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Clearing Up the Double Talk

Arch Intern Med. 1999;159:545-550.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

INTRODUCTION

RECENTLY, the rule of double effect, which has a long history in ethics, especially medical ethics, has come under serious criticism in the medical literature.^1-2 Because of its immense practical importance in the care of dying patients, any attack on this rule must be taken seriously. In this article, therefore, we present a systematic rejoinder to what we take to be serious misunderstandings of the nature and use of this rule.

A clear understanding of the proper use of the rule of double effect is essential if health care professionals are to maintain their opposition to euthanasia and assisted suicide and yet provide adequate pain relief to dying patients. Many Americans, including health care professionals, are fearful of unwittingly participating in euthanasia if a patient's death is hastened, however unintentionally, as a side effect of attempts to relieve pain and suffering. For such individuals, the rule of double effect provides . . . [Full Text of this Article]

NATURE AND CONTENT OF THE RULE OF DOUBLE EFFECT

THE UNDERLYING ISSUE

LOGICAL INCONSISTENCIES WITH POTENTIALLY DELETERIOUS EFFECTS ON PATIENT CARE

MISCONSTRUING DOUBLE EFFECT

DOUBLE EFFECT AND ASSISTED SUICIDE

DOUBLE TALK ABOUT TERMINAL SEDATION

WITHDRAWING LIFE-SUSTAINING TREATMENT IS NOT AN APPLICATION OF DOUBLE EFFECT

THE DISAMBIGUATION OF CLINICAL INTENTIONS

LAW DOES NOT SETTLE THE MORAL QUESTION

RELIGION, MORALITY, AND SOCIETY

PATIENT AUTONOMY: A MORAL ABSOLUTE?

CONCLUSIONS

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