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We are not for or against the doctrine itself, but are interested in its application in this case. However, some authors have recently maintained that many physicians do not intend this effect when practicing cds. Arima describes the dde as permitting acts with both a good and bad effect when (1) the act is good or indifferent, (2) only the good effect is intended, (3) the good effect is not produced by the bad effect’s means and (4) the good effect is serious enough to.
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Abstract continuous deep sedation (cds) has the effect of making the patient unconscious until death, and that it has this effect is clearly an undesirable aspect of cds. Arima (2025) argues that in many of these cases, consciousness diminishment is actually intended and not a side effect at all. While relief from suffering is good, a decrease in consciousness is usually considered undesirable.
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Continuous deep sedation and the doctrine of double effect:
In this paper, we argue that the doctrine of double effect is inappropriately and harmfully applied because the conditions of the doctrine of double effect are not met in cases of palliative sedation. Despite recent evidence suggesting that palliative sedation is safe and effective when properly titrated and does not hasten death, the principle of double effect continues to be utilized to justify this practice, even if it entails a small risk of hastening a patient's death. We are not for or against the doctrine itself, but. Do physicians not intend to make the patient unconscious until death if they gradually increase the sedatives?
If that is so, in those cases the use of drugs that cause consciousness diminishment cannot be justified by appeal to the doctrine of double effect alone. Arima claims this belief is often justified by the doctrine of double effect (dde). In palliative sedation (hereafter, sedation), the physician administers drugs that reduce the patient’s consciousness to relieve intense suffering.
