibate or married: (1) the one group was evangelical, the other Catholic (this was apparently the actual principle of division, since one group seems to have included all evangelical pastors, whether married or celibate). (2) One group (the evangelical) was taken as a sample from all over Canada, the other from only two dioceses. (3) The average age of the evangelical ministers was 44, while that of the priests was 60, a difference that the author points out, then proceeds to ignore. Lesser, though still significant problems, are that the response rate of priests was significantly lower than that of evangelical ministers, and that the total number of responses from priests was 80.

Was the author of the study clueless about what is necessary in order to establish a general statistical relationship? Or was he blinded by a bias with which he approached the study? It is not possible to say. But one thing is clear. If this kind of evidence is to be used to propose a change in the Latin or in the Oriental discipline, it should be collected much more soundly.

Instincts Regarding Determinism and Moral Responsibility

Shaun Nichols and Joshua Kolbe describe in a paper, Moral Responsibility and Determinism: The Cognitive Science of Folk Intuitions (PDF), several studies aimed at delineating common intuitions regarding the (in)compatibility of moral responsibility and determinism. Having one universe, universe A, described in which everything, including human decisions, is completely caused by the foregoing events, so that they cannot happen differently than they do, and another universe, universe B, in which human decisions are not completely caused by foregoing events, and could be different than they are, the vast majority (90%) say that the second universe is more like the one in which we live.

The participants are further asked either an abstract or a general question regarding the possibility of moral responsibility in universe A:

Of those asked the abstract question, "In Universe A, is it possible for a person to be fully morally responsible for their actions?   Yes    No", 86% responded that it is not possible for a person to be fully morally responsible for what they do.

Of those presented with the concrete scenario and question, "In Universe A, Bill stabs his wife and children to death so that he can be with his secretary. Is it possible that Bill is fully morally responsible for killing his family?", 50% responded that it is possible.

Presented with the even more detailed scenario, "In Universe A, a man named Bill has become attracted to his secretary, and he decides that the only way to be with her is to kill his wife and 3 children. He knows that it is impossible to escape from his house in the event of a fire. Before he leaves on a business trip, he sets up a device in his basement that burns down the house and kills his family. Is Bill fully morally responsible for killing his wife and children?", 72% responded that he is fully morally responsible!

The authors suggest that these contradictory intuitions suggest that the greater affective reaction to the concrete scenario.

Now, an alternative explanation would be that it was simply the concreteness of the scenarios that led to the different responses. The more concrete ways that the presents see in which the actions proceeded from Bill's intellect and will, the more likely they are to respond that he is or could be fully morally responsible.

In an attempt to exclude this possibility, the authors made another experiment in which all participants were presented with concrete situations. Some were asked:

As he has done many times in the past, Bill stalks and rapes a stranger. Is it possible that Bill is fully morally responsible for raping the stranger?

Others were asked:

As he has done many times in the past, Mark arranges to cheat on his taxes. Is it possible that Mark is fully morally responsible for cheating on his taxes?

Under the stipulation that these persons are supposed to exist in universe B, in which human decisions are not entirely caused by foregoing events, almost all responded that the persons could be fully morally responsible for their actions (95% responded that Bill could be fully morally responsible for the rape, and 89% that Mark could be fully morally responsible for cheating on his taxes).

Under the stipulation that these persons are supposed to exist in universe A, in which human decisions are entirely caused by foregoing events, nearly all responded that Mark could not be fully morally responsible for cheating on his taxes; only 23% answered that he could be fully morally responsible. 64%, on the other hand,  responded that Bill could be fully morally responsible.

The authors argue from this study that the concreteness of the question or scenario is not responsible for the different responses, but the kind of affective response elicited by the scenario.

It is an interesting study, and doubtless affect plays in a role in the responses, but there does occur to me another possible factor that the authors do not consider, namely that the participants' instinct is that, in fact, the decision to cheat on one's taxes, because it does not directly concern fundamental human goods, is only secondarily a moral matter and can be determined by circumstances and external causes, while the decision to rape someone, being more directly concerned with fundamental human good, cannot be determined by circumstances and external causes. Such an instinct would explain the results: since the persons have an intuition that the decision to rape cannot be a non-moral action, and also a belief that in a deterministic universe all actions are non-moral, their responses are close to 50-50; the persons asked about Mark have an intuition that the decision to cheat on taxes can be a non-moral action, though in normal circumstances it is a moral action, and so, since there is no conflict with their belief that in a deterministic universe full moral responsibility is impossible, the majority answer that Mark cannot be fully morally responsible.

