The Problem of Abortion and theDoctrine of the Double EffectPhilippa Foot1967. Oxford Review, No. 5. Included in Foot,
1977/2002 Virtues and Vices and Other Essays in
Moral Philosophy. (Minor stylistic amendments havebeen made.)
One of the reasons why most of us feel puzzled about the
problem of abortion is that we want, and do not want, toallow to the unborn child the rights that belong to adults
and children. When we think of a baby about to be born it
seems absurd to think that the next few minutes or evenhours could make so radical a difference to its status; yet
as we go back in the life of the fetus we are more andmore reluctant to say that this is a human being and mustbe treated as such. No doubt this is the deepest source ofour dilemma, but it is not the only one. For we are also
confused about the general question of what we may andmay not do where the interests of human beings conflict.
We have strong intuitions about certain cases; saying, forinstance, that it is all right to raise the level of educationin our country, though statistics allow us to predict that arise in the suicide rate will follow, while it is not all rightto kill the feeble-minded to aid cancer research. It is noteasy, however, to see the principles involved, and one
way of throwing light on the abortion issue will be bysetting up parallels involving adults or children once born.
So we will be able to isolate the “equal rights” issue andshould be able to make some advance.
I shall not, of course, discuss all the principles that may
be used in deciding how to act where the interests orrights of human beings conflict. What I want to do is tolook at one particular theory, known as the “doctrine ofthe double effect” which is invoked by Catholics insupport of their views on abortion but supposed by them
to apply elsewhere. As used in the abortion argument this
doctrine has often seemed to non-Catholics to be a pieceof complete sophistry. In the last number of the Oxford
Review it was given short shrift by Professor Hart.1 And
yet this principle has seemed to some non-Catholics aswell as to Catholics to stand as the only defence against
decisions on other issues that are quite unacceptable. It
will help us in our difficulty about abortion if this conflictcan be resolved.
The doctrine of the double effect is based on a distinction
between what a man foresees as a result of his voluntaryaction and what, in the strict sense, he intends. He intends
in the strictest sense both those things that he aims at asends and those that he aims at as means to his ends. The
latter may be regretted in themselves but neverthelessdesired for the sake of the end, as we may intend to keep
dangerous lunatics confined for the sake of our safety. By	  contrast a man is said not strictly, or directly, to intend theforeseen consequences of his voluntary actions wherethese are neither the end at which he is aiming nor themeans to this end. Whether the word “intention” should
be applied in both cases is not of course what matters:
Bentham spoke of “oblique intention,” contrasting it withthe “direct intention” of ends and means, and we may as
well follow his terminology. Everyone must recognizethat some such distinction can be made, though it may bemade in a number of different ways, and it is thedistinction that is crucial to the doctrine of the double
effect. The words “double effect” refer to the two effects
that an action may produce: the one aimed at, and the one
foreseen but in no way desired. By “the doctrine of the
double effect” I mean the thesis that it is sometimes
permissible to bring about by oblique intention what one
may not directly intend. Thus the distinction is held to be
relevant to moral decision in certain difficult cases. It issaid for instance that the operation of hysterectomy
involves the death of the fetus as the foreseen but notstrictly or directly intended consequence of the surgeon’sact, while other operations kill the child and count as the
direct intention of taking an innocent life, a distinctionthat has evoked particularly bitter reactions on the part ofnon-Catholics. If you are permitted to bring about thedeath of the child, what does it matter how it is done? The
doctrine of the double effect is also used to show why inanother case, where a woman in labor will die unless acraniotomy operation is performed, the intervention is not
to be condoned. There, it is said, we may not operate but
must let the mother die. We foresee her death but do notdirectly intend it, whereas to crush the skull of the childwould count as direct intention of its death.2
This last application of the doctrine has been queried byProfessor Hart on the ground that the child’s death is notstrictly a means to saving the mother’s life and should
logically be treated as an unwanted but foreseen
consequence by those who make use of the distinction
