Abstract
Both the principle of double effect and the teaching of the magisterium allow for the use of opioids for the suppression of pain and consciousness as death approaches, even if one foresees that the use of narcotics will shorten life. But the principle of double effect should not be used to justify the administration of large doses of opiates or other mind-altering medications under the assumption that a dying patient should or might be having pain, anxiety, or dyspnea. What makes a dying patient uncomfortable or causes them suffering must be determined and appropriately treated. The assessment should include the following questions: Is the patient experiencing physiological pain? Is the discomfort caused by psychological, emotional, or spiritual distress (suffering)? Or is there a particular distressing symptom that needs to be identified and appropriately treated? Medicine and nursing practice are based on the assessment and treatment of disease and symptoms.
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