Abstract
This chapter explores the nature of intention and ‘double effect’ in the moral evaluation of action. It begins with an explanation of the historical origins of the doctrine of double effect (DDE) drawing upon traditional Christian moral thinking and its prominent role in medical ethics. The DDE is regarded as particularly pertinent to palliative care and end of life decisions as it is thought to be a means of distinguishing permissible interventions such as pain relief and sedation from deliberate acts to assist in or bring about death directly. The chapter explores a number of ways in which the DDE can be used in the evaluation of complex moral judgements in end of life care but also points to a number of challenges which must be met if the DDE is to continue to play a role in the ethics of palliative care.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Aquinas T. The Summa Theologiæ of St. Thomas Aquinas Second and Revised Edition, 1920 Literally translated by Fathers of the English Dominican Province Online Edition Copyright © 2016 by Kevin Knight. http://www.newadvent.org/summa/
Aristotle. (2002). Nicomachean ethics (Sachs, J., Trans.). Focus publishing.
Association of Palliative Medicine. (1993). Submission from the ethics group of the Association of Palliative Medicine of Great Britain and Ireland to The Select Committee of the House of Lords on Medical Ethics. 1F/PJH/3/Lords.
Benner, P., Hughes, R. G., & Sutphen, M. (2008). Clinical reasoning, decisionmaking, and action: Thinking critically and clinically. In Patient safety and quality – An evidence-based handbook for nurses. Rockville.
Cherny, N. I., & Radbruch, L. (2009). The Board of the European Association for Palliative Care European Association for Palliative Care (EAPC) recommended framework for the use of sedation in palliative care. Palliat Med, 23(7), 581–593.
Clark, D. (2016). To comfort always: A history of palliative medicine since the nineteenth century. Oxford: Oxford University Press.
Fallon, M., Hanks, G., & Cherny, N. (2006). Principles of control of cancer pain. BMJ, 332, 1022.
Graven, V. P. (2015). Hospice philosophy in practice. Spiritual care for the dying in a hospice setting. Aalborg: Aalborg Universitets Forlag. Phd. serie: Det Samfundsfaglige Fakultet. Aalborg Universitet.
House of Lords. (2005). Select committee on the assisted dying for the terminally ill bill (Vol. II: Evidence). London: The Stationery Office Limited.
Huxtable, R. (2004). Get out of jail free? The doctrine of double effect in English law. Palliative Medicine, 18(1), 62–68.
Martinsen, K. (2008). Care and vulnerability. København: Akribe.
McEwan, J. (2001). Murder by design: The ‘feel-good factor’ and the criminal law. Medical Law Review, 9(3), 246–258.
McIntyre, A. (2014). “Doctrine of double effect”, the Stanford Encyclopedia of philosophy (E. N. Zalta, Ed. Winter 2014 Edition). https://plato.stanford.edu/archives/win2014/entries/double-effect/
Murphy, M. (2011). The natural law tradition in ethics. In E. N. Zalta (Ed.), The stanford encyclopedia of philosophy (Winter 2011 Edition). URL = https://plato.stanford.edu/archives/win2011/entries/natural-law-ethics/
Oderberg, D. (2000). Moral theory: A non-consequentialist approach. Oxford: Blackwell.
Rachels, J. (1986). The end of life: Euthanasia and morality. Oxford University Press. Oxford.
Randall, F., & Downie, R. S. (1999). Palliative care ethics: A companion for all specialties. Second Edition. Oxford University Press. Oxford.
Saunders Cicely. (1984/ 2003). Watch with me. Mortal Press. Sheffield.
Singer, P. (1975). Animal liberation: A new ethics for our treatment of animals. Harper Collins. New York.
Symons, X. (2017). Does the doctrine of double effect apply to the prescription of barbiturates? Syme vs the Medical Board of Australia Journal of Medical Ethics. Published Online First: 12 September 2017. https://doi.org/10.1136/medethics-2017-104230.
Twycross, R. G., & Lack, S. A. (1990). Therapeutics in terminal care (2nd ed.). Edinburgh/London/New York: Churchill Livingstone.
Walter, T. (2015). Secularisation In C. M. Parkes & W. Young (Eds.), Death and bereavement across cultures (2 edn, pp. 133-48-87). London: Routledge.
Woods, S. (2007). Death’s dominion: Ethics at the end of life. Maidenhead: Open University Press.
World Health Organisation. (2002). Cancer pain relife in palliative care, Technical report series. Geneva: WHO
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Woods, S., Graven, V. (2020). Intentions and the Doctrine of Double Effect. In: Emmerich, N., Mallia, P., Gordijn, B., Pistoia, F. (eds) Contemporary European Perspectives on the Ethics of End of Life Care. Philosophy and Medicine, vol 136. Springer, Cham. https://doi.org/10.1007/978-3-030-40033-0_12
Download citation
DOI: https://doi.org/10.1007/978-3-030-40033-0_12
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-40032-3
Online ISBN: 978-3-030-40033-0
eBook Packages: Religion and PhilosophyPhilosophy and Religion (R0)