between direct and oblique intention. To interpret thedoctrine in this way is perfectly reasonable given thelanguage that has been used; it would, however, makenonsense of it from the beginning. A certain event may bedesired under one of its descriptions, unwanted underanother, but we cannot treat these as two different events,
one of which is aimed at and the other not. And even if it
be argued that there are here two different events—thecrushing of the child’s skull and its death—the two are
obviously much too close for an application of thedoctrine of the double effect. To see how odd it would be
to apply the principle like this we may consider the story,
well known to philosophers, of the fat man stuck in themouth of the cave. A party of potholers have imprudently
allowed the fat man to lead them as they make their way
out of the cave, and he gets stuck, trapping the others
behind him. Obviously the right thing to do is to sit down
and wait until the fat man grows thin; but philosophers
have arranged that floodwaters should be rising within the2 / Foot / “The Problem of Abortion and the Doctrine of the Double Effect”
cave. Luckily (luckily?) the trapped party have with thema stick of dynamite with which they can blast the fat man
out of the mouth of the cave. Either they use the dynamiteor they drown. In one version the fat man, whose head isin the cave, will drown with them; in the other he will be
rescued in due course.3 Problem: may they use thedynamite or not? Later we shall find parallels to thisexample. Here it is introduced for light relief and because
it will serve to show how ridiculous one version of thedoctrine of the double effect would be. For suppose thatthe trapped explorers were to argue that the death of thefat man might be taken as a merely foreseen consequenceof the act of blowing him up. (“We didn’t want to kill him… only to blow him into small pieces” or even “… only
to blast him out of the cave.”) I believe that those who use
the doctrine of the double effect would rightly reject sucha suggestion, though they will, of course, haveconsiderable difficulty in explaining where the line is tobe drawn. What is to be the criterion of “closeness” if wesay that anything very close to what we are literally
aiming at counts as if part of our aim?
Let us leave this difficulty aside and return to thearguments for and against the doctrine, supposing it to be
formulated in the way considered most effective by its
supporters, and ourselves bypassing the trouble by taking
what must on any reasonable definition be clear cases of“direct” or “oblique” intention.
The first point that should be made clear, in fairness to thetheory, is that no one is suggesting that it does not matter
what you bring about as long as you merely foresee anddo not strictly intend the evil that follows. We might
think, for instance, of the (actual) case of wicked
merchants selling, for cooking, oil they knew to bepoisonous and thereby killing a number of innocent
people, comparing and contrasting it with that of someunemployed gravediggers, desperate for custom, who got
hold of this same oil and sold it (or perhaps they secretly
gave it away) in order to create orders for graves. They
strictly (directly) intend the deaths they cause, while themerchants could say that it was not part of their plan thatanyone should die. In morality, as in law, the merchants,
like the gravediggers, would be considered as murderers;
nor are the supporters of the doctrine of the double effectbound to say that there is the least difference between
them in respect of moral turpitude. What they arecommitted to is the thesis that sometimes it makes adifference to the permissibility of an action involving
harm to others that this harm, although foreseen, is notpart of the agent’s direct intention. An end such as
earning one’s living is clearly not such as to justify either
the direct or oblique intention of the death of innocent
people, but in certain cases one is justified in bringing
about knowingly what one could not directly intend.
It is now time to say why this doctrine should be taken
seriously in spite of the fact that it sounds rather odd, that
there are difficulties about the distinction on which it	
  depends, and that it seemed to yield one sophisticalconclusion when applied to the problem of abortion. The
reason for its appeal is that its opponents have often
seemed to be committed to quite indefensible views. Thus
the controversy has raged around examples such as thefollowing. Suppose that a judge or magistrate is facedwith rioters demanding that a culprit be found for acertain crime and threatening otherwise to take their own
bloody revenge on a particular section of the community.
The real culprit being unknown, the judge sees himself as
able to prevent the bloodshed only by framing someinnocent person and having him executed. Beside thisexample is placed another in which a pilot whose airplane