It's All Adam's Fault!

In several recent posts, I argued that when a person is to some degree determined toward evil on account of an external cause, he is to that degree less free and responsible for doing the evil. In a similar vein someone might argue: it is practically speaking a foregone conclusions that we are going to commit many sins, because we are born sinners, and we are born sinners not because of anything we did (as in Origen's account), but because of Adam. It's his fault, not ours. He's really the one responsible for our sins!

There are a couple of complementary ways to approach this objection. First, we may insist, as the Early Church Fathers, as well as nearly all the Eastern Fathers tend to do, that we still retain the basic freedom to choose what is good; the divine spark and light of the Spirit in the soul has been dimmed, but not totally extinguished from the soul. This is the objective approach to answering the objection.

But how do we reconcile all these affirmations, that (1) to the degree that one person's bad action is predictable on account of the agency of another person, the former is less free and less responsible for that bad action, that (2) on account of Adam's sin, we are virtually certain to commit numerous sins, and that (3) we remain free and responsible for our sins?

The first way of doing so is to recognize that our present freedom, while real freedom, is merely a dim shadow of the freedom that is possible to the human spirit. The freedom of all of our free acts and choices, both good and evil, is a shadow of the freedom of a man whose spirit possesses true mastery of choice, for whom the "perishable body" does not weigh down the soul. If our sins are ten thousand times less voluntary than Adam's sin (which may or may not be true), this does not mean that our sins are involuntary, or that we are not free, but that Adam's freedom was a freedom greater than we can possibly imagine.

The other way to answer the objection is that whatever the cause of our sinfulness, that is, our separation from the holiness of God and our tendency to sin, the fact remains that it is we who are sinful, we who sin, we who so often act in disgraceful and shameful fashions. C.S. Lewis illustrates this well in the Problem of Pain:

Theoretically, I suppose, we might say ‘Yes: we behave like vermin, but then that is because we are vermin. And that, at any rate, is not our fault.’ But the fact that we are vermin, so far from being felt as an excuse, is a greater shame and grief to us than any of the particular acts which it leads us to commit. The situation is not nearly so hard to understand as some people make out. It arises among human beings whenever a very badly brought up boy is introduced into a decent family. They rightly remind themselves that it is ‘not his own fault’ that he is a bully, a coward, a tale-bearer and a liar. But none the less, however it came there, his present character is detestable. They not only hate it, but ought to hate it. They cannot love him for what he is, they can only try to turn him into what he is not. In the meantime, though the boy is most unfortunate in having been so brought up, you cannot quite call his character a ‘misfortune’ as if he were one thing and his character another. It is he—he himself—who bullies and sneaks and likes doing it. And if he begins to mend he will inevitably feel shame and guilt at what he is just beginning to cease to be.

Augustine emphasizes (in some respects excessively) this second approach to the state of sinfulness in which we are born. This approach, in contrast to the first, is principally subjective, focusing on our experience of a separation from God, our corresponding behavior, and consequent shame. Though this second approach would not suffice on its own to answer the objection that would deny our responsibility for sin, it is a valuable complement to the first approach.

Are They Few Who Sin?

In the posts Is predictability incompatible with responsibility for sin and The Difference Between Truth and Error, I argued that external causes (genetics, upbringing, circumstances, etc.) that are not the result of a person's will, and yet make it more likely that that person will commit an objectively evil act, decrease the voluntariness of that act. As pointed out in a comment, this principle could be used to absolve almost everyone of responsibility for sin, and in fact is not infrequently so used in modern times. Clarence Darrow argued in the trial of Richard Loeb and Nathan Leopold for murder: "Nature is strong and she is pitiless. She works in mysterious ways, and we are her victims. We have not much to do with it ourselves. Nature takes this job in hand, and we only play our parts…. What had this boy had to do with it? He was not his own father; he was not his own mother….All of this was handed to him. He did not surround himself with governesses and wealth. He did not make himself. And yet he is to be compelled to pay." Though this argument was not credited by the judge, who stated that it did not pertain to the court to make a judgment of ultimate responsibility, one might argue that God judges precisely on the basis of ultimate responsibility, and does not condemn a person for an act to which he was largely led by upbringing, circumstances, etc.

