Professor Deirdre Madden:

On that point, obviously I am not a medical doctor but I also take the view that there are analgesic prescriptions that hasten death by causing respiratory depression. That is sometimes necessary to relieve the patient's pain. It is something that is recognised by various documents from the WHO, for example.

When a doctor is prescribing these kinds of analgesic, the death of the patient, we are always told, is an unintended but foreseen side-effect and, therefore, it is ethically permissible. The doctor has clearly reached the conclusion in those circumstances that death is an acceptable outcome for this patient in these circumstances, so even though death may not be the principal purpose of the prescription of the drugs, the doctor must have decided that the patient's interest in pain relief now outweighs the patient's interest in continued life. The doctor is, therefore, accepting that death is an acceptable outcome for the patient. Obviously, there are all sorts of arguments about distinguishing it from euthanasia or assisted suicide based on the intention of the doctor being to sedate, and not to kill, in order to relieve pain. However, from a practical perspective, as to what is the doctor's intention, level of foresight and knowledge, the doctor accepts that the patient's interest in pain relief outweighs his or her interest in continued life and that death is an acceptable outcome for this patient in the circumstances. Otherwise, the doctor would not give the drug.