ABSTRACT
Ubiquitous examples of harm are incision, amputation, organ removal, cellular poisoning or irradiation, all of which would be criminal acts outside the control of the clinical regulators. This dilemma of a double effect is stark when considering the use of powerful analgesics for pain relief. Palliation of pain is essential for the patient's well-being, the patient's life may be shortened. In 1957, Dr Bodkin Adams was charged with the murder of one of his patients by administration of morphine. Dr Adams had administered increasing doses of opiates, to ‘relieve her sensation of pain’. The judge held that doctors could take all necessary steps to relieve pain and suffering, even if the measures taken may incidentally shorten life. The defence had failed to convince the jury that the doctor's intention had solely been to relieve his patient's suffering. It can be deduced from the conviction that they believed he intended to kill her.
