ArticleBMC medical ethics2021
Goods, causes and intentions: problems with applying the doctrine of double effect to palliative sedation.
Article in BMC medical ethics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
8 citing papers in PubMed, 4 syntheses or guidelines pooled it, 20 citations in OpenAlex.
- The principle of double effect in palliative care: a systematic review of ethical, legal, and clinical perspectives.BMC palliative care · 2026Pooled it
- End-of-Life Care Experiences, Attitudes and Perceptions of Intensive Care Clinicians in Middle Eastern Countries: A Systematic Integrative Review.Nursing in critical care · 2025Pooled it
- Christian perspectives on palliative sedation: a literature study.BMC palliative care · 2025Pooled it
- The experience of nurses when providing care across acts that may be perceived as death hastening: A qualitative evidence synthesis.Palliative medicine · 2025Pooled it
- Is Unconsciousness the Intention? Physicians' Perspectives on Palliative Sedation Outside Specialized Palliative Care: A Qualitative Study.Journal of bioethical inquiry · 2026Article
- Evaluating Nurse Conscientious Objection: Application of a Novel Framework.HEC forum : an interdisciplinary journal on hospitals' ethical and legal issues · 2026Article
- Ethical Dilemmas in Newborn Infants with Hypoxic Ischemic Encephalopathy.Asian bioethics review · 2025Article
- Attitudes of medical doctors, nurses and paramedics towards death.Frontiers in public health · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPalliative 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.
conclusionsWe 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.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.