The Doctrine of Double Effect: Pharmacological Oblivion, Terminal Sedation and Slow Euthanasia
Morphine plays a major role in the practice of Pharmacological Oblivion or ‘Slow Euthanasia’ as it is also called. In a country where assisting a suicide is illegal, this practice is often the only way that a doctor can hasten the death of a patient and escape any legal consequence.
Known commonly as the ‘doctor’s loophole’, slow euthanasia allows a doctor to end a patient’s life by slowly increasing the amount of a pain-killing drug like morphine. A dose of morphine is given to the sick patient ‘to make them comfortable’. After a period of time, and upon review, it will be decided that the drug has been insufficient and that the patient is still in distress. A larger dose is then given and another period of time elapses. The patient may not be conscious or aware. They are effectively in a state of ‘pharmacological oblivion’ as the process continues. Eventually, a lethal dose will be reached and death will occur. The doctor will argue that the patient’s death was an unplanned consequence of either the patient’s disease or the necessary treatment for their pain.
It can often take a number of days for the levels of morphine to become high enough to cause death. It is important for the doctor’s legal well being that the process is slow. Indeed, it is the length of time taken that gives credibility to the argument that they tried to establish ‘just the right dose’ of morphine. If, for example, a single large dose of morphine were administered and death resulted, it would be almost impossible for the doctor to argue that their prime intention was the treatment of the patient’s pain. Slow euthanasia is necessarily slow. It must be, in order to safely exploit this legal loophole.
