Journal of Bioethical Inquiry

, Volume 15, Issue 1, pp 33–37 | Cite as

Knowing, Anticipating, Even Facilitating but Still not Intending: Another Challenge to Double Effect Reasoning

Critical Perspectives

Abstract

A recent administrative law decision in Victoria, Australia, applied double effect reasoning in a novel way. Double effect reasoning has hitherto been used to legitimate treatments which may shorten life but where the intent of treatment is pain relief. The situation reviewed by the Victorian tribunal went further, supporting actions where a doctor agrees to provide pentobarbitone (Nembutal) to a patient at some time in the future if the patient feels at that time that his pain is unbearable and he wants to end his life. The offer to provide the drug was described as a palliative treatment in that it gave reassurance and comfort to the patient. Double effect reasoning was extended in this instance to encompass potentially facilitating a patient’s death. This extension further muddies the murky double effect reasoning waters and creates another challenge to this concept.

Keywords

Double effect reasoning End of life Assisted dying Terminal sedation 

References

  1. Anderson, R. 2007. Boyle and the principle of double effect. The American Journal of Jurisprudence 52(1): 259–272.CrossRefGoogle Scholar
  2. Angner, E. 2016. A course in behavioral economics. London; New York: Palgrave Macmillan.CrossRefGoogle Scholar
  3. Aquinas, St Thomas. 2006. Summa theologica Part II (Secunda secundae). Project Gutenberg. Translated by The Fathers of the English Dominican Province.Google Scholar
  4. Beauchamp, T.L., and J.F. Childress. 2013. Principles of biomedical ethics. New York; Oxford: Oxford University Press.Google Scholar
  5. Boyle, J.M. 1980. Toward understanding the principle of double effect. Ethics 90(4): 527–538.CrossRefGoogle Scholar
  6. ———1991. Who is entitled to double effect? The Journal of Medicine and Philosophy 16(5): 475–494.CrossRefPubMedGoogle Scholar
  7. ———2004. Medical ethics and double effect: The case of terminal sedation. Theoretical Medicine and Bioethics 25(1): 51–60.CrossRefPubMedGoogle Scholar
  8. Cavanaugh, T.A. 1997. Aquinas’s account of double effect. The Thomist 61(1): 107–121.CrossRefGoogle Scholar
  9. Donagan, A. 1991. Moral absolutism and the double-effect exception: Reflections on Joseph Boyle’s “Who is entitled to double-effect?” Journal of Medicine and Philosophy 16(5): 495–509.CrossRefPubMedGoogle Scholar
  10. Douglas, C.D., I.H. Kerridge, and R.A. Ankeny. 2013. Narratives of “terminal sedation,” and the importance of the intention-foresight distinction in palliative care practice. Bioethics 27(1): 1–11.CrossRefPubMedGoogle Scholar
  11. ———2014. Double meanings will not save the principle of double effect. Journal of Medicine and Philosophy 39(3): 304–316.CrossRefPubMedGoogle Scholar
  12. Goldworth, A. 2008. Deception and the principle of double effect. Cambridge Quarterly of Healthcare Ethics 17(4): 471–472.CrossRefPubMedGoogle Scholar
  13. Hawryluck, L.A., and W.R.C. Harvey. 2000. Analgesia, virtue, and the principle of double effect. Journal of Palliative Care 16: S24–30.PubMedGoogle Scholar
  14. Juth, N., A. Lindblad, N. Lynöe, M. Sjöstrand, G. Helgesson. 2013. Moral differences in deep continuous palliative sedation and euthanasia. BMJ Supportive & Palliative Care 3(2): 203–206.CrossRefGoogle Scholar
  15. Keenan, J.F. 1993. The function of the principle of double effect. Theological Studies 54(2): 294–315.CrossRefGoogle Scholar
  16. Knauer, P. 1967. The hermeneutic function of the principle of double effect. The American Journal of Jurisprudence 12(1): 132–162.CrossRefGoogle Scholar
  17. Lindblad, A., N. Lynöe, and N. Juth. 2014. End-of-life decisions and the reinvented rule of double effect: A critical analysis. Bioethics 28(7): 368–377.CrossRefPubMedGoogle Scholar
  18. Mangan, J.T. 1949. An historical analysis of the principle of double effect. Theological Studies 10(1): 41–61.CrossRefGoogle Scholar
  19. Marquis, D.B. 1991. Four versions of double effect. Journal of Medicine and Philosophy 16(5): 515–544.CrossRefPubMedGoogle Scholar
  20. McIntyre, A. 2001. Doing away with double effect Ethics 111(2): 219–255.CrossRefGoogle Scholar
  21. Mikhail, J.M. 2011. Elements of moral cognition: Rawls’ linguistic analogy and the cognitive science of moral and legal judgment. Cambridge; New York: Cambridge University Press.CrossRefGoogle Scholar
  22. Nelkin, D.K., and S.C. Rickless. 2015. So close, yet so far: Why solutions to the closeness problem for the doctrine of double effect fall short. Noûs 49(2): 376–409.CrossRefGoogle Scholar
  23. Quinn, W.S. 1989. Actions, intentions, and consequences: The doctrine of double effect. Philosophy and Public Affairs 18(4): 334–351.PubMedGoogle Scholar
  24. Raus, K., and S. Sterckx 2016. How defining clinical practices may influence their evaluation: The case of continuous sedation at the end of life. Journal of Evaluation in Clinical Practice 22(3): 425–432.CrossRefPubMedGoogle Scholar
  25. Reed, P.A. 2012. The danger of double effect. Christian Bioethics 18(3): 287–300.CrossRefGoogle Scholar
  26. Schroth, J. 2014. Bibliography on the principle of double effect. http://www.ethikseite.de/bib/bpdw.pdf. Accessed November 4, 2017
  27. Singer, P. 2011. Practical ethics. Cambridge: Cambridge University Press.CrossRefGoogle Scholar
  28. Victoria Parliament Legislative Council Legal and Social Issues Committee. 2016. Inquiry into end of life choices: Final report. Melbourne: Parliament of Victoria.Google Scholar

Copyright information

© Journal of Bioethical Inquiry Pty Ltd. 2017

Authors and Affiliations

  1. 1.Grattan InstituteCarltonAustralia

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