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Medical Ethics in Reproductive Medicine
Published in Steven R. Bayer, Michael M. Alper, Alan S. Penzias, The Boston IVF Handbook of Infertility, 2017
Steven R. Bayer, Kim L. Thornton
The principle of double effect is in essence a compromise of two other important ethical principles: beneficence and non-maleficence. The principle of beneficence is the driving force of patient care. This principle refers to the ultimate goal of any treatment, which is to do something good for the patient. The principle of non-maleficence is to do no harm to the patient. If we strictly adhere to the non-maleficence principle, then no treatment would be offered to our patients because there is always the possibility of a bad outcome. The decision to move forward with a treatment occurs when there is a greater balance between good and bad outcomes. While it is important that the harm or risk of any treatment be recognized, the absolute avoidance of harm should not take more importance over the potential benefit of any treatment.
The religiously inspired principle of double effect in English medical law
Published in Clayton Ó Néill, Religion, Medicine and the Law, 2018
In the field of medical law and ethics, the doctrine or principle of double effect is sometimes used, explicitly or implicitly, when medical decisions find themselves at question at the bedside of a patient or in courts of law. The principle of double effect is a dogma, rooted certainly in the religious, but practised within the secular/neutral context of the medical arena.
The Road to Ixtlan in Neuro-Degenerative Diseases Is Paved with Palliative Cobblestones
Published in AJOB Neuroscience, 2023
Christopher Poppe, Manuel Trachsel
Guiding principles for palliative care are, inter alia, the four principles of biomedical ethics (Beauchamp and Childress 2019) but also the principle of double effect and the principle of proportionality, particularly for palliative sedation (e.g., Boyle 2004). The principle of double effect is often invoked to justify the use of palliative sedation. In simple terms, the principle of proportionality demands that extent of harm of palliative sedation must be offset by the suffering relieved, and the principle of double effect states that palliative sedation should only intend relief of suffering and should merely foresee the harms involved. Analogously, the use of psychedelics for symptom relief in AD/ADRD should be proportionate to its foreseeable harms and intended benefits. The use of psychedelics without a potentially troubling hallucinogenic experience or microdosing (with contested benefits, see Ona and Bouso 2020) might be proportionate when the person has already developed advanced dementia and experiences negative affective states. In contrast, a full dose of LSD, psilocybin, MDMA or another psychedelic substance could potentially allow for an existential re-orientation through psychedelic hallucinations in the pre-symptomatic or MCI stage of AD/ADRD.