Against Substitutive Harm

Frances Kamm's Principle of Secondary Permissibility (PSP) specifies a class of exceptions to the general rule not to kill as a means. The principle allows us to harm as a means some of those who would have been otherwise harmed as side effects. 'For example, suppose it is impermissible to paralyze A's legs as a means to a greater good. It would still be permissible to do this as the alternative to permissibly killing A as a mere indirect side effect.' I argue that, despite of its great appeal, PSP is incorrect; it is simply not true that the victims of substitutive harm are not worse off than they would otherwise permissibly have been. In fact, there is no moral difference between the purportedly substitutive harm licensed by PSP (and its extension) and the standard sort of harming as means repudiated by nonconsequentialists.