The Double Effect

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The principle of the double effect has come to have a very respected and influential position in medical ethics. This doctrine is often employed to explain the morality and validity of an action that may have harmful consequences—such as the death of a human as a “side effect” of advancing another good end. The principle goes that in certain situations, it is permissible to cause serious harm as long as, the good effect of the act is proportionately good enough, and the agent, while foreseeing the bad effect, only intends the good effect and not the bad one (Thomson, 1999). In Judith Jarvis Thomson’s article Physician-Assisted Suicide: Two Moral Arguments, Thomson further explores this principle with respect to the relevance of the difference …show more content…

This principle is heavily rooted in Catholic moral tradition, and Thomas Aquinas outlines the four conditions one must consider when an act has both good and bad effects: 1) The act must be inherently good, or at least morally neutral; 2) The bad effect may be anticipated, but not intended; 3) The good effect must not be achieved by means of the bad effect; and 4) There must be a proportionately grave reason for allowing the bad effect (Summa Theologica (II-II, Qu. 64, Art.7)). The example above about the woman with MS is an example of a situation with a double effect. Perhaps one of the most commonly cited examples is that of pain management at the end of life and the inadvertent suppression of respiration with the use of high doses of potentially lethal medication. Many health care professionals rely on the principle of the double effect to explain why these actions are permissible (Latimer, 1991). In Thomson’s report, she refers to this example and asserts that determining the legal permissibility of administering such a lethal dose should depend only on the patient’s condition and wishes. She goes on to say that weighing the permissibility of the action on whether the doctor would do so intending death or only intending relief from pain is an “absurdity” (Thomson,

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