Discussion 13

Imagine you are a physician treating a terminally ill cancer patient. The patient is in constant pain, and the only way to alleviate that pain is to treat your patient with a very potent medication. The medication will surely alleviate his pain, but because of its strength, runs the risk of shortening his life. Do you provide your patient with the medication?

Consider this question in light of The Doctrine of Double Effect. The doctrine (or principle) of double effect is often invoked to explain the permissibility of an action that causes a serious harm, such as the death of a human being, as a side effect of promoting some good end. It is claimed that sometimes it is permissible to cause such harm as a side effect (or “double effect”) of bringing about a good result even though it would not be permissible to cause such a harm as a means to bringing about the same good end. This reasoning is summarized with the claim that sometimes it is permissible to bring about as a merely foreseen side effect a harmful event that it would be impermissible to bring about intentionally.

In this case of our patient above, it would mean that it would be permissible to give your patient the potent pain medication to alleviate his pain, even though you run the risk of shortening his life and you may even foresee shortening his life, as long as that was not your intent.

How do you feel about the Doctrine of Double Effects for the treatment of pain? Do you think it is tantamount to physician-assisted suicide? Do you think that it matters that the harm foreseen is not intended?

Consider the following: You are treating the same severely ill patient as in the above scenario. Unfortunately, after administering the pain medication, the patient has begun to require more and more of the medication over time to alleviate his pain.

Do you continue to increase the dose, knowing that the more you give him the more likely you are to end his life? Do you consider the first scenario and the second scenario differently? If you do, why, and what is different about them? Does this seem closer to physician-assisted suicide?

Would your feelings change if your patient had expressed a desire to die?

Would your feelings change if your patient was not terminal?