is about to crash is deciding whether to steer from a more
to a less inhabited area. To make the parallel as close as
possible it may rather be supposed that he is the driver ofa runaway tram which he can only steer from one narrow
track on to another; five men are working on one trackand one man on the other; anyone on the track he enters isbound to be killed. In the case of the riots the mob have
five hostages, so that in both the exchange is supposed to
be one man’s life for the lives of five. The question is
why we should say, without hesitation, that the drivershould steer for the less occupied track, while most of us
would be appalled at the idea that the innocent man could
be framed. It may be suggested that the special feature of
the latter case is that it involves the corruption of justice,and this is, of course, very important indeed. But if weremove that special feature, supposing that some private
individual is to kill an innocent person and pass him off as
the criminal we still find ourselves horrified by the idea.
The doctrine of double effect offers us a way out of the
difficulty, insisting that it is one thing to steer towards
someone foreseeing that you will kill him and another toaim at his death as part of your plan. Moreover there isone very important element of good in what is here
insisted. In real life it would hardly ever be certain thatthe man on the narrow track would be killed. Perhaps hemight find a foothold on the side of the tunnel and cling
on as the vehicle hurtled by. The driver of the tram does
not then leap off and brain him with a crowbar. The
judge, however, needs the death of the innocent man for
his (good) purposes. If the victim proves hard to hang hemust see to it that he dies another way. To choose to
execute him is to choose that this evil shall come about,and this must therefore count as a certainty in weighing
up the good and evil involved. The distinction between
direct and oblique intention is crucial here, and is of great
importance in an uncertain world. Nevertheless this is no
way to defend the doctrine of double effect. For thequestion is whether the difference between aiming at
something and obliquely intending it is in itself relevant tomoral decisions; not whether it is important whencorrelated with a difference of certainty in the balance ofgood and evil. Moreover we are particularly interested in
the application of the doctrine of the double effect to thequestion of abortion, and no one can deny that in3 / Foot / “The Problem of Abortion and the Doctrine of the Double Effect”
medicine there are sometimes certainties so complete that
it would be a mere quibble to speak of the “probableoutcome” of this course of action or that. It is not,therefore, with a merely philosophical interest that weshould put aside the uncertainty and scrutinize theexamples to test the doctrine of the double effect. Why
can we not argue from the case of the steering driver tothat of the judge?
Another pair of examples poses a similar problem. We areabout to give a patient who needs it to save his life a
massive dose of a certain drug in short supply. Therearrive, however, five other patients each of whom could
be saved by one-fifth of that dose. We say with regret that
we cannot spare our whole supply of the drug for a single
patient, just as we should say that we could not spare thewhole resources of a ward for one dangerously ill
individual when ambulances arrive bringing in victims ofa multiple crash. We feel bound to let one man die rather
than many if that is our only choice. Why then do we notfeel justified in killing people in the interests of cancer
research or to obtain, let us say, spare parts for grafting onto those who need them? We can suppose, similarly, thatseveral dangerously ill people can be saved only if we killa certain individual and make a serum from his deadbody. (These examples are not over-fanciful considering
present controversies about prolonging the life of mortally
ill patients whose eyes or kidneys are to be used forothers.) Why cannot we argue from the case of the scarce
drug to that of the body needed for medical purposes?
Once again the doctrine of the double effect comes up
with an explanation. In one kind of case but not the otherwe aim at the death of an innocent man.
A further argument suggests that if the doctrine of the
double effect is rejected this has the consequences of
putting us hopelessly in the power of bad men. Suppose
for example that some tyrant should threaten to torture
five men if we ourselves would not torture one. Would it
be our duty to do so, supposing we believed him, because
this would be no different from choosing to rescue fivemen from his torturers rather than one? If so, anyone whowants us to do something we think wrong has only tothreaten that otherwise he himself will do something wethink worse. A mad murderer, known to keep his
