Goods, causes and intentions: problems with applying the doctrine of double effect to palliative sedation.

Autor: Faris H; Ottawa Hospital Research Institute, Ottawa, Canada. hfari012@uottawa.ca., Dewar B; Ottawa Hospital Research Institute, Ottawa, Canada., Dyason C; Department of Medicine, University of Ottawa, Ottawa, Canada., Dick DG; Department of Philosophy, University of Calgary, Calgary, Canada.; Canadian Centre for Advanced Leadership, Haskayne School of Business, University of Calgary, Calgary, Canada., Matthewson A; Ottawa Hospital Research Institute, Ottawa, Canada., Lamb S; Department of Innovation in Medical Education, University of Ottawa, Ottawa, Canada., Shamy MCF; Department of Medicine, University of Ottawa, Ottawa, Canada.; The Ottawa Hospital, Ottawa, Canada.
Jazyk: angličtina
Zdroj: BMC medical ethics [BMC Med Ethics] 2021 Oct 19; Vol. 22 (1), pp. 141. Date of Electronic Publication: 2021 Oct 19.
DOI: 10.1186/s12910-021-00709-0
Abstrakt: Background: Palliative sedation and analgesia are employed in patients with refractory and intractable symptoms at the end of life to reduce their suffering by lowering their level of consciousness. The doctrine of double effect, a philosophical principle that justifies doing a "good action" with a potentially "bad effect," is frequently employed to provide an ethical justification for this practice.
Main Text: We argue that palliative sedation and analgesia do not fulfill the conditions required to apply the doctrine of double effect, and therefore its use in this domain is inappropriate. Furthermore, we argue that the frequent application of the doctrine of double effect to palliative sedation and analgesia reflects physicians' discomfort with the complex moral, intentional, and causal aspects of end-of-life care.
Conclusions: We are concerned that this misapplication of the doctrine of double effect can consequently impair physicians' ethical reasoning and relationships with patients at the end of life.
(© 2021. The Author(s).)
Databáze: MEDLINE
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