Bernard Prusak

Contemporary philosophy offers two main accounts of how parental obligations are acquired: the causal and the voluntarist account. Elizabeth Brake's provocative paper "Fatherhood and Child Support: Do Men Have a Right to Choose?" seeks to clear the way for the voluntarist account by focusing on the relevance of abortion rights to parental obligations. The present paper is concerned with rebutting Brake's argument that, if a woman does not acquire parental obligations to an unborn child just by having voluntarily acted in such a way that had the reasonably foreseeable consequence of bringing him or her into being, neither does a man acquire parental obligations to a child once he or she is born just by having voluntarily acted in the same way.

As media reports have made widely known, in November 2009, the ethics committee of St. Joseph’s Hospital in Phoenix, Arizona, permitted the abortion of an eleven-week-old fetus in order to save the life of its mother. This woman was suffering from acute pulmonary hypertension, which her doctors judged would prove fatal for both her and her previable child. The ethics committee believed abortion to be permitted in this case under the so-called principle of double effect, but Thomas J. Olmsted, the bishop of Phoenix, disagreed with the committee and pronounced its chair, Sister Margaret McBride, excommunicated latae sententiae, “by the very commission of the act.” In this article, I take the much discussed Phoenix case as an occasion to subject the principle of double effect to another round of philosophical scrutiny. In particular, I examine the third condition of the principle in its textbook formulation, namely, that the evil effect in question may not be the means to the good effect. My argument, in brief, is that the textbook formulation of the principle does not withstand philosophical scrutiny. Nevertheless, in the end, I do not claim that we should then “do away” with the principle altogether. Instead, we do well to understand it within the context of casuistry, the tradition of moral reasoning from which it issued