Defining the Scope of Casey and Salzman's Application of the Rule of Double Effect to the Therapeutic and Prophylactic Uses of Combined Oral Contraceptives

Reducing the Risk of Gynecologic Cancer in Hereditary Breast Ovarian Cancer Syndrome Mutation Carriers

“…Two questions must be addressed before applying the principle of double effect to the prescription and use of COC intended to reduce the risk of müllerian carcinoma in highly susceptible women. The first question concerns moral agency and asks whether, in applying the principle, there is a significant moral difference between the Catholic physician who prescribes COC and the married Catholic woman who uses COC (Clark 2014). In response, we do not discern a significant moral difference when the direct intention of either agent is to prevent cancer and the unintended side effect is contraception.…”

“…In both cases, where an act has both good and bad effects, the agent’s moral judgment is subject to evaluation by the principle of double effect to determine whether or not its criteria are met and the act is morally justified. The second question concerns whether there is a moral distinction between treatment and prevention of gynecologic cancer that would allow the use of the principle of double effect in the former case but not in the latter (Clark 2014). Many Catholic biomedical ethicists do not recognize a moral distinction between treatment and prevention of a disease when the criteria of the principle of double effect are met (Cahill 2005, 158–59; Kelly, Magill, and ten Have 2013, 115; Tuohey 1990).…”

“…Many Catholic biomedical ethicists do not recognize a moral distinction between treatment and prevention of a disease when the criteria of the principle of double effect are met (Cahill 2005, 158–59; Kelly, Magill, and ten Have 2013, 115; Tuohey 1990). Others make a distinction and argue that in the case of treatment, the principle applies, but in the case of prevention it may not apply (Clark 2014). In his 1968 encyclical Humanae vitae , Pope Paul VI (1968) allows for the use of therapies to treat a pathology but does not consider cases of preventing a pathology (no.…”