货物、原因和意图：将双效作用理论应用于缓和性镇静的问题。
Goods, causes and intentions: problems with applying the doctrine of double effect to palliative sedation.
机构信息
Ottawa Hospital Research Institute, Ottawa, Canada.
Department of Medicine, University of Ottawa, Ottawa, Canada.
出版信息
BMC Med Ethics. 2021 Oct 19;22(1):141. doi: 10.1186/s12910-021-00709-0.
BACKGROUND
Palliative sedation and analgesia are employed in patients with refractory and intractable symptoms at the end of life to reduce their suffering by lowering their level of consciousness. The doctrine of double effect, a philosophical principle that justifies doing a "good action" with a potentially "bad effect," is frequently employed to provide an ethical justification for this practice.
MAIN TEXT
We argue that palliative sedation and analgesia do not fulfill the conditions required to apply the doctrine of double effect, and therefore its use in this domain is inappropriate. Furthermore, we argue that the frequent application of the doctrine of double effect to palliative sedation and analgesia reflects physicians' discomfort with the complex moral, intentional, and causal aspects of end-of-life care.
CONCLUSIONS
We are concerned that this misapplication of the doctrine of double effect can consequently impair physicians' ethical reasoning and relationships with patients at the end of life.
背景
在生命末期，对于难治性和顽固性症状的患者，姑息镇静和镇痛被用于减轻他们的痛苦，降低他们的意识水平。双重效应原则，即通过潜在的“坏效果”来实现“好行为”的哲学原则，常被用来为这种做法提供伦理上的辩护。
主要文本
我们认为，姑息镇静和镇痛不符合适用双重效应原则的条件，因此在该领域使用是不恰当的。此外，我们认为，双重效应原则在姑息镇静和镇痛中的频繁应用反映了医生对生命末期护理的复杂道德、意图和因果方面的不适应。
结论
我们担心这种对双重效应原则的错误应用会因此损害医生在生命末期与患者的伦理推理和关系。
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