What to say about this? For the sake of illustration, and in the spirit of modern science, let's describe a person's amount of responsibility with a number from 0 to 1, where 0 means the person is totally free of responsibility, and 1 means he is totally responsible. Where is the dividing line between the acts of sin for which God holds a man accountable, and the acts for which God does not hold a man accountable? If God does not condemn a person for sin unless he is at least 0.99999 responsible for it, the view that nearly everyone goes to heaven might be quite a bit more plausible. Conversely, if God condemns a person for sin if he is even 0.00001 responsible for it, the view that nearly everyone goes to hell would become more likely.

We do not have direct insight into the mind and judgment of God on this matter, but we have hints about his answer; God's answer to the question of this post would seem to be similar to his answer to the question "Are they few who will be saved?"

Strive to enter by the narrow door; for many, I tell you, will seek to enter and will not be able. (Luke 13:24).

Whatever God's future judgment may be about those who are led to sin through their upbringing, their culture, and so on, our earnest concern should be to avoid sin and to follow Christ, and similarly to draw others away from sin and to Christ.

Aquinas On The Evidence For Original Sin

In a previous post, I quoted Newman and Chesterton speaking of evil as evidence for either the non-existence of God or the existence of original sin. Aquinas touches briefly on this topic in the Summa Contra Gentiles III, ch. 52. He outlines the argument as follows: God in his providence rewards good deeds and punishes evil deeds. But the whole human race is subject to various bodily and spiritual punishments: death, hunger, thirst, ignorance, weakness, etc. Therefore there is some sin of the human race that is being punished by these pains. Aquinas then raises the objection that all of these pains need not be punishments, since they simply follow from man's nature; being made up of various elements, man must be capable of death and corruption; again, "the sensitive appetite must incline to things in which the senses delight, and which at times are contrary to reason, and the possible intellect is in potentiality to all things intelligible, and has none of them actually, but has by its very nature to acquire them through the senses, and therefore with difficulty acquires the knowledge of truth, and is easily led astray by the imagination."

In response, Aquinas says, "one can with sufficient probability think [one can reasonably think; satis probabiliter poterit aestimare] that, divine providence having fitted each perfection to that which is to be perfected, God united a higher to a lower nature in such a way that the former would dominate the latter, and, should any obstacle to this dominion arise through a defect of nature, God by a special and supernatural act of kindness would remove it." The empirical argument for original sin presupposes more than the kind of divine providence that can be philosophically proven; it presupposes something like a providence in which God's care for man knows no limits, in which, from the very beginning, he gives man as much as possible.

Now imagine several different suppositions: (1) the atheistic position that there is no God, (2) the position that there is a God who is the cause of the world, and who intervenes in the world, but has little special concern for man, (3) the position that there is a God who is the cause of the world, but whose special providence for man regards only the future destiny of man (or man's soul), (4) the Christian (and to some extent Jewish) faith in God.

The existence of evil constitutes significant evidence for original sin only on the fourth supposition or a similar one. And conversely, the doctrine of original sin makes the world in which we live more intelligible only in light of the fourth supposition (the Christian or similar view of divine providence).

Thus rather than taking the prevalence of evil as evidence that either there is no God or that there is Original Sin, it would be more accurate to say that the prevalence of evil constitutes evidence that either the Christian view of God and divine providence is wrong, or that the Christian doctrine of original sin is correct.

St. Therese of Lisieux

Today is the feastday of St. Therese, virgin and doctor of the Church.

"Merit does not consist in doing or giving much. It consists in loving much." (Letter 142, to Celine).

"When I have committed a fault that makes me sad, I know well that this sadness is the consequence of my infidelity. But do you think I stop there? Oh no, I'm not so silly! I hurry to say to God: My God, I know that I have merited this feeling of sadness, but let me offer you all of it as a test that you send me out of love. I regret my sin, but I am content to have this suffering to offer to you. (Last words of St. Thérèse as recollected by Sr. Agnes of Jesus.)

Sayings of St. Therese of Lisieux on Love