promises, could thus make it our duty to kill someinnocent citizen to prevent him from killing two. From
this conclusion we are again rescued by the doctrine ofthe double effect. If we refuse, we foresee that the greaternumber will be killed but we do not intend it: it is he who
intends (that is strictly or directly intends) the death of
innocent persons; we do not.
At one time I thought that these arguments in favor of thedoctrine of the double effect were conclusive, but I now
believe that the conflict should be solved in another way.
The clue that we should follow is that the strength of thedoctrine seems to lie in the distinction it makes between
what we do (equated with direct intention) and what we	
  allow (thought of as obliquely intended). Indeed it isinteresting that the disputants tend to argue about whether
we are to be held responsible for what we allow as we are
for what we do.4 Yet it is not obvious that this is what
they should be discussing, since the distinction between
what one does and what one allows to happen is not thesame as that between direct and oblique intention. To see
this one has only to consider that it is possible
deliberately to allow something to happen, aiming at it
either for its own sake or as part of one’s plan for
obtaining something else. So one person might wantanother person dead and deliberately allow him to die.
And again one may be said to do things that one does not
aim at, as the steering driver would kill the man on the
track. Moreover there is a large class of things said to bebrought about rather than either done or allowed where
either kind of intention is possible. So it is possible tobring about a man’s death by getting him to sea in a leaky
boat, and the intention of his death may be either direct oroblique.
Whatever it may, or may not, have to do with the doctrineof the double effect, the idea of allowing is worth looking
into in this context. I shall leave aside the special case ofgiving permission, which involves the idea of authority,and consider the two main divisions into which cases ofallowing seem to fall. There is firstly the allowing which
is forbearing to prevent. For this we need a sequence
thought of as somehow already in train, and somethingthat an agent could do to intervene. (The agent must beable to intervene, but does not do so.) So, for instance, he
could warn someone, but allows him to walk into a trap.
He could feed an animal but allows it to die for lack offood. He could stop a leaking tap but allows the water togo on flowing. This is the case of allowing with which weshall be concerned, but the other should be mentioned. It
is the kind of allowing which is roughly equivalent toenabling; the root idea being the removal of someobstacle which is, as it were, holding back a train of
events. So someone may remove a plug and allow water
to flow; open a door and allow an animal to get out; orgive someone money and allow him to get back on his
feet.
The first kind of allowing requires an omission, but there
is no other general correlation between omission andallowing, commission and bringing about or doing. An
actor who fails to turn up for a performance will generally
spoil it rather than allow it to be spoiled. I mention the
distinction between omission and commission only to set
it aside.
Thinking of the first kind of allowing (forbearing toprevent), we should ask whether there is any difference,from the moral point of view, between what one does orcauses and what one merely allows. It seems clear that on
occasions one is just as bad as the other, as is recognizedin both morality and law. A man may murder his child or
his aged relatives by allowing them to die of starvation as4 / Foot / “The Problem of Abortion and the Doctrine of the Double Effect”
by giving poison; he may also be convicted of murder oneither account. In another case we would, however, makea distinction. Most of us allow people to die of starvationin India and Africa, and there is surely something wrong
with us that we do; it would be nonsense, however, topretend that it is only in law that we make the distinction
between allowing people in the under-developed countries
to die of starvation and sending them poisoned food.
There is worked into our moral system a distinction
between what we owe people in the form of aid and what
we owe them in the way of non-interference. Salmond, in
his Jurisprudence, expressed as follows the distinction
between the two.
“A positive right corresponds to a positive duty, andis a right that he on whom the duty lies shall do somepositive act on behalf of the person entitled. A
negative right corresponds to a negative duty, and is aright that the person bound shall refrain from someact which would operate to the prejudice of theperson entitled. The former is a right to be positively
benefited; the latter is merely a right not to beharmed.”5
As a general account of rights and duties this is defective,
