Double-Effect Donation or Bodily Respect? A “Third Way” Response to Camosy and Vukov

Abstract

Is it possible to donate unpaired vital organs, foreseeing but not intending one's own death? We argue that this is indeed psychologically possible, and thus far agree with Charles Camosy and Joseph Vukov in their recent paper on “double effect donation.” Where we disagree with these authors is that we see double-effect donation not as a morally praiseworthy act akin to martyrdom but as a morally impermissible act that necessarily disrespects human bodily integrity. Respect for bodily integrity goes beyond avoiding the aim to kill: not all side effects of deliberate bodily interventions can be outweighed by intended benefits for another even if the subject fully consents. It is not any necessary intention to kill or harm another or oneself that makes lethal donation/harvesting illicit but the more immediate intention to accept or perform surgery on an (innocent) person combined with the foresight of lethal harm and no health-related good for him or her. Double-effect donation falls foul of the first condition of double-effect reasoning in that the immediate act is wrong in itself. We argue further that the wider effects of such donation would be socially disastrous and corrupting of the medical profession: doctors should retain a sense of nonnegotiable respect for bodily integrity even when they intervene on willing subjects for the benefit of others.

Summary: Lethal organ donation (for example, donating one's heart) is not a praiseworthy but a morally impermissible act. This is not because such donation necessarily involves any aim to kill oneself (if one is the donor) or to kill the donor (if one is the surgeon). Respect for bodily integrity goes beyond avoiding any hypothetical aim to kill or harm oneself or another innocent person. ‘Double effect donation’ of unpaired vital organs, defended by Camosy and Vukov, is in our view a form of lethal bodily abuse and would also harm the transplant team, the medical profession and society at large.

Keywords

Bodily integrity Direct killing Intention Intentional killing Organ donation Organ transplantation Principle of double effect Physician-assisted suicide Suicide Unintended morally determinative aspects

Get full access to this article

View all access options for this article.

References

Aquinas

Thomas

. 1920, revised 2017. “The Summa Theologiæ of St. Thomas Aquinas.” Literally translated by Fathers of the English Dominican Province, https://www.newadvent.org/summa/3124.htm.

Camosy

Charles C.

2021. Losing Our Dignity: How Secularized Medicine is Undermining Fundamental Human Equality. New York: New City Press.

Camosy

Charles C.

Vukov

Joseph

. 2021. “Double Effect Donation.” Linacre Quarterly 88 (2): 149–62.

Cavanaugh

Thomas A.

2022. “Double-Effect Donation Disputed.” The Linacre Quarterly 89 (3): 327–35.

Clement of Alexandria. 1885. The Stromata Book 4, Translated by William Wilson. From Ante-Nicene Fathers, Vol. 2, edited by Alexander Roberts, James Donaldson, and A. Cleveland Coxe. Buffalo, NY: Christian Literature Publishing Co., 147. Revised and edited for New Advent by Kevin Knight, http://www.newadvent.org/fathers/02104.htm.

Ely

2019. “Death by Organ Donation: Euthanizing Patients for Their Organs Gains Frightening Traction.” Intensive Care Medicine 45 (9): 1309–11.

Eyal

Nir.

2009. “Is the Body Special? Review of Cécile Fabre, Whose Body is it Anyway? Justice and the Integrity of the Person.” Utilitas 21 (2): 233–45.

Fabre

Cécile.

2006. Whose Body Is It Anyway?: Justice and the Integrity of the Person. Oxford: OUP.

Garcia

J. L. A.

1997. “Intentions in Medical Ethics.” In Human Lives: Critical Essays on Consequentialist Bioethics, edited by Oderberg

David

Laing

Jacqueline

, pp. 161–81. London: Macmillan.

10.

Juvin

Hervé

. 2010. The Coming of the Body. London: Verso.

11.

Knox

Ronald

. 1950. Enthusiasm: A Chapter in the History of Religion. Oxford: Oxford University Press.

12.

Masek

Lawrence

. 2018. Intention, Character, and Double Effect. Notre Dame, IN: University of Notre Dame Press.

13.

Masek

Lawrence

. 2021. “The Strict Definition of Intended Effects and Two Questions for Critics.” American Catholic Philosophical Quarterly 95 (4): 651–78.

14.

McCarthy

Anthony.

2015. “Unintended Morally Determinative Aspects (UMDAs): Moral Absolutes, Moral Acts and Physical Features in Sexual and Reproductive Ethics.” Studia Philosophiae Christianae 51(2): 47–65.

15.

McCarthy

Anthony.

2016. Ethical Sex: Sexual Choices and Their Nature and Meaning. Notre Dame: Fidelity.

16.

Mitchell

David

. 2008. “Legalise the Right to Die? Over My Dead Body.” Observer . https://www.theguardian.com/commentisfree/2008/dec/14/assisted-suicide-television-dignitas.

17.

Napier

Stephen

. 2019. Uncertain Bioethics: Moral Risk and Human Dignity. Abingdon: Taylor & Francis.

18.

Omelianchuk

2022. “Can Double-Effect Reasoning Justify Lethal Organ Donation?” Bioethics 36 (6): 648–54.

19.

Pruss

Alexander R.

2012. One Body: An Essay in Christian Sexual Ethics. South Bend: University of Notre Dame Press.

20.

Royal College of Physicians and British Medical Association. 2018. Clinically-Assisted Nutrition and Hydration (CANH) and Adults Who Lack the Capacity to Consent: Guidance for Decision-making in England and Wales. London.

21.

Shewmon

D. Alan

. 2021. “Statement in Support of Revising the Uniform Determination of Death Act and in Opposition to a Proposed Revision.” Journal of Medicine and Philosophy. https://doi.org/10.1093/jmp/jhab014.

22.

Velleman

J. David

. 2015. Beyond Price: Essays on Birth and Death. Cambridge: Open Book Publishers.

23.

Watt

Helen

. 2021. “Complicity or Justified Cooperation in Evil?: Negotiating the Terrain.” The National Catholic Bioethics Quarterly 21 (2): 209–18.

24.

Watt

Helen

McCarthy

Anthony

. 2020. “Targeting the Fetal Body and/or Mother–Child Connection: Vital Conflicts and Abortion.” The Linacre Quarterly 87 (2): 147–60.