The healthcare practitioners usually confront difficult ethical choices in their quest to provide appropriate health services especially for people with diverse values (McWay 2014 p 91). Consequently, different bioethics principles have been put in place to help resolve ethical issues in the event of such diversities (Koslowski 2001 p 137). The principle of double effect encompasses the two types of consequences that results from a single action (Yelon et.al., 2014 p 374). For example; a doctor may use morphine on a dying patient. Thus, the use of morphine will have a maleficent effect of cutting short the patient’s life while simultaneously having a beneficial effect of easing excessive pain hence prevent the patient from suffering further. Double-effect principle can also be applied in a case involving the separation of conjoined twins especially in cases where only one child will live (Kanniyakonil 2005 p 187; Magill’s Medical Guide 2005).
The double effect principle can undoubtedly be viewed as the combined effect of the non-maleficence principle and the beneficence principle. It is because an action might benefit the patient but also cause serious harm (Tefferi 2000 p 424; Tippet 1999 p 271). In addition, the principle needs to be free from any malice (Butts and Karen 2013 p 41). Conversely, the Principle of Proportionality and the Wedge Principle suggests that the good effects need to outweigh the bad effects (Bruera and Sriram 2011 p 284). The proportionality principle asserts that the risk-benefit ratio which should be assessed so as to determine the amount of harm that can be risked justifiably in order to effect good. Therefore, proportionate and rational reasoning needs to be applied before executing the double effect principle (Goodman 2003 p 53; Frankena 1973 p 49). As a result, the bad effect cannot override the good effect (Bernat 2008 p 153; Meads et. al., 2001 p 51)
Nevertheless, some people think that the principle of double effect is traditionally grounded in accordance to the natural law theory (Kenny 2000 p 41; Beauchamp 2013 p 21). However, the double effect principle is usually applied as a matter of necessity (Hitchcock 2003 p 143). Additionally, the natural law theory entails the practical rationality for all human beings. Thus, the double effect principle is not grounded in this sense (Gert et. al., 1997 p 23; Jonsen et. al., 2010 p 111). Otherwise, the double effect principle is intended to guide individuals on moral ethics. Thus, it has since directed different medical practitioners on the appropriate course of action (Hippocrates 1780 p 31; Hastings Center for Bioethics 2013).
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