The principle of double effect is an ethical issue that tackles movements aimed at good intentions with the permission that an inevitable evil may arise in the process (Gillon, 1986). The issue applies to any action with an end that is not malicious of foul but may entail such a consequence in its commission. The principle greatly applies to the case at hand, as Dr. Robinson’s situation urges him to render treatment of morphine to the ailing Mr. Mills, with full knowledge of the possibility that the patient, who is afflicted with a terminal sickness, might have his lifespan shortened.
As a doctor, he is obliged to take good care of all his patients, regardless of any illnesses he may have to deal with. While the case of Dr. Robinson is undeniably complicated, his duty as a doctor compels him to find a solution to alleviate the pain of his current client, Mr. Mills. The patient, helpless with his terminal illness, is desperate for help from his condition. With morphine being the only viable option for both the doctor and patient, the question on the viability of the drug based on moral grounds strikes an imposing dilemma pertaining to the double effect principle.
The case of Dr. Robinson shows that he while he does not have the intention to shorten the life of Mr. Mills in his move to administer morphine for pain alleviation he nevertheless faces the obligation to treat his patient so that he will experience a break from suffering. The obligation of the doctor to make the patient feel better triggers the dilemma brought about by the possible negative effect of the medicine itself. Several sets of propositions on the double effect principle could stand in favor or against the administration of morphine in this case. In my mind, there are two contrasting viewpoints.
As the presentation of morphine in this case gives the impression of its use as the only rational way to treat Mr. Mills, the question on whether or not its administration is morally excusable under the principle of double effect will inevitably come in. Lynn Jansen provides a potent argument in favor of using morphine for easing the condition of Mr. Mills. In pointing one of her cases on sedation, she said that as long as the method stands as the “rational response” to the problem at hand, then it is permissible under the ambit of double effect (2002).
Jansen also provided an antithesis to the permissibility of the method in question under double effect. She noted that those who will administer such method, with the intent to provide relief to the person in pain, would have to face the consequent premise that they have planned the means that can lead to the negative effect (2002). Raanan Gillon (1986) asserted a viewpoint on the premise pertaining to the sole production of the “good effect”, in which he stated that some people view those who administer such controversial methods as morally accountable for the foreseen “bad result”, even though the only intent therein is to produce the expected positive outcome.
In coming up with my stand, I made it a point to focus on the good effect intended by Dr. Robinson in using morphine for Mr. Mills. While the doctor is prudent enough to admit within himself that the medicine might cause the shortening of the patient’s life, his intent to alleviate the patient’s pain – in light of his duty as a doctor, balances out the perceived immoral outcome that comes along with the usage of the medicine. As asserted by Edward Lyons, there should be a balance in the delivery of palliative care “in view of the harm foreseen” (2005).
Combined with the earlier assertion of Jansen, I believe that Mr. Mills deserve the best treatment from Dr. Robinson, even in the view that morphine - the available medicine, could possibly inflict harm by subtracting the patient’s lifespan. This is because of the fact that there is substantial balance in view of the circumstances. Mr. Mills’ alleged terminal condition provides adequate backing against the objections raised by Jansen, which pertains to the use of potentially harmful palliative care being unjustified for those who are experiencing “existential suffering” but are not in a terminal state (2002). Therefore, Dr. Robinson is entitled to use morphine for Mr. Mills, in consonance to his duty as a doctor and in favor of lessening the patient’s pain.
Gillon, R. (1986). The principle of double effect and medical ethics. British Medical Journal, 292, 193-194.
Jansen, L. (2002). Sedation, alimentation, hydration, and equivocation: Careful conversation about care at the end of life. American College of Physicians- American Society of Internal Medicine, 136 (1), 845-849.
Lyons, E. (2005).In incognito – The principle of double effect in American Constitutional Law. Florida Law Review, 57 (3), 469-563.