Aquinas and Morphine: Notes On Double Effect At The End of Life
This chapter is concerned with the latter alleged moral distinction, the legitimacy of which it defends. Defense of this verbal distinction involves an appeal to the "doctrine of double effect" (DDE). Donagan has argued that Kantian ethics can sort between permissible and impermissible infliction of harms without resorting to a doctrine like DDE, and Nelson has made a similar point about a contractualist ethic. Assuming a role-specific duty to avoid harming patients, DDE may appropriately be used to separate permissible from impermissible infliction of harms by physicians upon patients. The chapter addresses two lingering problems; one concerning the sincerity of pain-medicating physicians and the other concerning the contemporary understanding of DDE as a doctrine of hard cases. The pain-medicating physician chooses the means of administering morphine; the euthanist the means of killing his patient. A physician wishes to perform a medical procedure - say, a coronary artery bypass graft (CABG).