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Previous Volume 337:1768-1771 December 11, 1997 Number 24 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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According to the ethical principle known as the "rule of double effect," effects that would be morally wrong if caused intentionally are permissible if foreseen but unintended. This principle is often cited to explain why certain forms of care at the end of life that result in death are morally permissible and others are not.^{1,2,3,4,5,6,7,8,9} According to the rule, administering high-dose opioids to treat a terminally ill patient's pain may be acceptable even if the medication causes the patient's death. In contrast, the rule does not authorize practices such as physician-assisted suicide, voluntary euthanasia, and certain instances of forgoing life-sustaining . . . [Full Text of this Article]

Background

Clinical Applications of the Rule of Double Effect to End-of-Life Decisions

The Rule of Double Effect and U.S. Criminal Law

Ethical and Policy Issues

Conclusions

Address reprint requests to Dr. Quill at the Department of Medicine, Genesee Hospital, 224 Alexander St., Rochester, NY 14607.

References

Related Letters:

The Rule of Double Effect
Preston T. A., Patterson J. R., Hodges M. O., Shorr A. F., Manfredi P. L., Morrison R. S., Meier D. E., Quill T. E., Dresser R., Brock D. W.
Extract | Full Text  
N Engl J Med 1998; 338:1389-1391, May 7, 1998. Correspondence

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