Case Study 5 :Pain Management
Challenges
A 46 y/o male patient was diagnosed with advanced bone cancer. To relieve the pain, the medical team administers increasing doses of morphine, but the members of the health care team express concern that this procedure would hasten death.
Question
Does giving increased dosages of painkillers meet ethical justification, even when it involves the risk of shortening life?
Solutions
This is another case that calls for the application of the Principle of Double Effect. The action being performed is the use of analgesics to relieve pain (the good effect), and not killing the patient (the shortening of life being the bad effect). If life is shortened, it remains an accidental, even though foreseen, result.
The procedure contemplated is ethically acceptable, given that it fulfills the conditions laid out by the principle of double effect:
1. Considered in itself, the action of giving analgesics is not evil.
2. What is intended is the good effect, not the bad effect.
3. The bad effect is not the cause of the good effect.
4. There is no available means to achieve the good effect without having the bad effect.
5. The good effect starts at least simultaneously or immediately after the bad effect (i.e., pain is relieved at the same time the process of hastening death starts).
It should also be noted that pain is more easily managed when human concern and care are given to the sick or elderly. More distressing indeed than physical pain are the loneliness and the feeling of dying alone. Studies show that if these feelings are overcome, pain would no longer be such a prominent factor, even for those dying of debilitating disease.