since not all are so closely connected with benefit andharm. Nevertheless for our purposes it will do well. Let us
speak of negative duties when thinking of the obligation
to refrain from such things as killing or robbing, and of
the positive duty, e.g., to look after children or aged
parents. It will be useful, however, to extend the notion of
positive duty beyond the range of things that are strictly
called duties, bringing acts of charity under this heading.
These are owed only in a rather loose sense, and someacts of charity could hardly be said to be owed at all, so I
am not following ordinary usage at this point.
Let us now see whether the distinction of negative andpositive duties explains why we see differently the actionof the steering driver and that of the judge, of the doctors
who withhold the scarce drug and those who obtain abody for medical purposes, of those who choose to rescue
five men rather than one man from torture and those whoare ready to torture the one man themselves in order tosave five. In each case we have a conflict of duties, butwhat kind of duties are they? Are we, in each case,weighing positive duties against positive, negative against
negative, or one against the other? Is the duty to refrainfrom injury, or rather to bring aid?
The steering driver faces a conflict of negative duties,
since it is his duty to avoid injuring five men and also his
duty to avoid injuring one. In the circumstances he is notable to avoid both, and it seems clear that he should do
the least injury he can. The judge, however, is weighing
the duty of not inflicting injury against the duty ofbringing aid. He wants to rescue the innocent people
threatened with death but can do so only by inflicting
injury himself. Since one does not in general have the	  same duty to help people as to refrain from injuring them,
it is not possible to argue to a conclusion about what heshould do from the steering driver case. It is interesting
that, even where the strictest duty of positive aid exists,
this still does not weigh as if a negative duty wereinvolved. It is not, for instance, permissible to commit amurder to bring one’s starving children food. If the choice
is between inflicting injury on one or many there seems
only one rational course of action; if the choice is between
aid to some at the cost of injury to others, and refusing toinflict the injury to bring the aid, the whole matter is open
to dispute. So it is not inconsistent of us to think that thedriver must steer for the road on which only one manstands while the judge (or his equivalent) may not kill theinnocent person in order to stop the riots. Let us now
consider the second pair of examples, which concern the
scarce drug on the one hand and on the other the bodyneeded to save lives. Once again we find a difference
based on the distinction between the duty to avoid injury
and the duty to provide aid. Where one man needs a
massive dose of the drug and we withhold it from him inorder to save five men, we are weighing aid against aid.
But if we consider killing a man in order to use his bodyto save others, we are thinking of doing him an injury tobring others aid. In an interesting variant of the model, we
may suppose that instead of killing someone wedeliberately let him die. (Perhaps he is a beggar to whom
we are thinking of giving food, but then we say “No, theyneed bodies for medical research.”) Here it does seem
relevant that in allowing him to die we are aiming at his
death, but presumably we are inclined to see this as a
violation of negative rather than positive duty. If this isright, we see why we are unable in either case to argue toa conclusion from the case of the scarce drug.
In the examples involving the torturing of one man or fivemen, the principle seems to be the same as for the lastpair. If we are bringing aid (rescuing people about to be
tortured by the tyrant), we must obviously rescue thelarger rather than the smaller group. It does not follow,
however, that we would be justified in inflicting the
injury, or getting a third person to do so, in order to savethe five. We may therefore refuse to be forced into acting
by the threats of bad men. To refrain from inflicting
injury ourselves is a stricter duty than to prevent otherpeople from inflicting injury, which is not to say that theother is not a very strict duty indeed.
So far the conclusions are the same as those at which wemight arrive following the doctrine of the double effect,
but in others they will be different, and the advantage
seems to be all on the side of the alternative. Suppose, forinstance, that there are five patients in a hospital whose
lives could be saved by the manufacture of a certain gas,
but that this inevitably releases lethal fumes into the roomof another patient whom for some reason we are unable tomove. His death, being of no use to us, is clearly a side
effect, and not directly intended. Why then is the case

