Certified Hospice and Palliative Assistant (CHPNA) Practice Test

What does the Rule of Double Effect (RDE) justify?

1. Actions that only have positive effects

2. Actions with known negative consequences that are unintended

3. Actions based solely on patient consent

4. Actions that increase patient suffering

The correct answer is: Actions with known negative consequences that are unintended

The Rule of Double Effect (RDE) is a principle in bioethics that applies to situations where an action has both good and bad consequences. The justification it provides is specifically for actions that are intended to produce a good effect while producing a negative effect as a foreseeable but unintended consequence. This principle acknowledges that in certain circumstances, it can be morally permissible to perform an action that has a negative effect, provided that the primary intention is to achieve a positive outcome. In the context of healthcare, particularly in hospice and palliative care, this rule is especially relevant when considering pain management. For example, administering high doses of pain relief medication may alleviate suffering (the good effect) but could also hasten death (the negative effect). As long as the intention behind the action is to relieve pain and not to cause death, the action can be deemed ethically justifiable under the RDE. The other options do not capture the essence of this ethical principle. Actions with only positive effects do not involve the complexity of weighing good and bad consequences, while actions based solely on patient consent do not necessarily consider the ethical implications of the intended and unintended effects. Similarly, actions that increase patient suffering contradict the principle's foundation, which aims to reduce suffering rather than exacerbate