Victoria’s Voluntary Assisted Dying Act 2017 (Vic) became the first state law to permit VAD in Australia under limited circumstances from June 2019. Before this, many palliative care physicians relied on the doctrine of double effect (DDE) to justify the use of pain relievers for terminally ill patients that were known to hasten death. The DDE claims that there is a morally significant difference between intending evil and merely foreseeing some bad side-effect will occur as a result of one’s actions. This article argues that the legacy of the DDE is promoting inequitable access to VAD in Victoria due to the assumption that death represents an “evil” for the patient and that the intentions of physicians providing VAD cannot be trusted. The latter claim relies on two common objections to the DDE: the risk of “purifying the intentions” and the issue of “closeness” when evaluating moral acts under this theory.

自 2019 年 6 月起，《2017 年维多利亚自愿辅助死亡法案》(Vic) 成为澳大利亚第一部允许在有限情况下进行 VAD 的州法律。在此之前，许多姑息治疗医生依靠双重效应 (DDE) 原则来证明使用止痛药的合理性对于已知会加速死亡的绝症患者。 DDE 声称，意图作恶与仅仅预见到自己的行为会产生一些不良副作用之间存在着道德上的显着差异。本文认为，DDE 的遗产正在促进维多利亚州获得 VAD 的不平等，因为人们认为死亡对患者来说是一种“邪恶”，并且提供 VAD 的医生的意图不可信。后一种主张依赖于对 DDE 的两个常见反对意见：“净化意图”的风险和根据该理论评估道德行为时的“接近性”问题。