The Rule of Double Effect – a Critique of its Role in End-of-life Decision Making

According to the rule of double effect, effects that would be morally wrong if caused intentionally are permissible if foreseen but unintended. The rule does not permit practices such as physician-assisted suicide or voluntary euthanasia. In this article, the authors examine the rule’s religious and philosophical origins, its inconsistencies with current law, & its shortcomings as a practical clinical guide. They also propose alternative principles to govern care at the end of life. (42 refs.)