Double Effect And Physician Aid In Dying

Technological advances have prolonged human life and changed not only what it means to practice medicine, but what it means to be alive. In some cases, patients turn to their physicians to assist them in dying. The purpose of this essay is not to promote physician aid in dying or even provide a stance on the subject. Rather, the purpose is to make readers question when it is morally permissible to “kill” a patient. Through defining the doctrine of double effect, physician aid in dying and exploring the types of medical cases where killing a patient is morally permissible, I argue that there is no moral difference between physician aid in dying and the doctrine of double effect.

Originating from “Thomas Aquinas’…discussion of the permissibility

While the doctrine of double effect is legally, clinically and ethically permissible, physician aid in dying is not legally or clinically permissible in all 50 states even though the result is the same, i.e., the death of the patient. This point will be further examined later in the essay, for now, it is essential to define physician aid in dying. “Assisted dying is typically used to describe an action in which an individual’s death is intentionally hastened by the administration of a drug or other lethal substance. This may take the form of either assisted suicide or euthanasia” (Volker, 2016, 30). Physician aid in dying (PAD) can therefore be defined as a licensed physician providing a patient with a lethal dose of a drug that the patient may use to end their own life. Furthermore, patients in this definition are terminally ill and request the aid of a physician voluntarily. Keeping this in mind, I will now move towards exploring the types of cases where it is currently permissible to kill a

male that had a cardiac arrest. While Phil was successfully resuscitated, he sustained severe brain damage. After three weeks in the ICU, he remained dependent upon mechanical ventilation. He was unresponsive, but not dead by neurological criteria. After several meetings between his family and clinicians, they agreed to withdraw the ventilator and let him die. The attending removed Phil’s endotracheal tube. Phil developed gasping respirations, 8 times a minute and appeared to be struggling. The physician then administered doses of morphine, 0.1 mg/kg every 5-30 minutes, titrated to Phil’s comfort. After approximately two hours, Phil developed bradycardic arrest and died (Altered Clinical Case from Class on Sept. 28th).

What makes this a case that passes the doctrine of double effect is the use of titrated morphine to relieve Phil’s pain. While death was foreseen, the clinician’s intent was not to hasten Phil’s death, nor was death the means by which the physician sought to relieve Phil’s pain. Based on this, the clinician’s actions are morally