5 / Foot / “The Problem of Abortion and the Doctrine of the Double Effect”
different from that of the scarce drug, if the point aboutthat is that we foresaw but did not strictly intend the deathof the single patient? Yet it surely is different. The
relatives of the gassed patient would presumably be
successful if they sued the hospital and the whole story
came out. We may find it particularly revolting thatsomeone should be used as in the case where he is killed
or allowed to die in the interest of medical research, andthe fact of using may even determine what we would
decide to do in some cases, but the principle seems
unimportant compared with our reluctance to bring suchinjury for the sake of giving aid.
My conclusion is that the distinction between direct andoblique intention plays only a quite subsidiary role indetermining what we say in these cases, while thedistinction between avoiding injury and bringing aid isvery important indeed. I have not, of course, argued that
there are no other principles. For instance it clearly makesa difference whether our positive duty is a strict duty or
rather an act of charity: feeding our own children or
feeding those in faraway countries. It may also make adifference whether the person about to suffer is one
thought of as uninvolved in the threatened disaster, andwhether it is his presence that constitutes the threat to theothers. In many cases we find it very hard to know what
to say, and I have not been arguing for any general
conclusion such as that we may never, whatever thebalance of good and evil, bring injury to one for the sakeof aid to others, even when this injury amounts to death. I
have only tried to show that even if we reject the doctrineof the double effect we are not forced to the conclusionthat the size of the evil must always be our guide.
Let us now return to the problem of abortion, carrying out
our plan of finding parallels involving adults or children
rather than the unborn. We must say something about thedifferent cases in which abortion might be considered on
medical grounds.
First of all there is the situation in which nothing that canbe done will save the life of child and mother, but where
the life of the mother can be saved by killing the child.
This is parallel to the case of the fat man in the mouth ofthe cave who is bound to be drowned with the others if
nothing is done. Given the certainty of the outcome, as it
was postulated, there is no serious conflict of interests
here, since the fat man will perish in either case, and it isreasonable that the action that will save someone should
be done. It is a great objection to those who argue that thedirect intention of the death of an innocent person is neverjustifiable that the edict will apply even in this case. The
Catholic doctrine on abortion must here conflict with thatof most reasonable men. Moreover we would be justifiedin performing the operation whatever the method used,
and it is neither a necessary nor a good justification of thespecial case of hysterectomy that the child’s death is notdirectly intended, being rather a foreseen consequence of	
  what is done. What difference could it make as to how thedeath is brought about?
Secondly we have the case in which it is possible toperform an operation which will save the mother and kill
the child or kill the mother and save the child. This isparallel to the famous case of shipwrecked mariners whobelieved that they must throw someone overboard if theirboat was not to founder in a storm, and to the otherfamous case of the two sailors, Dudley and Stephens, who
killed and ate the cabin boy when adrift on the sea
without food. Here again there is no conflict of interests
so far as the decision to act is concerned; only in deciding
whom to save. Once again it would be reasonable to act,
though one would respect someone who held back fromthe appalling action either because he preferred to perish
rather than do such a thing or because he held on past thelimits of reasonable hope. In real life the certainties
postulated by philosophers hardly ever exist, and Dudleyand Stephens were rescued not long after their ghastly
meal. Nevertheless if the certainty were absolute, as it
might be in the abortion case, it would seem better to save
one than none. Probably we should decide in favor of themother when weighing her life against that of the unborn
child, but it is interesting that, a few years later, we might
easily decide it the other way.
The worst dilemma comes in the third kind of example
where to save the mother we must kill the child, say bycrushing its skull, while if nothing is done the mother will
perish but the child can be safely delivered after her
death. Here the doctrine of the double effect has been
invoked to show that we may not intervene, since thechild’s death would be directly intended while themother’s would not. On a strict parallel with cases not
involving the unborn we might find the conclusion correct
though the reason given was wrong. Suppose, forinstance, that in later life the presence of a child wascertain to bring death to the mother. We would surely notthink ourselves justified in ridding her of it by a processthat involved its death. For in general we do not think that
we can kill one innocent person to rescue another, quite
apart from the special care that we feel is due to children
once they have prudently got themselves born. What wewould be prepared to do when a great many people wereinvolved is another matter, and this is probably the key to
one quite common view of abortion on the part of those
who take quite seriously the rights of the unborn child.
They probably feel that if enough people were involved
one must be sacrificed, and they think of the mother’s life
against the unborn child’s life as if it were many againstone. But of course many people do not view it like this atall, having no inclination to accord to the fetus or unborn
child anything like ordinary human status in the matter ofrights. I have not been arguing for or against these pointsof view but only trying to discern some of the currents
that are pulling us back and forth. The levity of theexamples is not meant to offend.

