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Issues in Depth: Ethical Commentaries
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Moral Complicity with Evil
Christian Medical and Dental Associations (USA)
Reproduced with permission

Related Links
CMDA- Health Care
Right of Conscience

CMDA- Moral
Complicity with Evil

CMDA- Double Effect


 

Moral complicity with evil is culpable association with or participation in wrongful acts. Evil is defined as anything immoral or wrong based on Biblical principles. Questions about moral complicity with evil can arise in regard to an individual’s relationship to or involvement with past, present or future evil.

Moral complicity may occur with the use of information, technology or materials obtained through immoral means. This complicity may involve using, rewarding, perpetuating, justifying, or ignoring past or present evil.1 Moral complicity may involve enabling or facilitating future immoral actions of patients or professionals.2

We must strive to never commit evil ourselves, nor should we participate in or encourage evil by others. While it may be impossible at times to completely distance ourselves from the evil actions of others, we are responsible to determine whether our action is appropriately distanced or inappropriately complicit. This determination is based on the revealed Word of God. In the absence of clear Biblical teaching, this determination is based on conscience as informed by the Holy Spirit, using but recognizing the innately fallible nature of human reason and prudence.

Biblical Guidelines
1. We must avoid every kind of evil (I Thessalonians 5:22)

2. We may never do evil that good may come. (Romans 3: 8)

3. We must hate and oppose evil. (Romans 12: 9)

4. We should separate ourselves from evil. (II Corinthians 6: 17)

5. We cannot totally separate ourselves from evil. (I Corinthians 5: 9 & 10)

6. We should overcome evil with good. (Romans 12: 21)

7. We should seek wisdom. (James 1: 2-5)

Applications
1. Intent. Our motives must be always to promote good, never evil.

2. Magnitude. Some evil acts are so heinous that any association with them is unacceptable.

3. Timing. Passage of time may diminish complicity with prior evil acts, though it does not diminish the evil nature of the original act.

4. Proximity. A greater degree of association with an evil act increases culpability.

5. Knowledge. Knowledge that an original act was evil and knowledge that a subsequent act is associated with that act are both required for culpability.

6. Certitude. A greater degree of certainty that the original action was evil increases complicity.

Conclusions
CMDA believes moral complicity with evil does not exist when all the following conditions are satisfied

1. our intent is for good;

2. the association with the past or present evil is sufficiently uncertain, or the act is sufficiently distanced from the original evil act; and

3. the action does not reward, perpetuate, justify, cooperate with, or ignore the original evil.


Footnotes
1.  For example, the potential for moral complicity exists in the use of (a) research data from unethical experiments, (b) textbooks or drawings made using tortured or executed prisoners, (c) vaccines made from aborted fetal tissue, etc. [Back]

2.   For example, enabling a patient to engage in immoral activity (sexual immorality, suicide, drug abuse, criminal activity) or facilitating an immoral procedure by another professional (cloning; genetic enhancement; referral for or assisting in abortion or unethical reproductive technologies) may involve some culpability. [Back]

Approved by the House of Representatives June 11, 2004 unanimously
 

Double Effect
Christian Medical and Dental Associations (USA)
Reproduced with permission

Related Links
CMDA- Health Care
Right of Conscience

CMDA- Moral
Complicity with Evil

CMDA- Double Effect

Rounding the Horn
with the Principle of
 Double Effect


 

 All medical treatments have the potential for adverse secondary effects, some anticipated and others not. The medical acceptability of such adverse secondary effects is judged on a risk-benefit basis. This involves assessing the likelihood of their occurrence, their severity, and the ability to treat them.

Some secondary effects have moral implications. An assessment of the moral acceptability of adverse secondary effects requires consideration of principles, motives, con-sequences, and implications.* The Rule of Double Effect, introduced into the discipline of moral reasoning by St. Thomas Aquinas, is particularly useful in evaluating the moral acceptability of adverse secondary effects.

The Rule of Double Effect furnishes guidance in a variety of situations such as relieving persistent or intractable pain with addicting narcotics, administering drugs or performing procedures that have harmful side effects, treating terminally ill patients with drugs that have the potential to shorten life, withdrawing burdensome and/or futile interventions even though these are life-sustaining, or using “terminal (palliative) sedation.” The Rule of Double Effect distinguishes between morally permissible actions that allow a patient to die and morally impermissible actions that cause a patient’s death. This distinction applies in a variety of situations, but is crucial in the public policy debates regarding appro-priate end of life care, euthanasia, and physician-assisted suicide.**

Actions leading to undesirable secondary effects, even if anticipated, can be permissible when all of the following criteria are met:

1. The primary act must be inherently good, or at least morally neutral.

2. The good effect must not be obtained by means of the bad effect.

3. The bad effect must not be intended, only permitted.

4. There must be no other means to obtain the good effect.

5. There must be a proportionately grave reason for permitting the bad effect.

CMDA endorses these guidelines, fully realizing that not all situations in patient care can be anticipated or provided for; nor can the intent of medical caregivers always be discerned with certainty.

* See CMDA statement Moral Complicity with Evil
**See CMDA statements Euthanasia and Physician-Assisted Suicide


Approved by the CMDA House of Representatives.
Passed by unanimous vote
June 10, 2005. Denver, Colorado.


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