6 / Foot / “The Problem of Abortion and the Doctrine of the Double Effect”

Who is Wronged?—Philippa Footon Double Effect: One Point
G.E.M Anscombe
1967. Oxford Review, No. 5, immediately following
Foot’s essay.
She says: “We are about to give to a patient who needs it
to save his life, a massive dose of a certain drug in short
supply. There arrive, however, five other patients each ofwhom could be saved by one fifth of that dose. E say withregret that we cannot spare out whole supply of the drug
for a single patient, just as we should say that we could
not spare the whole resource of a ward for one
dangerously ill individual when ambulances arrive
bringing in victims of a multiple crash. We feel bound tolet one man die rather than many if that is our only
choice.” — I feel a curious disagreement about this. Thereseems to me nothing wrong with giving the single patient
the massive dose and letting the others die, of withrefusing to deprive the single patient of care necessary tokeep him alive because the hands needed for that care
could help in saving the many victims of an accident. The
latter care is vaguely sketched, and one pictures resources
being lavishly used beyond necessity on one. But let it bemade exact; let there be a machine which it takes threepeople to operate—it will not work unless there are three
on the job; and these three could be summoned away tohelp more than one person. It seems to me justifiable tosay one can’t spare those three people because of the job
they are doing, if their work seems roughly as likely tosave that one person as to save several to whose aid they
could be called. Not that it seems (absolutely) necessary
to keep then on the job they are doing; but either course,
to leave the one to die or to keep them working his
machine, seems O.K. Yet Mrs. Foot regards it as obviousthat one must save the greater number.
Why is this, and how could the disagreement be resolve?
Suppose I am the doctor, and I don’t use the drug at all.
Whom do I wrong? None of them can say: “you owed it
to me.” For there might be nine, and if one can say that,
all can; but if I sued it, I let one at least go without and he
can’t say I owed it to him. Yet all can reproach me if I
gave it to none. It was there, ready to supply human need,and human need was not supplied. So any one of themcan say: you ought to have used it to help us who neededit; and so all are wronged. But if it was used for someone,
as much as he needed it to keep him alive, no one has any
ground for accusing me of having wronged himself. —Why, just because he was one of the five who could havebeen saved, is he wronged in not being saved, if someone
is supplied with it who needed it? What is his claim,
except the claim that what was needed go to him rather	  than be wasted? But it was not wasted. So he was notwronged. So who was wronged? And if no one waswronged, what injury did I do?
Similarly if there are a lot of people stranded on a rock,and one person on another, and someone goes with a boat
to rescue the single one, what cause, so far, have any of
the others for complaint? They are not injured unless helpthat was owing to them was withheld. There was the boatthat could have helped them; but it was not left idle; no, itwent to save that other one. What is the accusation thateach of them can make? What wrong can he claim has
been done him? None whatsoever: unless the preference
signalized some ignoble contempt.
I do not mean that “because they are more” isn’t a goodreason for helping these and not the one, or these rather
than those. It is a perfectly intelligible reason. But it
doesn’t follow from that that a man acts badly if hedoesn’t make it his reason. He acts badly if he chooses torescue rich people rather than poor ones, having ill regard
for the poor ones because they are poor. But he doesn’t
act badly if he uses his resources to save X, or X, Y andZ, for bad reason, and is not affected by the considerationthat he could save a larger number of people. For, one
more: who can say he is wronged? And if no on iswronged, how does the rescuer commit any wrong?
In this connection, the following observation si of some
importance, as the contrary may be taken for granted bysome: when I do action A for reasons R, it is notnecessary or even usual for me to have any special reason
for doing-action-A-rather-than-action-B, which may also
be possible.

	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  
1

H.L.A. Hart, “Intention and Punishment,” Oxford Review,
Number 4, Hilary 1967. Reprinted in Hart, Punishment andResponsibility (Oxford, 1968). I owe much to this article and toa conversation with Professor Hart, though I do not knowwhether he will approve of what follows.

2

For discussions of the Catholic doctrine on abortion see
Glanville Williams, The Sanctity of Life and the Criminal Law(New York, 1957); also N. St. John Stevas, The Right to Life
(London, 1963).

3

It was Professor Hart who drew my attention to this distinction.

4

See, e.g., J. Bennett, “Whatever the Consequences,” Analysis,
January 1966, and G.E.M. Anscombe’s reply in Analysis, June
1966. See also Miss Anscombe’s “Modern Moral Philosophy”
in Philosophy, January 1958.

5

J. Salmond, Jurisprudence, 11th edition, p. 283.